WO2020049656A1 - Medical information management system and member device used in same - Google Patents

Medical information management system and member device used in same Download PDF

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Publication number
WO2020049656A1
WO2020049656A1 PCT/JP2018/032887 JP2018032887W WO2020049656A1 WO 2020049656 A1 WO2020049656 A1 WO 2020049656A1 JP 2018032887 W JP2018032887 W JP 2018032887W WO 2020049656 A1 WO2020049656 A1 WO 2020049656A1
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WIPO (PCT)
Prior art keywords
medical information
medical
member device
patient
control unit
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PCT/JP2018/032887
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French (fr)
Japanese (ja)
Inventor
規 浦谷
Original Assignee
学校法人法政大学
株式会社ミックナイン
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Priority to PCT/JP2018/032887 priority Critical patent/WO2020049656A1/en
Publication of WO2020049656A1 publication Critical patent/WO2020049656A1/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
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients

Definitions

  • the present invention relates to a medical information management system.
  • it relates to a medical information management system that can be shared by a plurality of medical personnel.
  • the present invention relates to a member device constituting the medical information management system.
  • reception computer for calculating a medical fee
  • electronic medical records are widely used in hospitals and clinics.
  • medication notebooks that record a patient's medication history have been used, but the use of a medication history management system for each patient, which realizes this electronically instead of on paper, is also expanding.
  • FIG. 6 shows a flow of processing of a medical fee in conventional medical treatment.
  • a patient 10 receives treatment at a hospital 12. That is, the doctor at the hospital 12 provides the medical care service 12a to the patient and creates the medical record 12b of the patient 10.
  • the chart 12b is stored in the hospital 12.
  • the doctor of the hospital 12 creates a prescription 12c for a medicine to be prescribed for the patient 10 as a result of the medical service 12a, and passes it to the patient 10. This is shown in FIG.
  • the patient 10 pays a part of the medical fee (indicated by 10a in FIG. 6).
  • the patient 10 brings the prescription 12c to the pharmacy 14, and the pharmacist at the pharmacy 14 delivers the medicine based on the prescription 12c (indicated by 14a in FIG. 6).
  • the pharmacist of the pharmacy 14 provides the medicine notebook 14b to the patient 10.
  • the patient 10 pays a part of a medical fee (here, mainly a dispensing fee) (indicated by 10b in FIG. 3).
  • the hospital 12 and the pharmacy 14 create a so-called claim 12d and request the medical fee, and send it to the examination and payment organization 16 (indicated by 12e in FIG. 6).
  • the examination payment organization 16 Upon receipt of the receipt 12d, the examination payment organization 16 examines the receipt, and executes a request for the examination payment to the insurer 18 (indicated by 16a in FIG. 6). The insurer 18 pays the amount of the claim based on the request for the examination payment (indicated by 18a in FIG. 6). The insurer 18 also collects an insurance premium from the patient 10 (indicated by 10c in FIG. 6). The examination payment organization 16 pays the amount paid by the insurer 18 to the hospital 12 or the pharmacy 14 as a medical treatment fee and a dispensing fee. This payment is omitted in FIG.
  • Medical institution is a term indicating a medical providing facility such as a hospital (hospital 12 in FIG. 6) or a pharmacy (pharmacy 14 in FIG. 6).
  • institutions that handle claims, institutions that handle points for medical fees, and the like are broadly meant.
  • Drug stores that sell drugs, rehabilitation centers, insurers (insurers 18 in FIG. 6), examination and payment institutions (examination and payment institutions 16 in FIG. 6), and the like are also referred to as “medical institutions” in this patent.
  • the term "insurer” refers to the National Health Insurance Association that handles health insurance, mutual aid associations such as central government offices, prefectural offices and city halls, health insurance unions such as company factories, and association insurance companies.
  • the “examination payment institution” is an organization that examines medical reimbursement claims, and includes various payment funds, the National Health Insurance Union, and the like.
  • the “medical fee” is a fee for a medical practice, and in this patent, it particularly includes a dispensing fee for the pharmacy 14 (pharmacist).
  • Patent Document 1 discloses a system that can process a new electronic medical record and an old electronic medical record with one computer. According to this system, it is described that the old electronic medical record is sorted, and a copy means for copying the old electronic medical record to the new electronic medical record is provided, so that the new and old electronic medical records can be used together.
  • Patent Document 2 discloses a system that allows the user to browse medical questionnaires, figures, photographs, and the like written by the patient himself. According to this system, since a device that reads a document and digitizes it as color image data is used, it is described that the image data can be registered in a database.
  • Patent Document 3 discloses a medication document that can be used as a database. Specifically, a medication instruction sentence describing the side effects and precautions of the drug is registered corresponding to the drug code indicating the component of the drug. It is described that a database can be easily created by this.
  • each document such as a medical chart, a prescription, a medicine notebook, and a receipt is a mixture of paper data and electronic data.
  • electronic receipts are widely used for creating a receipt, etc., but the information is provided at the hospital 12 and pharmacy 14 units, and is not associated with the drug history record of the patient 10. It is enough. In other words, it means that the database of the medical information of the patient 10 itself is not sufficiently constructed. Such a database may be constructed based on the medical history and health management / medicine notebook 14b of the patient 10 itself, but it cannot be said that it is still sufficiently constructed.
  • the present invention has been made in view of the above-described problems, and manages medical histories, drug histories, and the like in a database using a distributed ledger technology, and mutually uses medical information, such as a patient's drug histories, It is an object of the present invention to provide a system that can contribute to improving the health of a patient by facilitating calculation of medical fees and realizing more appropriate medication.
  • the present invention provides a medical information management system using a blockchain (distributed ledger) (a drug history management system in an embodiment described later corresponds to a suitable example of a medical information management system). Is one of the features. Specifically, the present invention employs the following means.
  • the present invention is directed to a medical information management system including a plurality of member devices that hold a distributed ledger that records medical information relating to a medical practice for a patient, in order to solve the above-mentioned problems.
  • the communication unit is
  • the control unit transmits the medical information when the approval is transmitted from another predetermined member device after the medical information is transmitted from the communication unit.
  • Parts is a medical information management system characterized by adding to the distributed book store.
  • the present invention is directed to a medical information management system including a plurality of member devices that hold a distributed book that records medical information relating to medical practice for a patient, in order to solve the above-mentioned problems.
  • a storage unit that holds the distributed book, a communication unit that communicates with other member devices, a control unit that controls the distributed book, and a medical information input unit that inputs medical information related to medical practice for the patient
  • the medical information input unit when input medical information related to the medical practice for the input patient, transmits the medical information, the control unit, the control unit, the control unit, the medical information, Transmitting the medical information to the other member device when the medical information is received from the control unit. It is a medical information management system.
  • the present invention is directed to a medical information management system including a plurality of member devices that hold a distributed book that records medical information relating to a medical practice for a patient, in order to solve the above-mentioned problems.
  • one of the member devices is an approved member device
  • the approved member device is a storage unit that holds the distributed book
  • a communication unit that communicates with other member devices, and the distributed book.
  • a control unit for controlling, the communication unit when receiving the medical information from the other member device, transmits the received medical information to the control unit, the control unit, When the medical information is transmitted from the communication unit, it is determined whether or not to approve the medical information.
  • the communication unit is instructed to transmit the approval to another member device.
  • the communication unit when the said control unit is instructed to transmit the authorization the medical information, a medical information management system and transmitting the authorization to another member device.
  • the present invention is directed to a medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical care for a patient, in order to solve the above-mentioned problems.
  • a storage unit for holding the distributed ledger, a communication unit for communicating with other member devices, a control unit for controlling the distributed ledger, and a window unit for inputting information on the medicine delivered to the patient.
  • the window unit when inputting information about the medicine delivered to the patient, transmits the inputted information about the medicine delivered to the patient to the control unit, and the control unit Transmits, as the medical information, information on the medicine supplied to the patient to the communication unit, and the communication unit receives the medical information from the control unit.
  • a medical information management system and transmits the above medical information to the other member device.
  • the present invention is the medical information management system according to any one of (1) to (4), wherein the medical information includes at least a medication history (medication history), a prescription, and a claim. , A medical fee management system, a medical fee management system, a medical service fee payment, an insurance premium payment, and an insurance premium claim.
  • the present invention is the medical information management system according to any one of (1) to (4), wherein the medical information includes information on a medicine supplied to the patient. It is a medical information management system.
  • the present invention is the medical information management system according to any one of (1) to (4), wherein the member device is a pharmacy, a hospital, an examination and payment institution, an insurer, or a patient.
  • the medical information management system is any one of the computer systems.
  • the present invention is the member device of the medical information management system according to (1), wherein the storage unit holding the distributed ledger, a communication unit communicating with other member devices, And a control unit for controlling a type book, wherein the communication unit, when receiving the medical information from the other member device, transmits a transaction related to the received medicine to the control unit, the other When the approval of the medical information is received from the member device, the received approval is transmitted to the control unit.After the medical information is transmitted from the communication unit, the control unit transmits a predetermined other The member device, wherein when the approval is transmitted from the member device, the transmitted medical information is added to a distributed ledger stored in the storage unit.
  • the present invention is also the member device of the medical information management system according to (2), wherein the storage unit for holding the distributed ledger, a communication unit for communicating with other member devices, A control unit that controls a type book, and a medical information input unit that inputs medical information related to a medical practice for the patient, the medical information input unit is configured to input the medical information related to the entered medical practice for the patient. Transmitting the medical information to the control unit, the control unit transmits the medical information to the communication unit, and the communication unit receives the medical information from the control unit, The medical device transmits the medical information to the other member device.
  • the present invention is the approved member device of the medical information management system according to (3), wherein the storage unit that holds the distributed ledger, a communication unit that communicates with another member device, A control unit for controlling a distributed ledger, wherein the communication unit transmits the received medical information to the control unit when the medical information is received from the other member device; The unit, when the medical information is transmitted from the communication unit, determines whether to approve the medical information, if approved, the communication unit, so that the approval is transmitted to other member devices And the communication unit transmits the approval to another member device when instructed by the control unit to transmit the approval of the medical information.
  • the present invention is also the member device of the medical information management system according to (4), wherein each member device communicates with a storage unit that holds the distributed ledger and another member device.
  • the control unit transmits the information on the medicine supplied to the patient as the medical information. Transmitting to the communication unit, the communication unit, from the control unit, when receiving the medical information, the member device characterized by transmitting the received medical information to the other member device That.
  • the present invention is also the member device according to (10), wherein the control unit transmits the medical information and a destination of the medical information to the communication unit, and the communication unit From the control unit, when receiving the medical information, transmits the received medical information to the other member device, and sends an e-mail indicating that the medical information has been transmitted to the destination of the medical information A member device for transmitting.
  • the present invention is also the member device according to (9), wherein the storage unit holds a plurality of distributed books for a plurality of members, and the control unit stores the plurality of distributed books.
  • the present invention is the medical information management system according to (3), wherein the member devices are divided into a plurality of groups, and each of the groups includes an approved member device.
  • the member device to which the member device belongs transmits the medical information
  • the approval member device belonging to the predetermined group performs approval
  • the medical information is recorded in the distributed eye / other book. It is a management system.
  • the present invention is also the member device according to (9), wherein the storage unit stores different distributed books of different medical information management systems, and the control unit sets the different ones of the different types of medical information management systems.
  • FIG. 4 is an explanatory diagram showing a relationship between medical information. It is an explanatory view showing a situation of processing of conventional medicine history management.
  • a medication history management system 100 according to a preferred embodiment of the present invention will be described with reference to the drawings.
  • the present inventors have considered that a system using a blockchain, which is a distributed database, is very effective as a security measure for medical information data.
  • no specific method for realizing this method of managing medical information using blockchain has been known, and effective information on how to construct such a system is not yet known in the world.
  • the inventors of the present application have conducted intensive studies and have constructed the following system for managing medical information.
  • the present embodiment proposes a method of managing and operating receipt data and other medical information using a so-called consortium-type block chain in order to realize such a system.
  • medical information such as receipt data can be managed and operated by sharing in real time many medical sites (members) on an approved network.
  • members constituting the block chain are referred to as members, but may also be referred to as nodes or entities.
  • the blockchain is a preferred example of the distributed ledger in the claims.
  • FIG. 1 shows a conceptual diagram of a medication history management system 100.
  • the drug history management system 100 is a system that mainly records and manages drug history using a distributed ledger based on a so-called blockchain.
  • a drug history will be described as an example.
  • this is a system that manages a so-called drug history, a medication notebook, a prescription, a related receipt, and the like using a blockchain (distributed ledger).
  • the medication history management system 100 corresponds to a preferred example of the medical information management system in the claims.
  • a medication history, medication notebook, prescription, and the like are mainly shown as examples of management targets.
  • medical histories, medical records see FIG. 1
  • examination histories, medical examination histories, exercise histories, various medical treatment-related receipts see FIG. 1
  • the drug history management system 100 of the present embodiment is mainly for realizing a system for managing a drug history prescribed to a patient, but is actually (technically) a system for managing medical information in general. It is possible to build as.
  • various documents issued by the hospital 112, the pharmacy 114, and the like are sequentially stored and managed using a so-called consortium type blockchain 200.
  • This consortium-type blockchain 200 is stored and stored in a distributed manner in each member, similarly to a general blockchain.
  • FIG. 1 illustrates that only one consortium type blockchain 200 exists alone, this is a concept, and in fact, the blockchain 200 is distributed and stored in each member similarly to a general blockchain. May have been. That is, in the present embodiment, the “member” is a member configuring the blockchain, but is also a user using the blockchain. In addition, there is a literature in which these members (users) are called nodes or entities. Further, the block chain is characterized in that its constituent (using) members are connected by a so-called P2P network, and a separate server or the like is not necessarily required. However, a device for providing ancillary services and guidance may be separately prepared.
  • the members who can store the blockchain 200 are basically those shown in FIG. That is, a hospital 112 (including a clinic, etc.), a pharmacy 114 (including various institutions that can sell drugs in addition to a dispensing pharmacy), a patient 110 (including the patient and his / her family), an examination and payment organization 116 (various payment funds) Etc.), an insurer 118 (Kenpo Kenpo, etc.), etc.
  • the members are the above-mentioned hospital 112, pharmacy 114, patient 110, examination and payment organization 116, insurer 118, etc.
  • the hospital 112 it also means “the computer system of the hospital 112”. I do.
  • the members mean both the hospital 112 and the computer system of the hospital 112 that executes the processing of the blockchain.
  • a “computer system” it may be called a “member device”.
  • the member device in the claims means a computer system of members constituting a blockchain.
  • a computer system 300 or the like of the pharmacy 114 shown in FIG. 2 described below corresponds to an example of the member device in the claims.
  • not all the members described in FIG. 1 need to be members.
  • a drug prescription 112c using (concurrently with) a conventional “paper” is used. Payment may be made.
  • organizations other than FIG. 1 may be members. That is, the members in FIG. 1 are examples of members.
  • the merit of the present system can be enjoyed between the hospitals 112, pharmacies 114, and the like that have become members storing the blockchain 200.
  • the work with the pharmacy 112, the pharmacy 114, the examination payment organization 116, etc. may be performed in a conventional manner.
  • the pharmacies 114 and the like who are not these members can also enjoy the merit of the present drug history management system 100 by becoming members sequentially.
  • the patient 110 may have little merit in particular as compared to the labor (or the storage cost of the blockchain) as a member. For this reason, in the case of the patient 110, it is also appropriate to read the medicine notebook of the patient (the patient 110) from the blockchain (distributed ledger) and browse the medicine notebook via the members of the pharmacy 114 or the like, without being a member. Is one of the important processes. Thus, even if it is a non-member of the block chain, the data may be browsed via a member of the block chain 200.
  • the patient 110 as a member may have another person perform the function / operation as the member. That is, instead of the patient 110 as a member, the hospital 112 receiving the treatment of the patient 110 may manage the blockchain 200 to be held and managed by the patient 110 as a proxy. That is, the patient 110 may request the device of another person (hospital 112) to work as a member.
  • the hospital 112 is a small clinic, it may not always be necessary to become a member. In some cases, it is difficult to prepare a device having functions and functions for being a member of the blockchain. This can be determined by comparing the management cost of the blockchain 200 with the obtained merit. Therefore, in the case of a small clinic, various procedures may be performed via the large hospital 112, or the function as a member may be performed by the large hospital 112.
  • the blockchain 200 when a management object (medical information, a prescription, a receipt, etc.) generated every moment is stored in the blockchain, a consensus is obtained by a predetermined approval member.
  • this approval member must be a member who can perform the approval work. Therefore, a large hospital 112 or. It is preferable that a member having some computing capacity, such as the examination and payment institution 116, becomes an approved member and that the approved member take consensus.
  • the type of the block chain 200 in the present embodiment does not need to be limited, and any type of block chain can be adopted. However, for the reasons described above, so-called approved members have been recognized to be certain. It is more preferable that only the person can be configured. Therefore, in the present embodiment, for example, it is preferable to employ a so-called consortium type block chain 200.
  • FIG. 2 shows an example of a functional configuration diagram of a computer system provided by each member such as a hospital 112 and a pharmacy 114 that constitute the consortium type blockchain 200 .
  • FIG. 2 shows a functional configuration diagram of a computer system provided in the pharmacy 114, for example, but the same applies to the hospital 112 and the like.
  • the computer system 300 of the pharmacy 114 of the present embodiment corresponds to a preferred example of the members of the claims.
  • Each of the components shown in FIG. 1 can be a member of the block chain 200.
  • a hospital 112, a screening payment institution 116, etc. may be members.
  • the computer system of each member may be referred to as a “member” for convenience.
  • a “member” may be configured by combining a computer main body, a communication unit 304 that performs communication, and a storage unit 308 that is configured by a hard disk or the like.
  • FIG. 2 shows the configuration of the computer system 300 of the pharmacy 114, but the other members have almost the same computer system and are connected to each other via the Internet. It may be connected by a network other than the Internet.
  • the computer system 300 includes a storage unit 308 that stores a pharmacy blockchain 308a, a control unit 302 that controls the pharmacy blockchain 308a that is stored in the storage unit 308, and an external device via a network such as the Internet.
  • the communication unit 304 includes a communication unit 304 that communicates with another member, and a window input unit 306 that inputs information on drug provision performed at the window of the pharmacy that is the member.
  • the storage unit 308 is a storage unit that stores the pharmacy blockchain 308a, and may be configured by a semiconductor storage device or a magnetic storage device. Since this pharmacy is held by the pharmacy 114, the pharmacy is referred to as a pharmacy blockchain 308a for the sake of convenience, but the holding blockchain is the same blockchain for each member. In the case of the hospital 112, it can be called a hospital blockchain or the like. The same applies to other members (such as the examination payment organization 116).
  • the control unit 302 controls the pharmacy blockchain 308a. Specifically, a block including medical information to be managed in a predetermined manner is sequentially connected to the pharmacy blockchain 308a in the storage unit 308, and in the case of an authorized member, given medical information ( It also checks whether or not the medical information presented for registration in the blockchain 200 is valid. In addition, it executes overall reading and writing of data to and from the storage unit 308. In addition, when registering medical information in the pharmacy blockchain 308a, the control unit 302 may also execute generation of a block containing the medical information, depending on the situation. In addition, various processes for the storage unit 308 are executed.
  • the control unit 302 may be configured by, for example, a CPU of a computer and a program for causing the CPU to execute the above operation. Specifically, it may be constituted by a CPU of the computer system 300 of the pharmacy 114 and a program describing its operation. Note that “recept” and “prescription” in the present embodiment correspond to a suitable example of “medical information” and “managed object” in the claims.
  • the communication unit 304 is a communication interface for communicating with other members, and may be, for example, means for connecting to the Internet.
  • the communication unit 304 may be a communication interface adapted to the communication line (in-house private network, mobile communication network, LTE) used.
  • the window section 306 is a means for inputting a drug payment at the pharmacy window. That is, it is a unit for inputting medical information (medication history (medication history)) managed by the block chain 200 of the present embodiment. Also, depending on the pharmacy 114, the medicine notebook 114b may be provided from the window, and a memo about the method of taking the medicine may be provided. Therefore, it is also a means for outputting a medicine notebook, instructions for taking the medicine, and the like.
  • the window unit 306 is a unit for inputting or outputting medical information that is information relating to a medical practice performed on a patient.
  • the window unit 306 corresponds to a preferred example of the “medical information input unit” and the “window unit” in the claims.
  • any portion for inputting predetermined medical information corresponds to the window section 306, and corresponds to a preferred example of the medical information input section in the claims.
  • the hospital 112 it may be considered as a hospital reception, an input unit for medical practice performed by a doctor, an input unit for a medical record, and the like, and these correspond to a preferred example of a medical information input unit in the claims.
  • a unit for inputting information on the patient 110 can be considered as an example of the medical information input unit.
  • it is a means for inputting data of the health insurance card of the patient 11 and the like.
  • the hospital 112 it can be considered as an output means (a printer or the like) for delivering the prescription 112c or the like at the window of the hospital.
  • the contact unit 306 can perform predetermined output and input according to a control instruction from the control unit 302.
  • a window-like means In the case of other members, depending on the configuration, there may not be such a window-like means.
  • the billing and payment of the medical treatment / dispensing fee are mailed by paper, and in such a case, it can be considered as a means for inputting billing data on the paper.
  • a keyboard input by a person in charge, an optical reading device (scanner), and the like correspond to such means.
  • the examination and payment institution 116 of the embodiment described below describes an example in which all requests for medical treatment and dispensing fees are sent by electronic mail and processed by the communication unit 304.
  • the communication unit 304 corresponds to a preferred example of the medical information input unit in the claims.
  • the insurer 118 can be considered in the same manner as the examination and payment institution 116.
  • all communications with the outside are performed by e-mail or the like via the communication unit 306, means corresponding to the contact unit 306 in FIG. Is not provided.
  • the communication unit 304 corresponds to a preferred example of the medical information input unit in the claims.
  • the configuration corresponding to FIG. 2 corresponds to a personal computer or a smart phone of the patient 110.
  • the means corresponding to the window unit 306 corresponds to a keyboard input by a human, a display read by a human, and the like.
  • the hospital 112, the MY page server 250, and the like act on behalf of the patient 110 as a member of the blockchain 200.
  • a plurality of means and configurations as shown in FIG. 2 may be prepared for the number of substitute patients 110. If a plurality of processes (for example, processes (programs) of the control unit 302) are operated on a computer, it is easy to provide a plurality of the configurations shown in FIG.
  • the storage unit 308 may include a plurality of block chains 308a (block chains 200).
  • FIG. 3 is a flowchart illustrating an example of an operation of the medication history management system 100 according to the present embodiment. Based on this flowchart, an example of the processing flow of the procedure for prescribing a drug in the present embodiment will be described.
  • step S3-1 the patient 110 receives treatment at the hospital 112. That is, the doctor at the hospital 112 provides the medical care service 112a to the patient. The patient 110 pays a part of the treatment cost to the hospital 112 (indicated by 110a in FIG. 1).
  • step S3-2 the doctor of the hospital 112 creates the chart 112b of the patient 110. Then, (the system of) the hospital 112 registers the chart 112b in the blockchain 200.
  • This registration process itself is the same as the registration of a transaction in a general consortium type blockchain.
  • FIG. 1 shows a platform 360 that controls operations related to the block chain 200.
  • the platform 360 is provided with an MY page server 250 that manages and monitors the blockchain 200, and executes the provision of the medicine notebook 114b and the like. The details of the platform 360 will be described later with reference to FIG.
  • step S3-3 the doctor of the hospital 112 creates a prescription 112c for the medicine to be prescribed for the patient 110 as a result of the medical service 112a.
  • the system of the hospital 112 registers the prescription 112c in the blockchain 200. This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
  • step S3-4 the system of the hospital 112 notifies the patient 110 of the prescription ID, which is the ID of the prescription 112c for accessing the prescription 112c.
  • the prescription ID is the ID of the prescription 112c for accessing the prescription 112c.
  • a member of the blockchain 200 can take out the prescription 112c represented by the prescription ID from the blockchain 200.
  • the patient 110 who is a member of the blockchain 200 can use the prescription ID to take out the prescription 112c of the medicine prescribed for him / her from the blockchain 200.
  • a prescription copy (paper) describing the prescription ID may be given.
  • a two-dimensional barcode or the like is presented to the patient, and the patient 110 uses his / her smart phone (Smart Phone). ) May be read.
  • the hospital 118 may deliver the prescription 112c itself to the patient 110 by "paper" instead of the prescription ID, as in the past.
  • the patient 110 can also receive a prescription for a drug at any pharmacy that does not participate in the drug history management system 100.
  • the patient 110 goes to the pharmacy 114 and transmits the prescription ID of the prescription 112c.
  • the patient 110 may display the prescription ID of the prescription 112c on a screen of his / her smartphone or the like. This display may be the prescription ID itself or a two-dimensional barcode representing the prescription ID.
  • the pharmacist or the like of the pharmacy 114 can read the displayed prescription ID with a predetermined device, and can know the prescription ID of the prescription 112c.
  • the patient 110 may also present the patient ID to the pharmacy 114.
  • the pharmacy 114 can search and find a desired prescription 112c from the blockchain 200 based only on the prescription ID. Can be prevented beforehand. For example, in some cases, it is possible to prevent unauthorized acquisition of a medicine prescribed to another person.
  • step S3-6 the pharmacist of the pharmacy 114 searches the blockchain 200 based on the acquired prescription ID to find a prescription 112c that matches the prescription ID. Then, preferably, after confirming that the patient ID of the found prescription 112c matches the patient ID of the patient 110, it can be determined that the prescription 112c is a valid prescription 112c applied to the patient 110.
  • step S3-7 the pharmacist or the like of the pharmacy 114 prescribes the medicine based on the obtained prescription 112c and pays it to the patient 110 (indicated by 114a in FIG. 1).
  • the patient 110 pays a portion of the drug price to the pharmacy (indicated by 110b in FIG. 1).
  • the pharmacy may provide the medicine notebook 114b to the patient 10 simultaneously with the medicine.
  • the pharmacy notebook 114b may also be registered in the blockchain 200 by the pharmacy 114 (system thereof) (see FIG. 1).
  • the patient 110 can take out his / her medicine notebook 114b from the blockchain 200 and browse it, and can check the medicine history of medicine prescribed for him at any time.
  • FIG. 4 will be described as another process independent of the process in FIG. 3 for convenience, but may be executed in parallel with the operation in FIG. Further, the operation may be performed separately in time (for example, the next day) without being particularly parallel to the operation in FIG. Further, the processing of FIG. 4 may precede the processing of FIG. Although the processing of FIG. 3 includes the operation of the patient 100, the processing of FIG. 4 does not include the operation of the patient 100, and thus may be executed earlier than the processing of FIG.
  • step S4-1 the hospital 112 creates a receipt 112d to request a medical fee.
  • the system of the hospital 112 registers the receipt 112d in the blockchain 200.
  • This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
  • the system of the hospital 112 registers the receipt 112d in the blockchain 200, and sends an e-mail to the effect that the receipt 112d has been registered in the blockchain 200 to the examination payment organization 116.
  • This operation is shown in step S4-2.
  • Such an operation may be executed by, for example, the control unit 302 in FIG.
  • Such consensus building by approval is similar to that of the conventional blockchain 200.
  • an e-mail indicating that the medical information has been registered in the blockchain 200 is sent to the destination to which the medical information is to be transmitted (in this case, the examination payment organization 116). This is transmitted to the examination payment organization 116.
  • the examination payment organization 116 can know that the medical information addressed to itself (reception 112d) has been registered in the blockchain 200 (registration has been requested).
  • Some medical information does not have a destination, but in that case, an e-mail to the destination is not transmitted.
  • the examination payment organization 116 can determine that the medical information (recept 112d) has arrived at itself.
  • step S4-2 "claim for medical treatment” is performed, and the fact that the receipt 112d has been registered in the blockchain 200 is notified. Therefore, a receipt ID for identifying the receipt 112d is described in the electronic mail. By using such a receipt ID, the receipt 112d can be easily identified and taken out from the blockchain 200. As a result, the examination / payment agency 116 can know that the medical fee has been charged and that the claim 112d relating to the medical fee has been registered on the blockchain 200.
  • step S4-3 the pharmacy 114 creates a receipt 114d to request a dispensing reward.
  • the system of the pharmacy 114 registers the receipt 114d in the blockchain 200.
  • This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
  • the hospital 114 registers the receipt 114d in the blockchain 200 and sends an e-mail to the examination payment organization 116.
  • This operation is shown in step S4-4. Such an operation may be executed by, for example, the control unit 302 in FIG.
  • step S4-4 "dispensing reward" is requested, and the fact that the receipt 114d has been registered in the blockchain 200 is notified. Therefore, a receipt ID for identifying the receipt 114d is described in the electronic mail. By using such a receipt ID, the receipt 114d can be easily identified and taken out from the blockchain 200. As a result, the examination and payment institution 116 can know that the dispensing fee has been requested and that the receipt 114d relating to the dispensing fee has been registered on the blockchain 200.
  • step S4-5 the examination / payment agency 116 recognizes that the medical fee has been requested by receiving the above-mentioned mail (step S4-2) regarding the request for the medical fee. Based on the receipt ID described in the mail, the receipt 112d related to the request for the medical fee is taken out of the blockchain 200.
  • the examination / payment agency 116 examines the receipt 112d, and if it is determined to be valid, sends a request 116a for the examination payment to the insurer 118 (step S4-5).
  • the sending of the request 116a for the examination payment is executed by registering the request 116a in the block chain 200 as in the case of the receipt 112d and the like.
  • the examination payment organization 116 sends an e-mail to the insurer 118 indicating that the request 116a for the examination payment has been registered in the blockchain 200. Therefore, specifically, ⁇ Registration 116a of the examination payment is registered in the blockchain 200. -Send an e-mail to the insurer 118 indicating that the request 116a for the examination payment has been registered in the blockchain 200.
  • the transmission of the request 116a for the examination payment is realized (step S4-5). These two types of operations may be executed by, for example, the (applicable) control unit of the examination and payment institution 116 corresponding to the control unit 302 in FIG.
  • the examination payment organization 116 receives the above-mentioned mail (step S4-4) relating to the dispensing fee request, grasps that the dispensing fee has been requested, and based on the receipt ID described in the email, the blockchain 200. From the dispensing reward is retrieved.
  • the examination and payment organization 116 examines the receipt 114d, and if it is determined to be valid, sends a request 116a for the examination payment to the insurer 118 (step S4-5).
  • the operation of sending the request 116a for the examination payment is as described above, and the request 116a for the examination payment is registered in the blockchain 200, and the electronic notice indicating that the request 116a for the examination payment is registered in the blockchain 200.
  • the e-mail is sent to the insurer 118.
  • step S4-6 when the insurer 118 receives the e-mail request 116a for the examination request, the insurer 118 extracts the contents of the examination payment request 116a from the blockchain 200 based on the e-mail.
  • the insurer 118 examines the extracted examination payment request 116a, and if it is determined to be legitimate, pays the bill amount 118a.
  • the bill payment 118a may be paid by the same payment method as before, but the payment slip may also be registered in the blockchain 200. By doing so, by registering many documents (medical records, prescriptions, receipts, medication notebooks) and various slips related to medical treatment in the blockchain 200, the validity of those documents can be determined later (at a later date). It is possible to verify the validity of the procedure.
  • step S4-7 receiving the payment 118a of the billing amount in step S4-6, the examination payment organization 116 pays a medical fee to the hospital 112 and pays a dispensing fee to the pharmacy 114 (see FIG. 1).
  • Payment of this medical treatment / dispensing fee may be made by the same payment method as before, but a payment slip or the like may be registered in the blockchain 200 as in step S4-6 (FIG. 1). , Indicated by dashed lines). Such registration makes it possible to later (later) verify the validity of the payment and the validity of the procedure.
  • the insurer 118 collects an insurance premium 110c from the patient 110 (which may be a family member as well as the subscriber) who is a member of the insurance, and uses it for payment of medical treatment and dispensing fees. (Fig. 1).
  • FIG. 5 is a conceptual diagram illustrating the relationship between the medical information and the platform 360.
  • the platform 360 is a platform that can manage various medical information, and has the blockchain 200 that manages various medical information as described above.
  • the block chain 200 is described as being located at one place, but the block chain 200 is actually distributed and held by members (members) of the block chain. Therefore, the patient 110, which is a member, also holds the blockchain 200 in principle, but, for example, the hospital 112 where the patient 110 receives medical treatment substitutes a process to be executed by the patient 110 as a member of the blockchain 200. Is also good. That is, the block chain 200 to be held by the patient 110 may be held instead of the patient 110 (as the patient 110).
  • the medical information managed by the blockchain 200 may include various medical information such as the medical chart 112b, the claim 112d, the prescription 112c, the medicine notebook 114b, etc., as described above.
  • the blockchain 200 does not need to manage all the medical information described in FIG.
  • insurance membership information and the like held by the insurer 118 may be excluded from management by the blockchain 200 according to the insurer's and the insurance member's intention.
  • the chart 112b, the prescription 112c, the receipt 112d, and the like are very useful for grasping the treatment history of the patient 110, the medical history, the medical expenses history, and the like. Very desirable to manage.
  • the medicine notebook 114b can be configured based on the dispensing history 114d, which is very convenient. The method of configuring the medicine notebook 114b will be described in detail in the next section (MY page server 250).
  • the patient information 110b is also managed by the blockchain 200.
  • the management requires consent of the patient 110. Therefore, there may be a situation where the patient information 110b of a certain patient 110 is managed by the blockchain 200, but the patient information 110b of another patient 110 is not managed by the blockchain 200. Accept.
  • the platform 360 includes an MY page server 250 that provides MY pages (see FIG. 5).
  • the MY page server 250 creates an MY page (Web page) for the patient 110 based on the dispensing history and the like in the blockchain 200, and provides the MY page to the patient 10.
  • the MY page server 250 includes a Web server unit for providing an MY page, a communication unit that reads medical information on the patient 110 from the blockchain 200, and a read medical information. And an MY page construction unit that constructs an MY page from the Web server and provides the MY page to the Web server unit.
  • the patient 110 can access his / her medical history, medication history, hospital visit history, medical history, and various personal data (blood type, etc.) by referring to his / her MY page at any time.
  • the contents of the MY page are constructed by the MY page construction unit, but can include various contents.
  • the MY page construction unit in the MY page server 250 creates the MY page based on the management contents of the blockchain 200, and publishes it as a so-called Web page by the Web server unit.
  • the MY page server 250 is a Web server will be described.
  • the MY page server 250 may be configured to provide various types of medical information of the patient 110 by another method.
  • the MY page may include the contents of a so-called medicine notebook 114b. That is, the MY page construction unit may construct the contents of the medicine notebook 114b.
  • the system may be configured such that the patient 110 can easily access from a terminal such as a smart phone and display various kinds of information about the patient 110 and show it to a doctor or a pharmacist.
  • the communication unit of the MY page server 250 accesses the blockchain 200, but may access the blockchain 200 held by the hospital 112, for example. Further, the MY page server 250 itself may be a member of the block chain 200 and include a storage unit that holds the block chain 200 in the MY page server. Further, the MY page server 250 may act on behalf of the patient 110 as a member of the blockchain 200. In this case, the MY page server 250 may be provided with a control unit that executes an operation as a member, as in the configuration shown in FIG. Actually, the control unit may be realized by a program for realizing the control unit and a CPU or the like executing the program. Further, in this case, since the storage unit holds the blockchain 200 held by the patient 110 acting on behalf of the patient, the communication unit may actually access the blockchain 200 of the storage unit in the MY page server 250. .
  • the MY page server 250 provides information for the patient 110 (for individuals) as an MY page based on the registered contents of the blockchain 200. For example, as described above, it is conceivable to accumulate dispensing history data and create and provide a medicine notebook 114b. It is preferable that such an MY page is created for each individual by the MY page construction unit, and is disclosed to the individual only when the individual authentication from the individual succeeds.
  • the personal authentication may be executed by the Web server unit, and various conventionally known methods can be applied. Password authentication, biometric authentication, and mobile phone telephone number authentication may be used.
  • the MY page server 250 may be configured so that the patient 110 itself can register various medical information of the patient 100 itself. Such a registration function may be executed by the Web server unit. Since a Web server that realizes such a function is known in the world, it is easy for those skilled in the art to construct a Web server unit to which the patient 110 can write information. As described above, the patient 110 may be configured to be able to browse his / her own MY page and register predetermined self-registration information in the MY page. The configuration may be such that the self-measured physical information, health status, and the like can be registered. Items that can be registered by the patient 110 will be described later in detail.
  • the medical institution 212 in FIG. 5 includes, in addition to the hospital 112, various clinics, cancer centers, dental clinics, rehabilitation institutions, and the like.
  • the medical institution 212 is the hospital 112.
  • the medical information provided by the medical institution 212 includes a medical chart 112b, a prescription 112c, a receipt 112d, and the like. Only one type of medical information may be managed by the blockchain 200. Further, medical information other than the information listed here may be selected as a target to be managed by the blockchain 200. Also, the medical institution 212 may manage its own medical information and its own documents. The system of the medical institution 212 (for example, the hospital 112) registers these medical information in the blockchain 200 in the platform 360.
  • a system for creating a receipt 112d called a receipt computer has been widely known, but a system for creating a medical chart 112b and a prescription 112c has been increasingly used, and predetermined information (transactions and the like) has been stored in the blockchain 200.
  • the registration mechanism has also been known. Therefore, by combining these technologies, it is easy for those skilled in the art to construct a system having a function of creating these medical information and registering it in the blockchain 200.
  • the pharmacy 114 in FIG. 5 is the same as the pharmacy 114 in FIG.
  • the medical information provided by the pharmacy 114 includes a receipt 114d, a dispensing history 114e, and the like. However, only one type of medical information may be managed by the blockchain 200. Further, medical information other than the information listed here may be selected as a target to be managed by the blockchain 200. Further, the medical information and the unique documents of the pharmacy 114 may be managed.
  • the system of the pharmacy 114 registers the medical information in the blockchain 200 in the platform 360.
  • a system for creating a receipt 114d called a reception computer has been widely known, and a mechanism for registering predetermined information (transactions and the like) in the blockchain 200 has been used.
  • the pharmacy 114 can obtain the prescription 112c from the blockchain 200.
  • the prescription 112c is registered in the blockchain 200 by (the system of) the medical institution 212.
  • the pharmacy 114 provides the medicine to the patient 110 based on the prescription 112c (114a in FIG. 1).
  • the pharmacy 114 (system) may create the dispensing history 114e and register it in the blockchain 200.
  • the pharmacy 114 (system) may issue a receipt 114d when the medicine is supplied and register it in the blockchain 200.
  • the medicine notebook 114b in FIG. 5 may be created by the pharmacy 114 and registered in the blockchain 200.
  • the patient 110 who is a member of the blockchain 200, can take out the medicine notebook 114b from the blockchain 200, browse it appropriately, and present it to the hospital 112 or the like.
  • the above-mentioned MY page server 250 may create a medicine notebook 114b based on the contents of the above-described dispensing history 114e and present it on the MY page.
  • the patient 110 can browse the medicine notebook 114b through the MY page, show the medicine notebook 114b to the pharmacy 114 or the like. Since the medicine notebook 114b can be created based on the entire dispensing history 114e, a plurality of prescriptions 112c can be put together.
  • the examination / payment institution 116 in FIG. 5 is the same as the examination / payment institution 116 in FIG. 1 and includes a payment fund, a national health insurance association, and the like.
  • the medical information provided by the examination payment organization 116 includes an examination result 116b, a medical treatment fee 116c, and the like. Only one or more of these medical information can be managed by the blockchain 200. Note that the examination result 116b may be integrated with the medical fee 116c, and the examination result 116b may be included as one item of the document of the medical fee 116c.
  • the examination result 116b, the medical fee 116c, and the like may or may not be managed by the blockchain 200.
  • the medicine history management system 100 includes, for example, configuring a blockchain 200 including a medical institution 112, a pharmacy 114, and a patient 110, managing the medicine history therein, and using the notebook 114b. Is convenient for the patient 110 and the like. This is because it is considered that a certain effect can be obtained with respect to drug history management even when the examination payment organization 116 does not participate.
  • medical information other than the information listed here may be selected as a target to be managed by the blockchain 200.
  • medical information and original documents of the examination and payment organization 116 may be managed.
  • the system of the screening payment agency 116 eg, National Health Insurance
  • National Health Insurance may register these medical information with the blockchain 200 in the platform 360.
  • the examination and payment institution 116 needs to exchange data with a plurality of medical institutions and pharmacies 114, and one pharmacy 114 uses the blockchain 200 and another pharmacy 114 does not use the blockchain 200. It is also assumed that In that case, the configuration of the system of the examination and payment institution 116 may be slightly complicated. Therefore, depending on the examination / payment organization 116, the request for the medical treatment / dispensing fee and the payment of the medical treatment / dispensing fee may be performed as usual without using the blockchain 200. Further, the examination and payment institution 116 may perform a process of switching use / non-use of the blockchain 200 for each pharmacy 114 (or medical institution 112) of the partner.
  • the drug history management system 100 generates a larger Utaka if more institutions participate, but may be realized in a form in which only a few hospitals 112 and pharmacies 114 participate at first. Even with such a small scale, the benefits of the blockchain 200 are large, and it is possible to sufficiently check the prescription of the medicine from the prescription 112c, the dispensing history 114e, and the like at a later date, thereby contributing to appropriate medicine payment. It is possible. Thereafter, an embodiment in which the number of participating members is increased to achieve a greater effect and greater convenience is one of the preferable actual embodiments.
  • the hospital 112 which is a member of the medicinal history management system 100, registers the prescription 112c in the blockchain 200 and hands it over to the patient 110 by "paper" if desired. .
  • the medicine can be paid at the pharmacy 114, which is not a member, by handing over the paper.
  • the hospital 112 becomes a member of the blockchain 200, and immediately after using the platform 260, uses only the prescription 112c and the receipt 112d as medical information to be registered in the blockchain 200, and then sequentially registers the chart 112b and the like. It may be configured as follows. Thus, by giving flexibility to the medical information to be registered, the so-called participation barrier is reduced, and the configuration is such that small hospitals 112 and pharmacies 114 can easily participate.
  • the insurer 118 in FIG. 5 is the same as the insurer 118 in FIG.
  • the medical information provided by the insurer 118 includes the insurance membership information 118b, but other information may be managed by the blockchain 200 as a type of medical information.
  • the insurance member information 118b may require the consent of the member when registering with the blockchain 200, all the insurance member information 118b does not need to be registered in the blockchain 200 at one time.
  • the insurer 118 may wait until the consent of all the members has been obtained before registering with the blockchain 200, or may register with the blockchain 200 sequentially from the insurance member information 118b of the member whose consent has been obtained. Good.
  • the medicine history management system 100 uses the blockchain for each of the components (hospital 112, pharmacy 114, insurer 118, etc.) of FIG. It does not require registration to the 200. This aims to facilitate participation in the present drug history management system 100 and to make the merits widely known. Medical information handled by the medicinal history management system 100 is often personal information, and consent of the patient 110 is often required when registering with the blockchain 200. Therefore, the operation of registering only the medical information of the patient 110 for which consent has been obtained in the blockchain 200 is permitted.
  • the explanation has been given using the custody accession information 118b of the insurer 118 as an example, but other medical information may be handled similarly.
  • Patient 110 (including insured and dependents)
  • the patient 110 in FIG. 5 is the same as the patient 110 in FIG. 1, but includes insured persons, dependents, and the like.
  • the medical information provided by the patient 110 includes patient information 110b as shown in FIG.
  • the patient information 110b may be registered in the blockchain 200 by the patient 110 itself, or may be executed by the hospital 112 or the like with the consent of the patient 110. Further, the hospital 112 or the like may act on behalf of the patient 110 as a member of the blockchain 200. In that case, the hospital 112 may register the patient information 110b on the blockchain 200 instead of the patient 110. Good.
  • the MY page server 250 provides the MY page for the patient 110, and the patient 110 can register personal information on this MY page separately from the blockchain 200. it can. Since such personal information is less likely to be tampered with, it may be stored separately from the blockchain 200 on a MY page where individuals can be registered.
  • the present embodiment is characterized in that a MY page server 250 is provided in association with the block chain 200, and a platform 360 is configured by the MY page server 250 and the block chain 200. Then, the MY page server 250 can create and present an MY page for each patient 110 based on the registered contents of the blockchain 200.
  • the patient 110 can browse and use the MY page (self-oriented) configured based on the content registered in the blockchain 200, and also transmits the self-registration information 110d to the blockchain 200. It can be registered separately from the registered contents.
  • the self-registration information 110d can include a health insurance card (QR code (registered trademark)), self-measured values (height, weight), health status, and the like, but may have any content (see FIG. 5).
  • the patient 110 can browse the MY page browsing information 110e by browsing the MY page provided by the MY page server 250.
  • the MY page browsing information at the time of browsing includes self-registration information 110e registered by oneself, a difference from the target health status, a prescription 112c, a received medicine (medicine history), an outpatient treatment history (outpatient treatment history), and the like. May be.
  • the MY page browsing information may include other information, or may be less information depending on the intention of the patient 110 or the like.
  • the patient 110 can use his / her personal computer or the like to browse the MY page, register desired self-registration information in the MY page, and the like. Further, the patient can access the MY page using a personal computer, a smartphone (Smart Phone), or various portable terminals.
  • the MY page server 250 creates and presents an MY page (for example, a Web page) for the patient 110. Further, it is preferable that the MY page server 250 act on behalf of the patient 110 as a member of the block chain 200.
  • each member has, for example, a configuration as shown in FIG. 2, and has been described as executing the operation as a member of the block chain 200. If it is inconvenient or difficult to operate as a member of the blockchain, such as an individual patient 110, the (hospital) 112 or the like of the patient 110 may use the blockchain 200 instead of the patient 110.
  • the MY page server 250 may be configured to perform the operation of the patient 110 as a member of the blockchain 200 on behalf of the platform 360 as described above. When performing such substitution, it is also preferable to post the operation (proxy operation) on the MY page of the patient 110. This posting may also be executed by the control unit of the MY page server. With this configuration, the patient 110 can confirm what operation is being performed as a member of the blockchain 200 on his / her MY page, which is convenient.
  • the MY page server 250 disposed in the platform 360 has been described, but two or more MY page servers 250 may exist. For example, not only the inside of the platform 360 but also a plurality of separate and independent units may be provided. For example, it may be provided at the insurer 118 of the insurance to which the patient 110 belongs, or may be provided at the hospital 112 of the patient 110.
  • medication history management system 100 of the present embodiment secure the mutual possess block chain, billing and medical fees, electronic medical records between medical institutions, to storage and management in a distributed medication history personal information
  • a simple database can be constructed.
  • a database that can be used not only by the hospital 112 and the like but also by the patient 110 can be constructed.
  • the patient 110 may use another database (for example, the hospital 112 or the MY page server 250). May be requested for a processing substitute.
  • the patient 110 is a member of the blockchain 200 and operates as a member, the patient 110 holds the blockchain 200 and can see the blockchain 200 held by himself.
  • the content of the blockchain 200 can be viewed by accessing the agency.
  • the blockchain 200 be encrypted and the patient can register his or her intention to publish information regarding the patient. For example, it is also preferable to provide such a flag for each management target.
  • the patient 110 when the patient 110 itself participates in the drug history management system 100, it is preferable that the patient 110 obtains consent as to whether or not his / her own information may be shared among the members. If the medical chart of the patient 110 who agrees can be browsed at a plurality of hospitals 112, the possibility of performing duplicate tests can be reduced. Also, the possibility of duplicate dosing can be reduced. Such an agreement may be made for each management target. If a flag is provided for each management target, the patient's intention can be set and reflected for each management target.
  • consortium type block chain 200 has been described as an example of the block chain 200, other types may be used.
  • various algorithms can be adopted as a consensus-building expression for members to obtain (establish) consensus.
  • a PBFT (Practical Byzantine Fault Tolerance) method may be adopted.
  • Other various consensus methods may be adopted depending on the type of the management target, the business content, the type of the block chain to be adopted, and the like.
  • Proof of work (POA), proof of stake (PoS), proof of importance (PoI), or the like may be employed.
  • the members performing the approval are limited to the large hospital 112, the screening and payment organization 116, and the like, instead of all the members participating in the blockchain. In that case, the PBFT method may be adopted.
  • the present invention is not limited to these algorithms, and other methods may be adopted.
  • the blockchain 200 may be configured so that some approving members (e.g., the review and payment institution 116) approve the claim (obtain (establish) a consensus).
  • another member for example, a large pharmacy 114) serving as a leader may calculate a hash function and a nonce of each block as appropriate to create a block. .
  • the drug history management system 100 aims at promoting prevention and health promotion and optimizing medical expenses from the viewpoint of patients.
  • the present drug history management system 100 aims to "change patient consciousness" and "promote health” based on past patient drug history management, target health values, diagnoses, and prescription times.
  • the goal is to reduce or reduce the payment burden on associations and hospitals by reducing medical care and prescription costs as a result of patient health promotion (changes between target and current figures and provision of health promotion information).
  • the following service steps and approaches to medical institutions and pharmacies will be provided.
  • Step 1 Promotion of use of the present service to medical institutions and pharmacies
  • the service of the present drug history management system 100 shall be provided free of charge to medical institutions and pharmacies, and efforts shall be made to spread the service provided by the present drug history management system 100.
  • the function of the service provided by the medicinal history management system 100 is directly operated (registered) on the blockchain 200 without processing data of electronic medical records and prescriptions used by existing medical institutions and pharmacies, and operates as it is. Configure as a mechanism.
  • the conventional centralized system is merely replaced by the blockchain 200, and even if security and privacy are taken into consideration, it does not violate various regulations such as the Pharmaceutical Affairs Law.
  • the merits of each medical institution are clarified and appealed by introducing the service by the medicinal drug history management system 100.
  • Step2 Promotion of use to patients and creation of benefits
  • the promotion of use to patients is planned for the following two developments.
  • Companies are currently working to improve employee health management, their job satisfaction, efficiency and creativity, but many companies are only able to promote employee health through annual health examinations.
  • the health status of the patient who is a member of the member once gathers at the company from a member association or a kempo, its utilization may not be sufficient. Therefore, a company recommends the use of the service provided by the medicinal history management system 100 as a part of a welfare program.
  • stress check is mandatory for business establishments with 50 or more employees.
  • the stress check items recommended by the Ministry of Health, Labor and Welfare are 57 items in total, and consist of work stress factors (17 items), stress responses (29 items), and stress alleviation factors (social support 9 items, satisfaction 2 items). Is done. Changes in internal environment (number of seats, number of people per square meter, layout of those seats, etc.), changes in employee health, medical care, and prescriptions, measurement of benefits of benefits (in-house events and events to be implemented), It appeals that it is possible to weigh the relationship between stress management and the linkage with time management (sickness, early leave, lateness, etc.). In this regard, we plan to consider future alliances with office office equipment manufacturers and others.
  • Tipec Corporation offers a service called "Hello Health Consultation 24". According to this service, full-time doctors and other experienced staff can receive health consultations over the phone 24 hours a day, 7 days a week at the Tipek Consultation Center equipped with the latest reception system. is there. Based on the medication history of the patient 110, the content of the prescribed medicine, its effect, the prescribed medical treatment and the time series and the number of medicines can be notified. ⁇ Guide to the target health value, fundamental treatment (low back pain, exercise, etc.), lifestyle-related diseases, etc.
  • ⁇ Provide a medical expenses deduction application (self-medication (including tax system)) page (judgment / input / printout).
  • Health promotion information data and information on sleep, diet, and exercise
  • your own health information from height, weight, blood pressure, etc., daily steps, calories consumed, calories and nutritional bias from diet, etc.
  • ⁇ Provide a place for health management (performed by health calendar such as history / numerical management) of patients 110 themselves on a Web basis, and a place for competition, friendship, and exchange of opinions within fellows / communities.
  • Step3 Promotion of use to associations / kenpo, etc., and demonstrating merits From Step1 and Step2 described above, it is possible to contribute to a reduction in insurance premiums paid by improving the health of the patient 110 (resulting in a decrease in medical treatment and prescriptions).
  • the number of pharmacies has increased to about 59,000 stores that surpass convenience stores even if the focus is solely on reducing drug costs.
  • Pharmacies should have fulfilled their mission of reducing drug waste since the start of the system of drug division of labor, but dispensing medical expenses have increased by a factor of about 12 in the last quarter century and will reach about 10 trillion yen in FY2025. It is.
  • the medicinal history management system 100 it is possible to implement, for the first time, a mechanism capable of reporting a causal relationship between health promotion and medical treatment / prescription, and confirming insurance on the cloud. It is considered that the commercialization can be smoothly advanced through the above steps 1 to 3.
  • Such a drug history management system 100 be basically nationwide in consideration of sharing medical records and the like. However, approval may be given for each region or each municipality. That is, although the above-mentioned drug history management system 100 is a system using one block chain 200, a member who approves the drug history management system 100 may be selected for each municipality. This is because, in order to inspect and approve the management objects nationwide sequentially, the calculation cost may be large. In this case, a plurality of “approval groups” are formed in one block chain. For example, a configuration may be adopted in which medical information in Tokyo (managed object, (for example, a claim, a prescription, etc.)) is determined by several approved members including an examination and payment institution in Tokyo.
  • an “approval group” may be formed for each examination payment institution, centered on the examination payment institution.
  • the approval group is a set of members for approval. That is, a plurality of approval groups are formed in one block chain 200, and which approval group is to be approved is determined in advance according to a point where a registration target (medical information) for the block chain 200 is generated. Is preferred. For example, a rule may be provided that a prescription 112c generated at a hospital 112 in Tokyo is approved by an approval group in Tokyo.
  • the drug history management system 100 it is referred to as the drug history management system 100, but is not necessarily limited to the drug history, and manages management targets (medical records, survey results, radiographs, etc.) that make up the medical history and examination history. May be targeted. Further, an arrangement may be made wherein the approval member is changed for each type of management target.
  • the medication history may be determined by an approved member centered on the pharmacy 114.
  • the medical treatment history may be determined by an approved member centering on the hospital 112.
  • an institution that simultaneously participates in a plurality of block chains 200 and becomes a member plays a role as the above-described block chain bridge. Since we participate in multiple blockchains 200, for example, In response to a request from a member of any of the participating blockchains 200, a management target (medical information) on the blockchain is extracted. Register the management target (medical information) in another blockchain 200 related to the request. -Send a mail to that effect to a predetermined member of the other blockchain 200 related to the request. And the like, and exchange of medical information (managed objects) across the blockchain 200 is realized. However, the mail (notification) to the predetermined member may not be necessary. This is the case of merely transferring medical information.
  • the size of the block chain 200 it is also preferable to provide the block chain 200 for each examination payment organization 116.
  • the exchange of medical information across the blockchain 200 may be performed using the system of the examination and payment organization 116.
  • the examination and payment institution 116 participates as a member in the blockchain 200 in the relevant region, and also participates as a member in the blockchain 200 in another adjacent region.
  • the operation as the block chain bridge described above is, for example, In response to a request from a member of the blockchain 200 in the region to which the screening payment institution 116 belongs, the management target (medical information) on the blockchain 200 is extracted. Register the management target (medical information) in another adjacent blockchain 200 related to the request.
  • the request may be, for example, a request by e-mail.
  • the request may include, for example, target medical information (information for identifying, for example, a receipt ID, etc.), other blockchains to be sent, and other predetermined members to be sent. It is preferable to include them. However, notification to a predetermined member may not be necessary.

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Abstract

Through the present invention, medical care history, etc., is managed through use of a distributed ledger database, medical information is mutually utilized, calculation of medical service fees is facilitated, appropriate dosing of medication is realized, and patient health is promoted. A medical information management system provided with a plurality of member devices for holding a distributed account book for recording medical information, the medical information management system being characterized in that each member device is provided with a storage unit for holding a distributed account book, a communication unit for communicating with another member device, and a control unit for controlling the distributed account book, the communication unit transmitting a transaction relating to a medicine to the control unit when medical information is received from another member device and transmitting a received approval to the control unit when approval of the medical information is received from another member device, and the control unit adding the transmitted medical information to the distributed account book stored by the storage unit when approval is transmitted from another member device after medical information is transmitted from the communication unit.

Description

[規則26に基づく補充 05.10.2018]　医療情報管理システム及びそれに用いるメンバー装置[Supplements based on Rule 26 05.10.2018] Medical information management system and member devices used for it
　本発明は、医療情報管理システムに関する。特に、複数の医療従事者が共有することができる医療情報管理システムに関する。また、その医療情報管理システムを構成するメンバー装置に関する。 The present invention relates to a medical information management system. In particular, it relates to a medical information management system that can be shared by a plurality of medical personnel. Further, the present invention relates to a member device constituting the medical information management system.
　従来から、病院や薬局等の医療機関においては、さまざまな情報システムが利用されている。例えば、診療報酬を計算するためのレセプトコンピュータ（レセコンと略称する）が病院や薬局で広く利用されている。また、いわゆる電子カルテも病院や診療所で広く利用されている。また、近年においては、患者の薬歴を記録したお薬手帳が利用されているが、これを紙ではなく電子的に実現した患者毎の薬歴管理システムも利用が拡大している。 医療 Various information systems have been used in medical institutions such as hospitals and pharmacies. For example, a reception computer (abbreviated as reception computer) for calculating a medical fee is widely used in hospitals and pharmacies. Also, so-called electronic medical records are widely used in hospitals and clinics. In recent years, medication notebooks that record a patient's medication history have been used, but the use of a medication history management system for each patient, which realizes this electronically instead of on paper, is also expanding.
　＜従来の情報システム＞
　図６には、従来の医療における診療報酬の処理の流れが示されている。
　まず、患者１０は、病院１２で治療を受ける。つまり、病院１２の医師は、診療サービス１２ａを患者に提供し、その患者１０のカルテ１２ｂを作成する。カルテ１２ｂは病院１２内で保管する。また、病院１２の医師は、診療サービス１２ａの結果、患者１０に処方する薬の処方箋１２ｃを作成し、患者１０に渡す。この様子が図３に示されている。患者１０は、診療報酬の一部の負担を支払う（図６中、１０ａで示される）。 <Conventional information system>
FIG. 6 shows a flow of processing of a medical fee in conventional medical treatment.
First, a patient 10 receives treatment at a hospital 12. That is, the doctor at the hospital 12 provides the medical care service 12a to the patient and creates the medical record 12b of the patient 10. The chart 12b is stored in the hospital 12. In addition, the doctor of the hospital 12 creates a prescription 12c for a medicine to be prescribed for the patient 10 as a result of the medical service 12a, and passes it to the patient 10. This is shown in FIG. The patient 10 pays a part of the medical fee (indicated by 10a in FIG. 6).
　次に、患者１０は、処方箋１２ｃを薬局１４に持ち込み、薬局１４の薬剤師はその処方箋１２ｃに基づき、薬剤の給付を行う（図６中、１４ａで示される）。同時に薬局１４（の薬剤師）は患者１０に対してお薬手帳１４ｂを提供する。患者１０は、診療報酬（ここでは主として調剤報酬）の一部の負担を支払う（図３中、１０ｂで示される）。
　病院１２、薬局１４は、医療報酬を請求するために、いわゆるレセプト１２ｄを作成し、審査支払機関１６に送る（図６中、１２ｅで示される）。 Next, the patient 10 brings the prescription 12c to the pharmacy 14, and the pharmacist at the pharmacy 14 delivers the medicine based on the prescription 12c (indicated by 14a in FIG. 6). At the same time, (the pharmacist of) the pharmacy 14 provides the medicine notebook 14b to the patient 10. The patient 10 pays a part of a medical fee (here, mainly a dispensing fee) (indicated by 10b in FIG. 3).
The hospital 12 and the pharmacy 14 create a so-called claim 12d and request the medical fee, and send it to the examination and payment organization 16 (indicated by 12e in FIG. 6).
　審査支払機関１６は、レセプト１２ｄを受領すると、これを審査の上、審査支払分の請求を保険者１８に対して実行する（図６中、１６ａで示される）。保険者１８は、この審査支払分の請求に基づき、請求金額の支払いを実行する（図６中、１８ａで示される）。
　また、保険者１８は、保険料を患者１０から徴収する（図６中、１０ｃで示される）。
　審査支払機関１６は、保険者１８が支払ってきた金額を、診療報酬・調剤報酬として病院１２や薬局１４に支払う。この支払いは図６では省略している。 Upon receipt of the receipt 12d, the examination payment organization 16 examines the receipt, and executes a request for the examination payment to the insurer 18 (indicated by 16a in FIG. 6). The insurer 18 pays the amount of the claim based on the request for the examination payment (indicated by 18a in FIG. 6).
The insurer 18 also collects an insurance premium from the patient 10 (indicated by 10c in FIG. 6).
The examination payment organization 16 pays the amount paid by the insurer 18 to the hospital 12 or the pharmacy 14 as a medical treatment fee and a dispensing fee. This payment is omitted in FIG.
　＜用語＞
　「医療機関」とは、病院（図６の病院１２）や薬局（図６の薬局１４）等の医療提供施設を示す用語であるが、本特許では、医療行為及びそれに関する周辺業務を行い、特にレセプトを扱う機関や、診療報酬の点数を取り扱う機関等を広く意味するものとする。薬を販売するドラッグストアや、リハビリセンター、保険者（図６の保険者１８）や審査支払機関（図６の審査支払機関１６）等も、本特許における「医療機関」と呼ぶ。
　「保険者」とは、健康保険を扱う全国健康保険協会や、各中央官庁、県庁・市役所、等の共済組合、会社工場などの健康保険組合、及び協会けんぽ等を言い、健康保険を実行する者であり、医療機関からの診療報酬請求（点数）に応じて、診療報酬を支払い、患者からは保険料を徴収する者である。
　「審査支払機関」とは、診療報酬請求の審査を行う機関であり、各種の支払基金や、国保連合等がこれに該当する。
　「診療報酬」とは、医療行為の報酬であり、本特許では、特に、薬局１４（薬剤師）の調剤報酬も含む。 <Term>
“Medical institution” is a term indicating a medical providing facility such as a hospital (hospital 12 in FIG. 6) or a pharmacy (pharmacy 14 in FIG. 6). In particular, institutions that handle claims, institutions that handle points for medical fees, and the like are broadly meant. Drug stores that sell drugs, rehabilitation centers, insurers (insurers 18 in FIG. 6), examination and payment institutions (examination and payment institutions 16 in FIG. 6), and the like are also referred to as “medical institutions” in this patent.
The term "insurer" refers to the National Health Insurance Association that handles health insurance, mutual aid associations such as central government offices, prefectural offices and city halls, health insurance unions such as company factories, and association insurance companies. This is a person who pays a medical fee in response to a medical fee request (point) from a medical institution and collects a premium from a patient.
The “examination payment institution” is an organization that examines medical reimbursement claims, and includes various payment funds, the National Health Insurance Union, and the like.
The “medical fee” is a fee for a medical practice, and in this patent, it particularly includes a dispensing fee for the pharmacy 14 (pharmacist).
　先行特許文献
　医療情報を取り扱う仕組みは様々な技術・仕組みが利用され、また提案されている。
　下記の特許文献１には、新しい電子カルテと古い電子カルテとを１台のコンピュータで処理することができるシステムが開示されている。このシステムによれば、旧電子カルテを仕分けして、新しい電子カルテにコピーする複製手段を備えているので、新旧電子カルテを共に使用することができると記載されている。 Various technologies and mechanisms have been used and proposed for mechanisms for handling medical information in the prior patent documents .
Patent Document 1 below discloses a system that can process a new electronic medical record and an old electronic medical record with one computer. According to this system, it is described that the old electronic medical record is sorted, and a copy means for copying the old electronic medical record to the new electronic medical record is provided, so that the new and old electronic medical records can be used together.
　また、下記特許文献２には、患者自身が書いた問診票や図や写真等も閲覧することができるシステムが開示されている。このシステムによれば、書類を読み取ってカラーの画像データとして電子化する装置を利用しているので、画像データをデータベースに登録することができると記載されている。 Patent Document 2 below discloses a system that allows the user to browse medical questionnaires, figures, photographs, and the like written by the patient himself. According to this system, since a device that reads a document and digitizes it as color image data is used, it is described that the image data can be registered in a database.
　また、下記特許文献３には、データベースとして用いることができる服薬文書が開示されている。具体的には、薬剤の副作用や注意事項等を記載した服薬指導文を、薬剤の成分等を示す医薬品コードに対応して登録する。これによって、容易にデータベース化することができると記載されている。 下 記 Patent Document 3 below discloses a medication document that can be used as a database. Specifically, a medication instruction sentence describing the side effects and precautions of the drug is registered corresponding to the drug code indicating the component of the drug. It is described that a database can be easily created by this.
特開２０１５－１４９０３５号公報JP-A-2015-149035 特開２００５－２５２７７号公報JP 2005-25277 A 特開２００３－２２３５１０号公報JP 2003-223510 A
　従来の診療報酬の流れは上述のようになされている。特に、従来の診療報酬等の業務においては、カルテ、処方箋、お薬手帳、レセプトのような各書類が、紙によるデータと、電子データとが混在している。
　そのため、従来の処理によれば、レセプトの作成等のために電子レセプトが普及しているが、病院１２・薬局１４単位での情報となっており、患者１０の薬歴記録との紐付が不十分である。言い換えれば、患者１０自身の診療情報のデータベースが十分に構築されていないということでもある。このようなデータベースは、患者１０自身の薬歴及び健康管理／お薬手帳１４ｂを軸にして構築することが考えられるが、未だ十分に構築されているとは言い難い。 The conventional flow of medical fees is as described above. In particular, in the conventional business of medical fees and the like, each document such as a medical chart, a prescription, a medicine notebook, and a receipt is a mixture of paper data and electronic data.
For this reason, according to the conventional processing, electronic receipts are widely used for creating a receipt, etc., but the information is provided at the hospital 12 and pharmacy 14 units, and is not associated with the drug history record of the patient 10. It is enough. In other words, it means that the database of the medical information of the patient 10 itself is not sufficiently constructed. Such a database may be constructed based on the medical history and health management / medicine notebook 14b of the patient 10 itself, but it cannot be said that it is still sufficiently constructed.
　また、日本国の政府では、例えば２０１０年５月に「どこでもＭＹ病院」構想を発表しているが、中核病院を核とした中央集権型システムであって事業者視点に基づく者であり、患者１０側の目線にたった患者１０の診療データベースの構築には不十分と考えられる。例えば、ＨＰＫＩ（Healthcare Public Key Infrastructure）、すなわち保健医療福祉分野公開鍵基盤でのセキュリティ管理はあるものの、医療機関間での電子紹介状や電子カルテなどの取り組みなどのみの活用にとどまっている。 In addition, the Japanese government announced the concept of “anywhere MY hospital” in May 2010, for example. However, it is a centralized system centered on a core hospital, and is a person based on the viewpoint of a business operator. It is considered insufficient for the construction of the medical care database of the patient 10 who is just looking at the 10 side. For example, although there is security management based on HPKI (Healthcare Public Key Infrastructure), that is, a public key infrastructure in the field of healthcare and welfare, only medical institutions use electronic referral letters and electronic medical records.
　このように、従来の診療報酬の処理方法においては、患者の薬歴や診療履歴が、個々の病院や薬局のみにあった。そのため、患者が引っ越しをした場合等において、これまでの病歴や薬歴を参照することが困難である場合も想定された。その結果、重複する検査や重複する投薬等が生じる場合もあり、医療費の増大の一因となっている可能性も指摘されている。 Thus, in the conventional medical fee processing method, the medical history and medical history of the patient are only in individual hospitals and pharmacies. For this reason, it has been assumed that it is difficult to refer to the past medical histories and drug histories when the patient moves, for example. As a result, duplicate tests and duplicate medications may occur, which has been pointed out as a possible cause of an increase in medical expenses.
　本発明は、係る課題に鑑みなされたものであり、診療履歴や薬歴等を分散型台帳の技術を利用したデータベースで管理し、患者の薬歴等の医療情報を相互に利用することによって、診療報酬の計算を円滑にすることや、より適切な投薬を実現することによって、患者の健康増進に寄与することができるシステムを提供することを目的とする。 The present invention has been made in view of the above-described problems, and manages medical histories, drug histories, and the like in a database using a distributed ledger technology, and mutually uses medical information, such as a patient's drug histories, It is an object of the present invention to provide a system that can contribute to improving the health of a patient by facilitating calculation of medical fees and realizing more appropriate medication.
　本発明は、上記課題を解決するために、ブロックチェーン（分散型帳簿）を活用した医療情報管理システム（後述する実施形態における薬歴管理システムは、医療情報管理システムの好適な一例に相当する）を構築することを特徴の一つとする。具体的には、本発明は、下記のような手段を採用する。 In order to solve the above-described problems, the present invention provides a medical information management system using a blockchain (distributed ledger) (a drug history management system in an embodiment described later corresponds to a suitable example of a medical information management system). Is one of the features. Specifically, the present invention employs the following means.
　（１）本発明は、上記課題を解決するために、患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、前記各メンバー装置は、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、を具備し、前記通信部は、前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記薬に関する取引を前記制御部に送信し、前記他のメンバー装置から、前記医療情報の承認を受信した場合に、受信した承認を前記制御部に送信し、前記制御部は、前記医療情報が前記通信部から送信されてきた後、所定の他のメンバー装置から承認が送信されてきた場合に、送信されてきた前記医療情報を、前記記憶部が記憶する分散型帳簿に加えることを特徴とする医療情報管理システムである。 (1) The present invention is directed to a medical information management system including a plurality of member devices that hold a distributed ledger that records medical information relating to a medical practice for a patient, in order to solve the above-mentioned problems. Comprises a storage unit that holds the distributed ledger, a communication unit that communicates with another member device, and a control unit that controls the distributed ledger, wherein the communication unit is When the medical information is received, the transaction regarding the received medicine is transmitted to the control unit, and from the other member devices, when the medical information approval is received, the received approval is transmitted to the control unit. The control unit transmits the medical information when the approval is transmitted from another predetermined member device after the medical information is transmitted from the communication unit. Parts is a medical information management system characterized by adding to the distributed book store.
　（２）本発明は、上記課題を解決するために、患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、前記各メンバー装置は、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、前記患者に対する医療行為に関する医療情報を入力する医療情報入力部と、を具備し、前記医療情報入力部は、入力した前記患者に対する医療行為に関する医療情報を入力すると、前記医療情報を、前記制御部に送信し、前記制御部は、前記医療情報を、前記通信部に送信し、前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とする医療情報管理システムである。 (2) The present invention is directed to a medical information management system including a plurality of member devices that hold a distributed book that records medical information relating to medical practice for a patient, in order to solve the above-mentioned problems. A storage unit that holds the distributed book, a communication unit that communicates with other member devices, a control unit that controls the distributed book, and a medical information input unit that inputs medical information related to medical practice for the patient And, the medical information input unit, when input medical information related to the medical practice for the input patient, transmits the medical information, the control unit, the control unit, the control unit, the medical information, Transmitting the medical information to the other member device when the medical information is received from the control unit. It is a medical information management system.
　（３）本発明は、上記課題を解決するために、患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、前記複数のメンバー装置の中で、いずれかのメンバー装置は承認メンバー装置であり、前記承認メンバー装置は、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、を具備し、前記通信部は、前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記医療情報を前記制御部に送信し、前記制御部は、前記医療情報が前記通信部から送信されてきた場合、当該医療情報を承認するか否かを決定し、承認する場合は、承認を他のメンバー装置に送信するように、前記通信部に指示し、前記通信部は、前記制御部から前記医療情報の承認の送信を指示された場合、前記承認を他のメンバー装置に送信することを特徴とする医療情報管理システムである。 (3) The present invention is directed to a medical information management system including a plurality of member devices that hold a distributed book that records medical information relating to a medical practice for a patient, in order to solve the above-mentioned problems. Among the devices, one of the member devices is an approved member device, the approved member device is a storage unit that holds the distributed book, a communication unit that communicates with other member devices, and the distributed book. And a control unit for controlling, the communication unit, when receiving the medical information from the other member device, transmits the received medical information to the control unit, the control unit, When the medical information is transmitted from the communication unit, it is determined whether or not to approve the medical information. When the medical information is approved, the communication unit is instructed to transmit the approval to another member device. The communication unit, when the said control unit is instructed to transmit the authorization the medical information, a medical information management system and transmitting the authorization to another member device.
　（４）本発明は、上記課題を解決するために、患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、前記各メンバー装置は、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、前記患者に対して給付した薬剤に関する情報を入力する窓口部と、を具備し、前記窓口部は、前記患者に対して給付した薬剤に関する情報を入力すると、前記入力した前記患者に対して給付した薬剤に関する情報を、前記制御部に送信し、前記制御部は、前記患者に対して給付した薬剤に関する情報を、前記医療情報として、前記通信部に送信し、前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とする医療情報管理システムである。 (4) The present invention is directed to a medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical care for a patient, in order to solve the above-mentioned problems. A storage unit for holding the distributed ledger, a communication unit for communicating with other member devices, a control unit for controlling the distributed ledger, and a window unit for inputting information on the medicine delivered to the patient. And the window unit, when inputting information about the medicine delivered to the patient, transmits the inputted information about the medicine delivered to the patient to the control unit, and the control unit Transmits, as the medical information, information on the medicine supplied to the patient to the communication unit, and the communication unit receives the medical information from the control unit. A medical information management system and transmits the above medical information to the other member device.
　（５）また、本発明は、（１）から（４）のいずれか１項に記載の医療情報管理システムであって、前記医療情報は、少なくとも、薬剤服用歴（薬歴）、処方箋、レセプト、診療報酬請求、診療報酬支払い、保険料の支払い、保険料の請求、のうちいずれか１種を含むことを特徴とする医療情報管理システムである。 (5) Further, the present invention is the medical information management system according to any one of (1) to (4), wherein the medical information includes at least a medication history (medication history), a prescription, and a claim. , A medical fee management system, a medical fee management system, a medical service fee payment, an insurance premium payment, and an insurance premium claim.
　（６）また、本発明は、（１）から（４）のいずれか１項に記載の医療情報管理システムであって、前記医療情報は、前記患者に給付した薬の情報を含むことを特徴とする医療情報管理システムである。 (6) Further, the present invention is the medical information management system according to any one of (1) to (4), wherein the medical information includes information on a medicine supplied to the patient. It is a medical information management system.
　（７）また、本発明は、（１）から（４）のいずれか１項に記載の医療情報管理システムであって、前記メンバー装置は、薬局、病院、審査支払機関、保険者、患者のいずれかのコンピュータシステムであることを特徴とする医療情報管理システムである。 (7) Further, the present invention is the medical information management system according to any one of (1) to (4), wherein the member device is a pharmacy, a hospital, an examination and payment institution, an insurer, or a patient. The medical information management system is any one of the computer systems.
　（８）また、本発明は、（３）記載の医療情報管理システムであって、前記承認メンバー装置は、保険者、審査支払機関、のうち、いずれかのメンバー装置であることを特徴とする医療情報管理システムである。 (8) The medical information management system according to (3), wherein the approved member device is any one of an insurer and an examination and payment organization. It is a medical information management system.
　（９）また、本発明は、（１）記載の医療情報管理システムの前記メンバー装置であって、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、を具備し、前記通信部は、前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記薬に関する取引を前記制御部に送信し、前記他のメンバー装置から、前記医療情報の承認を受信した場合に、受信した承認を前記制御部に送信し、前記制御部は、前記医療情報が前記通信部から送信されてきた後、所定の他のメンバー装置から承認が送信されてきた場合に、送信されてきた前記医療情報を、前記記憶部が記憶する分散型帳簿に加えることを特徴とするメンバー装置である。 (9) Further, the present invention is the member device of the medical information management system according to (1), wherein the storage unit holding the distributed ledger, a communication unit communicating with other member devices, And a control unit for controlling a type book, wherein the communication unit, when receiving the medical information from the other member device, transmits a transaction related to the received medicine to the control unit, the other When the approval of the medical information is received from the member device, the received approval is transmitted to the control unit.After the medical information is transmitted from the communication unit, the control unit transmits a predetermined other The member device, wherein when the approval is transmitted from the member device, the transmitted medical information is added to a distributed ledger stored in the storage unit.
　（１０）また、本発明は、（２）記載の医療情報管理システムの前記メンバー装置であって、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、前記患者に対する医療行為に関する医療情報を入力する医療情報入力部と、を具備し、前記医療情報入力部は、入力した前記患者に対する医療行為に関する医療情報を入力すると、前記医療情報を、前記制御部に送信し、前記制御部は、前記医療情報を、前記通信部に送信し、前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とするメンバー装置である。 (10) The present invention is also the member device of the medical information management system according to (2), wherein the storage unit for holding the distributed ledger, a communication unit for communicating with other member devices, A control unit that controls a type book, and a medical information input unit that inputs medical information related to a medical practice for the patient, the medical information input unit is configured to input the medical information related to the entered medical practice for the patient. Transmitting the medical information to the control unit, the control unit transmits the medical information to the communication unit, and the communication unit receives the medical information from the control unit, The medical device transmits the medical information to the other member device.
　（１１）また、本発明は、（３）記載の医療情報管理システムの前記承認メンバー装置であって、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、を具備し、前記通信部は、前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記医療情報を前記制御部に送信し、前記制御部は、前記医療情報が前記通信部から送信されてきた場合、当該医療情報を承認するか否かを決定し、承認する場合は、承認を他のメンバー装置に送信するように、前記通信部に指示し、前記通信部は、前記制御部から前記医療情報の承認の送信を指示された場合、前記承認を他のメンバー装置に送信することを特徴とする承認メンバー装置である。 (11) Also, the present invention is the approved member device of the medical information management system according to (3), wherein the storage unit that holds the distributed ledger, a communication unit that communicates with another member device, A control unit for controlling a distributed ledger, wherein the communication unit transmits the received medical information to the control unit when the medical information is received from the other member device; The unit, when the medical information is transmitted from the communication unit, determines whether to approve the medical information, if approved, the communication unit, so that the approval is transmitted to other member devices And the communication unit transmits the approval to another member device when instructed by the control unit to transmit the approval of the medical information.
　（１２）また、本発明は、（４）記載の医療情報管理システムの前記メンバー装置であって、前記各メンバー装置は、前記分散型帳簿を保持する記憶部と、他のメンバー装置と通信する通信部と、前記分散型帳簿を制御する制御部と、前記患者に対して給付した薬剤に関する情報を入力する窓口部と、を具備し、前記窓口部は、前記患者に対して給付した薬剤に関する情報を入力すると、前記入力した前記患者に対して給付した薬剤に関する情報を、前記制御部に送信し、前記制御部は、前記患者に対して給付した薬剤に関する情報を、前記医療情報として、前記通信部に送信し、前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とするメンバー装置である。 (12) The present invention is also the member device of the medical information management system according to (4), wherein each member device communicates with a storage unit that holds the distributed ledger and another member device. A communication unit, a control unit for controlling the distributed ledger, and a contact unit for inputting information on the medicine supplied to the patient, wherein the contact unit relates to the medicine supplied to the patient. When the information is input, the information on the medicine supplied to the patient is transmitted to the control unit, and the control unit transmits the information on the medicine supplied to the patient as the medical information. Transmitting to the communication unit, the communication unit, from the control unit, when receiving the medical information, the member device characterized by transmitting the received medical information to the other member device That.
　（１３）また、本発明は、（１０）記載の前記メンバー装置であって、前記制御部は、前記医療情報と、前記医療情報の宛先とを、前記通信部に送信し、前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信すると共に、前記医療情報を送信した旨を表す電子メールを、前記医療情報の宛先に送信することを特徴とするメンバー装置である。 (13) The present invention is also the member device according to (10), wherein the control unit transmits the medical information and a destination of the medical information to the communication unit, and the communication unit From the control unit, when receiving the medical information, transmits the received medical information to the other member device, and sends an e-mail indicating that the medical information has been transmitted to the destination of the medical information A member device for transmitting.
　（１４）また、本発明は、（９）記載の前記メンバー装置であって、前記記憶部は、複数メンバー分の複数の分散型帳簿を保持し、前記制御部は、前記複数の分散型帳簿制御を制御し、複数のメンバーに対するメンバー装置として機能することを特徴とするメンバー装置である。 (14) The present invention is also the member device according to (9), wherein the storage unit holds a plurality of distributed books for a plurality of members, and the control unit stores the plurality of distributed books. A member device that controls a control and functions as a member device for a plurality of members.
　（１５）また、本発明は、（３）記載の医療情報管理システムであって、前記メンバー装置は、複数のグループに分けられ、前記グループ毎に、承認メンバー装置が含まれ、所定のグループに属する前記メンバー装置が前記医療情報を送信した場合に、前記所定のグループに属する前記承認メンバー装置が承認を行ってから、前記医療情報を前記分散眼他帳簿に記録することを特徴とする医療情報管理システムである。 (15) Further, the present invention is the medical information management system according to (3), wherein the member devices are divided into a plurality of groups, and each of the groups includes an approved member device. When the member device to which the member device belongs transmits the medical information, after the approval member device belonging to the predetermined group performs approval, the medical information is recorded in the distributed eye / other book. It is a management system.
　（１６）また、本発明は、（９）記載の前記メンバー装置であって、前記記憶部は、異なる前記医療情報管理システムの異なる前記分散型帳簿を記憶し、前記制御部は、前記異なる前記医療情報管理システムに対して前記異なる前記分散型帳簿を制御し、異なる前記医療機関情報管理システムのメンバー装置として機能することを特徴とするメンバー装置である。 (16) The present invention is also the member device according to (9), wherein the storage unit stores different distributed books of different medical information management systems, and the control unit sets the different ones of the different types of medical information management systems. A member device which controls the different distributed ledger for a medical information management system and functions as a member device of the different medical institution information management system.
　このように、本発明によれば、改竄が困難なように薬歴等の医療情報を管理することができる。そのため、重複する検査や重複する投薬等を調査することができ、かつ、調査後もそれを改竄することが困難とすることができる。したがって、重複する検査等を後から隠蔽すること等が困難になるので、より正確に不正の低減を図ることができる。 As described above, according to the present invention, it is possible to manage medical information such as drug history so that tampering is difficult. Therefore, it is possible to investigate duplicate tests, duplicate medications, and the like, and it is difficult to falsify them even after the investigation. Therefore, it is difficult to conceal duplicate inspections and the like later, and it is possible to more accurately reduce fraud.
本実施形態に係る薬歴管理システム１００の構成を示す構成図である。It is a lineblock diagram showing the composition of medicine history management system 100 concerning this embodiment. 本実施形態に係る薬歴管理システム１００の各メンバーのコンピュータシステムの機能を示す機能ブロック図である。It is a functional block diagram showing the function of the computer system of each member of medicine history management system 100 concerning this embodiment. 本実施形態のに係る薬歴管理システム１００における動作を表す説明図である。It is an explanatory view showing operation in medicine history management system 100 concerning this embodiment. 本実施形態のに係る薬歴管理システム１００における動作を表す説明図である。It is an explanatory view showing operation in medicine history management system 100 concerning this embodiment. 医療情報の関係を示す説明図である。FIG. 4 is an explanatory diagram showing a relationship between medical information. 従来の薬歴管理の処理の様子を示す説明図である。It is an explanatory view showing a situation of processing of conventional medicine history management.
　以下、本発明の好適な実施形態に係る薬歴管理システム１００を図面に基づいて説明する。
　本願発明者らは、医療情報データの安全対策は、分散データベースであるブロックチェーンを用いたシステムが非常に有効であると考えた。しかし、このブロックチェーンを用いた医療情報の管理手法を実現する具体的な手法は未だ知られておらず、どのようにしてそのようなシステムを構築するかについて有効な情報は未だ世の中に知られていない。
　本願発明者らは、鋭意研究を重ね、医療情報を管理する下記のようなシステムを構築するに至った。 Hereinafter, a medication history management system 100 according to a preferred embodiment of the present invention will be described with reference to the drawings.
The present inventors have considered that a system using a blockchain, which is a distributed database, is very effective as a security measure for medical information data. However, no specific method for realizing this method of managing medical information using blockchain has been known, and effective information on how to construct such a system is not yet known in the world. Not.
The inventors of the present application have conducted intensive studies and have constructed the following system for managing medical information.
　このシステムは、下記に説明するように、たとえ、故意の攻撃や自然災害によって数カ所（数拠点）のデータベースが利用不可能となった場合であっても、ネットワークに残存する他のデータサイト（メンバーと称する）から安全にデータを入手することができるシステムである。
　本実施形態は、このようなシステムを実現するために、レセプトデータやその他の医療情報を、いわゆるコンソーシアム型のブロックチェーンを用いて、管理・運営する手法を提案するものである。コンソーシアム型のブロックチェーンにおいては、レセプトデータ等の医療情報を数多くの承認されたネットワーク上のサイト（メンバー）がリアルタイムで共有することによって医療情報を管理・運営することができる。
　なお、本文では、、ブロックチェーンを構成する構成員（エンティティ）をメンバーと呼ぶが、ノードや、エンティティと呼ぶ場合もある。
　なお、ブロックチェーンは、請求の範囲の分散型帳簿の好適な一例である。 This system, as explained below, allows other data sites (members) to remain on the network even if several (several) databases become unavailable due to intentional attacks or natural disasters. This is a system that can safely obtain data from the system.
The present embodiment proposes a method of managing and operating receipt data and other medical information using a so-called consortium-type block chain in order to realize such a system. In a consortium-type blockchain, medical information such as receipt data can be managed and operated by sharing in real time many medical sites (members) on an approved network.
In the text, members constituting the block chain are referred to as members, but may also be referred to as nodes or entities.
The blockchain is a preferred example of the distributed ledger in the claims.
　第１．薬歴管理システム
　図１には、薬歴管理システム１００の概念図が示されている。この図に概念として示すように、薬歴管理システム１００は、いわゆるブロックチェーンに基づく分散型台帳を利用して、主として薬歴を記録・管理するシステムである。ここでは、薬歴を例として説明するが、いわゆる薬歴とともに、お薬手帳、処方箋、関連するレセプト等を、ブロックチェーン（分散型台帳）を利用して管理するシステムである。
　薬歴管理システム１００は、請求の範囲の医療情報管理システムの好適な一例に相当する。 First. Medication History Management System FIG. 1 shows a conceptual diagram of a medication history management system 100. As shown conceptually in this figure, the drug history management system 100 is a system that mainly records and manages drug history using a distributed ledger based on a so-called blockchain. Here, a drug history will be described as an example. However, this is a system that manages a so-called drug history, a medication notebook, a prescription, a related receipt, and the like using a blockchain (distributed ledger).
The medication history management system 100 corresponds to a preferred example of the medical information management system in the claims.
　本実施形態では、図１に示すように、主として、薬歴、お薬手帳、処方箋、等を管理対象の例として示している。しかし、同薬歴履歴管理システム１００を利用して、診療履歴や、カルテ（図１参照）、検査履歴、健康診断履歴、運動履歴、診療に関連する各種レセプト（図１参照））等も、当該薬歴管理システム１００の管理対象に含めてよい。
　つまり、本実施形態の薬歴管理システム１００は、主たる目的としては患者に処方される薬歴を管理するシステムの実現であるが、実際には（技術的には）医療情報全般を管理するシステムとして構築することが可能である。
　図１に示すように、本実施形態においては、いわゆるコンソーシアム型ブロックチェーン２００を用いて、病院１１２や、薬局１１４等が発行する種々の書類を順次保存し管理していくものである。 In the present embodiment, as shown in FIG. 1, a medication history, medication notebook, prescription, and the like are mainly shown as examples of management targets. However, using the drug history management system 100, medical histories, medical records (see FIG. 1), examination histories, medical examination histories, exercise histories, various medical treatment-related receipts (see FIG. 1), etc. It may be included in the management target of the drug history management system 100.
In other words, the drug history management system 100 of the present embodiment is mainly for realizing a system for managing a drug history prescribed to a patient, but is actually (technically) a system for managing medical information in general. It is possible to build as.
As shown in FIG. 1, in the present embodiment, various documents issued by the hospital 112, the pharmacy 114, and the like are sequentially stored and managed using a so-called consortium type blockchain 200.
　このコンソーシアム型ブロックチェーン２００は、各メンバーにおいて分散して格納・保存されていることは、一般的なブロックチェーンと同様である。図１ではコンソーシアム型ブロックチェーン２００が単独で１個のみ存在するように描かれているが、これは概念であり、実際は一般的なブロックチェーンと同様に各メンバーにおいて分散してブロックチェーン２００が保管されていてよい。つまり、本実施形態で「メンバー」とはブロックチェーンを構成する構成員であるが、同時にブロックチェーンを利用するユーザでもある。また、これらメンバ－（ユーザ）は、ノード（node）やエンティティ(entity)と呼ぶ文献もある。また、ブロックチェーンは、それを構成する（利用する）メンバーが、いわゆるＰ２Ｐのネットワークで接続されており、必ずしも、別途サーバー等を必要としないことを特徴とする。しかし、付随的なサービスや案内を行う装置が別途準備されていてもよい。 This consortium-type blockchain 200 is stored and stored in a distributed manner in each member, similarly to a general blockchain. Although FIG. 1 illustrates that only one consortium type blockchain 200 exists alone, this is a concept, and in fact, the blockchain 200 is distributed and stored in each member similarly to a general blockchain. May have been. That is, in the present embodiment, the “member” is a member configuring the blockchain, but is also a user using the blockchain. In addition, there is a literature in which these members (users) are called nodes or entities. Further, the block chain is characterized in that its constituent (using) members are connected by a so-called P2P network, and a separate server or the like is not necessarily required. However, a device for providing ancillary services and guidance may be separately prepared.
　ブロックチェーン２００を保管するメンバーとなり得るのは、基本的に図１に示す者達である。つまり、病院１１２（診療所等も含む）、薬局１１４（調剤薬局の他、薬を販売しうる種々の機関も含む）、患者１１０（本人、家族も含む）、審査支払機関１１６（各種支払基金等）、保険者１１８（協会けんぽ等）、等である。
　本特許でメンバーとは、上記病院１１２，薬局１１４、患者１１０、審査支払機関１１６、保険者１１８等であるが、具体的には、病院１１２の場合は「病院１１２のコンピュータシステム」をも意味する。すなわち、メンバーとは、病院１１２と、病院１１２のコンピュータシステムであってブロックチェーンの処理を実行するシステムと、の双方を意味する。他のメンバーも同様である。特に、「コンピュータシステム」を意味する場合は、「メンバー装置」と呼ぶ場合もある。請求の範囲のメンバー装置は、ブロックチェーンを構成するメンバーのコンピュータシステムを意味する。例えば、後述する図２に示した薬局１１４のコンピュータシステム３００等が、請求の範囲のメンバー装置の一例に相当する。 The members who can store the blockchain 200 are basically those shown in FIG. That is, a hospital 112 (including a clinic, etc.), a pharmacy 114 (including various institutions that can sell drugs in addition to a dispensing pharmacy), a patient 110 (including the patient and his / her family), an examination and payment organization 116 (various payment funds) Etc.), an insurer 118 (Kenpo Kenpo, etc.), etc.
In this patent, the members are the above-mentioned hospital 112, pharmacy 114, patient 110, examination and payment organization 116, insurer 118, etc. Specifically, in the case of the hospital 112, it also means “the computer system of the hospital 112”. I do. That is, the members mean both the hospital 112 and the computer system of the hospital 112 that executes the processing of the blockchain. The same applies to other members. In particular, when referring to a “computer system”, it may be called a “member device”. The member device in the claims means a computer system of members constituting a blockchain. For example, a computer system 300 or the like of the pharmacy 114 shown in FIG. 2 described below corresponds to an example of the member device in the claims.
　なお、図１に記載されている全員が必ずしもメンバーである必要はなく、例えば、メンバーではない薬局１１４との間では、従来の「紙」による処方箋１１２ｃを利用して（併用して）薬の給付等を行えばよい。また図１以外の機関が、メンバーとなってもよい。すなわち、図１のメンバーは、メンバーの一例である。
　本実施形態における薬歴管理システム１００においては、ブロックチェーン２００を保管するメンバーとなった病院１１２、薬局１１４等の間では、本システムのメリットを享受することができるが、それ以外の他の病院１１２や、薬局１１４、審査支払機関１１６等とは、従来のやり方で作業を実行すればよい。これらメンバーではない薬局１１４等も、順次メンバーになることによって、本薬歴管理システム１００のメリットを享受することができる。 In addition, not all the members described in FIG. 1 need to be members. For example, with a pharmacy 114 that is not a member, a drug prescription 112c using (concurrently with) a conventional “paper” is used. Payment may be made. In addition, organizations other than FIG. 1 may be members. That is, the members in FIG. 1 are examples of members.
In the medicine history management system 100 according to the present embodiment, the merit of the present system can be enjoyed between the hospitals 112, pharmacies 114, and the like that have become members storing the blockchain 200. The work with the pharmacy 112, the pharmacy 114, the examination payment organization 116, etc. may be performed in a conventional manner. The pharmacies 114 and the like who are not these members can also enjoy the merit of the present drug history management system 100 by becoming members sequentially.
　ただし、ブロックチェーンを保管する必要から、患者１１０は特にメンバーとなる労力（やブロックチェーンの保管コスト）に比してメリットは少ない場合もある。そのため、患者１１０の場合は、自らメンバーとはならずに、薬局１１４等のメンバーを介して、自分（患者１１０）のお薬手帳をブロックチェーン（分散型台帳）から読み出して閲覧する等も妥当な処理の一つである。このように、ブロックチェーンの非メンバーであっても、ブロックチェーン２００のメンバーを介してデータの閲覧が可能に構成してもよい。 However, since the blockchain needs to be stored, the patient 110 may have little merit in particular as compared to the labor (or the storage cost of the blockchain) as a member. For this reason, in the case of the patient 110, it is also appropriate to read the medicine notebook of the patient (the patient 110) from the blockchain (distributed ledger) and browse the medicine notebook via the members of the pharmacy 114 or the like, without being a member. Is one of the important processes. Thus, even if it is a non-member of the block chain, the data may be browsed via a member of the block chain 200.
　しかし、このような非メンバーによる閲覧を無制限に認めることはブロックチェーン２００の構成上、妥当ではない場合もある。そこで、メンバーである患者１１０は、そのメンバーとしての機能・動作を他者に代行してもらってもよい。つまり、メンバーである患者１１０に代わって、患者１１０が治療を受けている病院１１２が、当該患者１１０が保有・管理するべきブロックチェーン２００を代理で管理してもよい。つまり、患者１１０は、メンバーとしての働きを他者（病院１１２）の装置に依頼してもよい。 However, there is a case where it is not appropriate to allow such non-members to browse without limitation due to the configuration of the blockchain 200. Therefore, the patient 110 as a member may have another person perform the function / operation as the member. That is, instead of the patient 110 as a member, the hospital 112 receiving the treatment of the patient 110 may manage the blockchain 200 to be held and managed by the patient 110 as a proxy. That is, the patient 110 may request the device of another person (hospital 112) to work as a member.
　また、病院１１２も、小さな診療所の場合は、必ずしもメンバーとなる必要は無い場合もある。また、ブロックチェーンのメンバーであるための機能やを備える機器を準備することが困難な場合もある。それはブロックチェーン２００の管理コストと、得られるメリットとを比較して判断すればよい。そこで、小さな診療所の場合は、大きな病院１１２を介して各種手続きを行ってもよいし、またメンバーとしての機能を大きな病院１１２に代行してもらってもよい。 病院 Also, if the hospital 112 is a small clinic, it may not always be necessary to become a member. In some cases, it is difficult to prepare a device having functions and functions for being a member of the blockchain. This can be determined by comparing the management cost of the blockchain 200 with the obtained merit. Therefore, in the case of a small clinic, various procedures may be performed via the large hospital 112, or the function as a member may be performed by the large hospital 112.
　さて、ブロックチェーン２００においては、時々刻々発生する管理対象（医療情報、処方箋、レセプト等）を、ブロックチェーンで保管する際に、所定の承認メンバーによるコンセンサスがとられる。ブロックチェーンのメンバーの中でも、この承認メンバーとなり得るのは、承認作業を実行できるメンバーでなければならない。したがって、大きな病院１１２や。審査支払機関１１６等、一部の演算能力に余裕のあるメンバーが承認メンバーとなり、この承認メンバーがコンセンサスを取ることが好適である。
　本実施形態におけるブロックチェーン２００は、その種類が限定される必要はなく、どのような形態のブロックチェーンでも採用することができるが、上記のような理由により、いわゆる承認メンバーは一定の認められた者のみがなり得るように構成することがより好ましい。したがって、本実施形態では、例えば、いわゆるコンソーシアム型のブロックチェーン２００を採用することが好ましい。 By the way, in the blockchain 200, when a management object (medical information, a prescription, a receipt, etc.) generated every moment is stored in the blockchain, a consensus is obtained by a predetermined approval member. Among the members of the blockchain, this approval member must be a member who can perform the approval work. Therefore, a large hospital 112 or. It is preferable that a member having some computing capacity, such as the examination and payment institution 116, becomes an approved member and that the approved member take consensus.
The type of the block chain 200 in the present embodiment does not need to be limited, and any type of block chain can be adopted. However, for the reasons described above, so-called approved members have been recognized to be certain. It is more preferable that only the person can be configured. Therefore, in the present embodiment, for example, it is preferable to employ a so-called consortium type block chain 200.
　コンソーシアム型のブロックチェーン２００を構成する各メンバーの構成
　病院１１２、薬局１１４等の各メンバーの備えるコンピュータシステムの機能構成図の一例が図２に示されている。
　図２には、例えば薬局１１４が備えるコンピュータシステムの機能構成図が示されているが、病院１１２等でも基本は同様である。なお、本実施形態の薬局１１４（のコンピュータシステム３００）は、請求の範囲のメンバーの好適な一例に相当する。ブロックチェーン２００のメンバーとなり得るのは、図１に示す各構成である。例えば、病院１１２、審査支払機関１１６等がメンバーとなり得る。
　また、本実施形態において、各メンバーのコンピュータシステムも、便宜上「メンバー」と呼ぶ場合がある。例えばコンピュータ本体と、通信をする通信部３０４や、ハードディスク等で構成した記憶部３０８とを組み合わせて「メンバー」を構成してよい。 FIG. 2 shows an example of a functional configuration diagram of a computer system provided by each member such as a hospital 112 and a pharmacy 114 that constitute the consortium type blockchain 200 .
FIG. 2 shows a functional configuration diagram of a computer system provided in the pharmacy 114, for example, but the same applies to the hospital 112 and the like. Note that (the computer system 300 of) the pharmacy 114 of the present embodiment corresponds to a preferred example of the members of the claims. Each of the components shown in FIG. 1 can be a member of the block chain 200. For example, a hospital 112, a screening payment institution 116, etc. may be members.
In this embodiment, the computer system of each member may be referred to as a “member” for convenience. For example, a “member” may be configured by combining a computer main body, a communication unit 304 that performs communication, and a storage unit 308 that is configured by a hard disk or the like.
　図２では、薬局１１４のコンピュータシステム３００の構成を示しているが、他のメンバーもほぼ同様のコンピュータシステムを添えており、互いにインターネットで接続されている。インターネット以外のネットワークで接続されていてもよい。同図に示すように、コンピュータシステム３００は、薬局ブロックチェーン３０８ａを記憶する記憶部３０８と、記憶部３０８が記憶する薬局ブロックチェーン３０８ａを制御する制御部３０２と、インターネット等のネットワークを介して外部の他のメンバーと通信する通信部３０４と、当該メンバーである薬局の窓口において行われる薬の提供の情報を入力する窓口入力部３０６と、から構成される。 FIG. 2 shows the configuration of the computer system 300 of the pharmacy 114, but the other members have almost the same computer system and are connected to each other via the Internet. It may be connected by a network other than the Internet. As shown in the figure, the computer system 300 includes a storage unit 308 that stores a pharmacy blockchain 308a, a control unit 302 that controls the pharmacy blockchain 308a that is stored in the storage unit 308, and an external device via a network such as the Internet. The communication unit 304 includes a communication unit 304 that communicates with another member, and a window input unit 306 that inputs information on drug provision performed at the window of the pharmacy that is the member.
　記憶部３０８は、薬局ブロックチェーン３０８ａを記憶する記憶手段であり、半導体記憶装置や、磁気記憶装置で構成してよい。なお、このブロックチェーンは、薬局１１４が保持するので、薬局ブロックチェーン３０８ａと便宜上呼ぶが、保持するブロックチェーンは各メンバーで同一のブロックチェーンである。
　病院１１２の場合は、病院ブロックチェーン等とよぶことができる。他のメンバー（審査支払機関１１６等）でも同様である。 The storage unit 308 is a storage unit that stores the pharmacy blockchain 308a, and may be configured by a semiconductor storage device or a magnetic storage device. Since this pharmacy is held by the pharmacy 114, the pharmacy is referred to as a pharmacy blockchain 308a for the sake of convenience, but the holding blockchain is the same blockchain for each member.
In the case of the hospital 112, it can be called a hospital blockchain or the like. The same applies to other members (such as the examination payment organization 116).
　制御部３０２は、薬局ブロックチェーン３０８ａの制御をおこなう。具体的には、所定の管理対象である医療情報を含むブロックを、記憶部３０８中の薬局ブロックチェーン３０８ａに順次、付加接続していくことや、承認メンバーの場合は、与えられた医療情報（ブロックチェーン２００で登録するために提示された医療情報）が正当であるか否かの確認の処理も行う。またその他、記憶部３０８に対するデータの読み書き全般を実行する。また、制御部３０２は、医療情報を薬局ブロックチェーン３０８ａに登録する際に、医療情報を収容するブロックの生成等も状況によって実行する場合がある。その他記憶部３０８に対する種々の処理を実行する。 The control unit 302 controls the pharmacy blockchain 308a. Specifically, a block including medical information to be managed in a predetermined manner is sequentially connected to the pharmacy blockchain 308a in the storage unit 308, and in the case of an authorized member, given medical information ( It also checks whether or not the medical information presented for registration in the blockchain 200 is valid. In addition, it executes overall reading and writing of data to and from the storage unit 308. In addition, when registering medical information in the pharmacy blockchain 308a, the control unit 302 may also execute generation of a block containing the medical information, depending on the situation. In addition, various processes for the storage unit 308 are executed.
　制御部３０２は、例えばコンピュータのＣＰＵと、当該ＣＰＵに上記動作を実行させるためのプログラムと、から構成してよい。具体的には、薬局１１４のコンピュータシステム３００のＣＰＵとその動作を記述するプログラムとから構成してよい。
　なお、本実施形態の「レセプト」や、「処方箋」は、請求の範囲の「医療情報」「管理対象」の好適な一例に相当する。 The control unit 302 may be configured by, for example, a CPU of a computer and a program for causing the CPU to execute the above operation. Specifically, it may be constituted by a CPU of the computer system 300 of the pharmacy 114 and a program describing its operation.
Note that “recept” and “prescription” in the present embodiment correspond to a suitable example of “medical information” and “managed object” in the claims.
　通信部３０４は、他のメンバーと通信を行う通信インターフェースであり、例えば、インターネットと接続するための手段であってよい。この通信部３０４は、用いている通信回線（社内プライベートネットワーク、移動体通信網、ＬＴＥ）に合わせた通信インターフェースでよい。 The communication unit 304 is a communication interface for communicating with other members, and may be, for example, means for connecting to the Internet. The communication unit 304 may be a communication interface adapted to the communication line (in-house private network, mobile communication network, LTE) used.
　窓口部３０６は、当該薬局の窓口での薬剤給付を入力する手段である。すなわち、本実施形態のブロックチェーン２００で管理する医療情報（薬剤服用歴（薬歴））を入力する手段である。また、薬局１１４によっては、当該窓口からお薬手帳１１４ｂが提供されることもあり、薬の服用方法のメモを提供する場合もある。そのため、お薬手帳や服用方法の説明書等を出力する手段でもある。
　窓口部３０６は、患者に対して行った医療行為に関する情報である医療情報を入力または出力する手段である。窓口部３０６は、請求の範囲の「医療情報入力部」、「窓口部」の好適な一例に相当する。 The window section 306 is a means for inputting a drug payment at the pharmacy window. That is, it is a unit for inputting medical information (medication history (medication history)) managed by the block chain 200 of the present embodiment. Also, depending on the pharmacy 114, the medicine notebook 114b may be provided from the window, and a memo about the method of taking the medicine may be provided. Therefore, it is also a means for outputting a medicine notebook, instructions for taking the medicine, and the like.
The window unit 306 is a unit for inputting or outputting medical information that is information relating to a medical practice performed on a patient. The window unit 306 corresponds to a preferred example of the “medical information input unit” and the “window unit” in the claims.
　なお、他のメンバーの場合も、所定の医療情報を入力する部分であれば、この窓口部３０６に相当し、請求の範囲の医療情報入力部の好適な一例に相当する。病院１１２の場合は、病院の受付や、医師が行った医療行為の入力部、カルテの入力部等と考えてよく、これらが、請求の範囲の医療情報入力部の好適な一例に相当する。また例えば患者１１０の情報を入力する手段も、医療情報入力部の一例と考えることができる。例えば、患者１１の健康保険証のデータ等を入力する手段等である。また、病院１１２の場合は、病院の窓口で処方箋１１２ｃ等を渡すための出力手段（プリンター等）と考えることもできる。
　いずれにしても、窓口部３０６は、制御部３０２からの制御指示によって、所定の出力、入力を行うことができる。 In the case of other members as well, any portion for inputting predetermined medical information corresponds to the window section 306, and corresponds to a preferred example of the medical information input section in the claims. In the case of the hospital 112, it may be considered as a hospital reception, an input unit for medical practice performed by a doctor, an input unit for a medical record, and the like, and these correspond to a preferred example of a medical information input unit in the claims. Also, for example, a unit for inputting information on the patient 110 can be considered as an example of the medical information input unit. For example, it is a means for inputting data of the health insurance card of the patient 11 and the like. In the case of the hospital 112, it can be considered as an output means (a printer or the like) for delivering the prescription 112c or the like at the window of the hospital.
In any case, the contact unit 306 can perform predetermined output and input according to a control instruction from the control unit 302.
　他のメンバーの場合は、構成によっては、特にそのような窓口的な手段がない場合もある。例えば審査支払機関１１６の場合は、診療・調剤報酬の請求や支払い等が紙で郵送である場合があるが、その場合はその紙による請求データを入力する手段と考えることができる。例えば担当者が入力するキーボードや、光学的読み取り装置（スキャナー）等がこれのような手段に相当する。 In the case of other members, depending on the configuration, there may not be such a window-like means. For example, in the case of the examination / payment agency 116, there is a case where the billing and payment of the medical treatment / dispensing fee are mailed by paper, and in such a case, it can be considered as a means for inputting billing data on the paper. For example, a keyboard input by a person in charge, an optical reading device (scanner), and the like correspond to such means.
　ただし、後述する実施形態の審査支払機関１１６では、診療・調剤報酬の請求等がすべて電信メールで送付され通信部３０４で処理される場合を一例として説明している。そのような例の審査支払機関１１６の場合は、窓口部３０６に相当する手段は設けられない構成も考えられる。このような例の場合は、通信部３０４が、請求の範囲の医療情報入力部の好適な一例に相当する。
　保険者１１８の場合も、審査支払機関１１６と同様に考えることができ、すべて通信部３０６を介した電子メール等で外部とのやりとりが行われる場合は、図２における窓口部３０６に相当する手段は設けられない構成も考えられる。このような例の場合は、通信部３０４が、請求の範囲の医療情報入力部の好適な一例に相当する。 However, the examination and payment institution 116 of the embodiment described below describes an example in which all requests for medical treatment and dispensing fees are sent by electronic mail and processed by the communication unit 304. In the case of the examination and payment institution 116 in such an example, a configuration in which a means corresponding to the window unit 306 is not provided may be considered. In such an example, the communication unit 304 corresponds to a preferred example of the medical information input unit in the claims.
The insurer 118 can be considered in the same manner as the examination and payment institution 116. In the case where all communications with the outside are performed by e-mail or the like via the communication unit 306, means corresponding to the contact unit 306 in FIG. Is not provided. In such an example, the communication unit 304 corresponds to a preferred example of the medical information input unit in the claims.
　なお、患者１１０の場合は、図２に相当する構成は、患者１１０が持つパソコンやスマートホン（Smart phone）が該当する。この場合、窓口部３０６に相当する手段は、人間が入力するキーボードや、人間が読み取るディスプレイ等が該当する。
　なお、後述する実施形態において、病院１１２や、ＭＹページサーバ２５０等（後述する）が、ブロックチェーン２００のメンバーとしての患者１１０の動作を代行する例を説明しているが、その場合は、図２に示すような手段・構成を、代行する患者１１０の人数分、複数個用意すればよい。コンピュータの上で複数のプロセス（例えば制御部３０２のプロセス（プログラム））を稼働させれば、図２の構成を複数個備えさせることは容易である。また、記憶部３０８にも、ブロックチェーン３０８ａ（ブロックチェーン２００）を複数個備えさせればよい。 In the case of the patient 110, the configuration corresponding to FIG. 2 corresponds to a personal computer or a smart phone of the patient 110. In this case, the means corresponding to the window unit 306 corresponds to a keyboard input by a human, a display read by a human, and the like.
In the embodiment described below, an example is described in which the hospital 112, the MY page server 250, and the like (described later) act on behalf of the patient 110 as a member of the blockchain 200. A plurality of means and configurations as shown in FIG. 2 may be prepared for the number of substitute patients 110. If a plurality of processes (for example, processes (programs) of the control unit 302) are operated on a computer, it is easy to provide a plurality of the configurations shown in FIG. The storage unit 308 may include a plurality of block chains 308a (block chains 200).
　第２．動作
　図３には、本実施形態の薬歴管理システム１００における動作の一例を示すフローチャートが示されている。このフローチャートに基づき、本実施形態における薬の処方の手続きの処理の流れの一例を説明する。 Second. Operation FIG. 3 is a flowchart illustrating an example of an operation of the medication history management system 100 according to the present embodiment. Based on this flowchart, an example of the processing flow of the procedure for prescribing a drug in the present embodiment will be described.
　（１）治療から薬の給付まで
　まず、ステップＳ３－１において、患者１１０は、病院１１２で治療を受ける。つまり、病院１１２の医師は、診療サービス１１２ａを患者に提供する。なお、患者１１０は、治療費の一部負担分を病院１１２に対して支払う（図１中、１１０ａで示される）。
　次に、ステップＳ３－２において、病院１１２の医師はその患者１１０のカルテ１１２ｂを作成する。そして、病院１１２（のシステム）は、このカルテ１１２ｂをブロックチェーン２００に登録する。この登録処理自体は、一般的なコンソーシアム型ブロックチェーンにおけるトランザクションの登録と同様である。
　なお、このブロックチェーン２００に関連する動作を司るプラットフォーム３６０が図１に示されている。このプラットフォーム３６０は、ブロックチェーン２００の管理・監視を行うとともに、お薬手帳１１４ｂの提供等を実行するＭＹページサーバ２５０と、備えている。プラットフォーム３６０の詳細は図５において後述する。 (1) From Treatment to Drug Delivery First, in step S3-1, the patient 110 receives treatment at the hospital 112. That is, the doctor at the hospital 112 provides the medical care service 112a to the patient. The patient 110 pays a part of the treatment cost to the hospital 112 (indicated by 110a in FIG. 1).
Next, in step S3-2, the doctor of the hospital 112 creates the chart 112b of the patient 110. Then, (the system of) the hospital 112 registers the chart 112b in the blockchain 200. This registration process itself is the same as the registration of a transaction in a general consortium type blockchain.
FIG. 1 shows a platform 360 that controls operations related to the block chain 200. The platform 360 is provided with an MY page server 250 that manages and monitors the blockchain 200, and executes the provision of the medicine notebook 114b and the like. The details of the platform 360 will be described later with reference to FIG.
　次に、ステップＳ３－３において、病院１１２の医師は、診療サービス１１２ａの結果、患者１１０に処方する薬の処方箋１１２ｃを作成する。病院１１２のシステムは、この処方箋１１２ｃをブロックチェーン２００に登録する。この登録処理も、一般的なコンソーシアム型ブロックチェーンにおけるトランザクションの登録と同様であるので詳細な説明は省略する。 Next, in step S3-3, the doctor of the hospital 112 creates a prescription 112c for the medicine to be prescribed for the patient 110 as a result of the medical service 112a. The system of the hospital 112 registers the prescription 112c in the blockchain 200. This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
　ステップＳ３－４において、病院１１２のシステムは、この処方箋１１２ｃにアクセスするための処方箋１１２ｃのＩＤである処方箋ＩＤを患者１１０に伝える。この処方箋ＩＤを用いて、ブロックチェーン２００のメンバーは、ブロックチェーン２００から、当該処方箋ＩＤが表す処方箋１１２ｃを取り出すことができる。
　ブロックチェーン２００のメンバーである患者１１０は、この処方箋ＩＤを用いて、自分に処方された薬の処方箋１１２ｃをブロックチェーン２００から取り出すことができる。 In step S3-4, the system of the hospital 112 notifies the patient 110 of the prescription ID, which is the ID of the prescription 112c for accessing the prescription 112c. Using this prescription ID, a member of the blockchain 200 can take out the prescription 112c represented by the prescription ID from the blockchain 200.
The patient 110 who is a member of the blockchain 200 can use the prescription ID to take out the prescription 112c of the medicine prescribed for him / her from the blockchain 200.
　この処方箋ＩＤを患者１１０に伝えるためには、処方箋ＩＤを記載した処方箋控え（紙）を渡してもよいが、２次元バーコード等を患者に提示し、患者１１０が自己のスマートホン（Smart Phone）等でこれを読み取ってもよい。
　なお、病院１１８は、処方箋ＩＤではなく、処方箋１１２ｃそのものを従来通り「紙」で患者１１０に渡してもよい。患者１１０は、このように紙で処方箋１１２ｃを受け取ることによって、薬歴管理システム１００に参加していない任意の薬局でも薬の処方を受けることもできる。 In order to transmit the prescription ID to the patient 110, a prescription copy (paper) describing the prescription ID may be given. However, a two-dimensional barcode or the like is presented to the patient, and the patient 110 uses his / her smart phone (Smart Phone). ) May be read.
The hospital 118 may deliver the prescription 112c itself to the patient 110 by "paper" instead of the prescription ID, as in the past. By receiving the prescription 112c on paper in this way, the patient 110 can also receive a prescription for a drug at any pharmacy that does not participate in the drug history management system 100.
　ステップＳ３－５において、患者１１０は、薬局１１４に行き、処方箋１１２ｃの処方箋ＩＤを伝える。例えば、患者１１０は、自己のスマートホンの画面等に、処方箋１１２ｃの処方箋ＩＤを表示させてよい。この表示は、処方箋ＩＤそのものでもよいし、処方箋ＩＤを表す２次元バーコード等でもよい。薬局１１４の薬剤師等は、その表示された処方箋ＩＤを所定の機器で読み取ることができ、処方箋１１２ｃの処方箋ＩＤを知ることができる。
　また、同ステップＳ３－５において、患者１１０は、患者ＩＤも薬局１１４に提示してよい。薬局１１４は、処方箋ＩＤのみに基づき、ブロックチェーン２００から、所望の処方箋１１２ｃを検索して見つけることができるが、患者ＩＤが一致しているかどうかも確認するように構成すれば不正な薬の処方を未然に防止することができよう。例えば、他人に処方された薬を不正に取得すること等を未然に防止することができる場合がある。 In step S3-5, the patient 110 goes to the pharmacy 114 and transmits the prescription ID of the prescription 112c. For example, the patient 110 may display the prescription ID of the prescription 112c on a screen of his / her smartphone or the like. This display may be the prescription ID itself or a two-dimensional barcode representing the prescription ID. The pharmacist or the like of the pharmacy 114 can read the displayed prescription ID with a predetermined device, and can know the prescription ID of the prescription 112c.
In step S3-5, the patient 110 may also present the patient ID to the pharmacy 114. The pharmacy 114 can search and find a desired prescription 112c from the blockchain 200 based only on the prescription ID. Can be prevented beforehand. For example, in some cases, it is possible to prevent unauthorized acquisition of a medicine prescribed to another person.
　ステップＳ３－６において、薬局１１４の薬剤師等は、取得した処方箋ＩＤに基づき、ブロックチェーン２００を検索して、当該処方箋ＩＤと一致する処方箋１１２ｃを見つけ出す。そして、好ましくは、見つけ出した処方箋１１２ｃの患者ＩＤが、患者１１０の患者ＩＤと一致していることを確認した後、その患者１１０に当てられた正当な処方箋１１２ｃであると判断することができる。 In step S3-6, the pharmacist of the pharmacy 114 searches the blockchain 200 based on the acquired prescription ID to find a prescription 112c that matches the prescription ID. Then, preferably, after confirming that the patient ID of the found prescription 112c matches the patient ID of the patient 110, it can be determined that the prescription 112c is a valid prescription 112c applied to the patient 110.
　ステップＳ３－７において、薬局１１４の薬剤師等は、得られた処方箋１１２ｃに基づき、薬を処方して患者１１０に給付する（図１中、１１４ａで示される）。患者１１０は、薬価の一部負担金を薬局に対して支払う（図１中、１１０ｂで示される）。このようにして、患者１１０に対する治療から薬の給付までの動作が実行される。
　なお、ステップＳ３－７において、薬と同時に薬局１４（の薬剤師）は患者１０に対してお薬手帳１１４ｂを提供してもよい。なお、お薬手帳１１４ｂも、薬局１１４（のシステム）が、ブロックチェーン２００に登録してよい（図１参照）。患者１１０は、自分のお薬手帳１１４ｂをブロックチェーン２００から取り出して閲覧することができ、自分に対して処方された薬の薬歴をいつでも確認することができる。 In step S3-7, the pharmacist or the like of the pharmacy 114 prescribes the medicine based on the obtained prescription 112c and pays it to the patient 110 (indicated by 114a in FIG. 1). The patient 110 pays a portion of the drug price to the pharmacy (indicated by 110b in FIG. 1). In this way, the operations from the treatment to the patient 110 to the delivery of the medicine are performed.
In step S3-7, the pharmacy (the pharmacist) may provide the medicine notebook 114b to the patient 10 simultaneously with the medicine. The pharmacy notebook 114b may also be registered in the blockchain 200 by the pharmacy 114 (system thereof) (see FIG. 1). The patient 110 can take out his / her medicine notebook 114b from the blockchain 200 and browse it, and can check the medicine history of medicine prescribed for him at any time.
　（２）診療報酬、調剤報酬の授受
　次に、図４のフローチャートに基づき、診療報酬等のやりとりについてその動作を説明する。この図４の動作は、便宜上、図３の処理とは独立した別の処理として説明するが、時間的には、図３の動作と並行して実行してよい。また、図３の動作と特に並行することなく、時間的に別個に（例えば翌日に）実行してもよい。
　また、図４の処理は、図３の処理より先行してもよい。図３の処理は患者１００の動作が含まれるが、図４の処理は患者１００の動作を含まないので、図３の処理より早く実行してもよい。 (2) Delivery of Medical Fees and Dispensing Fees Next, the operation of the exchange of medical fees and the like will be described based on the flowchart of FIG. The operation in FIG. 4 will be described as another process independent of the process in FIG. 3 for convenience, but may be executed in parallel with the operation in FIG. Further, the operation may be performed separately in time (for example, the next day) without being particularly parallel to the operation in FIG.
Further, the processing of FIG. 4 may precede the processing of FIG. Although the processing of FIG. 3 includes the operation of the patient 100, the processing of FIG. 4 does not include the operation of the patient 100, and thus may be executed earlier than the processing of FIG.
　まず、ステップＳ４－１において、病院１１２は、診療報酬を請求するために、レセプト１１２ｄを作成する。病院１１２のシステムは、このレセプト１１２ｄをブロックチェーン２００に登録する。この登録処理も、一般的なコンソーシアム型ブロックチェーンにおけるトランザクションの登録と同様であるので詳細な説明は省略する。
　この際、病院１１２のシステムは、レセプト１１２ｄをブロックチェーン２００に登録するとともに、レセプト１１２ｄをブロックチェーン２００に登録した旨の電子メールを審査支払機関１１６に送る。この動作がステップＳ４－２に表されている。このような動作は、例えば図２の制御部３０２が実行してよい。
　レセプト１１２ｄをブロックチェーン２００に登録するためには、医療情報であるレセプト１１２ｄを他のメンバー（のシステム）に送信して、一定のアルゴリズムの下、承認を得る必要がある。そのような承認による合意形成は、従来のブロックチェーン２００と同様である。 First, in step S4-1, the hospital 112 creates a receipt 112d to request a medical fee. The system of the hospital 112 registers the receipt 112d in the blockchain 200. This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
At this time, the system of the hospital 112 registers the receipt 112d in the blockchain 200, and sends an e-mail to the effect that the receipt 112d has been registered in the blockchain 200 to the examination payment organization 116. This operation is shown in step S4-2. Such an operation may be executed by, for example, the control unit 302 in FIG.
In order to register the claim 112d in the blockchain 200, it is necessary to transmit the claim 112d, which is medical information, to another member (system) and obtain approval under a certain algorithm. Such consensus building by approval is similar to that of the conventional blockchain 200.
　本実施形態では、このような医療情報（レセプト１１２ｄ）の送信とともに、その医療情報を送信したい宛先に（この場合は、審査支払機関１１６）医療情報をブロックチェーン２００に登録した旨の電子メールを審査支払機関１１６に送信する。これによって審査支払機関１１６は、自分宛の当該医療情報（レセプト１１２ｄ）が、ブロックチェーン２００に登録されたこと（登録が要求されたこと）を知ることができる。なお、宛先がない医療情報もあるが、その場合は、当該宛先への電子メールは送信されない。
　なお、その後、審査支払機関１１６は、当該医療情報（レセプト１１２ｄ）に対する承認がなされたことを確認した後、当該医療情報（レセプト１１２ｄ）が自分宛に届いたと判断することができる。このような承認の確認は、電子メールを受領した場合、常に行われるが、以下の実施形態では、承認の確認については説明を省略し、当然に承認が得られたものとして説明を行う。もちろん、説明を省略しているだけであり、毎回、承認の確認が行われている。 In the present embodiment, along with the transmission of such medical information (reception 112d), an e-mail indicating that the medical information has been registered in the blockchain 200 is sent to the destination to which the medical information is to be transmitted (in this case, the examination payment organization 116). This is transmitted to the examination payment organization 116. As a result, the examination payment organization 116 can know that the medical information addressed to itself (reception 112d) has been registered in the blockchain 200 (registration has been requested). Some medical information does not have a destination, but in that case, an e-mail to the destination is not transmitted.
After that, after confirming that the medical information (recept 112d) has been approved, the examination payment organization 116 can determine that the medical information (recept 112d) has arrived at itself. Such confirmation of approval is always performed when an e-mail is received. However, in the following embodiments, explanation of confirmation of approval is omitted, and the explanation is given assuming that approval has been obtained. Of course, the explanation is omitted, and confirmation of approval is performed every time.
　ステップＳ４－２におけるこのような動作によって、「診療報酬の請求」を行うとともに、レセプト１１２ｄをブロックチェーン２００に登録したことを知らせる。したがって、当該電子メールには、レセプト１１２ｄを識別するための、レセプトＩＤを記載しておく。このようなレセプトＩＤを用いることによって、当該レセプト１１２ｄを識別し、ブロックチェーン２００から取り出すことが容易となる。
　これによって、審査支払機関１１６は、診療報酬の請求がなされたこと、及びその診療報酬の請求に係るレセプト１１２ｄがブロックチェーン２００上に登録されていることを知ることができる。 By such an operation in step S4-2, "claim for medical treatment" is performed, and the fact that the receipt 112d has been registered in the blockchain 200 is notified. Therefore, a receipt ID for identifying the receipt 112d is described in the electronic mail. By using such a receipt ID, the receipt 112d can be easily identified and taken out from the blockchain 200.
As a result, the examination / payment agency 116 can know that the medical fee has been charged and that the claim 112d relating to the medical fee has been registered on the blockchain 200.
　ステップＳ４－３において、薬局１１４は、調剤報酬を請求するために、レセプト１１４ｄを作成する。薬局１１４のシステムは、このレセプト１１４ｄをブロックチェーン２００に登録する。この登録処理も、一般的なコンソーシアム型ブロックチェーンにおけるトランザクションの登録と同様であるので詳細な説明は省略する。
　この際、病院１１４は、レセプト１１４ｄをブロックチェーン２００に登録するとともに、電子メールを審査支払機関１１６に送る。この動作がステップＳ４－４に表されている。このような動作は、例えば図２の制御部３０２が実行してよい。 In step S4-3, the pharmacy 114 creates a receipt 114d to request a dispensing reward. The system of the pharmacy 114 registers the receipt 114d in the blockchain 200. This registration process is the same as the registration of a transaction in a general consortium type blockchain, and therefore detailed description is omitted.
At this time, the hospital 114 registers the receipt 114d in the blockchain 200 and sends an e-mail to the examination payment organization 116. This operation is shown in step S4-4. Such an operation may be executed by, for example, the control unit 302 in FIG.
　ステップＳ４－４におけるこのような動作によって、「調剤報酬の請求」を行うとともに、レセプト１１４ｄをブロックチェーン２００に登録したことを知らせる。したがって、当該電子メールには、レセプト１１４ｄを識別するための、レセプトＩＤを記載しておく。このようなレセプトＩＤを用いることによって、当該レセプト１１４ｄを識別し、ブロックチェーン２００から取り出すことが容易となる。
　これによって、審査支払機関１１６は、調剤報酬の請求がなされたこと、及びその調剤報酬の請求に係るレセプト１１４ｄがブロックチェーン２００上に登録されていることを知ることができる。 By such an operation in step S4-4, "dispensing reward" is requested, and the fact that the receipt 114d has been registered in the blockchain 200 is notified. Therefore, a receipt ID for identifying the receipt 114d is described in the electronic mail. By using such a receipt ID, the receipt 114d can be easily identified and taken out from the blockchain 200.
As a result, the examination and payment institution 116 can know that the dispensing fee has been requested and that the receipt 114d relating to the dispensing fee has been registered on the blockchain 200.
　ステップＳ４－５において、審査支払機関１１６は、診療報酬の請求に関する上記メール（ステップＳ４－２）を受信することによって、診療報酬の請求があったことを把握する。当該メールに記載のレセプトＩＤに基づき、ブロックチェーン２００から当該診療報酬の請求に係るレセプト１１２ｄを取り出す。
　審査支払機関１１６は、このレセプト１１２ｄを審査し、正当であると判断した場合には、審査支払分の請求１１６ａを、保険者１１８に送付する（ステップＳ４－５）。
　この審査支払分の請求１１６ａの送付は、本実施形態においては、レセプト１１２ｄ等と同様にブロックチェーン２００に登録することによって実行される。さらに、審査支払機関１１６は、審査支払分の請求１１６ａをブロックチェーン２００に登録した旨の電子メールを保険者１１８に送信する。したがって、具体的には、
　・審査支払分の請求１１６ａをブロックチェーン２００への登録。
　・審査支払分の請求１１６ａをブロックチェーン２００に登録した旨の電子メールを保険者１１８へ送信。
　という（例えば２種類の）動作によって、審査支払分の請求１１６ａの送付が実現されている（ステップＳ４－５）。この２種の動作は例えば図２の制御部３０２に相当する審査支払機関１１６の（該当する）制御部が実行してよい。 In step S4-5, the examination / payment agency 116 recognizes that the medical fee has been requested by receiving the above-mentioned mail (step S4-2) regarding the request for the medical fee. Based on the receipt ID described in the mail, the receipt 112d related to the request for the medical fee is taken out of the blockchain 200.
The examination / payment agency 116 examines the receipt 112d, and if it is determined to be valid, sends a request 116a for the examination payment to the insurer 118 (step S4-5).
In the present embodiment, the sending of the request 116a for the examination payment is executed by registering the request 116a in the block chain 200 as in the case of the receipt 112d and the like. Further, the examination payment organization 116 sends an e-mail to the insurer 118 indicating that the request 116a for the examination payment has been registered in the blockchain 200. Therefore, specifically,
・ Registration 116a of the examination payment is registered in the blockchain 200.
-Send an e-mail to the insurer 118 indicating that the request 116a for the examination payment has been registered in the blockchain 200.
(For example, two types of operations), the transmission of the request 116a for the examination payment is realized (step S4-5). These two types of operations may be executed by, for example, the (applicable) control unit of the examination and payment institution 116 corresponding to the control unit 302 in FIG.
　以上、病院１１２のレセプト１１２ｄについて説明したが、薬局１１４のレセプト１１４ｄについても同様である。すなわち、審査支払機関１１６は、調剤報酬の請求に関する上記メール（ステップＳ４－４）を受信して調剤報酬の請求があったことを把握するとともに当該メールに記載のレセプトＩＤに基づき、ブロックチェーン２００から当該調剤報酬の請求に係るレセプト１１４ｄを取り出す。
　審査支払機関１１６は、このレセプト１１４ｄを審査し、正当であると判断した場合には、審査支払分の請求１１６ａを、保険者１１８に送付する（ステップＳ４－５）。
　この審査支払分の請求１１６ａの送付の動作は、上述したとおりであり、審査支払分の請求１１６ａをブロックチェーン２００へ登録するとともに、審査支払分の請求１１６ａをブロックチェーン２００に登録した旨の電子メールを保険者１１８へ送信する。 The description of the receipt 112d of the hospital 112 has been described above, but the same applies to the receipt 114d of the pharmacy 114. That is, the examination payment organization 116 receives the above-mentioned mail (step S4-4) relating to the dispensing fee request, grasps that the dispensing fee has been requested, and based on the receipt ID described in the email, the blockchain 200. From the dispensing reward is retrieved.
The examination and payment organization 116 examines the receipt 114d, and if it is determined to be valid, sends a request 116a for the examination payment to the insurer 118 (step S4-5).
The operation of sending the request 116a for the examination payment is as described above, and the request 116a for the examination payment is registered in the blockchain 200, and the electronic notice indicating that the request 116a for the examination payment is registered in the blockchain 200. The e-mail is sent to the insurer 118.
　ステップＳ４－６において、保険者１１８は、審査請求分の請求１１６ａメールを受信すると、当該メールに基づき審査支払分の請求１１６ａの内容をブロックチェーン２００から取り出す。保険者１１８は、取り出した審査支払分の請求１１６ａを審査し、正当であると判断した場合は、請求金額の支払い１１８ａを行う。
　請求金額の支払い１１８ａは、従来と同様の支払い方法で支払ってよいが、支払伝票は、ブロックチェーン２００にも登録してよい。このようにすることによって、診療に関する多くの書類（カルテ、処方箋、レセプト、お薬手帳）や、各種の伝票等をブロックチェーン２００に登録することによって、後で（後日）それら書類の妥当性、手続きの妥当性を検証することが可能となる。 In step S4-6, when the insurer 118 receives the e-mail request 116a for the examination request, the insurer 118 extracts the contents of the examination payment request 116a from the blockchain 200 based on the e-mail. The insurer 118 examines the extracted examination payment request 116a, and if it is determined to be legitimate, pays the bill amount 118a.
The bill payment 118a may be paid by the same payment method as before, but the payment slip may also be registered in the blockchain 200. By doing so, by registering many documents (medical records, prescriptions, receipts, medication notebooks) and various slips related to medical treatment in the blockchain 200, the validity of those documents can be determined later (at a later date). It is possible to verify the validity of the procedure.
　ステップＳ４－７において、審査支払機関１１６は、ステップＳ４－６における請求金額の支払い１１８ａを受けて、病院１１２に診療報酬を支払い、薬局１１４に調剤報酬を支払う（図１参照）。この診療・調剤報酬の支払い（図１）は、従来と同様の支払い方法で支払ってよいが、支払伝票等をステップＳ４－６と同様に、ブロックチェーン２００にも登録してよい（図１中、破線で示されている）。このような登録によって、後で（後日）支払いの妥当性、手続きの妥当性を検証することが可能となる。
　また、フローチャートでは示さないが、保険者１１８は、保険の加入者である患者１１０（加入者本人だけでなく、家族でもよい）から保険料１１０ｃを徴収し、診療・調剤報酬の支払いに用いている（図１）。 In step S4-7, receiving the payment 118a of the billing amount in step S4-6, the examination payment organization 116 pays a medical fee to the hospital 112 and pays a dispensing fee to the pharmacy 114 (see FIG. 1). Payment of this medical treatment / dispensing fee (FIG. 1) may be made by the same payment method as before, but a payment slip or the like may be registered in the blockchain 200 as in step S4-6 (FIG. 1). , Indicated by dashed lines). Such registration makes it possible to later (later) verify the validity of the payment and the validity of the procedure.
Although not shown in the flowchart, the insurer 118 collects an insurance premium 110c from the patient 110 (which may be a family member as well as the subscriber) who is a member of the insurance, and uses it for payment of medical treatment and dispensing fees. (Fig. 1).
　第３．プラットフォームの概要（各種医療情報の間の関係）
　以上説明してきたように、本実施形態においては、管理対象である様々な医療情報をブロックチェーン２００で管理する仕組みを提案するものである。管理対象である医療情報は、単に管理対象と呼ぶ場合もある。このブロックチェーン２００を管理・監視するプラットフォーム３６０では、種々の医療情報を管理することができるが、それら医療情報の関係を、プラットフォーム３６０を中心に描いた概念図が図５に示されている。
　（１）プラットフォーム Third. Platform overview (relationship between various medical information)
As described above, in the present embodiment, a mechanism for managing various medical information to be managed by the blockchain 200 is proposed. The medical information to be managed may be simply referred to as a managed object. The platform 360 that manages and monitors the blockchain 200 can manage various types of medical information. FIG. 5 is a conceptual diagram illustrating the relationship between the medical information and the platform 360.
(1) Platform
　ブロックチェーン２００
　この図に示すように、本プラットフォーム３６０は、種々の医療情報を管理しうるプラットフォームであり、これまで説明してきたように、種々の医療情報を管理するブロックチェーン２００を備える。
　図５では、ブロックチェーン２００は一カ所に存在するように記載されているが、ブロックチェーン２００は、実際はブロックチェーンのメンバー（構成員）によって分散保持されている。そのため、メンバーである患者１１０も、当該ブロックチェーン２００を原則としては保持するが、例えば、患者１１０が診療を受ける病院１１２が、患者１１０がブロックチェーン２００のメンバーとして実行すべき処理を代行してもよい。すなわち、患者１１０が保持すべきブロックチェーン２００を患者１１０に代わって（患者１１０として）保持してもよい。 Blockchain 200
As shown in this figure, the platform 360 is a platform that can manage various medical information, and has the blockchain 200 that manages various medical information as described above.
In FIG. 5, the block chain 200 is described as being located at one place, but the block chain 200 is actually distributed and held by members (members) of the block chain. Therefore, the patient 110, which is a member, also holds the blockchain 200 in principle, but, for example, the hospital 112 where the patient 110 receives medical treatment substitutes a process to be executed by the patient 110 as a member of the blockchain 200. Is also good. That is, the block chain 200 to be held by the patient 110 may be held instead of the patient 110 (as the patient 110).
　また、ブロックチェーン２００が管理する医療情報は、これまで説明してきたように、カルテ１１２ｂや、レセプト１１２ｄ、処方箋１１２ｃ、お薬手帳１１４ｂ等の種々の医療情報を含めてよい。一方、例えば、図１等で説明したすべての医療情報をブロックチェーン２００がすべて管理しなくてもよい。例えば、保険者１１８が保有する保険加盟情報等は、保険者やその保険の加盟者の意向によってブロックチェーン２００による管理から外してもよい。
　ただし、図５に示すように、カルテ１１２ｂや、処方箋１１２ｃ、レセプト１１２ｄ等は、患者１１０の治療履歴や、薬歴、医療費の履歴等の把握に非常に有用であるため、ブロックチェーン２００で管理することが非常に望ましい。また、ブロックチェーン２００が調剤履歴１１４ｄも管理している場合は、その調剤履歴１１４ｄに基づきお薬手帳１１４ｂを構成することができるので、非常に便利である。このようなお薬手帳１１４ｂの構成方法は、次節（ＭＹページサーバ２５０）で詳述する。 Further, the medical information managed by the blockchain 200 may include various medical information such as the medical chart 112b, the claim 112d, the prescription 112c, the medicine notebook 114b, etc., as described above. On the other hand, for example, the blockchain 200 does not need to manage all the medical information described in FIG. For example, insurance membership information and the like held by the insurer 118 may be excluded from management by the blockchain 200 according to the insurer's and the insurance member's intention.
However, as shown in FIG. 5, the chart 112b, the prescription 112c, the receipt 112d, and the like are very useful for grasping the treatment history of the patient 110, the medical history, the medical expenses history, and the like. Very desirable to manage. When the blockchain 200 also manages the dispensing history 114d, the medicine notebook 114b can be configured based on the dispensing history 114d, which is very convenient. The method of configuring the medicine notebook 114b will be described in detail in the next section (MY page server 250).
　また、例えば図１で説明したように、患者情報１１０ｂもブロックチェーン２００で管理することが望ましいが、個人情報であるので、その管理にはあくまでも患者１１０の同意が必要な情報である。したがって、ある患者１１０の患者情報１１０ｂはブロックチェーン２００で管理しているが、他の患者１１０の患者情報１１０ｂはブロックチェーン２００で管理していない、という状況がありえるし、プラットフォーム３６０は、システム上許容している。 Also, as described with reference to FIG. 1, for example, it is desirable that the patient information 110b is also managed by the blockchain 200. However, since this is personal information, the management requires consent of the patient 110. Therefore, there may be a situation where the patient information 110b of a certain patient 110 is managed by the blockchain 200, but the patient information 110b of another patient 110 is not managed by the blockchain 200. Accept.
　ＭＹページサーバ２５０
　さらに、プラットフォーム３６０は、ＭＹページを提供するＭＹページサーバ２５０を備えている（図５参照）。このＭＹページサーバ２５０は、ブロックチェーン２００中の調剤履歴等に基づき、患者１１０向けのＭＹページ（Ｗｅｂページ）を作成し、患者１０の利用に供するものである。
　ＭＹページサーバ２５０は、このような動作を実現するために、ＭＹページを提供するためのＷｅｂサーバ部と、ブロックチェーン２００から、当該患者１１０に関する医療情報を読み出す通信部と、その読み出した医療情報からＭＹページを構成してＷｅｂサーバ部に提供するＭＹページ構築部と、から主として構成される。 MY page server 250
Further, the platform 360 includes an MY page server 250 that provides MY pages (see FIG. 5). The MY page server 250 creates an MY page (Web page) for the patient 110 based on the dispensing history and the like in the blockchain 200, and provides the MY page to the patient 10.
In order to realize such an operation, the MY page server 250 includes a Web server unit for providing an MY page, a communication unit that reads medical information on the patient 110 from the blockchain 200, and a read medical information. And an MY page construction unit that constructs an MY page from the Web server and provides the MY page to the Web server unit.
　患者１１０は、いつでも自分のＭＹページを参照することによって、自分の治療歴、薬歴、通院歴、病歴、種々のパーソナルデータ（血液型等）にアクセスすることができる。ＭＹページの内容は、ＭＹページ構築部が構築するが種々の内容を含めることができる。基本的には、ブロックチェーン２００の管理内容に基づき、ＭＹページサーバ２５０中のＭＹページ構築部が作成し、Ｗｅｂサーバ部がいわゆるＷｅｂページとして公開する。本実施形態では、ＭＹページサーバ２５０は、Ｗｅｂサーバである例を説明するが、他の手法で患者１１０の各種の医療情報を提供するように構成してもよい。
　また例えば、当該ＭＹページは、いわゆるお薬手帳１１４ｂの内容を含んでよい。すなわち、ＭＹページ構築部が、お薬手帳１１４ｂの内容を構築してよい。また、患者１１０が保持するスマートホン等の端末から容易にアクセスし、自己に関する種々の情報を表示させて医者や薬剤師に見せることができるように構成してもよい。 The patient 110 can access his / her medical history, medication history, hospital visit history, medical history, and various personal data (blood type, etc.) by referring to his / her MY page at any time. The contents of the MY page are constructed by the MY page construction unit, but can include various contents. Basically, the MY page construction unit in the MY page server 250 creates the MY page based on the management contents of the blockchain 200, and publishes it as a so-called Web page by the Web server unit. In the present embodiment, an example in which the MY page server 250 is a Web server will be described. However, the MY page server 250 may be configured to provide various types of medical information of the patient 110 by another method.
Further, for example, the MY page may include the contents of a so-called medicine notebook 114b. That is, the MY page construction unit may construct the contents of the medicine notebook 114b. Further, the system may be configured such that the patient 110 can easily access from a terminal such as a smart phone and display various kinds of information about the patient 110 and show it to a doctor or a pharmacist.
　ＭＹページサーバ２５０の通信部は、ブロックチェーン２００にアクセスするが、例えば病院１１２が保持するブロックチェーン２００にアクセスしてよい。また、ＭＹページサーバ２５０自身が、ブロックチェーン２００のメンバーとなり、ＭＹページサーバ内にブロックチェーン２００を保持する記憶部を備えてもよい。
　また、ＭＹページサーバ２５０は、患者１１０のブロックチェーン２００のメンバーとしての動作を代行してもよい。この場合は、ＭＹページサーバ２５０は、図２に示す構成のように、メンバーとしての動作を実行する制御部が設けられていてよい。実際には、その制御部を実現するプログラムとそれを実行するＣＰＵ等とから制御部が実現されていてよい。
　また、この場合、上記記憶部に、その代行する患者１１０が保持するブロックチェーン２００を保持するので、上記通信部は、実際は、ＭＹページサーバ２５０内の記憶部のブロックチェーン２００にアクセスしてよい。 The communication unit of the MY page server 250 accesses the blockchain 200, but may access the blockchain 200 held by the hospital 112, for example. Further, the MY page server 250 itself may be a member of the block chain 200 and include a storage unit that holds the block chain 200 in the MY page server.
Further, the MY page server 250 may act on behalf of the patient 110 as a member of the blockchain 200. In this case, the MY page server 250 may be provided with a control unit that executes an operation as a member, as in the configuration shown in FIG. Actually, the control unit may be realized by a program for realizing the control unit and a CPU or the like executing the program.
Further, in this case, since the storage unit holds the blockchain 200 held by the patient 110 acting on behalf of the patient, the communication unit may actually access the blockchain 200 of the storage unit in the MY page server 250. .
　本実施形態において特徴的なことは、このＭＹページサーバ２５０が、ブロックチェーン２００の登録内容に基づき、患者１１０向け（個人向け）の情報をＭＹページとして提供していることである。例えば、上述のように、調剤履歴のデータを集積して、お薬手帳１１４ｂを作成して提供することが考えられる。このようなＭＹページは、ＭＹページ構築部が個人ごとに作成し、その個人からの個人認証が成功した場合にのみ当該個人に公開されるように構成することが好ましい。個人認証はＷｅｂサーバ部が実行してよく、従来から知られている種々の手法を適用することができる。パスワード認証でもよいし、生体認証でもよい、また、携帯電話の電話番号認証等でもよい。 A characteristic of the present embodiment is that the MY page server 250 provides information for the patient 110 (for individuals) as an MY page based on the registered contents of the blockchain 200. For example, as described above, it is conceivable to accumulate dispensing history data and create and provide a medicine notebook 114b. It is preferable that such an MY page is created for each individual by the MY page construction unit, and is disclosed to the individual only when the individual authentication from the individual succeeds. The personal authentication may be executed by the Web server unit, and various conventionally known methods can be applied. Password authentication, biometric authentication, and mobile phone telephone number authentication may be used.
　さらに、ＭＹページサーバ２５０は、患者１１０自身が、患者１００自身の各種医療情報を登録できるように構成してよい。このような登録の機能は、Ｗｅｂサーバ部が実行してよい。このような機能を実現するＷｅｂサーバは世の中に知られているので、患者１１０が情報を書き込むことができるＷｅｂサーバ部を構築することは当業者にとって容易である。
　このように、患者１１０は、自己のＭＹページを閲覧することができるとともに、そのＭＹページに、所定の自己登録情報を登録することができるように構成してよいが、例えば、健康保険証や、自己で測定した身体情報、健康状況等を登録できるように構成よい。患者１１０が登録できる事項は、後に詳述する。 Further, the MY page server 250 may be configured so that the patient 110 itself can register various medical information of the patient 100 itself. Such a registration function may be executed by the Web server unit. Since a Web server that realizes such a function is known in the world, it is easy for those skilled in the art to construct a Web server unit to which the patient 110 can write information.
As described above, the patient 110 may be configured to be able to browse his / her own MY page and register predetermined self-registration information in the MY page. The configuration may be such that the self-measured physical information, health status, and the like can be registered. Items that can be registered by the patient 110 will be described later in detail.
　（２）医療機関
　図５における医療機関２１２は、病院１１２の他、各種診療所、がんセンター、歯科医院、リハビリテーション機関、等を含む。例えば、医療機関２１２が病院１１２であるとして説明する。
　医療機関２１２が提供する医療情報としては、カルテ１１２ｂ、処方箋１１２ｃ、レセプト１１２ｄ等が挙げられる、いずれか１種の医療情報だけをブロックチェーン２００の管理対象としてもよい。また、ここで挙げた情報以外の医療情報を、ブロックチェーン２００で管理する対象として選択してもよい。また、その医療機関２１２の独自の医療情報、独自の書類、を管理する対象としてもよい。医療機関２１２（例えば病院１１２）のシステムが、これらの医療情報を、プラットフォーム３６０中のブロックチェーン２００に登録していく。 (2) Medical Institution The medical institution 212 in FIG. 5 includes, in addition to the hospital 112, various clinics, cancer centers, dental clinics, rehabilitation institutions, and the like. For example, it is assumed that the medical institution 212 is the hospital 112.
The medical information provided by the medical institution 212 includes a medical chart 112b, a prescription 112c, a receipt 112d, and the like. Only one type of medical information may be managed by the blockchain 200. Further, medical information other than the information listed here may be selected as a target to be managed by the blockchain 200. Also, the medical institution 212 may manage its own medical information and its own documents. The system of the medical institution 212 (for example, the hospital 112) registers these medical information in the blockchain 200 in the platform 360.
　従来から、レセコンと呼ばれるレセプト１１２ｄを作成するシステムが広く知られているが、カルテ１１２ｂや処方箋１１２ｃを作成するシステムも利用が進んでおり、また、ブロックチェーン２００に所定の情報（トランザクション等）を登録していく仕組みも従来から知られている。したがって、これらの技術を組み合わせれば、これら医療情報を作成するとともにブロックチェーン２００に登録する機能を備えたシステムの構築は当業者にとって容易である。 Conventionally, a system for creating a receipt 112d called a receipt computer has been widely known, but a system for creating a medical chart 112b and a prescription 112c has been increasingly used, and predetermined information (transactions and the like) has been stored in the blockchain 200. The registration mechanism has also been known. Therefore, by combining these technologies, it is easy for those skilled in the art to construct a system having a function of creating these medical information and registering it in the blockchain 200.
　（３）薬局１１４
　図５における薬局１１４は、図１における薬局１１４と同様である。
　薬局１１４が提供する医療情報としては、レセプト１１４ｄ、調剤履歴１１４ｅ等が挙げられるが、いずれか１種の医療情報だけをブロックチェーン２００の管理対象としてもよい。また、ここで挙げた情報以外の医療情報を、ブロックチェーン２００で管理する対象として選択してもよい。また、その薬局１１４の独自の医療情報、独自の書類、を管理する対象としてもよい。 (3) Pharmacy 114
The pharmacy 114 in FIG. 5 is the same as the pharmacy 114 in FIG.
The medical information provided by the pharmacy 114 includes a receipt 114d, a dispensing history 114e, and the like. However, only one type of medical information may be managed by the blockchain 200. Further, medical information other than the information listed here may be selected as a target to be managed by the blockchain 200. Further, the medical information and the unique documents of the pharmacy 114 may be managed.
　薬局１１４のシステムが、これらの医療情報を、プラットフォーム３６０中のブロックチェーン２００に登録していく。
　病院１１２と同様、薬局１１４においてはも、従来からレセコンと呼ばれるレセプト１１４ｄを作成するシステムが広く知られており、また、ブロックチェーン２００に所定の情報（トランザクション等）を登録していく仕組みも従来から知られている。したがって、これらの技術を組み合わせれば、これら医療情報を作成するとともにブロックチェーン２００に登録する機能を備えた薬局１１４のシステムの構築は当業者にとって容易である。 The system of the pharmacy 114 registers the medical information in the blockchain 200 in the platform 360.
As in the case of the hospital 112, in the pharmacy 114, a system for creating a receipt 114d called a reception computer has been widely known, and a mechanism for registering predetermined information (transactions and the like) in the blockchain 200 has been used. Known from. Therefore, by combining these technologies, it is easy for those skilled in the art to construct a system of the pharmacy 114 having a function of creating these medical information and registering it in the blockchain 200.
　図５に示すように、薬局１１４は、ブロックチェーン２００から処方箋１１２ｃを取得することができる。この処方箋１１２ｃは医療機関２１２（のシステム）がブロックチェーン２００に登録したものである。薬局１１４は、この処方箋１１２ｃに基づき、薬を患者１１０に給付する（図１の１１４ａ）。薬局１１４（のシステム）は、その際に調剤履歴１１４ｅを作成して、ブロックチェーン２００に登録してもよい。また、薬局１１４（のシステム）は、薬を給付した際にレセプト１１４ｄを発行して、ブロックチェーン２００に登録してもよい。 薬 As shown in FIG. 5, the pharmacy 114 can obtain the prescription 112c from the blockchain 200. The prescription 112c is registered in the blockchain 200 by (the system of) the medical institution 212. The pharmacy 114 provides the medicine to the patient 110 based on the prescription 112c (114a in FIG. 1). At this time, the pharmacy 114 (system) may create the dispensing history 114e and register it in the blockchain 200. Further, the pharmacy 114 (system) may issue a receipt 114d when the medicine is supplied and register it in the blockchain 200.
　＜お薬手帳＞
　なお、図５（図１）のお薬手帳１１４ｂは、薬局１１４が作成し、ブロックチェーン２００に登録してよい。ブロックチェーン２００のメンバーである患者１１０は、かかるお薬手帳１１４ｂをブロックチェーン２００から取り出して適宜閲覧することができ、病院１１２等に提示することもできる。
　また、上述したＭＹページサーバ２５０が、上述した調剤履歴１１４ｅの内容に基づいてお薬手帳１１４ｂを作成してＭＹページ上で提示してもよい。患者１１０は、ＭＹページを通じてこのお薬手帳１１４ｂを閲覧することや、お薬手帳１１４ｂを薬局１１４等に見せること等をすることができる。調剤履歴１１４ｅ全体に基づいてお薬手帳１１４ｂを作成することができるので、複数の処方箋１１２ｃをまとめることができる。 <Medication notebook>
The medicine notebook 114b in FIG. 5 (FIG. 1) may be created by the pharmacy 114 and registered in the blockchain 200. The patient 110, who is a member of the blockchain 200, can take out the medicine notebook 114b from the blockchain 200, browse it appropriately, and present it to the hospital 112 or the like.
Further, the above-mentioned MY page server 250 may create a medicine notebook 114b based on the contents of the above-described dispensing history 114e and present it on the MY page. The patient 110 can browse the medicine notebook 114b through the MY page, show the medicine notebook 114b to the pharmacy 114 or the like. Since the medicine notebook 114b can be created based on the entire dispensing history 114e, a plurality of prescriptions 112c can be put together.
　（４）審査支払機関
　図５における審査支払機関１１６は、図１における審査支払機関１１６と同様であり、支払基金、国保連合、等を含む。
　審査支払機関１１６が提供する医療情報としては、審査結果１１６ｂ、診療報酬１１６ｃ等が挙げられ、これらのうちいずれか１種以上の医療情報だけをブロックチェーン２００の管理対象とすることもできる。なお、審査結果１１６ｂは、診療報酬１１６ｃと統合されている場合もあり、診療報酬１１６ｃの書類の一項目として審査結果１１６ｂが含まれていてもよい。 (4) Examination / Payment Institution The examination / payment institution 116 in FIG. 5 is the same as the examination / payment institution 116 in FIG. 1 and includes a payment fund, a national health insurance association, and the like.
The medical information provided by the examination payment organization 116 includes an examination result 116b, a medical treatment fee 116c, and the like. Only one or more of these medical information can be managed by the blockchain 200. Note that the examination result 116b may be integrated with the medical fee 116c, and the examination result 116b may be included as one item of the document of the medical fee 116c.
　なお、本実施形態においては、審査結果１１６ｂ、診療報酬１１６ｃ等を、ブロックチェーン２００の管理対象としてもよいし、しなくてもよい。
　本実施形態における薬歴管理システム１００は、例えば、医療機関１１２と、薬局１１４と、患者１１０とでブロックチェーン２００を構成して、その中で薬歴を管理し、お手帳１１４ｂを利用することができれば、患者１１０等にとって便利である。審査支払機関１１６が参加していない場合でも一定の効果が薬歴管理に関して得られると考えられるからである。 In the present embodiment, the examination result 116b, the medical fee 116c, and the like may or may not be managed by the blockchain 200.
The medicine history management system 100 according to the present embodiment includes, for example, configuring a blockchain 200 including a medical institution 112, a pharmacy 114, and a patient 110, managing the medicine history therein, and using the notebook 114b. Is convenient for the patient 110 and the like. This is because it is considered that a certain effect can be obtained with respect to drug history management even when the examination payment organization 116 does not participate.
　また、ここで挙げた情報以外の医療情報を、ブロックチェーン２００で管理する対象として選択してもよい。また、その審査支払機関１１６の独自の医療情報、独自の書類、を管理する対象としてもよい。審査支払機関１１６（例えば国保連合）のシステムが、これらの医療情報を、プラットフォーム３６０中のブロックチェーン２００に登録してもよい。 医療 In addition, medical information other than the information listed here may be selected as a target to be managed by the blockchain 200. In addition, the medical information and original documents of the examination and payment organization 116 may be managed. The system of the screening payment agency 116 (eg, National Health Insurance) may register these medical information with the blockchain 200 in the platform 360.
　また、審査支払機関１１６は、複数の医療機関や薬局１１４とデータのやりとりを行う必要がある場合も多く、ある薬局１１４ではブロックチェーン２００を利用し、他の薬局１１４ではブロックチェーン２００を利用しないことも想定される。その場合には、審査支払機関１１６のシステムの構成がやや複雑になってしまうことも考えられる。そのため、審査支払機関１１６によっては、ブロックチェーン２００を利用せず、従来通りの診療・調剤報酬の請求、診療・調剤報酬の支払い、を行うようにしてもよい。
　また、審査支払機関１１６は、相手の薬局１１４（や医療機関１１２）ごとに、ブロックチェーン２００を利用する／利用しないを切り替える処理を行ってもよい。 In many cases, the examination and payment institution 116 needs to exchange data with a plurality of medical institutions and pharmacies 114, and one pharmacy 114 uses the blockchain 200 and another pharmacy 114 does not use the blockchain 200. It is also assumed that In that case, the configuration of the system of the examination and payment institution 116 may be slightly complicated. Therefore, depending on the examination / payment organization 116, the request for the medical treatment / dispensing fee and the payment of the medical treatment / dispensing fee may be performed as usual without using the blockchain 200.
Further, the examination and payment institution 116 may perform a process of switching use / non-use of the blockchain 200 for each pharmacy 114 (or medical institution 112) of the partner.
　＜薬歴管理システム１００の導入から、その拡大について＞
　本実施形態における薬歴管理システム１００は、より多くの機関が参加していればより大きな宇高かを生み出すが、最初は数カ所の病院１１２と薬局１１４のみが参加した形態で実現してもよい。このような小規模でも、ブロックチェーン２００による恩恵は大きく、後日処方箋１１２ｃや調剤履歴１１４ｅ等から、薬の処方のチェック等を行うことが十分に可能であり、適切な薬の給付のために資することが可能である。
　その後、参加するメンバーを増やしていき、より大きな効果と大きな利便性を実現していくという実現形態が好ましい実実現形態の一つである。
　したがって、本薬歴管理システム１００のメンバーである病院１１２は、例えば処方箋１１２ｃをブロックチェーン２００に登録するとともに、希望によっては患者１１０に「紙」で渡すように構成しておくことも好適である。このように紙で渡すことによって、メンバーになっていない薬局１１４で薬の給付を受けられる。 <From the introduction of the drug history management system 100 to its expansion>
The drug history management system 100 according to the present embodiment generates a larger Utaka if more institutions participate, but may be realized in a form in which only a few hospitals 112 and pharmacies 114 participate at first. Even with such a small scale, the benefits of the blockchain 200 are large, and it is possible to sufficiently check the prescription of the medicine from the prescription 112c, the dispensing history 114e, and the like at a later date, thereby contributing to appropriate medicine payment. It is possible.
Thereafter, an embodiment in which the number of participating members is increased to achieve a greater effect and greater convenience is one of the preferable actual embodiments.
Therefore, it is also preferable that the hospital 112, which is a member of the medicinal history management system 100, registers the prescription 112c in the blockchain 200 and hands it over to the patient 110 by "paper" if desired. . In this way, the medicine can be paid at the pharmacy 114, which is not a member, by handing over the paper.
　さらに病院１１２は、ブロックチェーン２００のメンバーとなり、プラットフォーム２６０の利用を開始した直後は、ブロックチェーン２００に登録する医療情報として処方箋１１２ｃ、レセプト１１２ｄだけを利用し、その後、順次カルテ１１２ｂ等も登録するように構成してもよい。このように登録対象である医療情報に柔軟性を持たせることによって、いわゆる参加障壁を下げ、小規模な病院１１２や薬局１１４でも参加しやすい構成としている。 Further, the hospital 112 becomes a member of the blockchain 200, and immediately after using the platform 260, uses only the prescription 112c and the receipt 112d as medical information to be registered in the blockchain 200, and then sequentially registers the chart 112b and the like. It may be configured as follows. Thus, by giving flexibility to the medical information to be registered, the so-called participation barrier is reduced, and the configuration is such that small hospitals 112 and pharmacies 114 can easily participate.
　（５）保険者（健保等）
　図５における保険者１１８は、図１における保険者１１８と同様であり、協会けんぽ等を含む。
　保険者１１８が提供する医療情報としては、保険加盟情報１１８ｂが挙げられるが、これ以外の情報でも医療情報の一種としてブロックチェーン２００の管理対象とすることもできる。ただし、保険加盟情報１１８ｂは、ブロックチェーン２００に対する登録に際して、加盟者の同意が必要である場合もあるので、すべての保険加盟情報１１８ｂを一度にブロックチェーン２００に登録しなくてもよい。
　保険者１１８は、すべての加盟者の同意を得るまで待ってからブロックチェーン２００に登録してもよいし、同意が得られた加盟者の保険加盟情報１１８ｂから順次ブロックチェーン２００に登録してもよい。 (5) Insurer (Health insurance, etc.)
The insurer 118 in FIG. 5 is the same as the insurer 118 in FIG.
The medical information provided by the insurer 118 includes the insurance membership information 118b, but other information may be managed by the blockchain 200 as a type of medical information. However, since the insurance member information 118b may require the consent of the member when registering with the blockchain 200, all the insurance member information 118b does not need to be registered in the blockchain 200 at one time.
The insurer 118 may wait until the consent of all the members has been obtained before registering with the blockchain 200, or may register with the blockchain 200 sequentially from the insurance member information 118b of the member whose consent has been obtained. Good.
　このように、本実施形態にかかる薬歴管理システム１００は、図１の各構成（病院１１２、薬局１１４、保険者１１８等）に対して、それらが保持している医療情報のすべてをブロックチェーン２００に登録することを要求するものではない。これによって、本薬歴管理システム１００への参加を容易にして、メリットが広く知られることを狙ったものである。
　本薬歴管理システム１００において扱う医療情報は個人情報である場合が多く、ブロックチェーン２００に対する登録に際して、患者１１０の同意が必要な場合も多い。そこで、同意が得られた患者１１０の医療情報のみをブロックチェーン２００に登録するような運用を許容している。ここでは、保険者１１８の保管加盟情報１１８ｂを例にして説明したが、他の医療情報も同様の取り扱いとしてよい。 As described above, the medicine history management system 100 according to the present embodiment uses the blockchain for each of the components (hospital 112, pharmacy 114, insurer 118, etc.) of FIG. It does not require registration to the 200. This aims to facilitate participation in the present drug history management system 100 and to make the merits widely known.
Medical information handled by the medicinal history management system 100 is often personal information, and consent of the patient 110 is often required when registering with the blockchain 200. Therefore, the operation of registering only the medical information of the patient 110 for which consent has been obtained in the blockchain 200 is permitted. Here, the explanation has been given using the custody accession information 118b of the insurer 118 as an example, but other medical information may be handled similarly.
　（６）患者１１０（被保険者・扶養者等含む）
　図５における患者１１０は、図１における患者１１０と同様であるが、被保険者や扶養者等も含む。
　患者１１０が提供する医療情報としては、図１に示すように患者情報１１０ｂが挙げられる。この患者情報１１０ｂは、患者１１０自らがブロックチェーン２００に登録してもよいし、患者１１０の同意を受けて、病院１１２等が実行してもよい。また、病院１１２等は、ブロックチェーン２００のメンバーとしての患者１１０の行為を代行してもよく、その場合は、病院１１２は、患者１１０に代わって患者情報１１０ｂをブロックチェーン２００に登録してもよい。 (6) Patient 110 (including insured and dependents)
The patient 110 in FIG. 5 is the same as the patient 110 in FIG. 1, but includes insured persons, dependents, and the like.
The medical information provided by the patient 110 includes patient information 110b as shown in FIG. The patient information 110b may be registered in the blockchain 200 by the patient 110 itself, or may be executed by the hospital 112 or the like with the consent of the patient 110. Further, the hospital 112 or the like may act on behalf of the patient 110 as a member of the blockchain 200. In that case, the hospital 112 may register the patient information 110b on the blockchain 200 instead of the patient 110. Good.
　さらに、本実施形態におけるプラットフォーム３６０は、ＭＹページサーバ２５０が、患者１１０向けのＭＹページを提供しており、患者１１０は、ブロックチェーン２００とは別に、このＭＹページに個人情報を登録することができる。
　このような個人情報は改竄される可能性が少ないので、ブロックチェーン２００とは別に、個人が登録可能なＭＹページ上に格納しておいてもよい。
　本実施形態において特徴的なことは、ブロックチェーン２００に付随してＭＹページサーバ２５０が設けられ、このＭＹページサーバ２５０と、ブロックチェーン２００と、からプラットフォーム３６０が構成されていることである。そして、ＭＹページサーバ２５０が、ブロックチェーン２００の登録内容に基づいて、患者１１０毎のＭＹページを作成して提示することができる。 Further, in the platform 360 in this embodiment, the MY page server 250 provides the MY page for the patient 110, and the patient 110 can register personal information on this MY page separately from the blockchain 200. it can.
Since such personal information is less likely to be tampered with, it may be stored separately from the blockchain 200 on a MY page where individuals can be registered.
The present embodiment is characterized in that a MY page server 250 is provided in association with the block chain 200, and a platform 360 is configured by the MY page server 250 and the block chain 200. Then, the MY page server 250 can create and present an MY page for each patient 110 based on the registered contents of the blockchain 200.
　このように、患者１１０は、ブロックチェーン２００に登録されている内容に基づいて構成された（自己向けの）ＭＹページを閲覧し利用することができるとともに、自己登録情報１１０ｄを、ブロックチェーン２００の登録内容とは別に登録することができる。
　自己登録情報１１０ｄは、健康保険証（ＱＲコード（登録商標））、自己測定値（身長、体重）健康状況、等を含むことができるが、どのような内容でもよい（図５参照）。患者１１０は、上述したように、ＭＹページサーバ２５０によって提供されるＭＹページを閲覧することによって、ＭＹページ閲覧情報１１０ｅを閲覧することができる。その閲覧時のＭＹページ閲覧情報は、自分で登録した自己登録情報１１０ｅ、目標健康状況との差異、処方箋１１２ｃ、受け取った薬（薬歴）、通院治療履歴（通院治療略歴）、等が含まれてよい。ＭＹページ閲覧情報は、他の情報を含めてもよいし、患者１１０の意向等によってより少ない情報でもよい。なお、患者１１０は、自分のパソコン等を利用して、ＭＹページを閲覧すること、ＭＹページに所望の自己登録情報を登録すること、等を実行することができる。また、患者は、パソコンの他、スマートフォン（Smart Phone）や、各種の携帯端末を利用してＭＹページにアクセスすることができる。 As described above, the patient 110 can browse and use the MY page (self-oriented) configured based on the content registered in the blockchain 200, and also transmits the self-registration information 110d to the blockchain 200. It can be registered separately from the registered contents.
The self-registration information 110d can include a health insurance card (QR code (registered trademark)), self-measured values (height, weight), health status, and the like, but may have any content (see FIG. 5). As described above, the patient 110 can browse the MY page browsing information 110e by browsing the MY page provided by the MY page server 250. The MY page browsing information at the time of browsing includes self-registration information 110e registered by oneself, a difference from the target health status, a prescription 112c, a received medicine (medicine history), an outpatient treatment history (outpatient treatment history), and the like. May be. The MY page browsing information may include other information, or may be less information depending on the intention of the patient 110 or the like. The patient 110 can use his / her personal computer or the like to browse the MY page, register desired self-registration information in the MY page, and the like. Further, the patient can access the MY page using a personal computer, a smartphone (Smart Phone), or various portable terminals.
　＜ＭＹページサーバ２５０についての説明その２＞
　このように、ＭＹページサーバ２５０は、患者１１０向けのＭＹページ（例えば、Ｗｅｂページ）を作成して提示する。さらに、ＭＹページサーバ２５０は、その患者１１０のブロックチェーン２００のメンバーとしての動作を代行することも好適である。
　上述した実施形態の説明では、ブロックチェーン２００のメンバーに関しては、各メンバーは例えば図２に示すような構成を有し、ブロックチェーン２００のメンバーとしての動作を実行するものとして説明してきた。また、個人の患者１１０等であって、ブロックチェーンのメンバーとして動作することが不便・困難である場合は、その患者１１０の病院１１２等（のシステム）が、患者１１０の代わりにブロックチェーン２００の保持等を行い、ブロックチェーン２００のメンバーとして患者１１０の動作を代行することができると説明をした。この場合は、病院１１２のシステム上で、図２に示すような構成を仮想的に構築する等によって、患者１１０の動作を代行することは当業者であれば容易である。 <Description 2 of MY page server 250>
As described above, the MY page server 250 creates and presents an MY page (for example, a Web page) for the patient 110. Further, it is preferable that the MY page server 250 act on behalf of the patient 110 as a member of the block chain 200.
In the above description of the embodiment, regarding the members of the block chain 200, each member has, for example, a configuration as shown in FIG. 2, and has been described as executing the operation as a member of the block chain 200. If it is inconvenient or difficult to operate as a member of the blockchain, such as an individual patient 110, the (hospital) 112 or the like of the patient 110 may use the blockchain 200 instead of the patient 110. It has been described that the operation of the patient 110 can be performed as a member of the block chain 200 by performing holding or the like. In this case, it is easy for those skilled in the art to substitute the operation of the patient 110 on the system of the hospital 112 by virtually constructing the configuration shown in FIG.
　この場合の病院１１２等と同様に、ＭＹページサーバ２５０が、患者１１０のブロックチェーン２００のメンバーとしての動作を代行するように構成してもよいことはすでに「プラットフォーム３６０」の項で説明した。なお、このような代行をする場合は、その動作（代行動作）の様子をその患者１１０のＭＹページ上で掲示することも好適である。この掲示もＭＹページサーバの制御部が実行してよい。
　このように構成すれば、患者１１０は、ブロックチェーン２００のメンバーとしてどのような動作を実行しているのかを自己のＭＹページ上で確認することができ、便利である。
　なお、図５の説明では、プラットフォーム内３６０内に配置されているＭＹページサーバ２５０を説明したが、ＭＹページサーバ２５０は、２台以上存在してもよい。例えば、プラットフォーム内３６０内だけでなく、別個独立して複数個設けてもよい。例えば、患者１１０が加盟している保険の保険者１１８に設けてもよいし、患者１１０の病院１１２に設けてもよい。 As in the case of the hospital 112 and the like in this case, the MY page server 250 may be configured to perform the operation of the patient 110 as a member of the blockchain 200 on behalf of the platform 360 as described above. When performing such substitution, it is also preferable to post the operation (proxy operation) on the MY page of the patient 110. This posting may also be executed by the control unit of the MY page server.
With this configuration, the patient 110 can confirm what operation is being performed as a member of the blockchain 200 on his / her MY page, which is convenient.
In the description of FIG. 5, the MY page server 250 disposed in the platform 360 has been described, but two or more MY page servers 250 may exist. For example, not only the inside of the platform 360 but also a plurality of separate and independent units may be provided. For example, it may be provided at the insurer 118 of the insurance to which the patient 110 belongs, or may be provided at the hospital 112 of the patient 110.
　第３．特徴
　このように、本実施形態の薬歴管理システム１００は、ブロックチェーンを相互保有し、診療報酬の請求業務や、医療機関間の電子カルテ、薬歴個人情報等を分散して保管管理するセキュアなデータベースを構築することができる。この結果、病院１１２等だけでなく、患者１１０自身が活用できるデータベースが構築できる。
　この場合、患者１１０は、上述したように、自己のパソコン等からブロックチェーン２００の分散型データベースにアクセスすることも好適であるが、他の機関（例えば、病院１１２や、ＭＹページサーバ２５０等）に処理代行を依頼してもよい。患者１１０自信がブロックチェーン２００のメンバーであり、メンバーとして動作している場合は、ブロックチェーン２００を保持しており、自己が保持するブロックチェーン２００を見ることができる。一方、他の機関に動作処理の代行を依頼している場合は、当該機関にアクセスして、ブロックチェーン２００の内容を見ることができる。 Third. Characterized Thus, medication history management system 100 of the present embodiment, secure the mutual possess block chain, billing and medical fees, electronic medical records between medical institutions, to storage and management in a distributed medication history personal information A simple database can be constructed. As a result, a database that can be used not only by the hospital 112 and the like but also by the patient 110 can be constructed.
In this case, as described above, it is preferable for the patient 110 to access the distributed database of the blockchain 200 from his / her personal computer or the like. However, the patient 110 may use another database (for example, the hospital 112 or the MY page server 250). May be requested for a processing substitute. When the patient 110 is a member of the blockchain 200 and operates as a member, the patient 110 holds the blockchain 200 and can see the blockchain 200 held by himself. On the other hand, when requesting another agency to perform the operation processing, the content of the blockchain 200 can be viewed by accessing the agency.
　また、本実施形態においては、ブロックチェーン２００を暗号化すると共に、当該患者が、自己に関する情報を公開するか否かをその意思を登録できるように構成しておくことが好ましい。例えば、各管理対象に、それぞれ、そのようなフラグを設けておくことも好適である。 In addition, in the present embodiment, it is preferable that the blockchain 200 be encrypted and the patient can register his or her intention to publish information regarding the patient. For example, it is also preferable to provide such a flag for each management target.
　また、例えば、患者１１０自身が、当該薬歴管理システム１００に参加する際に、自己の情報をメンバー間で共用してよいか否か同意を得ておくことも好適である。同意している患者１１０のカルテを複数の病院１１２で閲覧できれば、重複した検査を行う可能性を低減することができる。また、重複した投薬の可能性を低減することができる。
　かかる同意は、管理対象毎に行ってもよい。管理対象毎にフラグを設けておけば、患者の意思を管理対象毎に設定・反映させることができる。 Further, for example, when the patient 110 itself participates in the drug history management system 100, it is preferable that the patient 110 obtains consent as to whether or not his / her own information may be shared among the members. If the medical chart of the patient 110 who agrees can be browsed at a plurality of hospitals 112, the possibility of performing duplicate tests can be reduced. Also, the possibility of duplicate dosing can be reduced.
Such an agreement may be made for each management target. If a flag is provided for each management target, the patient's intention can be set and reflected for each management target.
　したがって、患者ｌ１０自身が利用でき、且つ、強い情報セキュリティを実現したデータベースを構築することができる。また、いわゆるブロックチェーン２００を用いているので、改竄が事実上不可能なデータベースを構築することができる。
　さらに、全てのデータ（管理対象）を、患者１１０の同意があればブロックチェーン２００上で他人（例えば薬局１１４）に対して公開でき、各医療情報を各メンバーが閲覧できる。すると、病院１１２からいわゆるオンラインで処方箋を薬局１１４に送ることが事実上可能となり、いわゆるオンラインでの調剤を行うことができる。 Therefore, it is possible to construct a database that can be used by the patient 110 and realizes strong information security. Further, since the so-called block chain 200 is used, it is possible to construct a database that is virtually impossible to falsify.
Furthermore, all data (managed objects) can be disclosed to others (for example, the pharmacy 114) on the blockchain 200 if the patient 110 has given consent, and each member can browse each medical information. Then, it is practically possible to send the prescription from the hospital 112 to the pharmacy 114 so-called online, so that so-called online dispensing can be performed.
　このような結果、「患者薬歴管理（無駄な医薬品及び偽造処方箋排除、長期・継続的な薬局処方箋保管期間（現状の３年以上）の実現）」「患者自身、お薬手帳活用し患者の健康推進に寄与（結果、薬剤減少）」等、「患者視点の目指すプラットフォーム」を構築することができる。
　また、医療機関１１２・薬局１１４の業務改善（将来の処方箋をカット、電子カルテへのリンク、レセプトへのリンク）を実現することができる。 As a result, "Patient drug history management (elimination of useless drugs and counterfeit prescriptions, realization of a long-term and continuous pharmacy prescription storage period (currently three years or more)") Contribute to health promotion (results in drug reduction) "and" platforms aimed at patients' perspectives ".
In addition, it is possible to realize the business improvement of the medical institution 112 and the pharmacy 114 (cutting a prescription in the future, linking to an electronic medical record, linking to a receipt).
　第５．コンセンサス
　上記ブロックチェーン２００として、コンソーシアム型ブロックチェーン２００を例にして説明したが、他の形式を利用してもよい。また、ブロックチェーンの運用においては、メンバーがコンセンサスを取る（確立する）ための合意形成式としても、種々のアルゴリズムを採用することができる。例えば、ＰＢＦＴ（Practical Byzantine Fault Tolerance）方式を採用してよい。管理対象の種別や、業務内容、採用するブロックチェーンのタイプやその他によって、他の種々のコンセンサス方式を採用してもよい。ＰＯＡ（Proof of Work）、ＰｏＳ（Proof of Stake）、ＰｏＩ（Proof of importance）等を採用してもよい。特に、本実施形態においては承認を行うメンバーを、ブロックチェーンに参加するメンバー全員ではなく、大きな病院１１２や、審査支払機関１１６等に限定することが好ましいので、コンソーシアム型のブロックチェーンを利用してよく、その場合は、ＰＢＦＴ方式を採用してよい。 Fifth. Consensus Although the consortium type block chain 200 has been described as an example of the block chain 200, other types may be used. Also, in the operation of the blockchain, various algorithms can be adopted as a consensus-building expression for members to obtain (establish) consensus. For example, a PBFT (Practical Byzantine Fault Tolerance) method may be adopted. Other various consensus methods may be adopted depending on the type of the management target, the business content, the type of the block chain to be adopted, and the like. Proof of work (POA), proof of stake (PoS), proof of importance (PoI), or the like may be employed. In particular, in the present embodiment, it is preferable that the members performing the approval are limited to the large hospital 112, the screening and payment organization 116, and the like, instead of all the members participating in the blockchain. In that case, the PBFT method may be adopted.
　しかし、これらのアルゴリズムに限られず、他の方式を採用してもよい。
　上述したＰＢＦＴの場合は、メンバー全員ではなく、一部のメンバーのみが承認を行う承認メンバーとなる。一部の承認メンバーである（例えば）審査支払機関１１６がレセプトの承認を行う（コンセンサスを取得する（確立する））ようにブロックチェーン２００を構成してよい。また、ＰＢＦＴにおいては、他にリーダーとなる１個のメンバー（例えば、大きな薬局１１４）が、各ブロックの適宜ハッシュ関数、ノンスを算出して、ブロックを作成していくように構成してもよい。 However, the present invention is not limited to these algorithms, and other methods may be adopted.
In the case of the PBFT described above, only some members, not all members, are approved members who approve. The blockchain 200 may be configured so that some approving members (e.g., the review and payment institution 116) approve the claim (obtain (establish) a consensus). Further, in the PBFT, another member (for example, a large pharmacy 114) serving as a leader may calculate a hash function and a nonce of each block as appropriate to create a block. .
　第６．本システムの事業性と、事業化までのステップ
　以上説明した本実施形態にかかる薬歴管理システム１００は、患者視点に立ち、予防・健康づくりの推進と医療費の適正化を目指すものである。本薬歴管理システム１００によって、過去の患者薬歴管理や目標健康数値・診断・処方回数の等から、「患者の意識改革」「健康増進」を図るものである。患者の健康づくり（目標数値と現状数値との推移やその健康推進情報提供等）の結果、診療・処方費用の減少によって協会・けんぽ等の支払負担を抑制・減少させることをそのゴールとする。その実現のため、以下のサービスＳｔｅｐ及び、医療機関・薬局に対するアプローチを設ける。 Sixth. The Business History of the System and the Steps to Commercialization The drug history management system 100 according to the present embodiment described above aims at promoting prevention and health promotion and optimizing medical expenses from the viewpoint of patients. The present drug history management system 100 aims to "change patient consciousness" and "promote health" based on past patient drug history management, target health values, diagnoses, and prescription times. The goal is to reduce or reduce the payment burden on associations and hospitals by reducing medical care and prescription costs as a result of patient health promotion (changes between target and current figures and provision of health promotion information). In order to achieve this, the following service steps and approaches to medical institutions and pharmacies will be provided.
　（１）Ｓｔｅｐ１：医療機関・薬局への本サービス利用推進
　医療機関・薬局へ本薬歴管理システム１００によるサービスを無償提供し、本薬歴管理システム１００によるサービスの普及に努めるものとする。本薬歴管理システム１００によるサービスの機能は、既存の医療機関・薬局が利用する電子カルテ・処方のデータ等を加工せず、ブロックチェーン２００上にそのまま投入する（登録する）ことによってそのまま稼働する仕組みとして構成する。
　すなわち、従来の中央集権的なシステムをブロックチェーン２００で置きかえるだけであり、セキュリティやプライバシーへの考慮は当然実施するとしても、薬事法等各種規制に違反するものではない。 (1) Step 1: Promotion of use of the present service to medical institutions and pharmacies The service of the present drug history management system 100 shall be provided free of charge to medical institutions and pharmacies, and efforts shall be made to spread the service provided by the present drug history management system 100. The function of the service provided by the medicinal history management system 100 is directly operated (registered) on the blockchain 200 without processing data of electronic medical records and prescriptions used by existing medical institutions and pharmacies, and operates as it is. Configure as a mechanism.
In other words, the conventional centralized system is merely replaced by the blockchain 200, and even if security and privacy are taken into consideration, it does not violate various regulations such as the Pharmaceutical Affairs Law.
　本薬歴管理システム１００によるサービスの利用推進を図る上では、本薬歴管理システム１００によるサービスの導入により各医療機関におけるメリットを明確化して訴求していく。
　すなわち、医療機関・薬局の事務処理におけるペーパレス化、診療報酬の計算・検証の自動化・自動承認化、薬局で過去処方された薬歴からその適正な薬選択等において、人員工数削減（人件費削減）等のコストダウンに繋がる旨のメリットをアピールする。
　更には、薬歴記録データより、例えば過去服用薬剤からの症状確認等、薬局から患者に対し、一層詳細な提案・説明が可能となる等のメリットも前面に押し出すことが好適である。 In promoting the use of the service by the medicinal drug history management system 100, the merits of each medical institution are clarified and appealed by introducing the service by the medicinal drug history management system 100.
In other words, reducing the number of man-hours (reducing labor costs) in paperless administrative work at medical institutions and pharmacies, automating and automatically approving the calculation and verification of medical fees, and selecting appropriate medicines based on the history of prescriptions at pharmacies. ) And other benefits that lead to cost reduction.
Further, it is preferable to push the merits such as confirmation of symptoms from the medicines taken in the past from the pharmacy history to the patient from the drug history record data such that a more detailed proposal and explanation can be made to the patient.
　（２）Ｓｔｅｐ２：患者への利用推進及びメリットの打ち出し
　患者に対する利用推進は、以下の2つの展開を計画している。
　（２ａ）企業内個人（企業単位での利用推進）
　企業においては、現在従業員の健康管理・その働きがい・効率性・創造性の向上に努めているが、多くの企業は年に1度の健康診断による社員健康推進程度に留まる。加入協会・けんぽ等からその加入者である患者の健康状況が企業に一旦集まるも、その活用は十分とは言えない場合がある。そこで、企業より、本薬歴管理システム１００によるサービスを福利厚生の一環として、企業に利用推奨して頂く。
　さらに、健康診断の結果を数値化するとともに、社員健康・診療・処方結果の集計・分析（平成２７年１２月１日施行、医師・保健師等による心理的な負担の程度を把握するための検査（通称「ストレスチェック」）を含む）に役立てることができる旨を企業に対してアピールする。 (2) Step2: Promotion of use to patients and creation of benefits The promotion of use to patients is planned for the following two developments.
(2a) Individuals within a company (promotion of use on a company basis)
Companies are currently working to improve employee health management, their job satisfaction, efficiency and creativity, but many companies are only able to promote employee health through annual health examinations. Although the health status of the patient who is a member of the member once gathers at the company from a member association or a kempo, its utilization may not be sufficient. Therefore, a company recommends the use of the service provided by the medicinal history management system 100 as a part of a welfare program.
In addition to quantifying the results of the health examination, tabulating and analyzing the results of employee health, medical treatment and prescription (enforced on December 1, 2015, to understand the degree of psychological burden by doctors, public health nurses, etc.) Appeal to companies that it can be used for inspections (including “stress check”).
　ここで、「ストレスチェック」は、従業員５０人以上の事業場については義務化されている。厚生労働省の推奨するストレスチェックの項目は全部で５７項目、内容は仕事のストレス要因（１７項目）、ストレス反応（２９項目）、ストレス緩和要因（社会的支援９項目、満足度２項目）で構成される。
　社内環境（座席数や、１平方メートルあたりの人員や、その人員の座席のレイアウト等）の変化と、社員健康・診療・処方の変化、福利厚生（実施する社内行事やイベント等）の効果測定、勤怠管理との連動（病欠・早退・遅刻等）等とストレスチェックとの関係を比較考量することができるとアピールする。この点において、オフィス事務機器メーカー等との将来提携の検討を実行する予定である。
　このように、いわゆる各種の企業に対しては、その従業員の健康状況における表彰等を推奨し、患者自らが「意識的に健康増進」を図るよう企業に対し提案することとする。そのため、患者自身の１年単位等の健康管理（履歴・数値管理等健康カレンダーで実施）や、職場内での競争・仲間意識・意見交換の場も実装する。 Here, "stress check" is mandatory for business establishments with 50 or more employees. The stress check items recommended by the Ministry of Health, Labor and Welfare are 57 items in total, and consist of work stress factors (17 items), stress responses (29 items), and stress alleviation factors (social support 9 items, satisfaction 2 items). Is done.
Changes in internal environment (number of seats, number of people per square meter, layout of those seats, etc.), changes in employee health, medical care, and prescriptions, measurement of benefits of benefits (in-house events and events to be implemented), It appeals that it is possible to weigh the relationship between stress management and the linkage with time management (sickness, early leave, lateness, etc.). In this regard, we plan to consider future alliances with office office equipment manufacturers and others.
In this way, it is recommended that so-called various companies be commended for the health status of their employees, and that the patients themselves be encouraged to “consciously promote health”. For this reason, a health management system for patients for one year, etc. (conducted on a health calendar such as history and numerical management) and a place for competition, friendship, and exchange of opinions in the workplace will be implemented.
　上述した実施形態では、患者１１０毎の患者ＭＹページを設ける例を説明したが、その他に、企業単位で専用ページを開設し、上記情報を提供するものとする。この場合、患者１１０には、本薬歴管理システム１００によるサービスの登録時に「承認」を経る処理の流れを採用する。
　なお、介護施設（老人ホーム等）において、例えば、要介護１・要介護２等と認定された比較的元気な高齢者に対しても、健康目標達成及びその結果より表彰・インセンティブ（介護施設・会社単位）を実行して、本薬歴管理システム１００によるサービスの利用推進を呼びかける。この点において、老人ホーム・介護施設等との将来提携の検討を実行する予定である。 In the above-described embodiment, an example has been described in which a patient MY page is provided for each patient 110, but in addition, a dedicated page is opened for each company and the above information is provided. In this case, for the patient 110, a process flow of “approval” when the service is registered by the medicinal history management system 100 is adopted.
In addition, in nursing homes (such as nursing homes), for example, even for relatively healthy elderly people who are recognized as needing nursing care 1 or nursing care 2 etc., commendation and incentives (nursing care facilities / (For each company), and calls for promotion of use of the service by the present drug history management system 100. In this regard, we plan to consider future alliances with nursing homes and nursing homes.
　（２ｂ） 個人
　個人に対しては、以下のメリットを打ち出し、利用推進を図る計画である。
　・医療相談（電話相談提携予定企業ティーペック株式会社http://www.t-pec.co.jp/）
　ティーペック株式会社は「ハロー健康相談２４」と呼ぶサービスを提供している。このサービスによれば、最新の受付システムを完備したティーペック相談センターにて、常勤のドクターをはじめとする経験豊かなスタッフが２４時間・年中無休体制で電話による健康相談を受けることが可能である。
　・患者１１０の薬歴に基づき、処方された薬の内容、その効用、処方された診療・薬の時系列・回数をお知らせすることができる。
　・目標健康数値・根本治療（腰痛等・運動）・生活習慣病等、カテゴリと診療・処方回数・内容を案内することができる。
　・医療費控除申請（セルフメディケーション（税制含む））ページ（判定・入力・プリントアウト）の提供。
　・健康増進情報（睡眠・食生活・運動のＤａｔａと情報）と自身の健康情報（身長・体重・血圧等から、日々の歩数・消費カロリー・食生活からのカロリーや栄養の偏り等）との比較・連動を行いながら、これらの情報の提供。
　・ 患者１１０自身の１年単位等の健康管理（履歴・数値管理等健康カレンダーで実施）や、仲間内・コミュニティ内での競争・仲間意識・意見交換の場をＷｅｂ上で提供する。 (2b) Individuals For individuals, the following merits are planned to promote the use.
・ Medical consultation (Telephone Co., Ltd., planned to cooperate with telephone consultation)
Tipec Corporation offers a service called "Hello Health Consultation 24". According to this service, full-time doctors and other experienced staff can receive health consultations over the phone 24 hours a day, 7 days a week at the Tipek Consultation Center equipped with the latest reception system. is there.
Based on the medication history of the patient 110, the content of the prescribed medicine, its effect, the prescribed medical treatment and the time series and the number of medicines can be notified.
・ Guide to the target health value, fundamental treatment (low back pain, exercise, etc.), lifestyle-related diseases, etc.
・ Provide a medical expenses deduction application (self-medication (including tax system)) page (judgment / input / printout).
・ Health promotion information (data and information on sleep, diet, and exercise) and your own health information (from height, weight, blood pressure, etc., daily steps, calories consumed, calories and nutritional bias from diet, etc.) Providing this information while performing comparisons and interlocking.
・ Provide a place for health management (performed by health calendar such as history / numerical management) of patients 110 themselves on a Web basis, and a place for competition, friendship, and exchange of opinions within fellows / communities.
　（３）Ｓｔｅｐ３：協会・けんぽ等への利用推進及びメリットの打ち出し
　上述したＳｔｅｐ１・Ｓｔｅｐ２より患者１１０の健康増進（結果、診療・処方箋減少等）から、支払保険料の減少への貢献できる。
　例えば、薬代の低減のみに焦点をあてても、現在、コンビニを凌駕する約５９，０００店にまでに薬局は増えている。医薬分業の制度が始まって以来、薬局は薬の無駄を減らす使命を全うしてきたはずだが、これまで四半世紀で調剤医療費は約１２倍に膨らみ、２０２５年度に約１０兆円に達するという状況である。
　これに対して、本薬歴管理システム１００によるサービスによって、健康増進と診療・処方箋の因果関係レポート及び、クラウド上での保険確認可能な仕組みを初めて実装することができる。
　以上のようなステップ１～３を経て、事業化を円滑に進めることができると考えられる。 (3) Step3: Promotion of use to associations / kenpo, etc., and demonstrating merits From Step1 and Step2 described above, it is possible to contribute to a reduction in insurance premiums paid by improving the health of the patient 110 (resulting in a decrease in medical treatment and prescriptions).
For example, the number of pharmacies has increased to about 59,000 stores that surpass convenience stores even if the focus is solely on reducing drug costs. Pharmacies should have fulfilled their mission of reducing drug waste since the start of the system of drug division of labor, but dispensing medical expenses have increased by a factor of about 12 in the last quarter century and will reach about 10 trillion yen in FY2025. It is.
On the other hand, with the service provided by the medicinal history management system 100, it is possible to implement, for the first time, a mechanism capable of reporting a causal relationship between health promotion and medical treatment / prescription, and confirming insurance on the cloud.
It is considered that the commercialization can be smoothly advanced through the above steps 1 to 3.
　第７．変形例
　（１）このような薬歴管理システム１００は、カルテ等の共用を考慮すれば基本的に全国規模とすることが好適である。ただし、承認は地方毎、市町村毎に行ってもよい。
　すなわち、上述した薬歴管理システム１００は、１個のブロックチェーン２００を用いたシステムではあるが、その承認を行うメンバーは市町村毎に選出してもよい。全国の管理対象を逐次検査し承認することは演算コストが大きい場合もあるからである。この場合、１個のブロックチェーンの中に複数の「承認グループ」が形成されることになる。例えば、東京の医療情報（管理対象、（例えばレセプト、処方箋等））は東京都内の審査支払機関を含めた数個の承認メンバーが判断する等の構成を採用してもよい。 Seventh. Modification (1) It is preferable that such a drug history management system 100 be basically nationwide in consideration of sharing medical records and the like. However, approval may be given for each region or each municipality.
That is, although the above-mentioned drug history management system 100 is a system using one block chain 200, a member who approves the drug history management system 100 may be selected for each municipality. This is because, in order to inspect and approve the management objects nationwide sequentially, the calculation cost may be large. In this case, a plurality of “approval groups” are formed in one block chain. For example, a configuration may be adopted in which medical information in Tokyo (managed object, (for example, a claim, a prescription, etc.)) is determined by several approved members including an examination and payment institution in Tokyo.
　また、審査支払機関を中心として、審査支払機関毎の「承認グループ」を形成してもよい。ここで承認グループとは、承認を行うメンバーの集合である。
　つまり、１個のブロックチェーン２００の中に複数の承認グループが形成されており、ブロックチェーン２００に対する登録対象（医療情報）を発生した地点によって、どの承認グループが承認するかを予め決定しておくことが好ましい。
　例えば、東京都内の病院１１２で発生した処方箋１１２ｃは、東京都内の承認グループで承認するという規則を設けておけばよい。 In addition, an “approval group” may be formed for each examination payment institution, centered on the examination payment institution. Here, the approval group is a set of members for approval.
That is, a plurality of approval groups are formed in one block chain 200, and which approval group is to be approved is determined in advance according to a point where a registration target (medical information) for the block chain 200 is generated. Is preferred.
For example, a rule may be provided that a prescription 112c generated at a hospital 112 in Tokyo is approved by an approval group in Tokyo.
　（２）上では、説明の便宜上、薬歴管理システム１００と称しているが、必ずしも薬歴に限られず、診療履歴、検査履歴を構成する管理対象（カルテ、調査結果、レントゲン写真等）を管理対象としてよい。
　また、管理対象の種別ごとに承認メンバーを変更するように構成してもよい。例えば、薬歴は薬局１１４を中心とする承認メンバーで判断してもよい。また例えば診療履歴は、病院１１２を中心とする承認メンバーで判断してもよい。 (2) In the above, for convenience of explanation, it is referred to as the drug history management system 100, but is not necessarily limited to the drug history, and manages management targets (medical records, survey results, radiographs, etc.) that make up the medical history and examination history. May be targeted.
Further, an arrangement may be made wherein the approval member is changed for each type of management target. For example, the medication history may be determined by an approved member centered on the pharmacy 114. Further, for example, the medical treatment history may be determined by an approved member centering on the hospital 112.
　（３）上述した（１）では、ブロックチェーン２００を全国規模とする例を説明したが、その規模のブロックチェーン２００を各メンバーにおいて分散保持することは負担が大きくなることも考えられる。
　（３ａ）
　そこで、各都道府県単位で、ブロックチェーン２００を構成するように構成することも好適である。このように構成した場合は、都道府県をまたがって処方箋をオンラインで送るためには、それぞれのメンバー同士がデータを送受信すればよいが、ブロックチェーン２００同士の登録内容を結びつける専用のメンバー（例えば、ここではブロックチェーンブリッジと呼ぶ）を構成すれば便利である。このようなメンバーとしては、例えば大きな病院１１２や大きな薬局１１４が受け持ってもよいし、審査支払機関１１６がその役割を担ってもよい。 (3) In the above (1), an example in which the blockchain 200 is set to be a nationwide scale has been described. However, it is conceivable that the decentralized holding of the blockchain 200 of that scale by each member may increase the burden.
(3a)
Therefore, it is also preferable to configure the blockchain 200 for each prefecture. In such a configuration, in order to send a prescription online across prefectures, each member only needs to transmit and receive data. However, a dedicated member that links the registered contents of the blockchains 200 (for example, Here, it is convenient to form a block chain bridge). As such a member, for example, a large hospital 112 or a large pharmacy 114 may be in charge, or the examination and payment organization 116 may play the role.
　また、複数のブロックチェーン２００に同時に参加してメンバーとなる機関が上述したブロックチェーンブリッジとしての役割を果たすことも好適である。複数のブロックチェーン２００に参加しているので、例えば、
　・参加しているいずれかのブロックチェーン２００のメンバーからのリクエストに応じて、そのブロックチェーン上の管理対象（医療情報）を取り出す。
　・リクエストにかかる他のブロックチェーン２００にその管理対象（医療情報）を登録する。
　・リクエストにかかる他のブロックチェーン２００の所定のメンバーにその旨のメールを送信する。　
　等の処理を実行し、ブロックチェーン２００にまたがった医療情報（管理対象）のやりとりを実現する。ただし、上記所定のメンバーへのメール（通知）は不要の場合もある。単なる医療情報の移動の場合である。 In addition, it is also preferable that an institution that simultaneously participates in a plurality of block chains 200 and becomes a member plays a role as the above-described block chain bridge. Since we participate in multiple blockchains 200, for example,
In response to a request from a member of any of the participating blockchains 200, a management target (medical information) on the blockchain is extracted.
Register the management target (medical information) in another blockchain 200 related to the request.
-Send a mail to that effect to a predetermined member of the other blockchain 200 related to the request.
And the like, and exchange of medical information (managed objects) across the blockchain 200 is realized. However, the mail (notification) to the predetermined member may not be necessary. This is the case of merely transferring medical information.
　（３ｂ）
　また、ブロックチェーン２００の大きさとしては、審査支払機関１１６毎のブロックチェーン２００を設けることも好適である。この場合、ブロックチェーン２００をまたがった医療情報のやりとりは、審査支払機関１１６のシステムを利用して行ってもよい。つまり、審査支払機関１１６は、当該地域のブロックチェーン２００にメンバーして参加しているとともに、他の隣接する地域のブロックチェーン２００にもメンバーとして参加する。この場合、上述したブロックチェーンブリッジとしての動作は、例えば、
　・その審査支払機関１１６の属する当該地域のブロックチェーン２００のメンバーからのリクエストに応じて、そのブロックチェーン２００上の管理対象（医療情報）を取り出す。
　・リクエストにかかる隣接する他のブロックチェーン２００にその管理対象（医療情報）を登録する。
　・リクエストにかかる他のブロックチェーン２００の所定のメンバーにその旨のメールを送信する。　
　のようになるが、他の処理動作でもよい。なお、上記リクエストとは、例えばメールによるリクエストでもよく、対象となる医療情報（を識別する情報、例えばレセプトＩＤ等）と、送りたい他のブロックチェーンと、送りたい他の所定のメンバー、等を含めておくことが好ましい。ただし、所定のメンバーへの通知は不要な場合もある。 (3b)
Further, as for the size of the block chain 200, it is also preferable to provide the block chain 200 for each examination payment organization 116. In this case, the exchange of medical information across the blockchain 200 may be performed using the system of the examination and payment organization 116. In other words, the examination and payment institution 116 participates as a member in the blockchain 200 in the relevant region, and also participates as a member in the blockchain 200 in another adjacent region. In this case, the operation as the block chain bridge described above is, for example,
In response to a request from a member of the blockchain 200 in the region to which the screening payment institution 116 belongs, the management target (medical information) on the blockchain 200 is extracted.
Register the management target (medical information) in another adjacent blockchain 200 related to the request.
-Send a mail to that effect to a predetermined member of the other blockchain 200 related to the request.
However, other processing operations may be used. The request may be, for example, a request by e-mail. The request may include, for example, target medical information (information for identifying, for example, a receipt ID, etc.), other blockchains to be sent, and other predetermined members to be sent. It is preferable to include them. However, notification to a predetermined member may not be necessary.
　第８．終言　　
　以上、本発明の実施形態について詳細に説明したが、前述した実施形態は、本発明を実施するにあたっての具体例を示したに過ぎない。本発明の技術的範囲は、前記実施形態に限定されるものではない。本発明は、その趣旨を逸脱しない範囲において種々の変更が可能であり、それらも本発明の技術的範囲に含まれる。 No. 8. Apocalypse
As described above, the embodiments of the present invention have been described in detail. However, the above-described embodiments merely show specific examples for implementing the present invention. The technical scope of the present invention is not limited to the above embodiment. The present invention can be variously modified without departing from the spirit thereof, and these are also included in the technical scope of the present invention.
　１０、１１０　患者
　１２、１１２　病院
　１４、１１４　薬局
　１６、１１６　審査支払機関
　１８、１１８　保険者
　１００　薬歴管理システム
　１１０ａ　一部負担支払い
　１１０ｂ　患者情報（健康保険、健康目標等）
　１１０ｃ　保険料
　１１２ａ　診療サービス
　１１２ｂ　カルテ
　１１２ｃ　処方箋
　１１２ｄ　レセプト
　１１４ａ　薬剤給付
　１１４ｃ　お薬手帳
　１１６ａ　審査支払い分の請求
　１１８ａ　請求金額の支払い
　２００　ブロックチェーン
　２１２　医療機関
　２５０　ＭＹページサーバ
　３００　コンピュータシステム
　３０２　制御部
　３０４　通信部
　３０６　窓口部
　３０８　記憶部
　３０８ａ　薬局ブロックチェーン
　３６０　プラットフォーム 10, 110 patients 12, 112 hospitals 14, 114 pharmacies 16, 116 screening and payment institutions 18, 118 insurers 100 drug history management system 110a partial payment 110b patient information (health insurance, health goals, etc.)
110c Insurance premium 112a Medical care service 112b Medical record 112c Prescription 112d Reception 114a Drug payment 114c Medicine notebook 116a Request for examination payment 118a Payment of bill amount 200 Blockchain 212 Medical institution 250 MY page server 300 Computer system 302 Control unit 304 Communication unit 306 Counter 308 Storage 308a Pharmacy blockchain 360 platform

Claims (16)

  1. 　患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、
    　前記各メンバー装置は、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　を具備し、
    　前記通信部は、
    　前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記薬に関する取引を前記制御部に送信し、
    　前記他のメンバー装置から、前記医療情報の承認を受信した場合に、受信した承認を前記制御部に送信し、
    　前記制御部は、前記医療情報が前記通信部から送信されてきた後、所定の他のメンバー装置から承認が送信されてきた場合に、送信されてきた前記医療情報を、前記記憶部が記憶する分散型帳簿に加えることを特徴とする医療情報管理システム。     A medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical practice for a patient,
    Each of the member devices,
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    With
    The communication unit,
    From the other member device, when the medical information is received, a transaction regarding the received drug is transmitted to the control unit,
    From the other member device, when receiving the approval of the medical information, transmitting the received approval to the control unit,
    The control unit stores the transmitted medical information in the storage unit when approval is transmitted from another predetermined member device after the medical information is transmitted from the communication unit. A medical information management system characterized by being added to a distributed ledger.
  2. 　患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、
    　前記各メンバー装置は、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　前記患者に対する医療行為に関する医療情報を入力する医療情報入力部と、
    　を具備し、
    　前記医療情報入力部は、入力した前記患者に対する医療行為に関する医療情報を入力すると、前記医療情報を、前記制御部に送信し、
    　前記制御部は、前記医療情報を、前記通信部に送信し、
    　前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とする医療情報管理システム。     A medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical practice for a patient,
    Each of the member devices,
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    A medical information input unit for inputting medical information related to medical practice for the patient,
    With
    When the medical information input unit inputs the medical information related to the medical practice for the input patient, transmits the medical information to the control unit,
    The control unit transmits the medical information to the communication unit,
    The medical information management system, wherein the communication unit transmits the received medical information to the another member device when receiving the medical information from the control unit.
  3. 　患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、
    　前記複数のメンバー装置の中で、いずれかのメンバー装置は承認メンバー装置であり、
    　前記承認メンバー装置は、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　を具備し、
    　前記通信部は、
    　前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記医療情報を前記制御部に送信し、
    　前記制御部は、前記医療情報が前記通信部から送信されてきた場合、当該医療情報を承認するか否かを決定し、承認する場合は、承認を他のメンバー装置に送信するように、前記通信部に指示し、
    　前記通信部は、前記制御部から前記医療情報の承認の送信を指示された場合、前記承認を他のメンバー装置に送信することを特徴とする医療情報管理システム。     A medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical practice for a patient,
    Among the plurality of member devices, one of the member devices is an approved member device,
    The approval member device,
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    With
    The communication unit,
    From the other member device, when receiving the medical information, transmitting the received medical information to the control unit,
    When the medical information is transmitted from the communication unit, the control unit determines whether to approve the medical information, and when approving, to transmit the approval to another member device, Instruct the communication unit,
    The medical information management system, wherein the communication unit transmits the approval to another member device when instructed by the control unit to transmit the approval of the medical information.
  4. 　患者に対する医療行為に関する医療情報を記録する分散型帳簿を保持する複数のメンバー装置を備えた医療情報管理システムであって、
    　前記各メンバー装置は、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　前記患者に対して給付した薬剤に関する情報を入力する窓口部と、
    　を具備し、
    　前記窓口部は、前記患者に対して給付した薬剤に関する情報を入力すると、前記入力した前記患者に対して給付した薬剤に関する情報を、前記制御部に送信し、
    　前記制御部は、前記患者に対して給付した薬剤に関する情報を、前記医療情報として、前記通信部に送信し、
    　前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とする医療情報管理システム。     A medical information management system including a plurality of member devices that hold a distributed ledger that records medical information related to medical practice for a patient,
    Each of the member devices,
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    A window section for inputting information on the medicine supplied to the patient,
    With
    The window section, when inputting information on the medicine delivered to the patient, transmits information on the medicine delivered to the inputted patient to the control section,
    The control unit transmits information on the medicine supplied to the patient as the medical information to the communication unit,
    The medical information management system, wherein the communication unit transmits the received medical information to the another member device when receiving the medical information from the control unit.
  5. 　請求項１から４のいずれか１項に記載の医療情報管理システムであって、
    　前記医療情報は、少なくとも、薬剤服用歴（薬歴）、処方箋、レセプト、診療報酬請求、診療報酬支払い、保険料の支払い、保険料の請求、のうちいずれか１種を含むことを特徴とする医療情報管理システム。     The medical information management system according to any one of claims 1 to 4,
    The medical information includes at least any one of drug use history (medicine history), prescription, receipt, medical fee billing, medical fee payment, insurance premium payment, insurance premium billing. Medical information management system.
  6. 　請求項１から４のいずれか１項に記載の医療情報管理システムであって、
    前記医療情報は、前記患者に給付した薬の情報を含むことを特徴とする医療情報管理システム。     The medical information management system according to any one of claims 1 to 4,
    The medical information management system according to claim 1, wherein the medical information includes information on a medicine supplied to the patient.
  7. 　請求項１～４のいずれか１項に記載の医療情報管理システムであって、
    　前記メンバー装置は、薬局、病院、審査支払機関、保険者、患者のいずれかのコンピュータシステムであることを特徴とする医療情報管理システム。     The medical information management system according to any one of claims 1 to 4, wherein
    The medical information management system, wherein the member device is any one of a computer system of a pharmacy, a hospital, an examination and payment organization, an insurer, and a patient.
  8. 　請求項３記載の医療情報管理システムであって、
    　前記承認メンバー装置は、保険者、審査支払機関、のうち、いずれかのメンバー装置であることを特徴とする医療情報管理システム。     The medical information management system according to claim 3,
    The medical information management system according to claim 1, wherein the approved member device is one of an insurer and an examination and payment organization.
  9. 　請求項１記載の医療情報管理システムの前記メンバー装置であって、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　を具備し、
    　前記通信部は、
    　前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記薬に関する取引を前記制御部に送信し、
    　前記他のメンバー装置から、前記医療情報の承認を受信した場合に、受信した承認を前記制御部に送信し、
    　前記制御部は、前記医療情報が前記通信部から送信されてきた後、所定の他のメンバー装置から承認が送信されてきた場合に、送信されてきた前記医療情報を、前記記憶部が記憶する分散型帳簿に加えることを特徴とするメンバー装置。     The member device of the medical information management system according to claim 1, wherein
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    With
    The communication unit,
    From the other member device, when the medical information is received, a transaction regarding the received drug is transmitted to the control unit,
    From the other member device, when receiving the approval of the medical information, transmitting the received approval to the control unit,
    The control unit stores the transmitted medical information in the storage unit when approval is transmitted from another predetermined member device after the medical information is transmitted from the communication unit. A member device that is added to a decentralized book.
  10. 　請求項２記載の医療情報管理システムの前記メンバー装置であって、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　前記患者に対する医療行為に関する医療情報を入力する医療情報入力部と、
    　を具備し、
    　前記医療情報入力部は、入力した前記患者に対する医療行為に関する医療情報を入力すると、前記医療情報を、前記制御部に送信し、
    　前記制御部は、前記医療情報を、前記通信部に送信し、
    　前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とするメンバー装置。     The member device of the medical information management system according to claim 2, wherein
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    A medical information input unit for inputting medical information related to medical practice for the patient,
    With
    When the medical information input unit inputs the medical information related to the medical practice for the input patient, transmits the medical information to the control unit,
    The control unit transmits the medical information to the communication unit,
    The member device, wherein, when receiving the medical information from the control unit, the communication unit transmits the received medical information to the other member device.
  11. 　請求項３記載の医療情報管理システムの前記承認メンバー装置であって、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　を具備し、
    　前記通信部は、
    　前記他のメンバー装置から、前記医療情報を受信した場合に、受信した前記医療情報を前記制御部に送信し、
    　前記制御部は、前記医療情報が前記通信部から送信されてきた場合、当該医療情報を承認するか否かを決定し、承認する場合は、承認を他のメンバー装置に送信するように、前記通信部に指示し、
    　前記通信部は、前記制御部から前記医療情報の承認の送信を指示された場合、前記承認を他のメンバー装置に送信することを特徴とする承認メンバー装置。     The approval member device of the medical information management system according to claim 3, wherein
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    With
    The communication unit,
    From the other member device, when receiving the medical information, transmitting the received medical information to the control unit,
    When the medical information is transmitted from the communication unit, the control unit determines whether to approve the medical information, and when approving, to transmit the approval to another member device, Instruct the communication unit,
    The approval member device, wherein the communication unit transmits the approval to another member device when instructed by the control unit to transmit the approval of the medical information.
  12. 　請求項４記載の医療情報管理システムの前記メンバー装置であって、
    　前記各メンバー装置は、
    　前記分散型帳簿を保持する記憶部と、
    　他のメンバー装置と通信する通信部と、
    　前記分散型帳簿を制御する制御部と、
    　前記患者に対して給付した薬剤に関する情報を入力する窓口部と、
    　を具備し、
    　前記窓口部は、前記患者に対して給付した薬剤に関する情報を入力すると、前記入力した前記患者に対して給付した薬剤に関する情報を、前記制御部に送信し、
    　前記制御部は、前記患者に対して給付した薬剤に関する情報を、前記医療情報として、前記通信部に送信し、
    　前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信することを特徴とするメンバー装置。     5. The member device of the medical information management system according to claim 4, wherein
    Each of the member devices,
    A storage unit for holding the distributed ledger,
    A communication unit that communicates with another member device;
    A control unit for controlling the distributed ledger,
    A window section for inputting information on the medicine supplied to the patient,
    With
    The window section, when inputting information on the medicine delivered to the patient, transmits information on the medicine delivered to the inputted patient to the control section,
    The control unit transmits information on the medicine supplied to the patient as the medical information to the communication unit,
    The member device, wherein, when receiving the medical information from the control unit, the communication unit transmits the received medical information to the other member device.
  13. 　請求項１０記載の前記メンバー装置であって、
    　前記制御部は、前記医療情報と、前記医療情報の宛先とを、前記通信部に送信し、
    　前記通信部は、前記制御部から、前記医療情報を受信した場合に、受信した前記医療情報を前記他のメンバー装置に送信すると共に、前記医療情報を送信した旨を表す電子メールを、前記医療情報の宛先に送信することを特徴とするメンバー装置。     The member device according to claim 10, wherein
    The control unit transmits the medical information and a destination of the medical information to the communication unit,
    The communication unit, when receiving the medical information from the control unit, transmits the received medical information to the other member devices, and transmits an electronic mail indicating that the medical information has been transmitted to the medical device. A member device for transmitting to a destination of information.
  14. 　請求項９記載の前記メンバー装置であって、
    　前記記憶部は、複数メンバー分の複数の分散型帳簿を保持し、
    　前記制御部は、前記複数の分散型帳簿制御を制御し、
    　複数のメンバーに対するメンバー装置として機能することを特徴とするメンバー装置。     The member device according to claim 9, wherein
    The storage unit holds a plurality of distributed books for a plurality of members,
    The control unit controls the plurality of distributed ledger controls,
    A member device that functions as a member device for a plurality of members.
  15. 　請求項３記載の医療情報管理システムであって、
    　前記メンバー装置は、複数のグループに分けられ、
    　前記グループ毎に、承認メンバー装置が含まれ、
    　所定のグループに属する前記メンバー装置が前記医療情報を送信した場合に、前記所定のグループに属する前記承認メンバー装置が承認を行ってから、前記医療情報を前記分散眼他帳簿に記録することを特徴とする医療情報管理システム。     The medical information management system according to claim 3,
    The member devices are divided into a plurality of groups,
    Approved member devices are included for each group,
    When the member device belonging to a predetermined group transmits the medical information, after the approval member device belonging to the predetermined group approves, the medical information is recorded in the distributed eye / other book. And a medical information management system.
  16. 　請求項９記載の前記メンバー装置であって、
    　前記記憶部は、異なる前記医療情報管理システムの異なる前記分散型帳簿を記憶し、
    　前記制御部は、前記異なる前記医療情報管理システムに対して前記異なる前記分散型帳簿を制御し、
    　異なる前記医療機関情報管理システムのメンバー装置として機能することを特徴とするメンバー装置。     The member device according to claim 9, wherein
    The storage unit stores different distributed books of different medical information management systems,
    The control unit controls the different distributed books for the different medical information management systems,
    A member device that functions as a member device of a different medical institution information management system.
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