WO2020049656A1 - Système de gestion d'informations médicales et dispositif membre utilisé dans ce dernier - Google Patents

Système de gestion d'informations médicales et dispositif membre utilisé dans ce dernier 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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Prior art keywords
medical information
medical
member device
patient
control unit
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PCT/JP2018/032887
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English (en)
Japanese (ja)
Inventor
規 浦谷
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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/fr
Publication of WO2020049656A1 publication Critical patent/WO2020049656A1/fr

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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.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Primary Health Care (AREA)
  • Public Health (AREA)
  • Chemical & Material Sciences (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Medicinal Chemistry (AREA)
  • Medical Treatment And Welfare Office Work (AREA)

Abstract

Grâce à la présente invention, un historique de soins médicaux, etc, est géré par l'utilisation d'une base de données de registre distribué, des informations médicales sont mutuellement utilisées, un calcul de frais de services médicaux est facilité, un dosage approprié de médicaments est réalisé, et la santé du patient est favorisée. Un système de gestion d'informations médicales comprend une pluralité de dispositifs membres pour contenir un livre de comptes distribué afin d'enregistrer des informations médicales, le système de gestion d'informations médicales étant caractérisé en ce que chaque dispositif membre est pourvu d'une unité de mémoire pour contenir un livre de comptes distribué, d'une unité de communication pour communiquer avec un autre dispositif membre, et d'une unité de commande pour commander le livre de comptes distribué, l'unité de communication transmettant une transaction relative à un médicament à l'unité de commande lorsque des informations médicales sont reçues en provenance d'un autre dispositif membre et transmettant une approbation reçue à l'unité de commande lorsque l'approbation des informations médicales est reçue d'un autre dispositif membre, et l'unité de commande ajoute les informations médicales transmises au livre de comptes distribué mémorisé par l'unité de mémoire lorsqu'une approbation est transmise à partir d'un autre dispositif membre après la transmission des informations médicales à partir de l'unité de communication.
PCT/JP2018/032887 2018-09-05 2018-09-05 Système de gestion d'informations médicales et dispositif membre utilisé dans ce dernier WO2020049656A1 (fr)

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CN114565326B (zh) * 2022-04-29 2022-08-30 深圳市誉兴通科技股份有限公司 基于物联网的药品管理方法及系统

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