WO2022123735A1 - Second opinion assistance system - Google Patents

Second opinion assistance system Download PDF

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Publication number
WO2022123735A1
WO2022123735A1 PCT/JP2020/046093 JP2020046093W WO2022123735A1 WO 2022123735 A1 WO2022123735 A1 WO 2022123735A1 JP 2020046093 W JP2020046093 W JP 2020046093W WO 2022123735 A1 WO2022123735 A1 WO 2022123735A1
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medical
opinion
information
doctor
primary
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PCT/JP2020/046093
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French (fr)
Japanese (ja)
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純 岡崎
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株式会社Peco
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Priority to PCT/JP2020/046093 priority Critical patent/WO2022123735A1/en
Publication of WO2022123735A1 publication Critical patent/WO2022123735A1/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

Definitions

  • This disclosure relates to a second opinion support system.
  • the clinical path referred to here is, for example, medical treatment schedule data in which medical information regarding the schedule and results of medical treatment (diagnosis and treatment) given to a patient is recorded in chronological order.
  • the clinical path management system disclosed in Patent Document 1 is a doctor different from the attending physician when the patient wishes to obtain a second opinion, which is the opinion of a doctor different from the attending physician regarding the medical treatment content. It has a function to request a second opinion.
  • Patent Document 1 does not show any such needs and a specific configuration for meeting the needs.
  • one of the purposes of this disclosure is to construct a second opinion support system that can efficiently establish a division of labor between doctors or hospitals.
  • a satellite terminal related to a primary medical record connected by a network a center terminal related to a secondary medical record corresponding to the instructor of the primary medical record, and the primary medical record or the secondary medical record are disclosed.
  • a second opinion support system including a system server having an electronic medical record database for storing electronic medical record information involved in the creation of the doctor, wherein the system server is described by the primary medical doctor via the satellite terminal.
  • the second opinion acquisition request receiving unit that accepts the second opinion acquisition request, which is the opinion of the secondary medical doctor, and the electronic medical record information to the secondary medical doctor via the center terminal when the acquisition request is received.
  • a second opinion support system including a review request transmission unit that requests a review of the above, and a communication control unit that receives a review result of the electronic medical record information from the center terminal and transmits the review result to the satellite terminal.
  • the present disclosure comprises the following configurations.
  • [Item 1] Center Hospital + Satellite Hospital
  • the satellite terminal related to the primary medical record connected by the network, the center terminal related to the secondary medical record which is the instructor of the primary medical record, and the primary medical record or the secondary medical record were involved in the creation.
  • a second opinion support system equipped with a system server having an electronic medical record database for storing electronic medical record information.
  • the system server A second opinion acquisition request reception unit that receives a second opinion acquisition request, which is the opinion of the secondary opinion, from the primary clinic via the satellite terminal.
  • a review request transmission unit that requests the secondary medical doctor to review the electronic medical record information via the center terminal when the acquisition request is received.
  • a communication control unit that receives the review result of the electronic medical record information from the center terminal and transmits it to the satellite terminal.
  • Second opinion support system [Item 2] (Organization is hierarchically related / Master-apprentice structure)
  • the electronic medical record database stores identification information of a primary medical doctor who has a teacher-apprentice relationship with the secondary medical doctor in association with the destination information of the secondary medical doctor.
  • the review request transmitter is When the request for acquisition of the second opinion is received from the primary medical doctor, the electronic medical record information is requested to be reviewed for the destination indicated by the destination information corresponding to the identification information of the primary medical doctor. Second opinion support system.
  • [Item 3] (Secondary medical doctor nomination system) The second opinion support system according to item 1 or item 2.
  • a career information storage unit that stores career information related to the career of the secondary medical doctor, and It is provided with a nomination notification transmission unit that sends a nomination notification to the secondary medical doctor who is the nomination destination when the corresponding secondary medical doctor is nominated from the primary medical doctor based on the background information.
  • the communication control unit receives the review result of the electronic medical record information from the center terminal related to the secondary medical doctor who is the destination of the nomination notification, and is related to the primary medical doctor who is the nominating source of the secondary medical doctor.
  • Second opinion support system [Item 4] (Number of medical treatments / cases / others) The second opinion support system described in item 3, The career information regarding the career of the secondary doctor includes the specialized subject of the secondary doctor and the past medical records. Second opinion support system.
  • the second opinion support system is, for example, between a satellite terminal provided on the primary medical doctor side and a center terminal provided on the secondary medical doctor side who is the instructor of the primary medical doctor.
  • the secondary medical doctor can instruct the primary medical doctor about his / her skills regarding a specific medical practice while communicating with each other via a network and exchanging information between the primary medical doctor and the secondary medical doctor. It is configured in.
  • FIG. 1 is a diagram showing a configuration example of a second opinion support system 1 according to an embodiment of the present disclosure.
  • the second opinion support system 1 includes an owner terminal 10 related to an owner K1 having an animal patient, a satellite terminal 20 related to a primary medical doctor V1, and a primary medical doctor's instructor. It includes a center terminal 30 related to the secondary medical doctor V2, and a system server 40 that mediates each terminal.
  • the owner terminal 10, the satellite terminal 20, the center terminal 30, and the system server 40 are communicably connected via the network NW. It should be noted that this configuration is an example, and a certain configuration may have another configuration or may include another configuration.
  • the network NW assumes the Internet.
  • the network NW is constructed by, for example, a public telephone line network, a mobile phone line network, a wireless communication network, Ethernet (registered trademark), and the like.
  • the owner terminal 10 is a terminal operated by the owner K1 of the animal patient.
  • the owner terminal 10 can be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
  • the satellite terminal 20 is a terminal owned or rented by the primary medical doctor V1.
  • the satellite terminal 20 can be operated by the primary clinician V1.
  • the "satellite” is a unit of a facility or organization provided to achieve a specific purpose, and is a concept including, for example, a small-scale clinic, a specialized venture medical facility, a clinic, and the like.
  • the satellite terminal 20 may be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
  • the center terminal 30 is a terminal owned or rented by the secondary medical doctor V2.
  • the center terminal 30 can be operated by the secondary medical doctor V2.
  • a "center” is a unit of a facility or organization established to achieve a specific purpose, and is a comprehensive facility having more capital than, for example, a small-scale clinic, a specialized venture medical facility, or a clinic. It is a concept that includes large-scale facilities such as hospitals.
  • the center terminal 30 may be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
  • the satellite facility A is a clinic where the primary doctor V1 of the family doctor of the animal patient owned by the owner K1 works.
  • the center facility B is a hospital where the secondary medical doctor V2, who is the instructor of the primary medical doctor, works, and is a general hospital capable of providing acute care.
  • the satellite facility A and the center facility B are assumed to be dispersed in a certain range of areas, and can form one hospital group as hospitals of the same series. In the case of a hospital group, the electronic medical record information described later may be distributed and arranged for each hospital in the group.
  • the fixed range is, for example, within the same municipality, but may be a distance that can be used by the owner K1 and may include a plurality of adjacent municipalities.
  • the family doctor of the satellite facility A may create a medical treatment plan including not only the medical treatment of the satellite facility A but also the medical treatment of the center facility B when treating the animal patient owned by the owner K1.
  • a medical treatment plan including not only the medical treatment of the satellite facility A but also the medical treatment of the center facility B when treating the animal patient owned by the owner K1.
  • an animal patient may visit Center Facility B to receive acute care.
  • the doctor or the like working at the center facility B may prepare a medical treatment plan including the medical treatment by the satellite facility A for the follow-up or outpatient treatment after the acute phase.
  • the provision of medical services to patients in cooperation with a plurality of medical facilities in the region in this way is referred to as "comprehensive community care" for convenience of explanation.
  • the second opinion support system 1 in this embodiment supports such community-based comprehensive care.
  • the second opinion support system 1 shares electronic medical record information representing the condition of an animal patient, and supports medical treatment by a plurality of medical institutions based on such information.
  • the medical practice here is a concept including medical examination and treatment provided by a medical institution to an animal patient.
  • the examination or treatment includes various medical services such as examination, surgery, medication, rehabilitation, and follow-up.
  • satellite facility A is in charge of a common test (screening test) that must be basically performed in medical treatment or a part in which the medical treatment content is predetermined.
  • a common test screening test
  • satellite facility A and center facility B are given as examples of a plurality of medical institutions, but the types and numbers of medical institutions are not limited to these.
  • the medical institution may include a hospital or a business operator that provides home medical care.
  • the system server 40 operates as a terminal that mediates between the owner terminal 10, the satellite terminal 20, and the center terminal 30.
  • the system server 40 may be managed directly by, for example, a medical institution, or may be managed by an organization that manages the medical institution, or a servicer that provides a second opinion support system 1 for at least one medical institution.
  • the system server 40 may be a general-purpose computer such as a workstation or a personal computer, or may be logically realized by cloud computing.
  • FIG. 2 is a diagram showing a hardware configuration example of a computer that realizes the system server 40 according to the present embodiment.
  • the computer includes at least a control unit 41, a memory 42, a storage 43, a communication unit 44, an input / output unit 45, and the like. These are electrically connected to each other through the bus 46.
  • the control unit 41 is an arithmetic unit that controls the operation of the entire system server 40, controls the transmission and reception of data between each element, and performs information processing necessary for application execution and authentication processing.
  • the control unit 41 is a processor such as a CPU (Central Processing Unit), and executes each information processing by executing a program or the like stored in the storage 43 and expanded in the memory 42.
  • CPU Central Processing Unit
  • the memory 42 includes a main storage composed of a volatile storage device such as a DRAM (Dynamic RandomAccessMemory) and an auxiliary storage composed of a flash memory or a non-volatile storage device such as an HDD (Hard Disk Drive). ..
  • the memory 42 is used as a work area or the like of the control unit 11, and also stores a BIOS (Basic Input / Output System) executed when the system server 40 is started, various setting information, and the like.
  • BIOS Basic Input / Output System
  • the storage 43 stores various programs such as application programs.
  • a database storing data used for each process may be built in the storage 43.
  • the communication unit 44 connects the system server 40 to the network NW.
  • the communication unit 44 may use, for example, a wired LAN (Local Area Network), wireless LAN, Wi-Fi (Wireless Fidelity, registered trademark), infrared communication, Bluetooth (registered trademark), short-range or non-contact communication, or the like. Communicate directly with the device or via a network access point.
  • the input / output unit 45 is, for example, an information input device such as a keyboard, a mouse, and a touch panel, and an output device such as a display.
  • the bus 46 is commonly connected to each of the above elements and transmits, for example, an address signal, a data signal, and various control signals.
  • the hardware configuration of a terminal such as a computer or a smartphone that realizes the owner terminal 10, the satellite terminal 20, and the center terminal 30 according to the present embodiment is the same as the hardware configuration example of the system server 40 shown in FIG. 2. Is omitted.
  • FIG. 3 is a diagram showing a software configuration example of the system server 40 according to the present embodiment.
  • the system server 40 includes an electronic medical record DB 400, a second opinion acquisition request reception unit 401, a review request transmission unit 402, a communication control unit 403, a history information storage unit 404, and a nomination notification transmission unit 405.
  • the electronic medical record DB 400 can be realized as a part of the storage area provided by the memory 42 and the storage 43.
  • the electronic medical record DB 400 may be realized as a part of an external storage area provided by one or a plurality of servers other than the system server 40.
  • Each unit 401 to 405 can be realized by the control unit 41 reading the program stored in the storage 43 into the memory 42 and executing the program.
  • the electronic medical record DB 400 is a database for managing the electronic medical record information involved in the creation of the primary medical record doctor V1 or the secondary medical record doctor V2.
  • Order means to include either or both of the primary clinician V1 and the secondary clinician V2.
  • Involvement means, for example, being actively or passively involved in at least a part of the procedures included in the process of creating electronic medical record information.
  • FIG. 4 is a diagram showing an example of the electronic medical record DB 400 according to the present embodiment.
  • the electronic medical record information is managed in association with, for example, an animal patient ID which is an identifier uniquely identifying an animal patient.
  • electronic medical record information for each animal patient is managed for each consultation day.
  • the items included in the electronic medical record information include animal information, interview information, physical findings, medical history, examination information, diagnostic information, treatment / medication information, prescription information, memos, image information, and the like.
  • the animal information includes the animal species information to which the animal patient is applicable.
  • animal species information include dogs, foxes, tanukis, phenecks, cats, hamsters, guinea pigs, pigeons, shimaris, taiwan squirrels, prairie dogs, momonga, rabbits, monkeys, miniature pigs, ferret, skunks, donkeys, horses (miniature horses, farabella).
  • Interview information is subjective information (chief complaint) obtained from the owner. For example, “I don't eat much rice”, “I have scratches on my legs”, “I'm getting fat”, “I'm not feeling well”, “I have a runny nose”, etc. It is an observed symptom.
  • the interview information may be obtained from the owner using a questionnaire or a questionnaire terminal when visiting a veterinary hospital, or it may be obtained by having the owner enter it in advance using a mobile terminal or the like owned by the owner. May be good. Interviews are also conducted at the time of admission and surgery, and the interview information may be included in the hospitalization chart information and the surgery chart information.
  • Physical findings are physical information that can be examined by veterinarians at veterinary hospitals and can be expressed as objective numerical values. For example, “weight”, “body temperature”, “heart rate”, “respiratory rate” and the like.
  • Medical history is subjective information heard by veterinarians and others.
  • the medical history is often the same as the above-mentioned interview information, but it also includes items that are difficult for the owner to actually confirm, such as "red throat”.
  • the information that "hematuria is occurring” is obtained from the interview information, the current medical history that "bleeding from the anus” may be heard when examined by a veterinarian or the like.
  • the test information includes at least the contents of the tests that the animal patient has received in the past.
  • the test information may include tests that have been performed in the past visits, hospitalizations or surgery, tests that have been performed in the examination, and the like.
  • the reaction to the test (information on the acceptability / permissibility of the test itself, such as whether or not it was disliked) may be associated and stored.
  • the diagnostic information includes at least the history of diagnoses received by the animal patient in the past.
  • the diagnostic information can include information such as the name of a specific disease or injury that has occurred in the past. Diagnostic information may include information about diagnoses suspected in previous visits, hospitalizations or surgery.
  • the treatment / medication information includes information regarding the treatment or medication that the animal patient has received in the past.
  • the treatment / dosing information may be associated with and stored in response to the treatment or medication (information regarding the acceptability / tolerance of the treatment or the medication itself, such as whether or not the patient disliked it or whether it affected the physical condition).
  • the contents of the treatment include, for example, anal gland treatment, nail cutting treatment, sole treatment, ear treatment, hair removal, ophthalmic treatment, dental treatment, Elizabeth color / abdominal band, acupuncture and moxibustion treatment, indwelling, stool removal, thread removal, disinfection, oxygen.
  • Treatment emetic treatment, emergency resuscitation treatment, drainage, forced feeding, washing, exclusion, massage, microchip, trimming, catheter, rehabilitation, surgery, anesthesia, hospitalization, injection, blood transfusion, drip, examination, radiation treatment, various docks, Nursing care, hygiene treatment, shampoo, training, supplements, snacks, contraception, neutering, flea mite extermination, mad dog disease medicine, vaccines, foods, internal medicines, ear drops, nasal drops, eye drops, external medicines (ointments / creams), external use Examples include medicines (disinfectants / sprays), local medicines, and prevention of filaria, but this is not the case.
  • Prescription information includes drugs, etc. prescribed by the animal patient in the past.
  • the user's mobile terminal contains information on the acceptability / acceptability of the treatment or the medication itself, such as whether or not the drug prescribed at home could be taken, whether or not it was disliked, and whether or not it affected the physical condition. It may be acquired and added via.
  • the memo is text data input by the doctor in charge of medical examination, hospitalization or surgery, the nurse in charge, the office work in charge, etc.
  • the image information is an image of an animal patient.
  • the image information may be a still image or a moving image.
  • the electronic medical record DB 400 has a data table that stores identification information of the primary medical doctor V1 who has a master-student relationship with the secondary medical doctor V2 in association with the destination information of the secondary medical doctor V2.
  • the "teacher-disciple relationship" is, for example, a relationship in which the knowledge and skills cultivated through experience are transferred, and the side to be taught is the platform and the side to be taught is the teacher.
  • the primary medical doctor V1 who diagnoses or treats at satellite facility A is a modifier
  • the more experienced specialist in the education staff
  • the secondary medical doctor V2 who works at center facility B is a teacher. be.
  • FIG. 5 is a table configuration diagram showing the relationship between the primary clinician V1 and the secondary clinician V2.
  • the table configuration shown in FIG. 5 can be obtained by a general method.
  • the organization information and the person information belonging to the organization are managed by the organization table 400A, the department table 400B, the organization affiliation table 400C, the person table 400D, and the person relationship degree table 400E, which are known information.
  • the organization table 400A is a table showing the correspondence between the organization ID and the organization name.
  • the department table 400B is a diagram showing the correspondence between the organization ID, the department ID, the department name, and the parent department ID.
  • the organization affiliation table 400C is associated with an organization ID, a department ID, a job type, and a designated ID.
  • the person table 400D is a table showing the relationship between the person ID and its name.
  • the person relationship degree table 400E is a table showing the relationship between a person ID and another person ID.
  • the second opinion acquisition request receiving unit 401 has a function of receiving a second opinion acquisition request, which is the opinion of the secondary medical doctor V2, from the primary medical doctor V1 via the satellite terminal 20.
  • the review request transmitting unit 402 has a function of requesting the secondary medical doctor V2 to review the electronic medical record information via the center terminal 30 when the second opinion acquisition request receiving unit 401 accepts the second opinion acquisition request.
  • the “review” is, for example, when a primary medical doctor V1 who diagnoses or treats in a medical field performs a double check by asking the secondary medical doctor V2 who is in charge of education for advice (providing diagnostic information, etc.). To say.
  • the communication control unit 403 has a function of receiving the review result of the electronic medical record information from the center terminal 30 and transmitting it to the satellite terminal 20.
  • the primary medical doctor V1 performs all face-to-face medical practices such as diagnosis or treatment.
  • the secondary medical doctor V2 looks over the electronic medical record information that the primary medical doctor V1 was involved in creating (double check). Then, at an appropriate timing, as the opinion of the secondary clinician V2, for example, "I think that the findings on the heartbeat are the same as the primary clinician V1 in my opinion, so I think it is appropriate.” "I think it's good" is sent to the primary clinician V1 in the form of a report, for example.
  • the career information storage unit 404 has a function of storing career information related to the career of the secondary medical doctor V2.
  • Such background information includes at least the specialized subjects of the secondary medical doctor V2 and the past medical records.
  • the nomination notification transmission unit 405 When the nomination notification transmission unit 405 receives the nomination of the corresponding secondary medical doctor V2 from the primary medical doctor V1 based on the background information, the nomination notification transmission unit 405 sends a nomination notification to the secondary medical doctor V2 to which the nomination is made. It has a function to send.
  • the communication control unit 403 receives the review result of the electronic medical record information from the center terminal 30 related to the secondary medical doctor V2 to which the nomination notification transmission unit 405 sends the nomination notification, and the communication control unit 403 receives the review result of the electronic medical record information at the nomination source of the secondary medical doctor V2. It is transmitted to the satellite terminal 20 related to a certain primary medical doctor V1.
  • FIG. 6 is a diagram schematically showing an example of a processing flow by the second opinion support system 1 according to the present embodiment.
  • the primary medical doctor V1 performs medical treatment for an animal patient (step S100).
  • the medical treatment here may be performed by online medical treatment using a video call or the like, or may be performed face-to-face.
  • This medical record result is transmitted from the satellite terminal 20 to the system server 40 and stored in the electronic medical record DB 400 as the electronic medical record information that the primary medical doctor V1 was involved in creating (step S102).
  • the second opinion acquisition request receiving unit 401 included in the system server 40 receives the second opinion acquisition request from the satellite terminal 20 (step S104).
  • the review request transmission unit 402 requests the secondary medical record information V2 indicated by the destination information corresponding to the identification information of the primary medical record doctor V1 to review the electronic medical record information (step S106).
  • the secondary medical doctor V2 which is the request destination, creates a review for the electronic medical record information (step S108) and transmits it to the system server 40 via the center terminal 30 (step S110).
  • the communication control unit 403 included in the system server 40 receives the review result from the secondary medical doctor V2 (step S112) and transmits it to the primary medical doctor V1 (step S114).
  • the second opinion support system 1 does not complete the medical practice such as diagnosis or treatment for one animal patient by one veterinarian, but another veterinarian always relates to the animal patient.
  • a so-called two-stage division of labor system for checking electronic medical record information is in mind.
  • the medical system based on this two-stage stance gives the owner of the animal patient a sense of conviction about the medical practice, and can alleviate the anxious feelings of the owner compared to the case where a single veterinarian performs the medical practice. As a result, the knowledge gap between the medical staff such as veterinarians and the owners of animal patients can be effectively corrected.
  • the second opinion support system 1 it is possible to efficiently establish a division of labor system between doctors or hospitals.
  • the series of processes by the apparatus described in the present specification may be realized by using any of software, hardware, and a combination of software and hardware. It is also possible to provide a computer-readable recording medium in which such a computer program is stored.
  • the recording medium is, for example, a magnetic disk, an optical disk, a magneto-optical disk, a flash memory, or the like. Further, the above computer program may be distributed, for example, via a network without using a recording medium.
  • Second opinion support system 10 Owner terminal 20 Satellite terminal 30 Center terminal 40 System server 400 Electronic medical record DB 401 Second opinion acquisition request reception unit 402 Review request transmission unit 403 Communication control unit 404 Academic information storage unit 405 Nomination notification transmission unit K1 Owner V1 Primary medical doctor V2 Secondary medical doctor

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  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
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Abstract

[Problem] To construct a second opinion assistance system which enables efficient setting of division of work among medical practitioners or among medical institutions. [Solution] A second opinion assistance system according to the present disclosure is provided with: a satellite terminal related to a primary medical practitioner; a center terminal related to a secondary medical practitioner who is a medical advisor for the primary medical practitioner; and a system server that has an electronic medical chart database for storing electronic medical chart information generated through involvement by the primary medical practitioner or by the secondary medical practitioner. The system server is provided with: a second opinion acquisition request reception unit that receives, from the primary medical practitioner through the satellite terminal, an acquisition request for a second opinion which is an opinion by the secondary medical practitioner; a review request transmission unit that, upon reception of the acquisition request, gives a request for review on electronic medical chart information to the secondary medical practitioner through the center terminal; and a communication control unit that receives, from the center terminal, results of the review on the electronic medical chart information and transmits the results to the satellite terminal.

Description

セカンドオピニオン支援システムSecond opinion support system
　本開示は、セカンドオピニオン支援システムに関する。 This disclosure relates to a second opinion support system.
　従来、医療分野において、患者の診療情報を記録したクリニカルパスを管理するクリニカルパス管理システムが知られている。ここでいうクリニカルパスとは、例えば、患者に対して施される診療（診断及び治療）の予定と実績に関する診療情報を時系列に記録した診療スケジュールデ一タである。 Conventionally, in the medical field, a clinical path management system that manages a clinical path that records medical information of a patient is known. The clinical path referred to here is, for example, medical treatment schedule data in which medical information regarding the schedule and results of medical treatment (diagnosis and treatment) given to a patient is recorded in chronological order.
　具体的に、特許文献１に開示されたクリニカルパス管理システムは、患者が、診療内容に関して、主治医とは別の医師の意見であるセカンドオピニオンの取得を希望する場合に、主治医とは別の医師に対して、セカンドオピニオンを依頼する機能を備えている。 Specifically, the clinical path management system disclosed in Patent Document 1 is a doctor different from the attending physician when the patient wishes to obtain a second opinion, which is the opinion of a doctor different from the attending physician regarding the medical treatment content. It has a function to request a second opinion.
国際公開第２０１５／０４５９７１号International Publication No. 2015/045791
  近年、患者のかかりつけ医が、自らが勤める医療機関だけではなく、他の医療機関とも積極的に連携して患者に対する診療を支援するような分業体制へのニーズが存在する。このようなニーズおよび当該ニーズに応える具体的な構成について、特許文献１には何ら示されていない。 In recent years, there has been a need for a division of labor system in which patients' family doctors actively cooperate not only with the medical institution they work for but also with other medical institutions to support medical care for patients. Patent Document 1 does not show any such needs and a specific configuration for meeting the needs.
　特に動物を患者とする診療の場合、人間の診療とは異なり、動物種又は個体差によって適応できる検査、診断、処置、投薬及び処方が根本的に異なることから、このような傾向は顕著に現れると考えられる。 Especially in the case of medical care with animals as patients, this tendency is remarkable because the tests, diagnoses, treatments, medications and prescriptions that can be applied differ depending on the animal species or individual differences, unlike human medical care. it is conceivable that.
　そこで、本開示は、医師間又は病院間で効率的に分業体制を整えることのできるセカンドオピニオン支援システムを構築することを一つの目的とする。 Therefore, one of the purposes of this disclosure is to construct a second opinion support system that can efficiently establish a division of labor between doctors or hospitals.
　本発明者は、上記目的を達成するため鋭意検討した結果、下記の構成により、医師間又は病院間で効率的に分業体制を整えることのできるセカンドオピニオン支援システムを構築することができることを見出し、本発明を完成した。 As a result of diligent studies to achieve the above object, the present inventor has found that a second opinion support system capable of efficiently establishing a division of labor between doctors or hospitals can be constructed by the following configuration. The present invention has been completed.
　すなわち、本開示は、ネットワークで接続された、一次診療医に関連するサテライト端末と、前記一次診療医の指導医にあたる二次診療医に関連するセンタ端末と、前記一次診療医又は前記二次診療医が作成に関与した電子カルテ情報を格納する電子カルテデータベースを有するシステムサーバと、を備えたセカンドオピニオン支援システムであって、前記システムサーバは、前記一次診療医から前記サテライト端末を介して、前記二次診療医の意見であるセカンドオピニオンの取得要求を受け付けるセカンドオピニオン取得要求受付部と、前記取得要求を受け付けた場合に、前記二次診療医に対して前記センタ端末を介して前記電子カルテ情報のレビューを要求するレビュー要求送信部と、前記電子カルテ情報のレビュー結果を前記センタ端末から受信して前記サテライト端末に送信する通信制御部と、を備える、セカンドオピニオン支援システムを提供する。 That is, in the present disclosure, a satellite terminal related to a primary medical record connected by a network, a center terminal related to a secondary medical record corresponding to the instructor of the primary medical record, and the primary medical record or the secondary medical record are disclosed. A second opinion support system including a system server having an electronic medical record database for storing electronic medical record information involved in the creation of the doctor, wherein the system server is described by the primary medical doctor via the satellite terminal. The second opinion acquisition request receiving unit that accepts the second opinion acquisition request, which is the opinion of the secondary medical doctor, and the electronic medical record information to the secondary medical doctor via the center terminal when the acquisition request is received. Provided is a second opinion support system including a review request transmission unit that requests a review of the above, and a communication control unit that receives a review result of the electronic medical record information from the center terminal and transmits the review result to the satellite terminal.
　本開示によれば、医師間又は病院間で効率的に分業体制を整えることのできるセカンドオピニオン支援システムを構築することができる。 According to this disclosure, it is possible to construct a second opinion support system that can efficiently establish a division of labor between doctors or hospitals.
本開示の一実施形態に係るセカンドオピニオン支援システムの構成例を示す図である。It is a figure which shows the configuration example of the second opinion support system which concerns on one Embodiment of this disclosure. 本開示の一実施形態に係るシステムサーバ４０を実現するコンピュータのハードウェア構成例を示す図である。It is a figure which shows the hardware configuration example of the computer which realizes the system server 40 which concerns on one Embodiment of this disclosure. 本開示の一実施形態に係るシステムサーバ４０のソフトウェア構成例を示す図である。It is a figure which shows the software configuration example of the system server 40 which concerns on one Embodiment of this disclosure. 本開示の一実施形態に係る電子カルテＤＢ４００の一例を示す図である。It is a figure which shows an example of the electronic medical record DB 400 which concerns on one Embodiment of this disclosure. 一次診療医Ｖ１と二次診療医Ｖ２との関係を示すテーブル構成図である。It is a table block diagram which shows the relationship between the primary medical doctor V1 and the secondary medical doctor V2. 本開示の一実施形態に係るセカンドオピニオン支援システム１による処理の流れの一例を概略的に示す図である。It is a figure which shows the example of the process flow by the second opinion support system 1 which concerns on one Embodiment of this disclosure schematically.
　本開示の実施形態の内容を列記して説明する。本開示は、以下のような構成を備える。
［項目１］（センタ病院＋サテライト病院）
　ネットワークで接続された、一次診療医に関連するサテライト端末と、前記一次診療医の指導医にあたる二次診療医に関連するセンタ端末と、前記一次診療医又は前記二次診療医が作成に関与した電子カルテ情報を格納する電子カルテデータベースを有するシステムサーバと、を備えたセカンドオピニオン支援システムであって、
　前記システムサーバは、
　前記一次診療医から前記サテライト端末を介して、前記二次診療医の意見であるセカンドオピニオンの取得要求を受け付けるセカンドオピニオン取得要求受付部と、
　前記取得要求を受け付けた場合に、前記二次診療医に対して前記センタ端末を介して前記電子カルテ情報のレビューを要求するレビュー要求送信部と、
　前記電子カルテ情報のレビュー結果を前記センタ端末から受信して前記サテライト端末に送信する通信制御部と、
　を備える、
セカンドオピニオン支援システム。
［項目２］（組織を上下関係にする／師弟構造）
　項目１に記載のセカンドオピニオン支援システムであって、
　前記電子カルテデータベースには、前記二次診療医の宛先情報に対応付けて、当該二次診療医と直下の師弟関係となる一次診療医の識別情報が格納されており、
　前記レビュー要求送信部は、
　前記一次診療医から前記セカンドオピニオンの取得要求を受け付けた場合に、前記一次診療医の識別情報に対応する前記宛先情報が示す宛先に対して前記電子カルテ情報のレビューを要求する、
セカンドオピニオン支援システム。
［項目３］（二次診療医の指名制度）
　項目１又は項目２に記載のセカンドオピニオン支援システムであって、
　前記二次診療医の経歴に関する経歴情報を記憶する経歴情報記憶部と、
　前記経歴情報に基づいて、対応する二次診療医の指名を一次診療医から受け付けた場合に、その指名先である二次診療医に対して指名通知を送信する指名通知送信部と、を備え、
　前記通信制御部は、前記指名通知の送信先である二次診療医に関連するセンタ端末から前記電子カルテ情報のレビュー結果を受信して前記二次診療医の指名元である一次診療医に関連するサテライト端末に送信する、
セカンドオピニオン支援システム。
［項目４］（診療件数／症例／その他）
　項目３に記載のセカンドオピニオン支援システムであって、
　前記二次診療医の経歴に関する経歴情報には、前記二次診療医の専門科目、過去の診療実績が含まれる、
セカンドオピニオン支援システム。 The contents of the embodiments of the present disclosure will be listed and described. The present disclosure comprises the following configurations.
[Item 1] (Center Hospital + Satellite Hospital)
The satellite terminal related to the primary medical record connected by the network, the center terminal related to the secondary medical record which is the instructor of the primary medical record, and the primary medical record or the secondary medical record were involved in the creation. A second opinion support system equipped with a system server having an electronic medical record database for storing electronic medical record information.
The system server
A second opinion acquisition request reception unit that receives a second opinion acquisition request, which is the opinion of the secondary opinion, from the primary clinic via the satellite terminal.
A review request transmission unit that requests the secondary medical doctor to review the electronic medical record information via the center terminal when the acquisition request is received.
A communication control unit that receives the review result of the electronic medical record information from the center terminal and transmits it to the satellite terminal.
To prepare
Second opinion support system.
[Item 2] (Organization is hierarchically related / Master-apprentice structure)
The second opinion support system described in item 1, which is the second opinion support system.
The electronic medical record database stores identification information of a primary medical doctor who has a teacher-apprentice relationship with the secondary medical doctor in association with the destination information of the secondary medical doctor.
The review request transmitter is
When the request for acquisition of the second opinion is received from the primary medical doctor, the electronic medical record information is requested to be reviewed for the destination indicated by the destination information corresponding to the identification information of the primary medical doctor.
Second opinion support system.
[Item 3] (Secondary medical doctor nomination system)
The second opinion support system according to item 1 or item 2.
A career information storage unit that stores career information related to the career of the secondary medical doctor, and
It is provided with a nomination notification transmission unit that sends a nomination notification to the secondary medical doctor who is the nomination destination when the corresponding secondary medical doctor is nominated from the primary medical doctor based on the background information. ,
The communication control unit receives the review result of the electronic medical record information from the center terminal related to the secondary medical doctor who is the destination of the nomination notification, and is related to the primary medical doctor who is the nominating source of the secondary medical doctor. Send to satellite terminals,
Second opinion support system.
[Item 4] (Number of medical treatments / cases / others)
The second opinion support system described in item 3,
The career information regarding the career of the secondary doctor includes the specialized subject of the secondary doctor and the past medical records.
Second opinion support system.
＜実施の形態の詳細＞
　以下、本開示の実施の形態について、図面を参照しながら説明する。なお、本明細書及び図面において、実質的に同一の機能構成を有する構成要素については、同一の符号を付することにより重複説明を省略する。 <Details of the embodiment>
Hereinafter, embodiments of the present disclosure will be described with reference to the drawings. In the present specification and the drawings, components having substantially the same functional configuration are designated by the same reference numerals, so that duplicate description will be omitted.
＜概要＞
　本開示の実施の形態に係るセカンドオピニオン支援システムは、例えば、一次診療医側に設けられたサテライト端末と、一次診療医の指導医にあたる二次診療医側に設けられたセンタ端末との間を、ネットワークを介して通信接続しておき、一次診療医と二次診療医とが相互に情報授受しながら、二次診療医が特定の医療行為に関して自己の技能を一次診療医に対して指導可能に構成されている。 <Overview>
The second opinion support system according to the embodiment of the present disclosure is, for example, between a satellite terminal provided on the primary medical doctor side and a center terminal provided on the secondary medical doctor side who is the instructor of the primary medical doctor. , The secondary medical doctor can instruct the primary medical doctor about his / her skills regarding a specific medical practice while communicating with each other via a network and exchanging information between the primary medical doctor and the secondary medical doctor. It is configured in.
＜システム構成＞
　図１は、本開示の一実施形態に係るセカンドオピニオン支援システム１の構成例を示す図である。図示するように、本実施形態に係るセカンドオピニオン支援システム１は、動物患者を保有する飼主Ｋ１に関連する飼主端末１０と、一次診療医Ｖ１に関連するサテライト端末２０と、一次診療医の指導医にあたる二次診療医Ｖ２に関連するセンタ端末３０と、各端末を仲介するシステムサーバ４０と、を備える。飼主端末１０と、サテライト端末２０と、センタ端末３０と、システムサーバ４０とは、ネットワークＮＷを介して通信可能に接続されている。なお、本構成は一例であり、ある構成が他の構成を兼ね備えていたり、他の構成が含まれていたりしてもよい。 <System configuration>
FIG. 1 is a diagram showing a configuration example of a second opinion support system 1 according to an embodiment of the present disclosure. As shown in the figure, the second opinion support system 1 according to the present embodiment includes an owner terminal 10 related to an owner K1 having an animal patient, a satellite terminal 20 related to a primary medical doctor V1, and a primary medical doctor's instructor. It includes a center terminal 30 related to the secondary medical doctor V2, and a system server 40 that mediates each terminal. The owner terminal 10, the satellite terminal 20, the center terminal 30, and the system server 40 are communicably connected via the network NW. It should be noted that this configuration is an example, and a certain configuration may have another configuration or may include another configuration.
　本実施形態においてネットワークＮＷはインターネットを想定している。ネットワークＮＷは、例えば、公衆電話回線網、携帯電話回線網、無線通信網、イーサネット（登録商標）などにより構築される。 In this embodiment, the network NW assumes the Internet. The network NW is constructed by, for example, a public telephone line network, a mobile phone line network, a wireless communication network, Ethernet (registered trademark), and the like.
　飼主端末１０は、動物患者の飼主Ｋ１が操作する端末である。例えば、飼主端末１０は、携帯電話、スマートフォン、タブレットコンピュータ又はパーソナルコンピュータ等であり得る。 The owner terminal 10 is a terminal operated by the owner K1 of the animal patient. For example, the owner terminal 10 can be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
　サテライト端末２０は、一次診療医Ｖ１が所有する又は貸与されている端末である。サテライト端末２０は、一次診療医Ｖ１により操作され得る。ここで、「サテライト」とは、特定の目的を達成するために設けられた施設又は組織の単位であり、例えば、小規模医院、専門的ベンチャー医療施設、クリニック等などを含む概念である。なお、サテライト端末２０は、携帯電話、スマートフォン、タブレットコンピュータ又はパーソナルコンピュータ等であり得る。 The satellite terminal 20 is a terminal owned or rented by the primary medical doctor V1. The satellite terminal 20 can be operated by the primary clinician V1. Here, the "satellite" is a unit of a facility or organization provided to achieve a specific purpose, and is a concept including, for example, a small-scale clinic, a specialized venture medical facility, a clinic, and the like. The satellite terminal 20 may be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
　センタ端末３０は、二次診療医Ｖ２が所有する又は貸与されている端末であるセンタ端末３０は、二次診療医Ｖ２により操作され得る。ここで、「センタ」とは、特定の目的を達成するために設けられた施設又は組織の単位であり、例えば、小規模医院、専門的ベンチャー医療施設、クリニック等と比べて資本力のある総合病院などの大規模施設を含む概念である。なお、センタ端末３０は、携帯電話、スマートフォン、タブレットコンピュータ又はパーソナルコンピュータ等であり得る。 The center terminal 30 is a terminal owned or rented by the secondary medical doctor V2. The center terminal 30 can be operated by the secondary medical doctor V2. Here, a "center" is a unit of a facility or organization established to achieve a specific purpose, and is a comprehensive facility having more capital than, for example, a small-scale clinic, a specialized venture medical facility, or a clinic. It is a concept that includes large-scale facilities such as hospitals. The center terminal 30 may be a mobile phone, a smartphone, a tablet computer, a personal computer, or the like.
　本実施形態では、サテライト施設Ａは、飼主Ｋ１が保有する動物患者のかかりつけ医の一次診療医Ｖ１が勤務する診療所であるものとする。また、センタ施設Ｂは、一次診療医の指導医にあたる二次診療医Ｖ２が勤務する病院であって、急性期医療を提供可能な総合病院であるものとする。また、サテライト施設Ａと、センタ施設Ｂとは、一定の範囲の地域内に分散して存在するものとし、同系列の病院として一つの病院グループを構成し得る。病院グループの場合、後述する電子カルテ情報は、グループ内の病院毎に分散して配置され得る。なお、一定の範囲とは、例えば同一市町村内等とするが、飼主Ｋ１が利用可能な距離であればよく、隣接する複数の市町村を含むものとしてもよい。 In the present embodiment, the satellite facility A is a clinic where the primary doctor V1 of the family doctor of the animal patient owned by the owner K1 works. Further, the center facility B is a hospital where the secondary medical doctor V2, who is the instructor of the primary medical doctor, works, and is a general hospital capable of providing acute care. Further, the satellite facility A and the center facility B are assumed to be dispersed in a certain range of areas, and can form one hospital group as hospitals of the same series. In the case of a hospital group, the electronic medical record information described later may be distributed and arranged for each hospital in the group. The fixed range is, for example, within the same municipality, but may be a distance that can be used by the owner K1 and may include a plurality of adjacent municipalities.
　かかる構成のもと、サテライト施設Ａのかかりつけ医は、飼主Ｋ１が保有する動物患者に対する診療に際して、サテライト施設Ａのみならず、センタ施設Ｂよる診療を含んだ形での診療計画を作成する場合がある。例えば、動物患者が急性期医療を受けるためにセンタ施設Ｂを受診する場合がある。このような場合は、センタ施設Ｂに勤務する医師等は、急性期後の経過観察又は通院治療については、サテライト施設Ａによる診療を含む診療計画を作成する場合がある。このように地域内の複数の医療施設が連携して患者に対して医療サービスを提供することを、説明の便宜上、「地域包括ケア」と呼ぶことにする。 Under such a configuration, the family doctor of the satellite facility A may create a medical treatment plan including not only the medical treatment of the satellite facility A but also the medical treatment of the center facility B when treating the animal patient owned by the owner K1. be. For example, an animal patient may visit Center Facility B to receive acute care. In such a case, the doctor or the like working at the center facility B may prepare a medical treatment plan including the medical treatment by the satellite facility A for the follow-up or outpatient treatment after the acute phase. The provision of medical services to patients in cooperation with a plurality of medical facilities in the region in this way is referred to as "comprehensive community care" for convenience of explanation.
　本実施形態におけるセカンドオピニオン支援システム１は、このような地域包括ケアを支援するものである。例えば、セカンドオピニオン支援システム１は、動物患者の状態を表す電子カルテ情報を共有し、かかる情報に基づいて複数の医療機関による診療行為を支援する。 The second opinion support system 1 in this embodiment supports such community-based comprehensive care. For example, the second opinion support system 1 shares electronic medical record information representing the condition of an animal patient, and supports medical treatment by a plurality of medical institutions based on such information.
　ここでの診療行為は、動物患者に対して医療機関が提供する診察および治療を含む概念である。本実施形態においては、診察または治療には、検査、手術、投薬、リハビリ、および経過観察等の各種の医療サービスが含まれるものとする。 The medical practice here is a concept including medical examination and treatment provided by a medical institution to an animal patient. In this embodiment, the examination or treatment includes various medical services such as examination, surgery, medication, rehabilitation, and follow-up.
　本実施形態では、例えば、診療に際して基本的に行われなければならない共通検査（スクリーニング検査）であったり、診療内容が予め定まっている部分であったりについてはサテライト施設Ａが担当し、その一方で、サテライト施設Ａで捌き切れないような難しい症例（特殊事例）についてはセンタ施設Ｂにオーダーを回すといった、いわば二段構えによる分業体制が念頭に置かれている。 In this embodiment, for example, satellite facility A is in charge of a common test (screening test) that must be basically performed in medical treatment or a part in which the medical treatment content is predetermined. For difficult cases (special cases) that cannot be handled at satellite facility A, an order is sent to center facility B, so to speak, a two-stage division of labor system is in mind.
　図１に示す例では、複数の医療機関の例としてサテライト施設Ａ、センタ施設Ｂを挙げたが、医療機関の種類および数はこれらに限定されるものではない。例えば、医療機関として、在宅医療を提供する病院または業者等を含むものとしてもよい。 In the example shown in FIG. 1, satellite facility A and center facility B are given as examples of a plurality of medical institutions, but the types and numbers of medical institutions are not limited to these. For example, the medical institution may include a hospital or a business operator that provides home medical care.
　システムサーバ４０は、飼主端末１０と、サテライト端末２０と、センタ端末３０と、を仲介する端末として動作する。システムサーバ４０は、例えば、医療機関において直接的に管理されてもよいし、医療機関を経営する組織、少なくとも一の医療機関に係るセカンドオピニオン支援システム１を提供するサービサーにおいて管理されてもよい。システムサーバ４０は、例えば、ワークステーション又はパーソナルコンピュータのような汎用コンピュータとしてもよいし、或いはクラウドコンピューティングによって論理的に実現されてもよい。 The system server 40 operates as a terminal that mediates between the owner terminal 10, the satellite terminal 20, and the center terminal 30. The system server 40 may be managed directly by, for example, a medical institution, or may be managed by an organization that manages the medical institution, or a servicer that provides a second opinion support system 1 for at least one medical institution. The system server 40 may be a general-purpose computer such as a workstation or a personal computer, or may be logically realized by cloud computing.
＜ハードウェア構成＞
　図２は、本実施形態に係るシステムサーバ４０を実現するコンピュータのハードウェア構成例を示す図である。コンピュータは、少なくとも、制御部４１、メモリ４２、ストレージ４３、通信部４４及び入出力部４５等を備える。これらはバス４６を通じて相互に電気的に接続される。 <Hardware configuration>
FIG. 2 is a diagram showing a hardware configuration example of a computer that realizes the system server 40 according to the present embodiment. The computer includes at least a control unit 41, a memory 42, a storage 43, a communication unit 44, an input / output unit 45, and the like. These are electrically connected to each other through the bus 46.
　制御部４１は、システムサーバ４０全体の動作を制御し、各要素間におけるデータの送受信の制御、及びアプリケーションの実行及び認証処理に必要な情報処理等を行う演算装置である。例えば制御部４１は、ＣＰＵ（Central Processing Unit）等のプロセッサであり、ストレージ４３に格納されメモリ４２に展開されたプログラム等を実行して各情報処理を実施する。 The control unit 41 is an arithmetic unit that controls the operation of the entire system server 40, controls the transmission and reception of data between each element, and performs information processing necessary for application execution and authentication processing. For example, the control unit 41 is a processor such as a CPU (Central Processing Unit), and executes each information processing by executing a program or the like stored in the storage 43 and expanded in the memory 42.
　メモリ４２は、ＤＲＡＭ（Dynamic Random Access Memory）等の揮発性記憶装置で構成される主記憶と、フラッシュメモリ又はＨＤＤ（Hard Disk Drive）等の不揮発性記憶装置で構成される補助記憶と、を含む。メモリ４２は、制御部１１のワークエリア等として使用され、また、システムサーバ４０の起動時に実行されるＢＩＯＳ（Basic Input/Output System）、及び各種設定情報等を格納する。 The memory 42 includes a main storage composed of a volatile storage device such as a DRAM (Dynamic RandomAccessMemory) and an auxiliary storage composed of a flash memory or a non-volatile storage device such as an HDD (Hard Disk Drive). .. The memory 42 is used as a work area or the like of the control unit 11, and also stores a BIOS (Basic Input / Output System) executed when the system server 40 is started, various setting information, and the like.
　ストレージ４３は、アプリケーション・プログラム等の各種プログラムを格納する。各処理に用いられるデータを格納したデータベースがストレージ４３に構築されていてもよい。 The storage 43 stores various programs such as application programs. A database storing data used for each process may be built in the storage 43.
　通信部４４は、システムサーバ４０をネットワークＮＷに接続する。通信部４４は、例えば、有線ＬＡＮ（Local Area Network）、無線ＬＡＮ、Ｗｉ－Ｆｉ（Wireless　Fidelity、登録商標）、赤外線通信、Ｂｌｕｅｔｏｏｔｈ（登録商標）、近距離または非接触通信等の方式で、外部機器と直接またはネットワークアクセスポイントを介して通信する。 The communication unit 44 connects the system server 40 to the network NW. The communication unit 44 may use, for example, a wired LAN (Local Area Network), wireless LAN, Wi-Fi (Wireless Fidelity, registered trademark), infrared communication, Bluetooth (registered trademark), short-range or non-contact communication, or the like. Communicate directly with the device or via a network access point.
　入出力部４５は、例えば、キーボード、マウス、タッチパネル等の情報入力機器、及びディスプレイ等の出力機器である。 The input / output unit 45 is, for example, an information input device such as a keyboard, a mouse, and a touch panel, and an output device such as a display.
　バス４６は、上記各要素に共通に接続され、例えば、アドレス信号、データ信号及び各種制御信号を伝達する。 The bus 46 is commonly connected to each of the above elements and transmits, for example, an address signal, a data signal, and various control signals.
　本実施形態に係る飼主端末１０、サテライト端末２０、センタ端末３０を実現するコンピュータ又はスマートフォン等の端末のハードウェア構成は、図２に示すシステムサーバ４０のハードウェア構成例と同様であるため、説明を省略する。 The hardware configuration of a terminal such as a computer or a smartphone that realizes the owner terminal 10, the satellite terminal 20, and the center terminal 30 according to the present embodiment is the same as the hardware configuration example of the system server 40 shown in FIG. 2. Is omitted.
＜ソフトウェア構成＞
　図３は、本実施形態に係るシステムサーバ４０のソフトウェア構成例を示す図である。システムサーバ４０は、電子カルテＤＢ４００、セカンドオピニオン取得要求受付部４０１、レビュー要求送信部４０２、通信制御部４０３、経歴情報記憶部４０４、指名通知送信部４０５を備える。 <Software configuration>
FIG. 3 is a diagram showing a software configuration example of the system server 40 according to the present embodiment. The system server 40 includes an electronic medical record DB 400, a second opinion acquisition request reception unit 401, a review request transmission unit 402, a communication control unit 403, a history information storage unit 404, and a nomination notification transmission unit 405.
　電子カルテＤＢ４００は、メモリ４２及びストレージ４３が提供する記憶領域の一部として実現され得る。なお、電子カルテＤＢ４００は、システムサーバ４０以外の一または複数のサーバが提供する外部の記憶領域の一部として実現されてもよい。各部４０１～４０５は、制御部４１がストレージ４３に記憶されているプログラムをメモリ４２に読み出して実行することにより実現され得る。 The electronic medical record DB 400 can be realized as a part of the storage area provided by the memory 42 and the storage 43. The electronic medical record DB 400 may be realized as a part of an external storage area provided by one or a plurality of servers other than the system server 40. Each unit 401 to 405 can be realized by the control unit 41 reading the program stored in the storage 43 into the memory 42 and executing the program.
　電子カルテＤＢ４００は、一次診療医Ｖ１又は二次診療医Ｖ２が作成に関与した電子カルテ情報を管理するためのデータベースである。「又は」とは、一次診療医Ｖ１及び二次診療医Ｖ２のうちのいずれか一方と両方を含む意である。「関与」するとは、例えば、電子カルテ情報の作成過程に包含される少なくとも一部の手順に能動的に又は受動的に関わることをいう。 The electronic medical record DB 400 is a database for managing the electronic medical record information involved in the creation of the primary medical record doctor V1 or the secondary medical record doctor V2. "Or" means to include either or both of the primary clinician V1 and the secondary clinician V2. "Involvement" means, for example, being actively or passively involved in at least a part of the procedures included in the process of creating electronic medical record information.
　図４は、本実施形態に係る電子カルテＤＢ４００の一例を示す図である。図４に示すように、電子カルテ情報は、例えば、動物患者を一意に特定する識別子である動物患者ＩＤと関連づけて管理される。また、動物患者毎の電子カルテ情報は、受診日毎に管理される。 FIG. 4 is a diagram showing an example of the electronic medical record DB 400 according to the present embodiment. As shown in FIG. 4, the electronic medical record information is managed in association with, for example, an animal patient ID which is an identifier uniquely identifying an animal patient. In addition, electronic medical record information for each animal patient is managed for each consultation day.
　電子カルテ情報に含まれる項目には、図４に示すように、動物情報、問診情報、身体所見、病歴、検査情報、診断情報、処置／投薬情報、処方情報、メモ、画像情報などがある。 As shown in FIG. 4, the items included in the electronic medical record information include animal information, interview information, physical findings, medical history, examination information, diagnostic information, treatment / medication information, prescription information, memos, image information, and the like.
　動物情報には、当該動物患者が該当する動物種情報が含まれる。動物種情報の例としては、イヌ、キツネ、タヌキ、フェネック、ネコ、ハムスター、モルモット、ハツカネズミ、シマリス、タイワンリス、プレーリードッグ、モモンガ、ウサギ、サル、ミニブタ、フェレット、スカンク、ロバ、ウマ（ミニチュアホース、ファラベラ）、九官鳥、ジュウシマツ、セキセイインコ、オカメインコ、ワカケホンセイインコ、文鳥、鳩、ミズガメ、リクガメ、ヤモリ、トカゲ、ヘビ、ワニ、カエル、サンショウウオ、金魚、錦鯉、熱帯魚、エビ、カブトムシ、クワガタムシ、スズムシ、水生昆虫、カマキリ、クモ、サソリ、サソリモドキ、ウデムシ、ヒヨケムシ、ムカデ、ヤスデなどが例示されるがこの限りではない。更に、イヌにおいても、犬種（犬の品種）等の下位概念が存在し得る。動物情報は、診察カルテ情報、入院カルテ情報及び手術カルテ情報の全てに含まれうる。 The animal information includes the animal species information to which the animal patient is applicable. Examples of animal species information include dogs, foxes, tanukis, phenecks, cats, hamsters, guinea pigs, pigeons, shimaris, taiwan squirrels, prairie dogs, momonga, rabbits, monkeys, miniature pigs, ferret, skunks, donkeys, horses (miniature horses, farabella). ), Nine Government Birds, Juushimatsu, Budgerigar, Okamainko, Rose-ringed Parakeet, Bungo, Pigeon, Mizugame, Rikugame, Gecko, Sauria, Snake, Crocodile, Frog, Sanshouo, Goldfish, Nishikigoi, Tropical Fish, Shrimp, Beetle, Examples include aquatic insects, parakeets, spiders, scorpions, budgerigars, parakeets, rose-ringed parakeets, mucades, and spiders, but this is not the case. Furthermore, even in dogs, there may be subordinate concepts such as dog breeds (dog breeds). Animal information can be included in all of the medical record information, the hospitalized medical record information and the surgical chart information.
　問診情報は、飼い主から取得する主観的な情報（主訴）である。例えば、「ご飯をあまり食べていない」「足に擦り傷ができている」「太ってきた」「元気がない」「鼻水が出ている」等であり、飼い主が所有する動物を見たときに観察される症状である。問診情報は、動物病院に来院した際に問診表又は問診用端末等を利用して飼い主から取得することとしてもよいし、飼い主が所有する携帯端末等で事前に入力してもらい取得することとしてもよい。入院時及び手術時においても問診は行われ、入院カルテ情報及び手術カルテ情報にも問診情報は含まれうる。 Interview information is subjective information (chief complaint) obtained from the owner. For example, "I don't eat much rice", "I have scratches on my legs", "I'm getting fat", "I'm not feeling well", "I have a runny nose", etc. It is an observed symptom. The interview information may be obtained from the owner using a questionnaire or a questionnaire terminal when visiting a veterinary hospital, or it may be obtained by having the owner enter it in advance using a mobile terminal or the like owned by the owner. May be good. Interviews are also conducted at the time of admission and surgery, and the interview information may be included in the hospitalization chart information and the surgery chart information.
　身体所見は、動物病院等において獣医師等が調べることができ、客観的な数値で表せる身体情報である。例えば「体重」「体温」「心拍」「呼吸数」等である。 Physical findings are physical information that can be examined by veterinarians at veterinary hospitals and can be expressed as objective numerical values. For example, "weight", "body temperature", "heart rate", "respiratory rate" and the like.
　病歴とは、獣医師等が聴取した主観的な情報である。病歴は、上述した問診情報と同一になる場合も多いが、例えば「喉が赤い」というように飼い主だけでは実際に確認するのが困難な項目も含まれている。また、問診情報では「血尿が出ている」という情報が取得されたとしても、獣医師等によって診察したところ「肛門から出血している」という現病歴が聴取されることもある。 Medical history is subjective information heard by veterinarians and others. The medical history is often the same as the above-mentioned interview information, but it also includes items that are difficult for the owner to actually confirm, such as "red throat". In addition, even if the information that "hematuria is occurring" is obtained from the interview information, the current medical history that "bleeding from the anus" may be heard when examined by a veterinarian or the like.
　検査情報には、少なくとも当該動物患者が過去に受けた検査の内容を含んでいる。検査情報には、過去の通院、入院又は手術において受けたことのある検査、検診において受けたことのある検査などを含めることができる。その際に、検査に対する反応（嫌がったかどうか等、検査自体の受容性・許容性に関する情報）を関連付けて記憶することとしてもよい。 The test information includes at least the contents of the tests that the animal patient has received in the past. The test information may include tests that have been performed in the past visits, hospitalizations or surgery, tests that have been performed in the examination, and the like. At that time, the reaction to the test (information on the acceptability / permissibility of the test itself, such as whether or not it was disliked) may be associated and stored.
　診断情報には、少なくとも当該動物患者が過去に受けた診断の履歴が含まれている。診断情報には、過去に罹患した具体的な疾患名又は怪我等の情報を含めることができる。診断情報には、過去の通院、入院又は手術において疑われた診断に関する情報を含めてもよい。 The diagnostic information includes at least the history of diagnoses received by the animal patient in the past. The diagnostic information can include information such as the name of a specific disease or injury that has occurred in the past. Diagnostic information may include information about diagnoses suspected in previous visits, hospitalizations or surgery.
　処置／投薬情報には、当該動物患者が過去に受けた処置または投薬に関する情報を含んでいる。処置／投薬情報には、処置または投薬に対する反応（嫌がったかどうか、体調に影響を来たしたか等、処置又は投薬自体の受容性・許容性に関する情報）を関連付けて記憶することとしてもよい。処置の内容としては、例えば、肛門腺処置、爪切処置、足裏処置、耳処置、毛抜き、眼科処置、歯科処置、エリザベスカラー・腹帯など、鍼灸処置、留置、便出し、抜糸、消毒、酸素処置、催吐処置、緊急蘇生処置、水抜き、強制給餌、洗浄、圧排、マッサージ、マイクロチップ、トリミング、カテーテル、リハビリ、手術、麻酔、入院、注射、輸血、点滴、検査、放射線治療、各種ドック、介護、衛生処置、シャンプー、しつけ、サプリメント、おやつ、避妊、去勢、ノミダニ駆除、狂犬病薬、ワクチン、フード、内用薬、点耳薬、点鼻薬、点眼薬、外用薬（軟膏・クリーム）、外用薬（消毒薬・スプレー）、外用薬、フィラリア予防などが例示できるがこの限りではない。 The treatment / medication information includes information regarding the treatment or medication that the animal patient has received in the past. The treatment / dosing information may be associated with and stored in response to the treatment or medication (information regarding the acceptability / tolerance of the treatment or the medication itself, such as whether or not the patient disliked it or whether it affected the physical condition). The contents of the treatment include, for example, anal gland treatment, nail cutting treatment, sole treatment, ear treatment, hair removal, ophthalmic treatment, dental treatment, Elizabeth color / abdominal band, acupuncture and moxibustion treatment, indwelling, stool removal, thread removal, disinfection, oxygen. Treatment, emetic treatment, emergency resuscitation treatment, drainage, forced feeding, washing, exclusion, massage, microchip, trimming, catheter, rehabilitation, surgery, anesthesia, hospitalization, injection, blood transfusion, drip, examination, radiation treatment, various docks, Nursing care, hygiene treatment, shampoo, training, supplements, snacks, contraception, neutering, flea mite extermination, mad dog disease medicine, vaccines, foods, internal medicines, ear drops, nasal drops, eye drops, external medicines (ointments / creams), external use Examples include medicines (disinfectants / sprays), local medicines, and prevention of filaria, but this is not the case.
　処方情報は、当該動物患者が過去に処方された薬剤等を含む。処方情報には、自宅にて処方された薬剤を服用できたか否か、嫌がったかどうか、体調に影響を来たしたか等、処置又は投薬自体の受容性・許容性に関する情報をユーザの携帯端末を介して取得して追加するようにしてもよい。 Prescription information includes drugs, etc. prescribed by the animal patient in the past. In the prescription information, the user's mobile terminal contains information on the acceptability / acceptability of the treatment or the medication itself, such as whether or not the drug prescribed at home could be taken, whether or not it was disliked, and whether or not it affected the physical condition. It may be acquired and added via.
　メモは、診察、入院又は手術の担当医、担当看護師、担当事務などにより入力されたテキストデータである。画像情報は、動物患者の様子を撮影した画像である。画像情報は、静止画像であっても動画像であってもよい。 The memo is text data input by the doctor in charge of medical examination, hospitalization or surgery, the nurse in charge, the office work in charge, etc. The image information is an image of an animal patient. The image information may be a still image or a moving image.
　電子カルテＤＢ４００は、二次診療医Ｖ２の宛先情報に対応付けて、当該二次診療医Ｖ２と直下の師弟関係となる一次診療医Ｖ１の識別情報を格納したデータテーブルを有している。「師弟関係」とは、例えば、経験によって培った知識・技能などを伝授する関係で、伝授される側が弟子、伝授する側が師となる。この例では、サテライト施設Ａで診断又は治療を行う一次診療医Ｖ１が弟子であり、その教育係のより経験が豊かな専門医であって、センタ施設Ｂに勤務する二次診療医Ｖ２が師である。 The electronic medical record DB 400 has a data table that stores identification information of the primary medical doctor V1 who has a master-student relationship with the secondary medical doctor V2 in association with the destination information of the secondary medical doctor V2. The "teacher-disciple relationship" is, for example, a relationship in which the knowledge and skills cultivated through experience are transferred, and the side to be taught is the disciple and the side to be taught is the teacher. In this example, the primary medical doctor V1 who diagnoses or treats at satellite facility A is a disciple, the more experienced specialist in the education staff, and the secondary medical doctor V2 who works at center facility B is a teacher. be.
　図５は、一次診療医Ｖ１と二次診療医Ｖ２との関係を示すテーブル構成図である。図５に示すテーブル構成は、一般的な手法で得ることができる。組織情報とその組織に所属する人物情報は、既知の情報である組織テーブル４００Ａ、部門テーブル４００Ｂ、組織所属者テーブル４００Ｃ、人物テーブル４００Ｄ、人物関係度テーブル４００Ｅによって管理される。 FIG. 5 is a table configuration diagram showing the relationship between the primary clinician V1 and the secondary clinician V2. The table configuration shown in FIG. 5 can be obtained by a general method. The organization information and the person information belonging to the organization are managed by the organization table 400A, the department table 400B, the organization affiliation table 400C, the person table 400D, and the person relationship degree table 400E, which are known information.
　組織テーブル４００Ａは、組織ＩＤと組織名との対応を示すテーブルである。部門テーブル４００Ｂは、組織ＩＤ、部門ＩＤ、部門名、親部門ＩＤの対応関係を示す図である。組織所属者テーブル４００Ｃは、組織ＩＤ、部門ＩＤ、職種、指名ＩＤを対応付けている。人物テーブル４００Ｄは、人物ＩＤとその氏名との関係を示すテーブルである。人物関係度テーブル４００Ｅは、人物ＩＤと別の人物ＩＤとの関係を示すテーブルである。 The organization table 400A is a table showing the correspondence between the organization ID and the organization name. The department table 400B is a diagram showing the correspondence between the organization ID, the department ID, the department name, and the parent department ID. The organization affiliation table 400C is associated with an organization ID, a department ID, a job type, and a designated ID. The person table 400D is a table showing the relationship between the person ID and its name. The person relationship degree table 400E is a table showing the relationship between a person ID and another person ID.
　セカンドオピニオン取得要求受付部４０１は、一次診療医Ｖ１からサテライト端末２０を介して、二次診療医Ｖ２の意見であるセカンドオピニオンの取得要求を受け付ける機能を有する。 The second opinion acquisition request receiving unit 401 has a function of receiving a second opinion acquisition request, which is the opinion of the secondary medical doctor V2, from the primary medical doctor V1 via the satellite terminal 20.
　レビュー要求送信部４０２は、セカンドオピニオン取得要求受付部４０１がセカンドオピニオンの取得要求を受け付けた場合に、二次診療医Ｖ２に対してセンタ端末３０を介して電子カルテ情報のレビューを要求する機能を有する。「レビュー」とは、例えば、医療現場で診断又は治療を行う一次診療医Ｖ１が、その教育係の二次診療医Ｖ２にアドバイス（診断情報の提供等）を求める等してダブルチェックを行う場合をいう。 The review request transmitting unit 402 has a function of requesting the secondary medical doctor V2 to review the electronic medical record information via the center terminal 30 when the second opinion acquisition request receiving unit 401 accepts the second opinion acquisition request. Have. The “review” is, for example, when a primary medical doctor V1 who diagnoses or treats in a medical field performs a double check by asking the secondary medical doctor V2 who is in charge of education for advice (providing diagnostic information, etc.). To say.
　通信制御部４０３は、電子カルテ情報のレビュー結果をセンタ端末３０から受信してサテライト端末２０に送信する機能を有する。本実施形態では、診断又は治療等の対面での医療行為全般を一次診療医Ｖ１が行う。その後、一次診療医Ｖ１が作成に関与した電子カルテ情報に二次診療医Ｖ２が目を通す（ダブルチェック）。そして、適当なタイミングで、二次診療医Ｖ２の意見として、例えば、「心拍に対する所見は私の考えとしても一次診療医Ｖ１と同じなので適切だと思います」、「体温はもう少し調べた方がいいと思います」といった内容が一次診療医Ｖ１に対して、例えばレポート形式で送られてくる仕組みとなっている。 The communication control unit 403 has a function of receiving the review result of the electronic medical record information from the center terminal 30 and transmitting it to the satellite terminal 20. In the present embodiment, the primary medical doctor V1 performs all face-to-face medical practices such as diagnosis or treatment. After that, the secondary medical doctor V2 looks over the electronic medical record information that the primary medical doctor V1 was involved in creating (double check). Then, at an appropriate timing, as the opinion of the secondary clinician V2, for example, "I think that the findings on the heartbeat are the same as the primary clinician V1 in my opinion, so I think it is appropriate." "I think it's good" is sent to the primary clinician V1 in the form of a report, for example.
　経歴情報記憶部４０４は、二次診療医Ｖ２の経歴に関する経歴情報を記憶する機能を有する。かかる経歴情報には、少なくとも二次診療医Ｖ２の専門科目、過去の診療実績が含まれる。 The career information storage unit 404 has a function of storing career information related to the career of the secondary medical doctor V2. Such background information includes at least the specialized subjects of the secondary medical doctor V2 and the past medical records.
　指名通知送信部４０５は、前記経歴情報に基づいて、対応する二次診療医Ｖ２の指名を一次診療医Ｖ１から受け付けた場合に、その指名先である二次診療医Ｖ２に対して指名通知を送信する機能を有する。 When the nomination notification transmission unit 405 receives the nomination of the corresponding secondary medical doctor V2 from the primary medical doctor V1 based on the background information, the nomination notification transmission unit 405 sends a nomination notification to the secondary medical doctor V2 to which the nomination is made. It has a function to send.
　通信制御部４０３は、指名通知送信部４０５による指名通知の送信先である二次診療医Ｖ２に関連するセンタ端末３０から電子カルテ情報のレビュー結果を受信して二次診療医Ｖ２の指名元である一次診療医Ｖ１に関連するサテライト端末２０に送信する。 The communication control unit 403 receives the review result of the electronic medical record information from the center terminal 30 related to the secondary medical doctor V2 to which the nomination notification transmission unit 405 sends the nomination notification, and the communication control unit 403 receives the review result of the electronic medical record information at the nomination source of the secondary medical doctor V2. It is transmitted to the satellite terminal 20 related to a certain primary medical doctor V1.
＜処理の流れ＞
　続いて、図６を参照しながら、本実施形態のセカンドオピニオン支援システム１が実行する処理の流れについて説明する。図６は、本実施形態に係るセカンドオピニオン支援システム１による処理の流れの一例を概略的に示す図である。 <Processing flow>
Subsequently, with reference to FIG. 6, the flow of processing executed by the second opinion support system 1 of the present embodiment will be described. FIG. 6 is a diagram schematically showing an example of a processing flow by the second opinion support system 1 according to the present embodiment.
　まず、一次診療医Ｖ１は、動物患者に対して診療を行う（ステップＳ１００）。ここでの診療はビデオ通話等を用いたオンライン診療で行われてもよく、対面で行われてもよい。 First, the primary medical doctor V1 performs medical treatment for an animal patient (step S100). The medical treatment here may be performed by online medical treatment using a video call or the like, or may be performed face-to-face.
　この診療結果は、一次診療医Ｖ１が作成に関与した電子カルテ情報として、サテライト端末２０からシステムサーバ４０に送信されて電子カルテＤＢ４００に格納される（ステップＳ１０２）。 This medical record result is transmitted from the satellite terminal 20 to the system server 40 and stored in the electronic medical record DB 400 as the electronic medical record information that the primary medical doctor V1 was involved in creating (step S102).
　そして、システムサーバ４０が備えるセカンドオピニオン取得要求受付部４０１は、サテライト端末２０から、セカンドオピニオンの取得要求を受け付ける（ステップＳ１０４）。これを受けて、レビュー要求送信部４０２は、一次診療医Ｖ１の識別情報に対応する宛先情報が示す二次診療医Ｖ２に対して電子カルテ情報のレビューを要求する（ステップＳ１０６）。 Then, the second opinion acquisition request receiving unit 401 included in the system server 40 receives the second opinion acquisition request from the satellite terminal 20 (step S104). In response to this, the review request transmission unit 402 requests the secondary medical record information V2 indicated by the destination information corresponding to the identification information of the primary medical record doctor V1 to review the electronic medical record information (step S106).
　要求先である二次診療医Ｖ２は、電子カルテ情報に対するレビューを作成し（ステップＳ１０８）、センタ端末３０を介してシステムサーバ４０に送信する（ステップＳ１１０）。システムサーバ４０が備える通信制御部４０３は、かかるレビュー結果を二次診療医Ｖ２から受信すると共に（ステップＳ１１２）、一次診療医Ｖ１に送信する（ステップＳ１１４）。 The secondary medical doctor V2, which is the request destination, creates a review for the electronic medical record information (step S108) and transmits it to the system server 40 via the center terminal 30 (step S110). The communication control unit 403 included in the system server 40 receives the review result from the secondary medical doctor V2 (step S112) and transmits it to the primary medical doctor V1 (step S114).
　従来、患者のかかりつけ医が、自らが勤める医療機関だけではなく、他の医療機関とも積極的に連携して患者に対する診療を支援するような分業体制へのニーズが存在する。例えば、小規模診療施設では応対し切れないような診療技術が要求された場合には、診療設備又は診療機器等がより充実した大規模医療機関へ診療を移すといった分業体制へのニーズが存在する。 Conventionally, there is a need for a division of labor system in which a patient's family doctor actively cooperates not only with the medical institution where he / she works but also with other medical institutions to support medical care for the patient. For example, if medical care technology that cannot be handled by small-scale medical facilities is required, there is a need for a division of labor system such as transferring medical care to a large-scale medical institution with more complete medical facilities or equipment. ..
　特に動物を患者とする診療の場合、人間の診療とは異なり、動物種又は個体差によって適応できる検査、診断、処置、投薬及び処方が根本的に異なることから、このような傾向は顕著に現れると考えられる。 Especially in the case of medical care with animals as patients, this tendency is remarkable because the tests, diagnoses, treatments, medications and prescriptions that can be applied differ depending on the animal species or individual differences, unlike human medical care. it is conceivable that.
　この点、本実施形態に係るセカンドオピニオン支援システム１は、一動物患者に対する診断又は治療等の医療行為を一人の獣医師によって完結させるのではなく、必ず、別の獣医師もその動物患者に係る電子カルテ情報をチェックするいわば二段構えによる分業体制が念頭に置かれている。 In this regard, the second opinion support system 1 according to the present embodiment does not complete the medical practice such as diagnosis or treatment for one animal patient by one veterinarian, but another veterinarian always relates to the animal patient. A so-called two-stage division of labor system for checking electronic medical record information is in mind.
　かかる二段構えによる医療体制は、動物患者を保有する飼主に医療行為に対する納得感を与え、単に一人の獣医師が医療行為を行う場合と比べて飼主の不安な感情を軽減することができる。ひいては、獣医師等の医療従事者側と動物患者を保有する飼主側との知識的格差を効果的に是正することができる。 The medical system based on this two-stage stance gives the owner of the animal patient a sense of conviction about the medical practice, and can alleviate the anxious feelings of the owner compared to the case where a single veterinarian performs the medical practice. As a result, the knowledge gap between the medical staff such as veterinarians and the owners of animal patients can be effectively corrected.
　かくして、本実施形態に係るセカンドオピニオン支援システム１によれば、医師間又は病院間で効率的に分業体制を整えることができる。 Thus, according to the second opinion support system 1 according to the present embodiment, it is possible to efficiently establish a division of labor system between doctors or hospitals.
　以上、本開示に係る実施形態について説明したが、これらはその他の様々な形態で実施することが可能であり、種々の省略、置換および変更を行なって実施することが出来る。これらの実施形態および変形例ならびに省略、置換および変更を行なったものは、特許請求の範囲の技術的範囲とその均等の範囲に含まれる。 Although the embodiments according to the present disclosure have been described above, these can be implemented in various other embodiments, and can be implemented by making various omissions, substitutions, and changes. These embodiments and modifications, as well as those omitted, replaced or modified, are included in the technical scope of the claims and the equivalent scope thereof.
　なお、上述した実施形態では、本システムを動物患者に適用する例について述べたが、これに限らない。本システムを患者であるヒトに適用してもよい。 In the above-described embodiment, an example of applying this system to an animal patient has been described, but the present invention is not limited to this. The system may be applied to humans who are patients.
　本明細書において説明した装置による一連の処理は、ソフトウェア、ハードウェア、及びソフトウェアとハードウェアとの組合せのいずれを用いて実現されてもよい。また、このようなコンピュータプログラムが格納された、コンピュータで読み取り可能な記録媒体も提供することができる。記録媒体は、例えば、磁気ディスク、光ディスク、光磁気ディスク、フラッシュメモリ等である。また、上記のコンピュータプログラムは、記録媒体を用いずに、例えばネットワークを介して配信されてもよい。 The series of processes by the apparatus described in the present specification may be realized by using any of software, hardware, and a combination of software and hardware. It is also possible to provide a computer-readable recording medium in which such a computer program is stored. The recording medium is, for example, a magnetic disk, an optical disk, a magneto-optical disk, a flash memory, or the like. Further, the above computer program may be distributed, for example, via a network without using a recording medium.
　また、本明細書においてフローチャート図を用いて説明した処理は、必ずしも図示された順序で実行されなくてもよい。いくつかの処理ステップは、並列的に実行されてもよい。また、追加的な処理ステップが採用されてもよく、一部の処理ステップが省略されてもよい。 Further, the processes described in the present specification using the flowchart diagram do not necessarily have to be executed in the order shown in the drawings. Some processing steps may be performed in parallel. Further, additional processing steps may be adopted, and some processing steps may be omitted.
　また、本明細書に記載された効果は、あくまで説明的または例示的なものであって限定的ではない。つまり、本開示に係る技術は、上記の効果とともに、または上記の効果に代えて、本明細書の記載から当業者には明らかな他の効果を奏しうる。 Further, the effects described in the present specification are merely explanatory or exemplary and are not limited. That is, the techniques according to the present disclosure may have other effects apparent to those skilled in the art from the description herein, in addition to or in place of the above effects.
１　　　　セカンドオピニオン支援システム
１０　　　飼主端末
２０　　　サテライト端末
３０　　　センタ端末
４０　　　システムサーバ
４００　　電子カルテＤＢ
４０１　　セカンドオピニオン取得要求受付部
４０２　　レビュー要求送信部
４０３　　通信制御部
４０４　　経歴情報記憶部
４０５　　指名通知送信部
Ｋ１　　　飼主
Ｖ１　　　一次診療医
Ｖ２　　　二次診療医 1 Second opinion support system 10 Owner terminal 20 Satellite terminal 30 Center terminal 40 System server 400 Electronic medical record DB
401 Second opinion acquisition request reception unit 402 Review request transmission unit 403 Communication control unit 404 Career information storage unit 405 Nomination notification transmission unit K1 Owner V1 Primary medical doctor V2 Secondary medical doctor

Claims (4)

  1. 　ネットワークで接続された、一次診療医に関連するサテライト端末と、前記一次診療医の指導医にあたる二次診療医に関連するセンタ端末と、前記一次診療医又は前記二次診療医が作成に関与した電子カルテ情報を格納する電子カルテデータベースを有するシステムサーバと、を備えたセカンドオピニオン支援システムであって、
    　前記システムサーバは、
    　前記一次診療医から前記サテライト端末を介して、前記二次診療医の意見であるセカンドオピニオンの取得要求を受け付けるセカンドオピニオン取得要求受付部と、
    　前記取得要求を受け付けた場合に、前記二次診療医に対して前記センタ端末を介して前記電子カルテ情報のレビューを要求するレビュー要求送信部と、
    　前記電子カルテ情報のレビュー結果を前記センタ端末から受信して前記サテライト端末に送信する通信制御部と、
    　を備える、
    セカンドオピニオン支援システム。     The satellite terminal related to the primary medical record connected by the network, the center terminal related to the secondary medical record which is the instructor of the primary medical record, and the primary medical record or the secondary medical record were involved in the creation. A second opinion support system equipped with a system server having an electronic medical record database for storing electronic medical record information.
    The system server
    A second opinion acquisition request reception unit that receives a second opinion acquisition request, which is the opinion of the secondary opinion, from the primary clinic via the satellite terminal.
    A review request transmission unit that requests the secondary medical doctor to review the electronic medical record information via the center terminal when the acquisition request is received.
    A communication control unit that receives the review result of the electronic medical record information from the center terminal and transmits it to the satellite terminal.
    To prepare
    Second opinion support system.
  2. 　請求項１に記載のセカンドオピニオン支援システムであって、
    　前記電子カルテデータベースには、前記二次診療医の宛先情報に対応付けて、当該二次診療医と直下の師弟関係となる一次診療医の識別情報が格納されており、
    　前記レビュー要求送信部は、
    　前記一次診療医から前記セカンドオピニオンの取得要求を受け付けた場合に、前記一次診療医の識別情報に対応する前記宛先情報が示す宛先に対して前記電子カルテ情報のレビューを要求する、
    セカンドオピニオン支援システム。     The second opinion support system according to claim 1.
    The electronic medical record database stores identification information of a primary medical doctor who has a teacher-apprentice relationship with the secondary medical doctor in association with the destination information of the secondary medical doctor.
    The review request transmitter is
    When the request for acquisition of the second opinion is received from the primary medical doctor, the electronic medical record information is requested to be reviewed for the destination indicated by the destination information corresponding to the identification information of the primary medical doctor.
    Second opinion support system.
  3. 　請求項１又は請求項２に記載のセカンドオピニオン支援システムであって、
    　前記二次診療医の経歴に関する経歴情報を記憶する経歴情報記憶部と、
    　前記経歴情報に基づいて、対応する二次診療医の指名を一次診療医から受け付けた場合に、その指名先である二次診療医に対して指名通知を送信する指名通知送信部と、を備え、
    　前記通信制御部は、前記指名通知の送信先である二次診療医に関連するセンタ端末から前記電子カルテ情報のレビュー結果を受信して前記二次診療医の指名元である一次診療医に関連するサテライト端末に送信する、
    セカンドオピニオン支援システム。     The second opinion support system according to claim 1 or 2.
    A career information storage unit that stores career information related to the career of the secondary medical doctor, and
    It is provided with a nomination notification transmission unit that sends a nomination notification to the secondary medical doctor who is the nomination destination when the corresponding secondary medical doctor is nominated from the primary medical doctor based on the background information. ,
    The communication control unit receives the review result of the electronic medical record information from the center terminal related to the secondary medical doctor who is the destination of the nomination notification, and is related to the primary medical doctor who is the nominating source of the secondary medical doctor. Send to satellite terminals,
    Second opinion support system.
  4. 　請求項３に記載のセカンドオピニオン支援システムであって、
    　前記二次診療医の経歴に関する経歴情報には、前記二次診療医の専門科目、過去の診療実績が含まれる、
    セカンドオピニオン支援システム。     The second opinion support system according to claim 3.
    The career information regarding the career of the secondary doctor includes the specialized subject of the secondary doctor and the past medical records.
    Second opinion support system.
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JP7390769B1 (en) 2023-08-23 2023-12-04 国立大学法人 鹿児島大学 Veterinary medical technology improvement support device, veterinary medical technology improvement support system, veterinary medical technology improvement support method, and veterinary medical technology improvement support program

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JP2014048858A (en) * 2012-08-31 2014-03-17 Fujifilm Corp Medical support device and medical support method
JP2018169864A (en) * 2017-03-30 2018-11-01 富士通株式会社 Work management program, work management device and work management method

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2014048858A (en) * 2012-08-31 2014-03-17 Fujifilm Corp Medical support device and medical support method
JP2018169864A (en) * 2017-03-30 2018-11-01 富士通株式会社 Work management program, work management device and work management method

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP7390769B1 (en) 2023-08-23 2023-12-04 国立大学法人 鹿児島大学 Veterinary medical technology improvement support device, veterinary medical technology improvement support system, veterinary medical technology improvement support method, and veterinary medical technology improvement support program

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