WO2024116304A1

WO2024116304A1 - Medical information processing device, medical information processing method, and program recording medium

Info

Publication number: WO2024116304A1
Application number: PCT/JP2022/044093
Authority: WO
Inventors: 亮平齊藤
Original assignee: 日本電気株式会社
Priority date: 2022-11-30
Filing date: 2022-11-30
Publication date: 2024-06-06

Abstract

To achieve smooth operation of a framework for suppressing polypharmacy in patients, this medical information processing device 90 is provided with a suggestion unit 91, a generation unit 92, and a processing unit 93. The suggestion unit 91 receives a result of determination as to whether or not a drug prescribed to a patient poses a polypharmacy risk, and when the determination result has indicated that there is a polypharmacy risk, outputs revision-suggesting information for suggesting revising the prescription details of the drug. The generation unit 92, when the prescription details have been revised, generates suppression record information indicating that prescription details have been revised while associating the information with at least a prescribing physician involved in the revision of the prescription details. The processing unit 93 executes suppression record-related processing including quantification processing that numerically expresses records of revision of prescription details using the suppression record information.

Description

Medical information processing device, medical information processing method, and program storage medium

The present invention relates to a technology for preventing polypharmacy in patients.

Elderly people are prone to developing ailments in multiple parts of their body at the same time, and may end up visiting multiple medical institutions to treat those ailments. In such cases, patients often end up taking multiple types of medication prescribed by each medical institution at the same time. For these reasons, polypharmacy has become a problem in geriatric care. Polypharmacy is the harmful use of multiple medications. Harmful polypharmacy is not just about taking a large number of different medications at the same time, but also about increasing the risk of adverse drug events and leading to medication errors such as taking medication in the wrong way.

Patent Document 1 (JP Patent Publication No. 2015-84132) shows a configuration for preventing patients from taking excessive or duplicate medicines at a dispensing pharmacy.

JP 2015-84132 A

In the configuration described in Patent Document 1, the patient's prescription information is compared with the patient's dispensing history, and if it is determined that the prescription contains unnecessary medicines that should not be dispensed to the patient, the result of the determination is sent to the communication terminal of the dispensing pharmacy or the communication terminal of the patient. In the configuration of Cited Document 1, information that the prescription contains unnecessary medicines is simply sent to the communication terminal of the dispensing pharmacy or the communication terminal of the patient. Even if a pharmacist or patient receives this information, they cannot change the prescription content, such as reducing the number of medicines to be dispensed, without the doctor's judgment. For this reason, pharmacists and patients need to consult with a doctor when changing the prescription content, but this can lead to a situation where the prescription content is not changed because they are unable to consult with a doctor for reasons such as finding it difficult to ask the doctor to change the prescription content.

The present invention was conceived to solve the problems described above. In other words, the main objective of the present invention is to provide technology that facilitates the smooth operation of a system that prevents patients from engaging in polypharmacy.

In order to achieve the above object, a medical information processing device according to the present invention comprises, as one aspect thereof:
a suggestion unit that outputs review suggestion information for suggesting a review of the drug prescription content when a result of the determination of whether or not a drug prescribed to a patient is likely to cause polypharmacy is that the drug is likely to cause polypharmacy;
a generating unit that generates, when the prescription content is revised, suppression record information indicating that the prescription content has been revised, in association with at least the prescribing doctor involved in the revision of the prescription content;
The apparatus further includes a processing unit that executes a process related to the prevention record, including a digitization process that uses the prevention record information to express the results of the revision of the prescription contents in numbers.

In addition, one aspect of the medical information processing method according to the present invention is
By computer,
outputting review suggestion information for proposing a review of the drug prescription content when the result of the determination of whether or not the drug prescribed to the patient is likely to cause polypharmacy indicates that the drug is likely to cause polypharmacy;
When the prescription content is reviewed, suppression record information indicating that the prescription content has been reviewed is generated in association with at least the prescribing physician involved in the review of the prescription content;
The prevention record-related process includes a digitization process that uses the prevention record information to express the results of the revision of the prescription contents in numbers.

Furthermore, a program storage medium according to the present invention comprises, as one aspect thereof:
a process for outputting review suggestion information for proposing a review of the drug prescription content when the result of the determination of whether or not a drug prescribed to a patient may cause polypharmacy indicates that the drug may cause polypharmacy;
When the prescription content is revised, a process of generating suppression record information indicating that the prescription content has been revised in association with at least the prescribing doctor involved in the revision of the prescription content;
The device stores a computer program for causing a computer to execute a process for executing a deterrence record-related process including a digitization process for expressing the results of revision of prescription contents using the deterrence record information in numbers.

The present invention makes it possible to smoothly implement a system for preventing polypharmacy among patients.

1 is a diagram illustrating a polypharmacy prevention system including a medical information processing device according to a first embodiment of the present invention. FIG. 2 is a diagram illustrating an example of the configuration of an information processing device that constitutes the polypharmacy prevention system. FIG. 13 is a diagram showing an example of a reward given according to achievements related to polypharmacy prevention. FIG. 2 is a diagram illustrating an example of the configuration of a personal information management device that constitutes the polypharmacy prevention system. FIG. 13 is a diagram illustrating an example of reference information presented to a patient regarding a review of prescription contents to prevent polypharmacy. 13 is a diagram illustrating an example of a notification content notifying a patient that the prescription content has been revised. FIG. FIG. 13 is a diagram showing an example of a physical condition information input screen used when obtaining information from a patient about their physical condition after taking a medicine. FIG. 13 is a diagram illustrating another example of reference information presented to a patient regarding a review of prescription contents to prevent polypharmacy. 1 is a diagram illustrating an example of the configuration of a medical information processing apparatus according to a first embodiment; FIG. 13 is a diagram showing an example of a display screen that suggests to the prescribing doctor that the prescription contents be revised. FIG. 13 is a diagram showing another example of a display screen suggesting to the prescribing doctor that he or she review the prescription contents. 13 is a diagram showing an example of a display screen that suggests to the pharmacist to review the prescription contents. 13 is a diagram showing an example of a display screen on which a pharmacist proposes to a prescribing doctor to review the prescription contents via a medical information processing device. FIG. 13 is a diagram showing an example of a notification to notify a prescribing physician that suppression history information has been generated and registered. 13 is a flowchart illustrating an example of an operation related to generation of review suggestion information in the medical information processing device. 13 is a flowchart illustrating an example of an operation related to generation of inhibition record information in the medical information processing device. FIG. 13 is a diagram illustrating an example of display of information presented to a patient. FIG. 13 is a diagram illustrating yet another example of display of information presented to a patient. FIG. 13 is a diagram illustrating an example of the configuration of a medical information processing device according to another embodiment of the present invention. 13 is a flowchart illustrating an example of an operation of a medical information processing device according to another embodiment of the present invention.

Below, an embodiment of the present invention will be described with reference to the drawings.

First Embodiment
Figure 1 shows the overall configuration of a system (hereinafter referred to as the polypharmacy prevention system) devised to prevent polypharmacy in patients, using solid lines. In this polypharmacy prevention system, it is determined whether or not a drug prescribed by a prescribing doctor may cause polypharmacy in a patient, and if there is a risk of polypharmacy, a review of the drug prescription is suggested to the prescribing doctor, pharmacist, and patient to prevent polypharmacy. Note that the prescribing doctor is a general term that includes doctors and dentists who prescribe drugs.

However, for the prescribing physician, reviewing the prescription is troublesome and increases the burden, so it is conceivable that the prescribing physician will hesitate to review the prescription. Also, for the pharmacist, even if a review of the prescription is proposed, the pharmacist cannot change the prescription at his/her own discretion and must consult with the prescribing physician about the change. For this reason, the pharmacist first proposes a review of the prescription to the patient, and after obtaining the patient's consent to the review of the prescription, requests the prescribing physician to review the prescription. If the request to the prescribing physician is made by the pharmacist, for example, by telephone or e-mail, it is time-consuming and increases the burden on the pharmacist, so it is conceivable that the pharmacist will hesitate to propose a review of the prescription. Furthermore, for the patient, if a reduction in the dosage is proposed as a result of the review of the prescription, the patient may feel anxious that the reduced medication will not be effective and that the symptoms will not improve, and therefore the patient may hesitate to review the prescription. In this way, the reality is that the review of the prescription is difficult to proceed smoothly due to the respective circumstances of the prescribing physician, the pharmacist, and the patient.

The polypharmacy prevention system shown in Figure 1 therefore gives each of the prescribing physician, pharmacist, and patient an incentive to review prescription contents to prevent polypharmacy. In this way, the polypharmacy prevention system encourages each of the prescribing physician, pharmacist, and patient to proactively take action to review prescription contents.

In other words, the polypharmacy prevention system shown in Figure 1 has a function to record the performance of the prescribing doctor, pharmacist, and patient involved in the review of the prescription content. Recording the performance of the review of the prescription content can be said to give the prescribing doctor, pharmacist, and patient a grade for the review of the prescription content. It is thought that giving a grade in this way gives an incentive to the prescribing doctor, pharmacist, and patient to review the prescription content. Furthermore, the polypharmacy prevention system shown in Figure 1 has the following functions to more reliably give incentives. In other words, since local governments (local public organizations) and health insurance associations bear part of the drug costs of patients, they have a desire to limit the types of drugs prescribed to patients not only from the perspective of polypharmacy prevention but also from the perspective of reducing drug costs. Taking advantage of this, in the polypharmacy prevention system, the prescribing doctor, pharmacist, and patient involved in the review of the prescription content related to polypharmacy prevention are given rewards by the local government, health insurance association, etc. according to their performance (score) regarding the review of the prescription content.

Furthermore, the polypharmacy prevention system also has a function to provide prescribing physicians and pharmacists with information that is useful for reviewing prescription contents related to polypharmacy prevention, as well as a function to provide reference information regarding reviewing prescription contents at the request of patients. Furthermore, the polypharmacy prevention system also has a function that aims to reduce the workload of pharmacists requesting (suggesting) a review of prescription contents to prescribing physicians. It is believed that this function will make it easier for pharmacists to suggest a review of prescription contents to prescribing physicians.

Next, we will explain the configuration of the polypharmacy prevention system devised by the inventor to realize a polypharmacy prevention system with the functions described above.

In other words, a medical information processing system 1 including a medical information processing device according to a first embodiment of the present invention is a main element constituting a polypharmacy prevention system. As shown in FIG. 1, the medical information processing system 1 is connected to a personal information management system 2, a prescription management system 3, and a linkage system 4. Before explaining the configuration of the medical information processing system 1, the configurations of the personal information management system 2, the prescription management system 3, and the linkage system 4 will be explained.

The linkage system 4 here refers to systems such as those of local governments and health insurance associations that manage public medical insurance, and systems of organizations involved in community medical care, and in addition to existing functions, it is equipped with functions related to the polypharmacy prevention system (polypharmacy prevention function). The polypharmacy prevention function in this linkage system 4 is a function that uses performance conversion information generated by the medical information processing system 1 to award rewards to prescribing doctors, pharmacists, and patients according to their performance in preventing polypharmacy. The performance conversion information is information calculated from the prevention performance information generated by the medical information processing system 1.

In other words, the deterrence record information is information that represents the record of the review of the prescription contents for each of the prescribing doctor, pharmacist, and patient involved in the review of the prescription contents, and is generated by the medical information processing system 1 in correspondence with each of the prescribing doctor, pharmacist, and patient. The deterrence record information includes, for example, identification information of the prescription information (prescription information) that includes the prescription contents that were the subject of review, information on the date of the review, and information indicating that the patient's consent has been obtained for the review of the prescription contents. Furthermore, the deterrence record information includes information indicating the number of types of medicine that have been reduced as information indicating the content of the review. Furthermore, the deterrence record information may include information indicating the duration of the state in which the medicine has been reduced as information indicating the content of the review. Items related to the deterrence of polypharmacy are included as points added to the medical fees paid by insurers to medical institutions and pharmacies. The deterrence record information may include information related to items related to the deterrence of polypharmacy that are points added to the medical fees as information indicating the content of the review.

Such deterrence performance information is associated with the identification information of the prescribing doctor who considered revising the prescription contents (prescriber identification information), the patient (patient identification information), and the pharmacist (pharmacist identification information). Here, conversion information that converts the information indicating the content of the review contained in the deterrence performance information as described above into a score is determined in advance. The medical information processing system 1 uses the conversion information to calculate a score according to the content of the review contained in the deterrence performance information of each of the prescribing doctor, the pharmacist, and the patient. The performance conversion information provided from the medical information processing system 1 to the linkage system 4 is information that indicates the score calculated in this way. Using this performance conversion information, the polypharmacy deterrence device in the linkage system 4 grants a reward to each of the prescribing doctor, the pharmacist, and the patient according to their performance regarding polypharmacy deterrence.

That is, in order to realize the polypharmacy deterrence function described above, the linkage system 4 includes an information processing device 14 as shown in FIG. 2. The information processing device 14 is a computer device, and includes a control device 40 and a storage device 45. The storage device 45 includes a storage medium for storing data and a computer program (hereinafter also referred to as a program) 46. The control device 40 is configured with a processor such as a CPU (Central Processing Unit), and can have various functions based on the program 46 by reading and executing the program 46 stored in the storage device 45. Here, the control device 40 includes an acquisition unit 41, a reward granting unit 42, and an output unit 43 as functional units for polypharmacy deterrence. Note that the control device 40 of the information processing device 14 constituting the linkage system 4 also has functions other than the polypharmacy deterrence function, but in FIG. 2, the functional units related to functions other than the polypharmacy deterrence function are not shown, and their explanations are also omitted.

The acquisition unit 41 acquires actual performance conversion information from the medical information processing system 1 at a predetermined timing (for example, once a month, such as the 15th of each month). The acquisition unit 41 may also acquire suppression actual performance information from the medical information processing system 1. The actual performance conversion information and suppression actual performance information acquired from the medical information processing system 1 are associated with the corresponding prescribing doctor's identification information (prescribing doctor identification information), patient's identification information (patient identification information), and pharmacist's identification information (pharmacist identification information). The acquisition unit 41 uses the prescribing doctor's identification information, patient's identification information, and pharmacist identification information to store the acquired actual performance conversion information and suppression actual performance information in the storage device 45 or database (storage device) 80 for each individual prescribing doctor, patient, and pharmacist.

The deterrence record information acquired by the acquisition unit 41 may be used in the linkage system 4 for research and analysis related to the status of polypharmacy deterrence, such as tabulating and investigating the status of polypharmacy deterrence for each predetermined unit (e.g., each hospital, each district).

The reward granting unit 42 executes a process of granting a reward to a prescribing doctor, a patient, or a pharmacist according to the performance of the review of the prescription contents using the performance conversion information. One example of the reward is points (benefits) that can be exchanged for goods or services. Other examples of the reward include prizes or services according to the performance of the review of the prescription contents, and images (hereinafter also referred to as reward images) containing marks or words (characters) expressing rewards or gratitude as shown in FIG. 3, or goods such as badges and stickers (hereinafter also referred to as reward display items). Another example of the reward is a discount service that can be received at a participating store of the polypharmacy prevention system according to the performance of the review of the prescription contents. The content of the reward granted to a prescribing doctor, a pharmacist, or a patient from the polypharmacy prevention system (linkage system 4) may be determined as appropriate by the operating organization of the linkage system 4, and is not limited here. The method by which the reward granting unit 42 uses the performance conversion information to calculate the reward (e.g., points (benefits)) and to decide on the grant of the reward (reward image or reward display) may also be determined appropriately by the organization that operates the linked system 4, and is not limited here, so a description of it will be omitted. Furthermore, here, a history of matters related to the rewards granted for each individual prescribing doctor, patient, and pharmacist is stored in the storage device 45 and database 80.

The output unit 43 outputs information about the awarded reward to the prescribing doctor, the patient, or the pharmacist according to a predetermined output procedure. For example, in the case where the reward is points (benefit), the information processing device 14 receives a request to refer to the points (point reference request) from the

terminal device

7, 8, or 9 operated by the prescribing doctor, the patient, or the pharmacist. In this case, the output unit 43 reads information representing the requested points from the storage device 45 or the database 80 using the prescribing doctor identification information, the patient identification information, or the pharmacist identification information associated with the point reference request, and returns the information. In addition, when a request to exchange points for goods or services is received from the

terminal device

7, 8, or 9, the output unit 43 outputs information about the point exchange to a point exchange processing unit (not shown) that performs processing to exchange points for goods or services. The processing procedure by which the point exchange processing unit exchanges points for goods or services is not limited here, and its description is omitted.

In addition, if the reward is a reward image, the output unit 43 outputs the reward image to the prescribing doctor, patient, or pharmacist who has been decided to grant the reward image at a predetermined timing after the decision to grant the reward image. When outputting the reward image in this way, the linkage system 4 holds address information of the prescribing doctor, patient, or pharmacist to whom the reward image is to be sent in order to send the reward image to the

terminal devices

7, 8, and 9 of the prescribing doctor, patient, or pharmacist. Furthermore, if the reward is a discount service, the output unit 43 outputs, for example, a barcode (one-dimensional code) or two-dimensional code including information on the discount rate and coupon contents together with an image such as a character or mark indicating that a discount is available, to the prescribing doctor, patient, or pharmacist who has been decided to grant the reward. In this case, for example, the prescribing doctor, patient, or pharmacist can receive the discount service by presenting the screen of a terminal device on which such a barcode (one-dimensional code) or two-dimensional code is displayed to a participating store of the polypharmacy prevention system.

Next, the prescription management system 3 will be described. The prescription management system 3 is a system that manages electronic prescriptions, which are computerized prescriptions. For example, a specific example is a system operated by the National Health Insurance Association, a public interest incorporated association. The prescription management system 3 is connected to a terminal device (computer device) 7 installed in a medical institution (hospital, dental clinic, or clinic) and a terminal device (computer device) 8 installed in a pharmacy, and exchanges information between the

terminal devices

7 and 8. For example, the prescription management system 3 accepts prescription information input by the terminal device 7 through the operation of a prescribing doctor. Prescription information is information (electronic prescription) that includes the prescription contents of a drug prescribed by a prescribing doctor to a patient. The prescription contents include, for example, the prescription date, the name of the prescribed drug, the shape of the drug (tablet, powder, etc.), the prescribed quantity of the drug, and the method of taking the drug (the time of day to take the drug (for example, after meals in the morning and evening) and the period to take the drug (for example, three days)). The prescription information also includes insurance information, patient information, and medical institution information. Insurance information is the number of the insurance card of the national health insurance or health insurance association to which the patient is enrolled. Patient information is information that represents an individual patient, including the name and date of birth. Medical institution information is information that represents the medical institution or prescribing doctor that prescribed the medicine.

Some medical institutions have a medical administration system 5 as shown by the dotted line in Figure 1. This medical administration system 5 is a system known as an electronic medical record system or a receipt computer, and is a system related to the generation of medical receipts (medical fee statements) and medical fee invoices. When a prescribing doctor at a medical institution where such a medical administration system 5 has been built generates prescription information, the prescription information is also registered in the medical administration system 5. In some cases, the prescription information is also registered in the prescription management system 3 via the medical administration system 5.

The prescription management system 3 further accepts dispensing information input by the terminal device 8. The dispensing information is information including the contents of the prescription dispensed by the pharmacist to the patient. The contents of the prescription include, for example, the name of the medicine dispensed by the pharmacist, the date of dispensing, the shape of the medicine (tablet, powder, etc.), the quantity of the medicine dispensed, and the method of taking the medicine. The dispensing information also includes insurance information, patient information, and pharmacy information. The insurance information and patient information are similar to the insurance information and patient information included in the prescription information. The pharmacy information is information that indicates the pharmacy that dispensed the medicine.

The prescription management system 3 manages prescription information received from the medical institution's terminal device 7 and dispensing information received from the pharmacy's terminal device 8 in association with patient identification information. Patient identification information is information that identifies a patient, and is not limited here, but examples include My Number (a personal number designated by the national My Number system) and a number assigned to an individual patient by the prescription management system 3. In the polypharmacy prevention system shown in FIG. 1, it is assumed that multiple types of personal identification information including My Number are used as patient identification information, but here, they are referred to as patient identification information without distinction. In addition, here, the prescription management system 3 has an authentication function that performs authentication processing to determine whether or not to allow connection to the terminal devices 7 and 8 (prescribing doctors and pharmacists). Here, the authentication method is not limited, and a description of the authentication function is omitted.

The prescription management system 3 also uses the received prescription information and dispensing information to generate medication history information for each patient that represents the history of prescribed (dispensed) medications, and manages the medication history information in association with patient identification information.

Furthermore, the prescription management system 3 outputs prescription information, dispensing information, and medication history information to the medical information processing system 1 in response to a request from the medical information processing system 1. Note that the functions of the prescription management system 3, such as information management and authentication, as described above, are realized by a computer device (server device). A description of the configuration and operation of the computer device will be omitted here.

Next, the personal information management system 2 will be described. The personal information management system 2 is a system that provides patients with an electronic medicine notebook service. That is, the personal information management system 2 has a function of providing information such as the prescription contents of the prescription information acquired from the prescription management system 3 to the terminal device 9 of the patient connected to the personal information management system 2. Here, the route by which the personal information management system 2 acquires the prescription information from the prescription management system 3 is not limited, and for example, it may be acquired via a minor portal or directly. In addition, the connection between the terminal device 9 and the personal information management system 2 is executed by an application program (app) that gives the terminal device 9 a function to cooperate with the personal information management system 2. Alternatively, the connection between the terminal device 9 and the personal information management system 2 may be executed by a browser (software for browsing information on the Internet). Whether the connection between the terminal device 9 and the personal information management system 2 is executed by an app or a browser is appropriately set by a system designer or the like, and is not limited here. Furthermore, the terminal device 9 operated by the patient is a computer device, has a communication function, and has a display control function for controlling a display device to display information. The type of terminal device 9 is not limited as long as it has a communication function and a display control function, but specific examples include a smartphone, a tablet, a personal computer, etc. If the terminal device 9 is a smartphone or a tablet, the display device is integrated with the terminal device 9, but if the terminal device 9 is a personal computer, the display device may be external.

The personal information management system 2 is further connected to the medical information processing system 1 and has a configuration that performs part of the functions of a patient polypharmacy prevention system. In other words, the personal information management system 2 has a function of outputting information related to polypharmacy prevention received from the medical information processing system 1 to the terminal device 9, and acquiring information related to the patient's physical condition by the terminal device 9 and transmitting it to the medical information processing system 1. FIG. 4 is a diagram explaining an example of the configuration of the personal information management system 2 having such functions. The personal information management system 2 has a personal information management device (computer device (server)) 12. The personal information management device 12 has a control device 20 and a storage device 28. The storage device 28 has a storage medium that stores data and a program (computer program) 29. The control device 20 is composed of a processor such as a CPU (Central Processing Unit). The control device 20 can have various functions based on the program 29 by reading and executing the program 29 stored in the storage device 28. Here, in addition to the notebook control unit 21, the control device 20 has an acquisition unit 22, an output unit 23, a recording unit 24, a provision unit 25, and a performance-related unit 26 as functional units related to the polypharmacy prevention function.

The notebook control unit 21 has a function of providing an electronic medicine notebook service to patients in cooperation with the prescription management system 3 and the terminal device 9. Several methods have been proposed for providing an electronic medicine notebook service to patients, and any method may be adopted, so a description of the methods will be omitted.

The acquisition unit 22 acquires information from the medical information processing system 1. One type of information that the acquisition unit 22 acquires from the medical information processing system 1 is review proposal information. Review proposal information is information that proposes a review of the prescription contents from the perspective of preventing polypharmacy. For example, assume that a prescribing doctor judges that the prescription contents of a drug that has already been prescribed to a patient should be reviewed from the perspective of preventing polypharmacy, and proposes to the patient that the prescription contents be reviewed. In the first embodiment, the terminal device 9 is capable of accepting a command (request) from the patient requesting reference information regarding the review, and outputting the command to the personal information management device 12. When the acquisition unit 22 receives the request via the terminal device 9, it requests the reference information for the review proposal from the medical information processing system 1. The request (command) is associated with the patient identification information of the requesting patient who is requesting the information.

Here, the medical information processing system 1 outputs the review proposal information as reference information in response to the request. The acquisition unit 22 acquires the review proposal information output from the medical information processing system 1.

The output unit 23 outputs information to the terminal device 9. One piece of information that the output unit 23 outputs to the terminal device 9 is the review proposal information acquired by the acquisition unit 22 as described above. The review proposal information output to the terminal device 9 by the output unit 23 is displayed in a predetermined display mode on the display device 99 by the display control operation of the terminal device 9. The display mode of the reference information (review proposal information) by the terminal device 9 is appropriately set in consideration of ease of understanding, and is not limited to this, but an example is shown in FIG. 5. In the example of FIG. 5, a message suggesting a review of the prescription contents ("Please consult with your doctor or pharmacist about reducing the dosage") is displayed in text on the display screen of the display device 99, and a comment such as the possibility of polypharmacy, which is the reason for the review, is also displayed in text. Furthermore, an image 98 of a photograph or illustration of the drug to be reviewed is also displayed on the display screen of the display device 99.

Another type of information that the output unit 23 outputs to the terminal device 9 is review notification information. The review notification information is information that notifies the patient that the prescription contents have been reviewed, and is output from the medical information processing system 1. The review notification information includes, for example, information indicating the revised medication (changed medication information). The review notification information output to the terminal device 9 by the output unit 23 is displayed on the screen of the display device 99 by the display control of the terminal device 9. FIG. 6 shows an example of review notification information displayed on the screen of the display device 99 by the display control of the terminal device 9. In the example of FIG. 6, a sentence (characters) notifying that the prescription contents have been changed is displayed on the screen of the display device 99, and an image 98 of a photo or illustration of the revised medication is also displayed. Furthermore, a sentence calling attention to the state in which polypharmacy is likely to occur is also displayed on the screen of the display device 99.

The recording unit 24 acquires post-dose physical condition information from the patient using the terminal device 9, and stores (records) the acquired post-dose physical condition information in, for example, the database 70 in a state associated with the patient identification information. The post-dose physical condition information is information about the physical condition of the patient after taking the medicine. Here, a specific example of processing by the recording unit 24 is given. For example, when a patient to whom a new medicine has been dispensed is detected using information acquired by the notebook control unit 21, the recording unit 24 requests the patient to register information about the physical condition after taking the newly dispensed medicine to the terminal device 9 of the patient. As a method of sending this request, for example, when the terminal device 9 connects to the personal information management device 12 by an app, a request to register the post-dose physical condition information is sent by push notification. Also, when the terminal device 9 connects to the personal information management device 12 by a browser, for example, a request to register the post-dose physical condition information is sent by e-mail or the like using address information that is the contact information of the patient registered in advance.

When the recording unit 24 detects that the patient has input information to the terminal device 9 indicating that the patient intends to register post-dose physical condition information in response to the request, the recording unit 24 causes the display device 99 to display a physical condition information input screen on which the patient can register post-dose physical condition information. At this time, for example, information related to the drug, such as information indicating the drug to be input (drug identification information) and information on the date the drug was dispensed (date information), is transmitted from the recording unit 24 to the terminal device 9. The display mode of the physical condition information input screen is not limited as long as it allows the patient to input post-dose physical condition information, and one example is the display mode shown in FIG. 7. In the example of FIG. 7, an image 97 of the drug to be registered is displayed on the screen of the display device 99, and a text requesting the input of information indicating the post-dose physical condition and a text of options for selecting and registering information indicating the post-dose physical condition are displayed. As another example of the display mode of the post-dose physical condition information input screen, a message such as "Please enter how you felt after taking the prescribed medicine XXX" is displayed in text on the display screen. Along with the message, a field for the patient to manually enter information may also be displayed on the display screen.

When the recording unit 24 receives from the terminal device 9 post-drug physical condition information inputted into the physical condition information input screen of the display device 99 as described above, the recording unit 24 stores the post-drug physical condition information in the database 70. The post-drug physical condition information stored in the database 70 includes information indicating the physical condition after taking the medicine, drug identification information, and information on the dispensed date, and the post-drug physical condition information is associated with patient identification information. Such post-drug physical condition change information is accumulated for each patient.

The recording unit 24 further has the following functions. That is, the recording unit 24 has a function of compiling the accumulated information on changes in physical condition after taking a medicine for each patient and generating a post-drug physical condition report. The information included in the post-drug physical condition report includes information that is useful for the prescribing doctor or pharmacist when prescribing (dispensing) medicine to the patient. For example, it includes information for displaying a list of the name of the medicine that caused the patient's physical condition to worsen after taking the medicine, the date the medicine was prescribed, and information indicating the state of the worsened physical condition. The post-drug physical condition report is associated with the patient identification information of the corresponding patient and stored in the database 70. In addition, the recording unit 24 reviews the accumulated information on changes in physical condition after taking a medicine for each patient at predetermined times and updates the post-drug physical condition report as necessary.

In addition, the post-drug physical condition information recorded by the recording unit 24 and information regarding the post-drug physical condition extracted from the post-drug physical condition report may be presented as reference information for review suggestions by the output unit 23, as shown in FIG. 8.

The providing unit 25 transmits the post-drug health report to the medical information processing system 1 upon request. That is, when the providing unit 25 receives a command from the medical information processing system 1 requesting the transmission of a post-drug health report, it reads the post-drug health report to be transmitted from the database 70 using the patient identification information associated with the command. The providing unit 25 then transmits the read post-drug health report to the medical information processing system 1.

The result association unit 26 accepts the deterrence result information output from the medical information processing system 1, and stores the accepted deterrence result information in the database 70 in association with the patient identification information. The result association unit 26 may also execute predetermined processing related to the deterrence result information. For example, the result association unit 26 outputs the deterrence result information to the patient's terminal device 9 in response to a request from the patient.

The medical information processing system 1 will be described below. The medical information processing system 1 is the main element of the polypharmacy prevention system, and includes a medical information processing device (computer device) 10 as shown in FIG. 9. The medical information processing device 10 includes a control device 50 and a storage device 60. The storage device 60 includes a storage medium for storing data and a program (computer program) 61. There are multiple types of storage devices, and a computer device may be equipped with multiple types of storage devices. Here, the types and number of storage devices equipped in the medical information processing device 10 are not limited, and a description thereof will be omitted. Furthermore, when the medical information processing device 10 is equipped with multiple types of storage devices, they will be collectively referred to as storage device 60.

The control device 50 is composed of a processor such as a CPU. The control device 50 can have various functions based on a program 61 stored in a storage device 60 by reading and executing the program 61. Here, the control device 50 has an acquisition unit 51, a judgment unit 52, a proposal unit 53, a generation unit 54, a provision unit 55, a processing unit 56, a notification unit 57, and an output unit 58 as functional units related to the polypharmacy prevention function.

In the polypharmacy prevention system, prescription information including prescription details indicating the details of the medicine prescribed by the prescribing doctor to the patient is registered in the prescription management system 3 using a terminal device 7, and is also transmitted to the medical information processing system 1. Furthermore, in medical institutions where a medical administration system 5 has been established, the prescription information is also registered in the medical administration system 5.

When prescription information is transmitted to the medical information processing device 10, the acquisition unit 51 of the medical information processing device 10 acquires the transmitted prescription information as new prescription information. In addition, when the acquisition unit 51 acquires new prescription information, it acquires the patient's medication history information corresponding to the new prescription information from the prescription management system 3 using the patient identification information included in the new prescription information (prescription information).

When the determination unit 52 receives new prescription information, it extracts information on the newly prescribed medication from the new prescription information and determines whether the newly prescribed medication may cause polypharmacy for the patient. Here, this determination regarding polypharmacy (hereinafter also referred to as polypharmacy determination) uses the medication history information acquired by the acquisition unit 51, and information on incompatible medication interactions and polypharmacy determination criteria that are preregistered in the storage device 60 and database 70. The patient's medication history information includes information such as the name that identifies the prescribed (dispensed) medication, and information on the dispensing date and duration of use of the medication. Thus, information that identifies the medications that the patient is taking at the time of determination can be obtained from the medication history information. In addition, information on the patient's illness (physical condition) can be obtained from the medication history information.

Information on prohibited drug combinations is information on combinations of drugs that are not recommended to be taken together. In other words, there are drug combinations that increase the risk of adverse events, such as when the ingredients of multiple drugs taken together react with each other and have a strong effect on the patient. Information that describes such drug combinations is referred to as information on prohibited drug combinations here. Polypharmacy assessment criteria are information that serves as a criterion for determining whether or not a patient is at risk of developing polypharmacy. Polypharmacy occurs not only in relation to the number of types of drugs taken together, but also in relation to the combination of drugs taken together and the type of illness of the patient (in other words, the patient's physical condition). For this reason, the polypharmacy assessment criteria here are predetermined criteria for determining whether or not a patient is at risk of developing polypharmacy, using multiple factors such as the combination of drugs taken by the patient and the number of types, and the type of illness of the patient.

The determination unit 52 stores the information on the determination result in the storage device 60 or the database 70 in association with, for example, new prescription information (prescription information). The determination unit 52 also generates information indicating the basis for the determination as determination-related information for the information on the determination result. The generated determination-related information is stored in the storage device 60 or the database 70 in association with the information on the determination result.

The suggestion unit 53 generates review proposal information that proposes a review of the prescription contents of the medicine when the judgment unit 52 judges that there is a risk of polypharmacy. The review proposal information includes, for example, information on the medicine, patient identification information, prescription identification information, and identification information of the prescribing doctor (prescribing doctor identification information) included in the new prescription information (prescription information) that was the subject of judgment by the judgment unit 52. Furthermore, the review proposal information may include information representing multiple types of medicines that the patient is taking. Furthermore, the review proposal information may include information that is the basis for proposing the review (judgment-related information). For example, information on the basis of the review proposal, such as the medicine prescribed by an orthopedic doctor being likely to have adverse effects on the kidneys and the patient's kidney function being weakened, may be included in the review proposal information as judgment-related information. Such review proposal information is stored in the storage device 60 or database 70 in association with the new prescription information (prescription information).

Furthermore, the suggestion unit 53 outputs the generated review proposal information to the prescribing doctor, the pharmacist, and the patient. The timing at which the suggestion unit 53 outputs the review proposal information to the prescribing doctor is, for example, the timing at which the suggestion unit 53 generates the review proposal information in response to the judgment result by the judgment unit 52. In this case, if the review proposal information is generated by the processing of the judgment unit 52 and the suggestion unit 53 after the prescription information is output to the medical information processing device 10 by the terminal device 7 of the prescribing doctor, the review proposal information is immediately returned from the medical information processing device 10 to the terminal device 7. The terminal device 7 that receives the review proposal information displays the review proposal information in a predetermined display mode on the display device whose display operation is controlled by the terminal device 7. FIG. 10 shows an example of the display mode of the review proposal information. In the example of FIG. 10, a sentence (characters) proposing a review is displayed on the display screen of the display device, and a sentence explaining the grounds for proposing the review is also displayed. Furthermore, an icon 72 including link information for calling up a screen for correcting the prescription content to input the revised prescription content is displayed on the display screen of the display device.

When proposing a review of the prescription contents to the prescribing doctor, the suggestion unit 53 may output review proposal information to the prescribing doctor's terminal device 7, and may also output to the terminal device 7 the medical history information of the patient to be reviewed and the patient's post-drug physical condition information obtained from the personal information management device 12 as reference information for the review. In this case, for example, by display control of the prescribing doctor's terminal device 7, the display screen of the display device may display information on the patient's post-drug physical condition related to the drug to be reviewed as shown in FIG. 11 or the patient's medical history information as reference information for reviewing the prescription contents.

When the prescription contents revised by the prescribing physician are input using the terminal device 7, for example, into a screen for correcting prescription contents, and the revised prescription information is generated, the prescription information is output to the prescription management system 3 and the medical administration system 5. As a result, for example, the prescription information to be reviewed in the prescription management system 3 and the medical administration system 5 is updated to the revised prescription information. In addition, information indicating that the prescription contents have been revised is added to the patient's medical history information in the prescription management system 3.

The following timings are considered as the timings when the suggestion unit 53 outputs the review suggestion information to the pharmacist. That is, in the polypharmacy prevention system, as described above, when there is a risk of polypharmacy, the suggestion unit 53 suggests to the prescribing doctor that the prescription contents be reviewed. However, at the time when the pharmacist dispenses the medicine to the patient, it is considered that the prescribing doctor has not reviewed the prescription contents for some reason. In consideration of such a case, the suggestion unit 53 has a function of suggesting to the pharmacist that the prescription contents be reviewed. For example, here, when the pharmacist reads out the prescription information registered in the prescription management system 3 using the terminal device 8 in order to dispense the medicine to the patient, the terminal device 8 is also connected to the medical information processing system 1. Then, the terminal device 8 requests the result of the polypharmacy judgment for the prescription information to be read out to the medical information processing device 10. This request is associated with the prescription identification information and patient identification information used to read out the prescription information. In response to the request, the suggestion unit 53 reads out information on the judgment result of the judgment unit 52 stored in the storage device 60 or database 70 for the prescription information to be read out, using the prescription identification information and the patient identification information. Then, if the judgment result read out by the judgment unit 52 is that there is no risk of inducing polypharmacy, the suggestion unit 53 returns information to that effect to the terminal device 8. On the other hand, if the judgment result read out by the judgment unit 52 is that there is a risk of inducing polypharmacy, the suggestion unit 53 returns (outputs) review suggestion information associated with the prescription information to be read out to the terminal device 8.

The terminal device 8 that has received the review proposal information displays the review proposal information in a predetermined display mode on a display device whose display operation is controlled by the terminal device 8. FIG. 12 shows an example of the display mode of the review proposal information on the display device of the terminal device 8. In the example of FIG. 12, a sentence (characters) proposing the review is displayed on the display screen of the display device, and a sentence explaining the reason for proposing the review is also displayed. Furthermore, an icon 82 requesting that the prescribing doctor be asked to review the prescription contents is displayed on the display screen of the display device. For example, if a pharmacist discusses a review of the prescription contents with a patient and the patient agrees to the review, the pharmacist uses the icon 82 to request the prescribing doctor to review the prescription contents. This request information is output to the medical information processing device 10.

When the suggestion unit 53 detects that the pharmacist has requested the prescribing doctor to review the prescription contents through the pharmacist's operation of the terminal device 8, it outputs review proposal information to the terminal device 7 of the prescribing doctor that generated the prescription information corresponding to the request. The review proposal information output in this manner is associated with, for example, information that the pharmacist has requested a review and that the patient's consent has been obtained. The terminal device 7 that has received such review proposal information displays the review proposal information from the pharmacist on the display device in a predetermined display form. FIG. 13 shows an example of the display form of the review proposal information from the pharmacist. In the example of FIG. 13, the display screen of the display device displays a sentence (characters) indicating that the pharmacist has requested a review and that the patient's consent has been obtained, and also displays a sentence explaining the reason for proposing the review. Furthermore, as in FIG. 10, an icon 72 including link information for calling up a prescription content correction screen for inputting the reviewed prescription contents is displayed on the display screen of the display device. In addition, when the review proposal information from the pharmacist is displayed on the display device of the terminal device 7, information on the patient's physical condition after taking the drug to be reviewed or the patient's medication history information may be displayed as reference information for reviewing the prescription contents, as in the case of FIG. 11.

When the prescription contents are reviewed by the prescribing physician due to such a review suggestion from the pharmacist, the suggestion unit 53 outputs a review completion notification to the terminal device 8 of the pharmacist who proposed the review, informing the pharmacist that the prescription contents have been reviewed. This allows the pharmacist to know that the revised prescription information reviewed and changed by the prescribing physician has been registered in the prescription management system 3. The pharmacist can then read out the revised prescription information from the prescription management system 3, dispense the medicine according to the reviewed prescription contents that have been considered to prevent the patient's polypharmacy, and provide the medicine to the patient.

When the suggestion unit 53 receives a request for reference information for a revision proposal from the personal information management device 12 (patient), it returns (outputs) the revision proposal information to the personal information management device 12 for the patient. In other words, the suggestion unit 53 returns (outputs) the review proposal information read from the storage device 60 or database 70 using the patient identification information associated with the request and, for example, information on the date and time when the request was received, to the personal information management device 12. As a result, by the function of the acquisition unit 22 of the personal information management device 12 as described above, reference information related to the revision of the prescription contents as shown in FIG. 5 is displayed on the display device of the patient's terminal device 9.

When the generating unit 54 detects that the prescription contents have been reviewed from the information on the processing execution status of the proposing unit 53 or the update status of the prescription information, the generating unit 54 generates the prevention record information using the review proposal. As described above, the prevention record information is information that indicates the record of the prescription contents review by the prescribing doctor, the pharmacist, and the patient who were involved in the review of the prescription contents to suppress polypharmacy.

The generation unit 54 stores the generated suppression record information in the storage device 60 or database 70 in association with the identification information of the prescribing doctor who considered revising the prescription contents (prescribing doctor identification information), the identification information of the patient (patient identification information), and the identification information of the pharmacist (pharmacist identification information).

The output unit 58 outputs the deterrence record information generated by the generation unit 54 to the medical administration system 5 (i.e., the medical institution). By receiving such deterrence record information, the medical administration system 5 can easily provide a function for automatically registering information on records related to polypharmacy deterrence in medical receipts (medical fee reports) or electronic medical records. This improves the efficiency of medical administration (in other words, the efficiency of administrative processing at medical institutions) compared to when information indicating involvement in polypharmacy deterrence is manually entered into electronic medical records or medical receipts in the medical administration system 5. Note that a medical receipt (medical fee report) is one of the documents that a medical institution submits to an insurer, and an electronic medical record is electronic data of the medical record (medical fee report) at the medical institution.

When the prescribing doctor prescribes a drug to a patient, the providing unit 55 provides the prescribing doctor with the patient's post-drug physical condition information as reference information. In other words, as described above, the patient's post-drug physical condition information is information that records the patient's physical condition after taking the drug. The post-drug physical condition information is generated by the recording unit 24 of the personal information management device 12 and stored in the storage device 28 or database 70 in association with the patient identification information. For example, when the providing unit 55 detects that the prescribing doctor has used the terminal device 7 to request the patient's post-drug physical condition information, the providing unit 55 acquires the patient's post-drug physical condition information from the personal information management device 12 using the patient identification information. The providing unit 55 then returns the acquired post-drug physical condition information to the prescribing doctor's terminal device 7 as reference information.

The providing unit 55 may further include the following functions. That is, the providing unit 55 judges whether or not the post-drug physical condition information includes abnormal medication information that indicates abnormal physical condition after taking the medicine, for example, by using information on words such as headache or palpitations that indicate abnormal physical condition. Then, when the post-drug physical condition information includes abnormal medication information, the providing unit 55 extracts the abnormal medication information from the post-drug physical condition information. Furthermore, when the post-drug physical condition information is output to the prescribing doctor's terminal device 7, the providing unit 55 outputs the extracted abnormal medication information as warning information. In the terminal device 7 that receives the post-drug physical condition information that includes such warning information (abnormal medication information), for example, the warning information selected from the post-drug physical condition information is displayed on the display device as reference information, or the warning information is selectively highlighted from the displayed post-drug physical condition information.

The information provided by the providing unit 55 is considered to be useful when the prescribing physician prescribes medicine to the patient, so the providing unit 55 can provide the prescribing physician with information that is useful when prescribing.

The processing unit 56 executes a deterrence performance-related process using the deterrence performance information. The deterrence performance-related process includes the following quantification process. For example, the processing unit 56 executes a process of converting information indicating the content of the review contained in the deterrence performance information into a score (i.e., a number) as the quantification process using conversion information given in advance. The score calculated by such a quantification process is associated with the deterrence performance information from which it was calculated as performance conversion information and stored in the storage device 60 or database 70. In addition, the performance conversion information is acquired by the linkage system 4 as described above, and is used in the process of granting a reward according to the performance of the review of the prescription content.

Another example of the quantification process of the deterrence performance-related process executed by the processing unit 56 is a process of investigating and aggregating the status of polypharmacy deterrence for each predetermined unit (e.g., for each hospital or region) and expressing it in numbers. The processing unit 56 may further execute deterrence performance-related processes that also include a process of analyzing information on the polypharmacy deterrence status that has been quantified in this way. The results of such deterrence performance-related processes are provided to the linkage system 4, for example.

The notification unit 57 notifies the patient of a notification indicating that the prescription contents have been reviewed as review notification information. This notification of review notification information is triggered, for example, by the generation unit 54 generating deterrence record information for the patient. The review notification information is also notified via the personal information management device 12. For example, when the generation unit 54 generates deterrence record information for the patient, the notification unit 57 associates the deterrence record information with patient identification information and outputs the review notification information to the personal information management device 12. The output unit 23 of the personal information management device 12 receives the review notification information and notifies the patient of the review notification information using the patient identification information associated with the review notification information.

Furthermore, when the generating unit 54 generates the deterrence record information of the prescribing physician, the notification unit 57 may notify the terminal device 7 of the prescribing physician involved in the review of the prescription contents of record registration completion information. The record registration completion information is a notification that notifies the medical information processing system 1 that record information related to the deterrence of polypharmacy has been registered. In the terminal device 7 that receives the record registration completion information, the record registration completion information is displayed on the display device, as shown in FIG. 14, for example.

As described above, the medical information processing device 10 of the first embodiment has a function to execute polypharmacy assessment processing related to polypharmacy prevention and processing to suggest a revision of prescription contents. In addition, the medical information processing device 10 has a function to generate deterrence record information that represents the record of involvement in deterring polypharmacy. In this way, by generating deterrence record information, an incentive can be given to prescribing doctors, pharmacists, and patients to encourage actions related to deterring polypharmacy. In other words, the medical information processing device 10 can provide technology that ensures the smooth operation of a system to deter patients from polypharmacy.

Next, an example of the operation of the medical information processing device 10 will be described with reference to Figures 15 and 16. Figure 15 is a flowchart explaining an example of the operation related to the generation of review suggestion information in the medical information processing device 10. Figure 16 is a flowchart explaining an example of the operation related to the generation of deterrence record information in the medical information processing device 10.

For example, when the medical information processing device 10 receives prescription information from the prescribing doctor's terminal device 7 (step 101 in FIG. 15), the acquisition unit 51 acquires the transmitted prescription information as new prescription information. The acquisition unit 51 also acquires the patient's medication history information corresponding to the new prescription information from the prescription management system 3 using the patient identification information included in the new prescription information (prescription information).

Then, the judgment unit 52 judges whether the newly prescribed drug based on the information extracted from the new prescription information is likely to cause polypharmacy for the patient (step 102). In this judgment, the patient's medication history information, incompatible drug interactions information, and polypharmacy judgment criteria are used.

Then, the judgment unit 52 stores the information of the judgment result in the storage device 60 or the database 70 in association with, for example, new prescription information (prescription information). Then, if the judgment result by the judgment unit 52 is that there is no risk of polypharmacy, the operation of the process related to the generation of review suggestion information ends. Then, the medical information processing device 10 goes into a standby state for the reception of the next new prescription information (prescription information) with regard to the process related to the generation of review suggestion information. On the other hand, if the judgment result by the judgment unit 52 is that there is a risk of polypharmacy, the suggestion unit 53 generates review suggestion information that suggests a review of the drug prescription contents (step 103). Then, the suggestion unit 53 outputs the generated review suggestion information to the prescribing doctor's terminal device 7 (step 104).

Furthermore, suppose that after that, the pharmacist's terminal device 8 requests the result of the polypharmacy assessment for the new prescription information (prescription information) from the medical information processing device 10. In this case, the suggestion unit 53 refers to the information on the assessment result stored in the storage device 60 or the database 70. Then, if the result of the polypharmacy assessment is that there is a risk of polypharmacy, the suggestion unit 53 outputs review proposal information associated with the new prescription information (prescription information) for which that assessment has been made to the pharmacist's terminal device 8.

Next, an example of the operation related to the generation of the deterrence performance information in the medical information processing device 10 will be described. For example, after the proposal unit 53 generates the review proposal information, the generation unit 54 detects that the prescription information related to the review proposal information has been reviewed from the information on the update status of the prescription information (step 201 in FIG. 16). As a result, the generation unit 54 generates deterrence performance information corresponding to each of the prescribing doctor, pharmacist, and patient involved in the review of the prescription content to suppress polypharmacy (step 202). After that, the processing unit 56 calculates the performance conversion information by converting the information representing the review content included in the deterrence performance information into a score as a numerical processing of the deterrence performance related processing (step 203). Furthermore, after that, for example, the processing unit 56 outputs the performance conversion information and the deterrence performance information to the linkage system 4 (step 204). The performance conversion information output to the linkage system 4 in this way is used for processing related to the provision of rewards to the prescribing doctor, patient, and pharmacist involved in the review of the prescription content.

The polypharmacy prevention system including the medical information processing device 10 of the first embodiment is configured as described above. In this polypharmacy prevention system, the medical information processing device 10 generates deterrence performance information that indicates the performance of the review of the prescription contents, corresponding to each of the prescribing physician, pharmacist, and patient who was involved in the review of the prescription contents to deter polypharmacy. Furthermore, this polypharmacy prevention system uses the deterrence performance information to provide rewards to each of the prescribing physician, pharmacist, and patient who was involved in the review of the prescription contents. By generating such deterrence performance information and providing rewards, the polypharmacy prevention system can provide each of the prescribing physician, pharmacist, and patient with an incentive to review the prescription contents to deter polypharmacy. In other words, the polypharmacy prevention system can encourage each of the prescribing physician, pharmacist, and patient to proactively perform actions related to reviewing the prescription contents.

Therefore, the polypharmacy prevention system can ensure the smooth operation of a mechanism for preventing polypharmacy among patients.

The polypharmacy prevention system can also provide prescribing physicians and pharmacists with information that is useful for reviewing prescription contents to prevent polypharmacy, and can also provide reference information regarding reviewing prescription contents upon request from patients. Furthermore, the polypharmacy prevention system can reduce the workload on pharmacists to request (suggest) a review of prescription contents to prescribing physicians.

<Other embodiments>
The medical information processing device according to the present invention is not limited to the aspect described in the first embodiment described above, and may adopt various embodiments. For example, in the first embodiment, the judgment unit 52 in the medical information processing device 10 refers to the polypharmacy judgment criteria stored in the storage device 60, for example, when making a polypharmacy judgment. Alternatively, the judgment unit 52 may make a polypharmacy judgment using a judgment model generated by AI (Artificial Intelligence) technology. For example, the judgment model is generated by machine learning the following teacher data. The teacher data is, for example, actual data on matters that lead to changes in physical condition due to taking medication, such as the patient's medical history information, information on the combination of types of drugs taken together, and information on the patient's physical condition (disease), and relationship data between the data indicating the occurrence or non-occurrence of polypharmacy. When the judgment model is generated using such teacher data, the data input to the judgment model when making a polypharmacy judgment includes, for example, the patient's medical history information, information indicating the combination of types of drugs taken together, and information indicating the patient's physical condition (disease). In addition, by inputting such input data, the judgment model outputs information indicating the judgment result on whether or not the patient is at risk of developing polypharmacy. In other words, such a judgment model can be said to be a model that has learned the polypharmacy judgment criteria, and the polypharmacy judgment by the judgment unit 52 using the judgment model is a judgment using the polypharmacy judgment criteria.

Furthermore, such a judgment model may be a model generated by an explainable AI technology. In this case, the judgment model generates and outputs, for example, text data explaining the basis of the judgment result as judgment-related information. Such an explanation of the basis (judgment-related information) may be associated with the review proposal information by, for example, the suggestion unit 53 and provided as reference information to, for example, the prescribing doctor or the patient.

In addition, in the first embodiment, the judgment unit 52 performs polypharmacy judgment using information about combinations of drugs that are not recommended to be taken together (information about incompatible drug combinations). The information about incompatible drug combinations may include not only information about drug-drug combinations, but also, for example, information about combinations of supplements and drugs that are not recommended to be taken together.

Furthermore, in the first embodiment, the linkage system 4 uses the performance conversion information (deterrence performance information) to grant rewards to the prescribing doctor, pharmacist, and patient. Alternatively, for example, the processing unit 56 of the medical information processing device 10 may execute, on behalf of the linkage system 4, processing related to the granting of rewards by including it in the deterrence performance-related processing.

Furthermore, in the first embodiment, the medical information processing device 10 includes a determination unit 52. Alternatively, for example, another computer device connected to the medical information processing device 10 includes a function similar to that of the determination unit 52, and the medical information processing device 10 can acquire information representing the results of the polypharmacy assessment from that computer device. In this case, the determination unit 52 may be omitted in the medical information processing device 10 by using the results of the polypharmacy assessment by that computer device.

Furthermore, the suggestion unit 53 of the medical information processing device 10 may have the following functions. For example, when the result of the polypharmacy judgment by the judgment unit 52 is that there is a risk of polypharmacy, the suggestion unit 53 may suggest a type of drug that is recommended to be reduced from among multiple types of drugs (including newly prescribed drugs) taken by the patient. In this case, the suggestion unit 53 requests the prescribing doctor who prescribed the drug for which reduction is proposed to review the prescription contents by outputting review proposal information. Such a suggestion of a drug to be reduced is made, for example, by a drug reduction proposal model generated using AI technology. The drug reduction proposal model is generated, for example, by machine learning relationship data between a combination of types of drugs to be taken together and the types of drugs to be reduced from the combination that are recommended to be reduced in order to prevent polypharmacy.

The suggestion unit 53 may also receive prescribing doctor designation information from the terminal device 8, which is operated by the pharmacist to designate a prescribing doctor who should review the prescription contents, and may request the designated prescribing doctor to review the prescription contents by outputting review suggestion information.

Furthermore, in the first embodiment, the generating unit 54 of the medical information processing device 10 generates deterrence record information on prescribing doctors, pharmacists, and patients who have considered revising the prescription contents. The generating unit 54 may further generate deterrence record information on medical institutions and pharmacies including prescribing doctors and pharmacists who have considered revising the prescription contents, as well as prescribing doctors, pharmacists, and patients. The polypharmacy deterrence system may, for example, use the deterrence record information to grant such medical institutions and pharmacies the right to state that they have been certified by the polypharmacy deterrence system. This allows, for example, such medical institutions and pharmacies to include information that they have been certified by the polypharmacy deterrence system in information introducing medical institutions and pharmacies that is published on the Internet. This information allows patients and the like to easily find medical institutions and pharmacies that have been certified by the polypharmacy deterrence system from information published on the Internet using an information search function.

Furthermore, in the first embodiment, an example is described in which the output unit 23 in the personal information management device 12 outputs information (review proposal information and review notification information) output from the medical information processing device 10 to the patient's terminal device 9. For example, when the output unit 23 outputs review proposal information to the patient's terminal device 9, it may cooperate with the notebook control unit 21 to output information acquired by the notebook control unit 21 to the terminal device 9, and cause the terminal device 9 to display it on the display device 99. Specific examples of information acquired by the notebook control unit 21 include prescription information, dispensing information, and medical history information of the patient managed in the prescription management system 3, and information registered by the patient in the database 70 of the personal information management device 12 using the terminal device 9. In addition, it is assumed that the personal information management device 12 is connected to, for example, an electronic medical record system (medical office system 5) of a medical institution and can acquire information such as the patient's test results from the system. In this case, the information output by the output unit 23 in cooperation with the notebook control unit 21 to the terminal device 9 includes, for example, information included in the electronic medical record of the medical institution (information on the medicine notebook), which is displayed on the display device 99 of the terminal device 9 as shown in FIG. 17. Furthermore, when outputting, for example, review proposal information to the terminal device 9, the output unit 23 may also output an instruction to read and display information on the patient's own physical condition registered by the patient in the storage device of the terminal device 9. In this case, in addition to the information output from the personal information management device 12 to the terminal device 9, the information held in the terminal device 9 is also displayed on the display device 99 of the terminal device 9. Furthermore, regarding the display on the display device 99 of the patient's terminal device 9, the information from the medical information processing device 10 by the output unit 23 and the information (information on the medicine notebook) in cooperation with the notebook control unit 21 may be displayed on the same screen, or may be displayed on separate screens as shown in FIG. 18. Note that the display device 99 of the patient's terminal device 9 may display information based on the function of the notebook control unit 21 alone.

Furthermore, in the first embodiment, the personal information management device 12 is provided with a recording unit 24, and the recording unit 24 executes the process of acquiring post-drug physical condition information from the patient. Alternatively, the medical information processing device 10 may be provided with a function similar to that of the recording unit 24. In this way, in the configuration of the first embodiment, at least a part of the functions related to polypharmacy prevention provided in the personal information management device 12 and the information processing device 14 may be provided in the medical information processing device 10 instead of the personal information management device 12 and the information processing device 14.

FIG. 19 is a block diagram illustrating the configuration of a medical information processing device according to another embodiment of the present invention. This medical information processing device 90 is, for example, a computer device, and can have the following functional units by executing a computer program. That is, the medical information processing device 90 includes a proposal unit 91, a generation unit 92, and a processing unit 93.

The suggestion unit 91 receives the result of the judgment as to whether or not the drug prescribed to the patient may lead to polypharmacy, and outputs review proposal information that suggests a review of the drug prescription contents when the judgment result indicates that there is a risk of polypharmacy. When the prescription contents have been reviewed, the generation unit 92 generates deterrence record information indicating that the prescription contents have been reviewed, in association with at least the prescribing physician involved in the review of the prescription contents. The processing unit 93 executes deterrence record related processing including a quantification process that uses the deterrence record information to express the results of the prescription contents review in numbers.

Next, an example of the operation of the medical information processing device 90 will be described with reference to FIG. 20. FIG. 20 is a flowchart for explaining an example of the operation of the medical information processing device 90. For example, assume that the result of the judgment as to whether or not the medicine prescribed to the patient may lead to polypharmacy is received. In this case, if the judgment result is that there is a risk of leading to polypharmacy, the suggestion unit 91 outputs review proposal information that proposes a review of the prescription contents of the medicine (step 901 in FIG. 20). If the prescription contents are subsequently reviewed, the generation unit 92 generates deterrence record information indicating that the prescription contents have been reviewed, in association with at least the prescribing doctor involved in the review of the prescription contents (step 902). Thereafter, the processing unit 93 executes deterrence record related processing including a quantification process that uses the deterrence record information to express the results of the review of the prescription contents in numbers (step 903).

The medical information processing device 90 has the above-mentioned configuration, and by generating deterrence record information indicating that the prescription contents have been reviewed, it is possible to provide prescribing physicians and others involved in reviewing the prescription contents with an incentive to do so. This is expected to encourage prescribing physicians and others to proactively review the prescription contents in order to deter polypharmacy. In other words, the medical information processing device 90 can ensure the smooth operation of a system that deters patients from polypharmacy.

The present invention has been described above using the above-mentioned embodiment as an exemplary example. However, the present invention is not limited to the above-mentioned embodiment. In other words, the present invention can be applied in various aspects that can be understood by a person skilled in the art within the scope of the present invention.

10, 90 Medical

information processing device

53, 91

Proposal unit

54, 92

Generation unit

56, 93 Processing unit

Claims

a suggestion means for outputting review suggestion information for suggesting a review of the prescription content of a drug when a result of the judgment as to whether or not a drug prescribed to a patient is likely to cause polypharmacy is that the drug is likely to cause polypharmacy;
A generating means for generating, when the prescription content is revised, suppression record information indicating that the prescription content has been revised, in association with at least the prescribing doctor involved in the revision of the prescription content;
A medical information processing device comprising: a processing means for executing a suppression record-related process including a digitization process for expressing the results of revision of prescription contents in numbers using the suppression record information.
An acquisition means for acquiring new prescription information representing the contents of a drug prescribed to a patient;
The medical information processing device according to claim 1 , further comprising a determination means for determining whether or not the drug prescribed to the patient is likely to cause polypharmacy by using the new prescription information, the patient's medical history information, and polypharmacy determination criteria.
The determination means generates determination-related information related to a determination that there is a risk of inducing polypharmacy,
The medical information processing apparatus according to claim 2 , wherein the suggestion means outputs the review suggestion information in association with the judgment-related information.
The medical information processing device according to claim 1, wherein the deterrence performance-related processing by the processing means further includes a process of using the numbers calculated by the quantification process to provide a reward to at least the prescribing physician involved in reviewing the prescription contents in accordance with the performance of the review.
The medical information processing apparatus according to claim 1 , wherein the suppression record-related process by the processing means includes, as the digitization process, a process of tallying up the record of revision of prescription contents for each predetermined unit.
The medical information processing device according to claim 1, further comprising a providing means for acquiring post-medication health information that records the patient's health condition after taking the medicine, and outputting, if the post-medication health information contains information about abnormalities in the patient's health condition after taking the medicine, the information about abnormalities in the patient's health condition after taking the medicine as warning information.
The medical information processing apparatus according to claim 1 , further comprising a notification unit for notifying the patient of the fact that the prescription contents have been revised.
The medical information processing device of claim 1, further comprising an output means for outputting the prevention performance information to the medical institution in order to reflect information on the performance related to polypharmacy prevention in the receipt (medical fee report) that the medical institution submits to the insurer or the electronic medical record, which is electronic data of the medical institution's medical record (medical record).
By computer,
outputting review suggestion information for proposing a review of the drug prescription content when the result of the determination of whether or not the drug prescribed to the patient is likely to cause polypharmacy indicates that the drug is likely to cause polypharmacy;
When the prescription content is reviewed, suppression record information indicating that the prescription content has been reviewed is generated in association with at least the prescribing physician involved in the review of the prescription content;
A medical information processing method that executes a suppression record-related process that includes a quantification process that uses suppression record information to express the results of prescription content review in numbers.
a process for outputting review suggestion information for proposing a review of the drug prescription content when the result of the determination of whether or not a drug prescribed to a patient may cause polypharmacy indicates that the drug may cause polypharmacy;
When the prescription content is revised, a process of generating suppression record information indicating that the prescription content has been revised in association with at least the prescribing physician involved in the revision of the prescription content;
and a program storage medium that stores a computer program that causes a computer to execute a process related to deterrence performance, including a quantification process that uses deterrence performance information to numerically represent the results of reviewing prescription contents.