JP2007299261A - Medical system - Google Patents

Abstract

An object of the present invention is to provide a mechanism for improving the convenience of system operation in medical information processing and enhancing security.
In a medical system comprising a user terminal 10 for processing medical information and a medical information storage means 30, when the user terminal 10 reads identification information of a portable medium, detects an operation, and detects an operation. The identification information is recorded in association with the operation, and when the portable medium is no longer detected, the operation is not accepted from the user, and when it is detected, the operation is accepted. Thus, even if a third-party person who entered using a portable medium sits after using it and operates it if the third-party does not have a portable medium Can be operated if the third party has his / her portable medium, but the user is recorded as this third party and recorded as the input of the user who has finished using it. Can be prevented.
[Selection] Figure 2

Description

  The present invention relates to a medical system that improves the convenience of operation of a system for processing medical information and enhances security.

In medical institutions including hospitals, a plurality of people such as doctors and nurses are involved as team medical care. An electronic medical record used in a medical institution is a card into which all health information of a patient such as a medical history and a medical examination record is input. Doctors, nurses, and the like who are engaged in medical institutions share information about patients through electronic medical records, and perform processing such as inputting and referencing information about electronic medical records as necessary. In an ordinary electronic medical record, in order to leave information on who wrote the medical record, it is common to input the medical record information after inputting the user ID. In addition, there are various functions / screens that need to be entered in the electronic medical record, but it is necessary to re-enter the user's code again when another person inputs the same screen on the same terminal. It is a mechanism that does not save the recordr correctly.
As a medical record information management system as a background art, there is one disclosed in Japanese Patent Laid-Open No. 2003-337862, which will be described below.

  The medical record information management system in the background art is a medical record information management system in which a doctor stores patient examination information in a storage device and manages the medical record information management system for a doctor having a storage means storing doctor specific information for specifying a doctor and a calculation function A storage means storing patient-specific information for identifying a patient, a storage medium for a patient having a calculation function, a reader for reading the information stored in the storage medium, and storing patient examination information A diagnosis information database, a doctor specific information database in which doctor specific information is registered in advance, and a control unit for specifying a writing area of the diagnosis information from the diagnosis information database based on the patient specific information read from the reading device; The doctor specific information read from the reader and the doctor specific information registered in the doctor specific information database And collating means for collating, characterized by comprising a host computer system and a write enable means to permit writing process examination information for the examination information database only if they match the collation by the collating means.

  As described above, the medical record information management system of the background art requires a storage medium for a doctor and a storage medium for a patient as preconditions for writing patient examination information, and further stores the information in each storage medium. If a medical error occurs because the doctor can write the patient's examination information for the first time on condition that the matching information matches the matching information registered in the database in advance. However, there is an effect that it is not possible to maliciously tamper with the diagnostic results made when the doctor has examined the patient in the past, the medical treatment performed on the patient, and the record of the administered drug. In addition, only when the patient-specific information is read from the reading device by the control means, the fraud prevention by the doctor can be checked more strictly by performing the writing process of the diagnosis information in the diagnosis information database. This is preferable.

Moreover, as an electronic medical chart management system as a background art, there is one disclosed in Japanese Patent Laid-Open No. 2002-251462, which will be described below.
The electronic medical record management system of the background art is based on the information recording command of the operator, the electronic medical record storage unit in which the medical record data related to the information recording command is recorded and stored, and the electronic medical record data read from the electronic medical record storage unit are Based on the copyable external storage medium to be recorded and the operator's copy request command, the electronic medical record data related to the copy request command is read from the electronic medical record storage unit, and the read electronic medical record data is stored in the operator's unique The electronic medical record management system includes an electronic medical record copy recording control unit that encrypts based on the identification information, appends falsification detection data, and records the copy on the external storage medium. It is an operator ID and a password.

According to the electronic medical record management system of this background art, the electronic medical record copied and recorded on the external storage medium can be decoded and read only by the operator who records and stores the electronic medical record in the electronic medical record storage unit. Electronic medical records that have been made confidential and can be tampered with and stored in an external storage medium cannot be tampered with, and the authenticity of the electronic medical records is not lost, and security is completely secured. It is possible to obtain an external storage medium in which electronic medical records are recorded and stored. Using this external storage medium, the medical record diagnosis / treatment data recorded on the external storage medium among a plurality of medical institutions can be obtained. By sharing and using, it is possible to perform efficient medical care without waste and enhance the medical effect.
JP 2003-337862 A JP 2002-251462 A

  However, when using the electronic medical record, the login check is only performed at the beginning of use, so that once someone logs in, another person can input as it is. Therefore, if someone who entered the third party enters while the person who logged in is urgently present, this input is also recorded as the input of the user who entered the first logged-in user code. Has the problem.

  In order to solve the above-described problems, an object of the medical system according to the present invention is to enhance the security of a system that processes medical information and to provide a mechanism for correctly recording a user who has performed an operation. It is another object of the present invention to provide a medical system that improves user convenience while maintaining security.

(1) A medical system according to the present invention is a medical system including a user terminal that processes medical information and a storage unit that stores the medical information. The user terminal includes a unit that reads identification information of the portable medium, and an operation. Means for detecting, means for recording the identification information in association with the operation when an operation is detected, and means for receiving the operation when it is detected without receiving an operation from the user when the portable medium is no longer detected Is included. Here, the medical information includes, for example, patient information of an electronic medical record, order information from doctors, nurses, and medical personnel engaged in professional occupations, and vacant room information of a hospital. The storage means includes a database, a hard disk, a main memory, and the like. That is, when recording information, for example, it may be recorded in a database outside the computer, or may be recorded in the main memory of the computer. The portable medium includes a magnetic card, an IC card, a USB memory, and the like. Further, the operations include, for example, updating information in the database, adding and updating orders, correcting and updating medical charts. All operations may be recorded, or only a specific operation may be recorded. For example, the reference operation is not recorded, and the data update operation is recorded.

  As a result, when the operation is detected, the identification information is recorded in association with the operation. When the mobile medium is no longer detected, the operation is not accepted from the user. When the operation is detected, the mobile medium is used. Even if a third party inputs after someone uses it, it cannot be operated if the third party does not have a portable medium. It is possible to operate if the user has his / her own portable medium, but the user is recorded as this third party and is prevented from being recorded as the user's input before the third party operates be able to.

(2) The medical system according to the present invention includes means for displaying a screen capable of accepting an operation, as necessary.
As a result, a user using a portable medium can operate while looking at a screen that can accept the operation, and when the user removes the portable medium and no longer detects, the screen is displayed only by not accepting the operation. Does not change, and the subsequent user can grasp that the previous user ended the operation in the middle of input. Here, when the information for identifying the previous user is displayed on the screen, the subsequent user can specify the previous user. It is possible to confirm the previous user before the subsequent user erases the screen in the middle of input. Also, the current user can take over the previous user's input. For example, when a doctor is operating an add order for tomorrow for a patient and an emergency is carried and a response is requested, the continuation of the input will be given verbally to the nurse or resident before the response. When the doctor asks for input by explanation and the doctor takes out the portable medium and the nurse or the trainee inserts the portable medium later, the doctor's input can be taken over as it is. At this time, it is desirable to record not only the nurse or the resident as the user of the input operation but also the doctor.

(3) If necessary, the medical system according to the present invention allows the user terminal to determine whether or not it is an input intermediate screen when the identification information of the portable medium cannot be read by the user terminal. And means for recording information in the middle of input, means for ending the screen during input when identification information of the portable medium cannot be read in the user terminal, and detection of the previous portable medium is lost In this case, there are included means for determining whether or not the input is in progress, and means for returning and displaying the input intermediate screen when it is determined that the input is in progress.

  As a result, when the identification information of the portable medium can no longer be read by the user terminal, it is determined whether or not the screen is in the middle of input, and information in the middle of input is recorded in the middle of input. The input halfway screen is returned to the current user who has detected the medium, so if the previous user and the current user are the same, input can be resumed from the middle of the previous input. If the current user is different from the current user, the current user can grasp that the previous user has made the portable medium in the non-detection state during the input, and has finished the operation.

(4) The medical system according to the present invention includes a means for reading the user authority based on the identification information and a means for receiving an operation based on the read user authority, as necessary.
Thereby, for example, since the user on the IC card can manage the authority of the operation based on the authority of the user as a medical record recorder, the unnecessary operation by an unauthorized third party can be reduced. it can. In particular, even if the previous user has finished the operation in the middle of input and this user takes over the middle of input, this user can not operate for all operations. It can be operated based on the user authority. In other words, it can be taken over within its own user authority.

(5) In the medical system according to the present invention, the user terminal, as necessary, locks the specific medical information, and an operation from a user other than the user related to the locked specific medical information. And means for restricting.
Thereby, about the specific medical information locked, in order to restrict | limit operation of users other than the user who concerns on a lock | rock, medical information can be correct | amended correctly and updated. For example, it is possible to prevent the correction and update of duplicate medical information from other user terminals.

(6) When necessary, the medical system according to the present invention allows the user terminal to forcibly unlock the specific medical information that has been locked, and to use the specific medical information that has been forcibly unlocked for the forced unlocking. And means for releasing the restriction of the operation from the person.
As a result, forced unlocking is performed, and there is medical information that has been unlocked by a previous user taking out a portable medium in the middle of input in order to remove the restriction of operation for specific medical information. In addition, the medical information can be operated by forcibly releasing the lock.

(7) When necessary, the medical system according to the present invention includes information and an updater for identifying the update operation performed when the update operation to the specific medical information to be performed when the forced lock is released. A means for recording the information to be identified, a means for determining whether or not the input was in progress when the portable medium was not detected last time, and a notification that the input was updated in another user terminal if the input was in progress Means.
As a result, when the previous user has locked the specific medical information and finished the operation in the middle of input, the lock is forcibly released at another user terminal and the specific medical information is When an update operation is performed, it is notified that the update has been made on another user terminal, and a user who resumes or takes over the input can perform an operation based on the update of specific medical information. .

For example, the update here means not only the update of the order but also the addition of a new order. This is because it is a new addition when viewed in order units, but if it is regarded as information of a certain patient, the addition of a new order also means updating of the information of a certain patient.
These outlines of the invention do not enumerate the features essential to the present invention, and a sub-combination of these features can also be an invention.

The present invention can be implemented in many different forms. Therefore, it should not be interpreted only by the description of the following embodiments. In addition, the same reference numerals are given to the same elements throughout the embodiments.
In each embodiment, the system will be mainly described. However, as will be apparent to those skilled in the art, the present invention can also be implemented as a program and method usable in a computer. In addition, the present invention can be implemented in hardware, software, or software and hardware embodiments. The program can be recorded on any computer-readable medium such as a hard disk, CD-ROM, DVD-ROM, optical storage device, or magnetic storage device. Furthermore, the program can be recorded on another computer via a network.

(First embodiment of the present invention)
A first embodiment of the present invention will be described with reference to FIGS.
FIG. 1 is a system configuration diagram of a medical system and a hardware configuration diagram of a computer according to the first embodiment of the present invention. In the example illustrated in FIG. 1, one or a plurality of user terminals 10, a database 30, and a network that connects the user terminals 10 and the database 30 to be communicable are configured. In the medical system according to the embodiment of the present invention, the database 30 can also be realized by linking a plurality of databases. Moreover, the medical system which concerns on embodiment of this invention can construct | assemble a network as a server client system. That is, a server is separately arranged with the user terminal 10 as a client, a module mounted on the user terminal 10 is mounted on the server, and a service is provided in response to a request from the user terminal 10 as a client. be able to. Here, the server computer can also be realized by linking a plurality of servers. Furthermore, the database can be constructed on one computer that constructs the server, but is constructed separately on another computer, and the server connects to the other computer and acquires desired data as necessary. It can also be. Such a change in the mounting configuration in the system configuration and the hardware configuration itself has various well-known technologies and can be appropriately realized by those skilled in the art, and thus detailed description thereof is omitted here.

  The user terminal 10 includes a CPU 111 for performing arithmetic processing, a RAM 112 for performing storage processing, a ROM 113, a flash memory 114, an HD 115, a LAN card 116 for communication connection, a mouse 117 for performing input processing, and a keyboard 118. A video card 119 for connecting video, a display 119a for performing output processing, a sound card 120 for connecting audio, a speaker 120a, a drive 121 for processing a storage medium, and an IC card reader USB connector 122 and IC card reader 122a.

FIG. 2 is a block configuration diagram of the medical system according to the first embodiment of the present invention.
First, an IC card which is a kind of portable medium in which the “card ID” is recorded is inserted into the IC card reader 122 a of the user terminal 10. The “card ID” is read by the card processing means 11 which is means for reading identification information of the portable medium. When an appropriate IC card is inserted, a window for inputting a “password” is displayed, and the user inputs the “password” with the keyboard 118 according to the display.

The authentication means 12 passes the “card ID” and “password” to the database 30 as keys, and determines whether the information matches the information registered on the database 30.
User authority reading means 13 which is means for reading out the user authority based on the identification information reads out the user authority set for each user from the user DB.
The in-input screen determining unit 14 determines whether the screen of the user terminal 10 is an in-input screen. The patient selection is performed when the input halfway screen determining unit 14 determines that the screen is not a halfway input screen.

In order to select the patient input by the keyboard 118, the patient selection processing means 16 reads patient information from the patient DB which is the database 30. The patient information includes, for example, “patient ID”, “patient name”, and “room number”.
When updating the specific medical information, the user terminal 10 updates the specific medical information by locking the specific medical information. When locking the medical information of a patient, the patient ID and terminal ID are written in the patient exclusion DB.

The selected patient exclusion determination unit 17 reads the “patient ID” from the patient exclusion DB and determines whether or not it is exclusive. Based on the result of this determination, the mode determination means 18 determines whether or not the specific medical information is locked in an exclusive mode that restricts operations from users other than the user related to the lock.
The flag determination unit 19 refers to the screen control DB in the database 30 using the mode determination information and the user authority as keys, and acquires the screen control information.

  The screen control means 20 performs control such as limiting each operation on the screen. When the mobile medium including the IC card is no longer detected, an operation from the user may not be accepted, and the operation may be accepted when detected. When the IC card is inserted or not inserted, the mode and the user authority are determined, and the screen control means 20 controls according to the corresponding screen control information, thereby accepting, not accepting, displaying, or displaying the operation. It can be absent, selectable, or unselectable. For example, it can be implemented by activating / deactivating text boxes, text labels, list boxes, toggle buttons, option buttons, check boxes, command buttons, tab controls, and the like (controls).

  The user terminal 10 can also be configured to terminate the mid-input screen when the mid-input screen determining means 14 determines that the mid-input screen is present and the IC card cannot be read. In such a case, information in the middle of input can be recorded in the temporary storage area. That is, a log file is left at the time of card insertion / removal, and history management is enabled. In the history management, the history of execution of data copy processing to an external drive (FD (registered trademark), USB memory, etc.) (execution time, operator login ID, information for specifying data to be copied, etc.) is also included. Record. Thereby, it is possible to monitor the action of information leakage. Further, when the input item is not saved and the card is removed, the previous input person / contact number can be displayed on the screen. That is, when the authentication unit 12 authenticates the user, the card ID or the user ID is recorded, and information on the operator is obtained from the database 30 based on the recorded card ID or the user ID. By displaying on the screen, it is possible for the user who newly tried to start the use to specify the user who is in the middle of the previous input. In the database 30, it is assumed that information on the staff such as the name, title, qualification, and contact information of the staff specified by the card ID or the user ID is registered in advance. Furthermore, when the input halfway screen is terminated in this way, it is possible to provide means for returning and displaying the halfway entry screen when the next user inserts an IC card.

  The user terminal 10 displays a screen that can accept an operation. This screen is a screen on which controls such as the text box that can accept an operation are arranged. The control can be accepted or not accepted depending on the control.

When there is medical information that has been unlocked by the previous user taking out the portable medium in the middle of input, when the user wishes to change specific medical information from another user terminal 10, the exclusive release means 21 The lock of specific medical information can be forcibly released. For example, it includes a case in which when a previous user is in the middle of an input due to a sudden illness, it is necessary to urgently correct the order information from another user terminal. The “patient ID” and “user ID” are input by the other user terminal 10 and stored in the patient exclusion DB in the database 30. In the other user terminal 10, correction and update regarding the specific medical information whose lock is released are performed. Such information is recorded in the patient exclusion DB. Here, the user terminal 10 records information for identifying the performed update operation and information for identifying the updater. The “update ID”, which is optional data, is read from the patient exclusive DB in the database 30 and is a means for notifying that another user terminal 10 has updated the data when the user resumes input. The input resumption notice notifying unit 15 notifies the screen that it is necessary to pay attention to the specific medical information updated in the input resumption. By doing so, the user can update the specific medical information, for example, after confirming the updated information. For example, the act of registering the same or similar order twice can be prevented.
The process related to patient selection from the patient selection processing means 16 to the screen control means 20 performed after the user authority reading process can be processed recursively for a plurality of patients.

FIG. 3 shows the structure of data used in the medical system according to the first embodiment of the present invention.
The patient exclusive data in FIG. 3A has attributes of “patient ID”, “terminal ID”, “input halfway flag”, and “exclusive release”. “Patient ID” is a patient identification number. “Terminal ID” is an identification number of the user terminal. The “input halfway flag” indicates whether or not the screen on the terminal being used is being input. “Exclusion release” indicates an update ID when the content is updated in a state where the exclusion is released. For example, specifically, “patient ID” is “001”, “terminal ID” is “00A”, “input halfway flag” is “1”, and “exclusion cancellation” is “(111002 (update ID)). In such a case, the user has the terminal of “00A” in the state where the patient having the patient ID of “001” is excluded from the other user terminal 10. Indicates that input is in progress. By referring to the patient exclusive data, the user can grasp the use status of the medical information.

  FIG. 3B shows the order information of “update ID”, “patient ID”, “inserter ID”, “insertion date”, “prescription”, “implementation date”, “implementation flag”, and “implementer ID”. Has attributes. “Update ID” is an identification number indicating that the update has been made. “Patient ID” is a patient identification number. The “inserter ID” is an identification number of the inserter of update information. The “insertion date” is a date when update information is inserted. “Prescription” is prescription instruction content by the inserter. The “implementation date” is the date on which the prescription was conducted. The “execution flag” indicates whether or not it has been executed. “Performer ID” is an identification number of a prescriber. Specifically, as an example, “update ID” is “111002”, “patient ID” is “001”, “inserter ID” is “D005”, “insertion date” is “March 1, 2006”, “ “Prescription” holds data “Cef ○○○○ 100 g”, “Implementation date” is “March 3, 2006”, “Implementation flag” is “1”, and “Implementer ID” is “N002”. Yes. In such a case, the user having the inserter ID “D005” indicates that the patient having the patient ID “001” will prescribe “Sef XXX 100 g” on “March 3, 2006”. “March 1, 2006” is recorded as an update ID “111002”. By recording the updated order information, a clear history of the user can be managed.

  FIG. 4 is a flowchart of card insertion processing of the medical system according to the first embodiment of the present invention. In the card insertion process, a card insertion check table exists and a fixed period check of the card insertion determination process is performed. Here, as the card insertion check table information, a state of “1” or “0” for the card insertion processing is stored in a storage device such as the RAM 112. That is, “1” is checked when a card is inserted, and “0” is checked when a card is not inserted. Specifically, the card processing means 11 of the user terminal 10 performs a card insertion check (S101). Next, the card processing means 11 determines whether or not an IC card has been inserted (S111). When the IC card is inserted, the card processing means 11 sets the card insertion flag to “1” (S121). Then, after a predetermined time has elapsed, the card processing means 11 checks the insertion of the card again (S101). When the IC card is not inserted, the card processing means 11 sets the card insertion flag to “0” (S131).

  FIG. 5 is a flowchart after the card insertion process of the medical system according to the first embodiment of the present invention. The card processing means 11 confirms the check table (S201). The card processing means 11 determines whether or not a flag is set (S202). Here, as the card insertion check table information, a state of “1” or “0” is stored in the storage device in the machine. When the flag determination is “0”, the process returns to S201. The screen control and the screen control flag will be described later. If the determination is “1”, a password confirmation screen is displayed (S211). Next, the user inputs a password (S212). This is to prevent a person who has picked up an IC card from using it by impersonation. The authentication unit 12 determines a password (S213). In the password determination, after the IC card is read, the existence of the user ID read from the user DB in the database 30 and the check of the password are checked. Here, if the authentication unit 12 determines that the password determination is NG, the process returns to step 201. When the password determination is OK, the user authority reading unit 13 reads the user authority (S221).

  It is determined whether the input screen determination unit 14 is in the process of input (S231). When the input screen determination unit 14 determines that the input is not in progress, a patient selection screen is displayed. Note that patient selection may not be performed. For example, a case where a nurse or the like refers to confirm an empty room is included. If it is determined that input is in progress, it is determined whether there is optional data exclusive for the patient (S241). When it is determined that there is optional data for patient exclusion, the input resumption notice notifying unit 15 notifies the updater and the update contents (S251). Then, including the case where it is determined that there is no optional data for patient exclusion, the selected patient exclusion determination unit 17 determines whether the selected patient is exclusive (S271). If the patient is in the middle of input, the patient is selected, so the patient is not selected.

  When it is determined that the input is not in progress, a patient selection screen is displayed and the user selects a patient (S261). Then, the process proceeds to S271. Here, “patient ID”, “terminal ID”, “input halfway flag”, and “update ID” are read from the patient exclusion DB. When the selected patient exclusion determination unit 17 determines that the selected patient is exclusive, the mode determination unit 18 determines the exclusive mode in addition to the user authority (S272). Here, as an example of the exclusive mode, the user can refer to and newly create information in the chart, but cannot modify or delete the information. When it is determined that the selected patient is not exclusive, the user authority is given. Next, the flag determination means 19 sets a screen control flag (S281). Here, the screen control information of “screen ID”, “control ID”, “user authority flag”, and “exclusive flag” is read from the screen control DB. Using the user authority and the exclusive mode, the surface control means 20 displays the name of the user on the screen according to the screen control flag setting (S282). Control operations on the screen. The user terminal 10 reads necessary medical information from the database 30 in accordance with the screen and displays it on the screen. For example, a window that displays order information of a patient but does not accept an operation to add a new order is displayed.

FIG. 6 is a flowchart of forced lock release processing of the medical system according to the first embodiment of the present invention.
It is determined whether or not an exclusive forced lock is requested (S301). When the exclusive forced lock release is not requested, the process returns to step 301. When it is determined that a request for a forced lock of exclusion is received from the user, the selected patient exclusion determination unit 17 refers to the input halfway flag to determine whether or not the exclusion is during the input (S302). When the selected patient exclusion determination unit 17 determines that the exclusion is not in the middle of input, the process returns to step 301. When the selected patient exclusion determination unit 17 determines that the exclusion is in the middle of input, the mode determination unit 18 shifts to the exclusive mode of the current user (S311). Here, the user ID is updated to the current user. Next, the flag determination means 19 sets a screen control flag (S321). Here, the screen control information is read from the screen control DB. Then, the surface control means 20 displays the screen according to the screen control flag setting and controls the operation on the screen.

FIG. 7 is a flowchart of card removal processing of the medical system according to the first embodiment of the present invention.
The card processing means 11 determines whether or not a card is not inserted (S401). Incidentally, since the user has no authority when the card is not inserted, the user can select the end. Here, when the application is terminated, exclusion of the selected patient is terminated as the termination process. When the card processing means 11 determines that the card is not inserted, it is determined whether or not the user terminal 10 has released the forced lock and updated. If the user terminal 10 releases the forced lock and determines that the user terminal 10 has been updated, the optional data is added to the corresponding data (S412). That is, the “update ID” of the “patient ID” is added in the patient exclusion DB. The data of the patient is updated with the order information, and the update ID related to the update is added to the patient exclusion DB. When a plurality of updates are made, all update IDs related to the plurality of updates are added to the patient exclusion DB. Next, the user terminal 10 shifts to the exclusive mode of the previous user (S413). Here, the user ID is updated to the previous user.

  If it is determined in S411 that the lock is not released and the update is not performed, the input screen determination unit 14 determines whether or not the input is in progress (S414). When it is determined that the input is in progress, the user terminal 10 sets an input halfway flag (S415). Here, in the data of the input halfway flag, the flag information of the patient exclusion DB is changed from “0” to “1”. The selected patient exclusion determination unit 17 determines whether the selected patient is exclusive (S421). When the selected patient exclusion determination unit 17 determines that the selected patient is exclusive, the patient exclusion is maintained (S431). Here, patient exclusion information is read from the patient exclusion DB. When the selected patient exclusion determination unit 17 determines that the selected patient is not exclusive, the flag determination unit 19 sets a screen control flag (S441). Here, the screen control information is read from the screen control DB. Then, the surface control means 20 displays the screen according to the screen control flag setting and controls the operation on the screen (S442).

  Here, there are four patterns in which the operation is controlled with the user authority of the newly input person taking over the input state of the previous screen, and will be described. First, (a) when the previous user and the subsequent user have authority, the input can be taken over, and the user of the final confirmed person is recorded on the log even if the input is halfway. Also, (b) if the previous user is authorized but the subsequent user is not authorized, the input cannot be taken over and only the end can be pressed, so the input content is discarded. (C) If the previous user is not authorized, but the subsequent user is authorized, there is no input on the previous screen, and therefore a new input can be created. Further, (d) when the previous user and the subsequent user are not authorized, it is possible to press only the end without inputting the previous screen.

  Specifically, for example, when (1) Mr. A pulls out an IC card during screen input and Mr. B inserts his own IC card into a predetermined part of the terminal, (1-1) Mr. A If it is determined that Mr. B has the authority to use due to the screen that was being input immediately before removing the IC card, or (1-2) Mr. A was inputting immediately before removing the IC card. When it is determined that Mr. B does not have the authority to use due to the relationship with the screen, or when Mr. A is inputting immediately before removing the IC card in (1-1) and (1-2) above It is. (2) This is a case where Mr. B performs screen input using Mr. A's screen. (3) When Mr. B uses Mr. A's screen to input a screen, Mr. B removes his own IC card and Mr. C inserts his own IC card into a predetermined part of the terminal (3-1) Mr. C has authority to use in relation to the screen that Mr. A was inputting immediately before removing the IC card and Mr. B was inputting immediately before removing the IC card. Or (3-2) C in relation to the screen that was being input immediately before Mr. A removed the IC card and was input immediately before Mr. B removed the IC card. The cases (a) to (d) of the operation processing with the above-described user authority can be assumed to include the case where it is determined that the user has the authority to use.

  As an operation log image, for example, “User A (ID = 98765) logged in at 11:30:20 on August 24” for the same patient, “At 11:45:51 on August 24,” “User B (ID = 12345) is logged in”, “Issuance of injection order at 11:48:38 on August 24th”, “Patient selection complete at 11:48:45 on August 24th (Patient ID = 9812356)” The log is displayed on the same screen, and the final confirmed person is User B. Furthermore, on the screen, “screen top menu on August 24th 11:49:03”, “patient selection on August 24th 11:49:12” (patient ID = (8763434), “August 24th 12:21 : User C (ID = 64828) is logged in at 33. In this way, even when the IC card is removed, the fact that it has been removed is recorded, and the operation log recorded during that time is recorded. The user can be identified by recording in the same manner even when the USB memory is inserted with the FD (Floppy Disk (registered trademark)) inserted, and it becomes possible to track when information leaks. .

FIG. 8 is an explanatory diagram of screen control of the medical system according to the first embodiment of the present invention.
(1) is the display content of the screen, which will be explained next. (A) is a regular prescription, (b) is a temporary prescription, and (c) is an emergency prescription input frame. Further, (d) to (f) are “detailed reference” buttons corresponding to the above (a) to (c). In the lower part of the screen, buttons of (g) “medical chart screen”, (h) “past prescription”, (i) “decision”, and (j) “cancel” are shown.

  (2) is obtained by holding a flag in the screen controls (a) to (j). The 1st byte indicates user authority. The 2nd byte indicates a patient exclusion flag. The user authority is set from “0” to “5”, and when the user authority of one user is “2”, a screen whose 1st byte flag of the screen control is 2 or more is displayed. The display control can be operated. The authority is set stronger as the numerical value is smaller. The patient exclusion flag “0” indicates that the other user terminal 10 is not selected, and “1” indicates that the other user terminal 10 is selected. In other words, the control displaying “0” can be input by the user, and the control displaying “1” cannot be input by the user because the patient information is used in another terminal. . For example, when logging in to correct the content written in the patient's medical record, if the patient's medical record was used on another terminal, the flag is displayed as “0”. Only reference or end can be selected.

(Other embodiments)
[System standardization]
Since it is considered that an operation error occurs because a doctor needs to perform an operation in accordance with a system installed in each hospital, it is also desired to promote standardization of a medical system. Therefore, even if a system for each hospital is different depending on an institution that authenticates card information, it is possible to provide a rule that does not depend on the system for the registration function of the user's operation screen. Specifically, by providing the user terminal 10 with user information registration means that allows the function of the IC card to be used at other hospitals, it is possible to share information on operation screens at other hospitals. The user terminal 10 includes means for holding a user operation screen that can be used in other hospitals and a dictionary function for sharing medical information, and further means for setting an operation screen registration function that does not depend on the system. You can also. Thereby, the dictionary function or the authentication function can be standardized.

  Although the present invention has been described with the above embodiments, the technical scope of the present invention is not limited to the scope described in the embodiments, and various modifications or improvements can be added to these embodiments. . And embodiment which added such a change or improvement is also contained in the technical scope of the present invention. This is apparent from the claims and the means for solving the problems.

1 is a system configuration diagram of a medical system and a hardware configuration diagram of a computer according to a first embodiment of the present invention. It is a block block diagram of the medical system which concerns on the 1st Embodiment of this invention. It is a structure of the data used with the medical system which concerns on the 1st Embodiment of this invention. It is a flowchart of the card | curd insertion process of the medical system which concerns on the 1st Embodiment of this invention. It is a flowchart after the card | curd insertion process of the medical system which concerns on the 1st Embodiment of this invention. It is a flowchart of the forced lock release process of the medical system which concerns on the 1st Embodiment of this invention. It is a flowchart of the card | curd extraction process of the medical system which concerns on the 1st Embodiment of this invention. It is explanatory drawing of the screen control of the medical system which concerns on the 1st Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 User terminal 11 Card processing means 12 Authentication means 13 User authority reading means 14 Input screen determination means 15 Input resumption notice notification means 16 Patient selection processing means 17 Selected patient exclusion determination means 18 Mode determination means 19 Flag determination means 20 Screen Control means 21 Exclusive release means 30 Database 111 CPU
112 RAM
113 ROM
114 Flash memory 115 HD
116 LAN card 117 mouse 118 keyboard 119 video card 119a display 120 sound card 120a speaker 121 drive 122 USB connector 122a IC card reader

Claims (7)

In a medical system comprising a user terminal for processing medical information and storage means for storing medical information,
User terminal
Means for reading identification information of the portable medium;
Means for detecting the operation;
Means for recording identification information in association with an operation when an operation is detected;
A medical system including means for not accepting an operation from a user when no portable medium is detected and accepting an operation when detected. The user terminal has a means for displaying a screen that can accept an operation,
The medical system according to claim 1. The user terminal is a halfway input screen judging means for judging whether or not it is a halfway input screen when the identification information of the portable medium can no longer be read by the user terminal,
A means of recording information in the middle of input,
Means for terminating the input halfway screen when the identification information of the portable medium cannot be read at the user terminal;
Means for determining whether or not the input was in progress when the previous detection of the portable medium was lost,
Means for returning and displaying the input halfway screen when it is determined that the input is in progress;
The medical system according to claim 1 or 2, comprising: The user terminal has a means for reading user authority based on the identification information, a means for receiving an operation based on the read user authority,
The medical system according to any one of claims 1 to 3. The user terminal includes a means for locking specific medical information, a means for restricting operations from users other than the user related to the lock for the specific medical information locked,
The medical system according to claim 1, comprising: The user terminal includes means for forcibly unlocking the specific medical information that is locked, and means for releasing the restriction of the operation from the user related to the compulsory unlock for the specific medical information that has been forcibly unlocked. 5. The medical system described in 5. Means for recording information for identifying an update operation performed when an update operation for specific medical information to be performed when a forced lock is released and information for identifying an updater, and detection of the previous portable medium A means for determining whether or not the input is in progress when there is no data, a means for notifying that the data has been updated on another user terminal when the input is in progress,
The medical system according to claim 6.

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