JP2009075828A - Medical network system and request information management apparatus and method - Google Patents

Abstract

To improve medical work efficiency.
A medical network system includes a medical department terminal and a request information management server. The medical department terminal 12 has a function of issuing an inspection request to the request information management server 14. The request information management server 14 stores the accepted inspection request in the request information DB 18. The medical department terminal 12 can group a plurality of related examination requests O 1 and O 2 and issue an association instruction to the request information management server 14 when making an examination request. Upon receiving the instruction, the request information management server 14 stores a plurality of inspection requests O1 and O2 in association with each other. Thereby, a plurality of inspection requests O1 and O2 are handled as related inspection requests on the system.
[Selection] Figure 1

Description

  The present invention relates to a medical network system for managing medical request information, and a request information management apparatus and method.

  In hospitals where medical departments and examination departments are divided, the necessity of medical examinations is judged by doctors in clinical departments (for example, surgery and internal medicine) and requested to examination departments. The examination request is made online, for example, from a medical department terminal through a hospital network. The request information issued from the medical department terminal is notified to the examination department reception server, and the examination is performed based on this notification. In the examination department that performs image diagnosis such as radiology, various medical examination devices (modalities) such as CR (Computed Radiography) equipment, CT (Computed Tomography) equipment, MRI (Magnetic Resonance Imaging) equipment, and ultrasonic diagnostic (US) equipment. Thus, a medical image (examination image) of the patient is taken. The taken examination image is interpreted by, for example, an interpretation doctor specializing in image diagnosis, and the interpretation results are collected as a medical report (interpretation report). The requesting doctor (requesting doctor) receives the inspection image and the interpretation report as the inspection result.

In addition to the findings and comments of the inspection image being entered in the interpretation report, for example, a key image that serves as a key for interpretation is attached and an annotation mark is added to the region of interest in the key image. Edits are made to convey the results of image diagnosis to the requester in an easy-to-understand manner. Patent Document 1 describes a medical report apparatus that has an enhanced report editing function. In this medical report apparatus, link information for associating a finding input in text with an annotation mark added in a key image can be added to report data. According to this, for example, an annotation mark corresponding to a finding portion can be identified and displayed by clicking on a finding portion with a link with a pointing device such as a mouse. It becomes possible to convey it in an easy-to-understand manner.
JP 2004-305289 A

  By the way, in order for the requesting doctor to decide the treatment policy of the patient, there are many cases where a plurality of types of test results such as a CR test and a CT test, or a CT test and a US test are necessary. When the requesting doctor recognizes the necessity of a plurality of types of examinations based on the examination results, the requesting doctor issues each examination request one by one and requests each examination from the examination department. Then, the requesting doctor tells the interpreting doctor that he / she wants the report to be compiled based on a plurality of types of examination results. When the interpretation doctor receives such a report, the interpretation doctor waits for the completion of imaging of a plurality of types of examination images, and while observing both examination images, combines the individual interpretation results into one report.

  However, even if there are multiple examinations related to the same patient, the examination request is made for each examination, so that the interpreting physician can identify patient IDs and It had to be confirmed while checking the date of acceptance of the inspection request, which was complicated. In addition, if the interpretation doctor does not notice the above notification, a situation may arise in which a report must be recreated. These problems cause a significant decrease in the efficiency of medical services.

  The present invention has been made in view of such a background, and an object thereof is to improve the efficiency of medical work.

  The medical network system according to the present invention includes a plurality of terminals including a request source terminal, and a request information management server that is connected to each terminal via the network and manages request information related to medical care issued by the request source terminal. In the medical network system, a request information storage unit that stores the request information, an association instruction reception unit that receives an association instruction for associating the plurality of request information, and a plurality of the request information that are targets based on the association instruction And request information recording means for recording the request information in the request information storage means. By managing a plurality of related request information in this way, it becomes possible to easily check the request information from one to the other and the relationship between the request information, thereby improving the work efficiency.

  The request information management server preferably includes distribution means for receiving a distribution request for the request information from the terminal and distributing it to the requesting terminal. As a result, each terminal can inquire request information with respect to the request information management server and acquire request information. Moreover, it is preferable that the request information distributed by the distribution means includes identification information for identifying the plurality of associated request information. In this way, when the terminal makes an inquiry or acquisition of the request information, it can be easily known that there is a request related to the request information. Further, in the terminal or the request information management server, provided with related inspection request determination means for determining presence / absence of request information related to the request information specified by the terminal, and when there is the related request information, It is preferable that a message to that effect is displayed on the display means of the terminal. By notifying the user of not only the identification information but also such a message, it is possible to actively inform the existence of a related request. Furthermore, it is preferable that the terminal can display a list of the request information based on the request information distributed by the distribution unit. According to this, since a plurality of request information can be listed, it is convenient when examining a plurality of related requests based on identification information or the like.

  The plurality of associated request information is a plurality of examination request information regarding a plurality of medical examinations, and an examination result storage server that stores examination results corresponding to each of the examination request information is connected to the network. It is preferable. When the request information is an inspection request, there is an inspection result corresponding to the request, and if the inspection result can be acquired via the network, access to the information becomes simple and contributes to improvement in business efficiency. This examination result includes a report in which a medical image and its findings are written. The plurality of examination requests are, for example, a plurality of examination request information of different types for the same patient. According to this, it is possible to easily refer to test results related to a plurality of test requests of one patient.

  In addition, it is preferable that the said terminal is provided with the data acquisition part which accesses the said test result storage server and acquires the some test result linked | related based on the said test request information which the said delivery means delivers. According to this, access to the inspection result from the request information is facilitated, and the work efficiency is further improved. This terminal includes, for example, a report creation terminal that creates a report. The message is, for example, a message related to the inspection request.

  The request information management server includes progress information recording means for recording progress information indicating the progress of the inspection for each inspection request information, and the distribution means adds the progress information to the inspection request information. It is preferable to include and distribute. In this way, since the progress of the inspection request can be easily grasped, the cooperation between departments can be smoothly performed, for example, when the preparation of the report is started after the completion of the imaging of the inspection image.

  In addition, it is preferable that the request source terminal is provided with an association instruction issuing unit that issues the association instruction, and the association instruction receiving unit receives the association instruction issued by the association instruction issuing unit. In this way, the requester's instruction can be easily transmitted. Furthermore, the request source terminal includes a display unit that displays a medical chart operation screen for displaying and editing an electronic medical chart, and the association instruction issuing unit performs an issuing process based on an operation from the medical chart operation screen. It is preferable. By linking the association between the electronic medical record and the inspection request, the work efficiency of the request source is improved.

  The request information management server of the present invention is connected to a plurality of terminals including a request source terminal via a network, and stores the request information in the request information management server that manages request information related to medical care issued by the request source terminal. Request information storage means, an association instruction reception means for receiving an association instruction for associating a plurality of the request information, and a plurality of the request information to be associated with each other based on the association instruction and recorded in the request information storage means Request information recording means.

  The request information management method of the present invention is a request information management method for managing medical request information issued by the request source terminal connected to a plurality of terminals including a request source terminal via a network. An association instruction receiving step for receiving an association instruction for associating, and a request information recording step for recording request information by associating a plurality of the request information as targets based on the association instruction.

  According to the present invention, a plurality of related request information received from a request source is managed in association with each other, so that reference work between request information and reference work of other request information from one request information Can be simplified, so that operational efficiency can be improved.

  A medical network system 10 shown in FIG. 1 is constructed in a medical facility such as a hospital, for example. The medical network system 10 includes a medical department terminal 12 installed in the medical department 11 and a request information management server 14 installed in the examination department 13. The medical department terminal 12 and the request information management server 14 are communicably connected via a LAN (Local Area Network) 16. The request information management server 14 accepts an examination request issued by the medical department terminal 12 as a request source online via the LAN 16.

  As will be described in detail later, the medical department terminal 12 may issue a request to the request information management server 14 as an inspection request set 17 in which a plurality of related inspection requests O1 and O2 are grouped and the inspection request information is collected. Is possible. Upon receiving such a plurality of inspection requests O1 and O2, the request information management server 14 records each inspection request information in a request information DB (Data Base) 18 in a state of being associated with each other.

  In the imaging room 13a of the examination department 13, a plurality of types of modalities 19 including, for example, a CT apparatus 19a, an MRI apparatus 19b, a CR apparatus 19c, a US apparatus 19d, and the like are installed. Inspection images taken by these modalities 19 are output to the image server 21 via the LAN 16. In the interpretation room 13b of the examination department 13, a report creation terminal 23 for creating an interpretation report describing the interpretation result including the findings of the examination image is installed. The report creation terminal 23 accesses the image server 21 via the LAN 16 to acquire an inspection image, and registers the created interpretation report in the report server 24.

  When shooting and interpretation are completed, a completion notification is sent to the request information management server 14 from the imaging room 13a and the interpretation room 13b. When the interpretation is completed, the completion is also notified to the medical department terminal 12. After receiving the completion notification, the medical department terminal 12 accesses the image server 21 and the report server 24 and receives the examination result including the examination image and the interpretation report.

  The image server 21 and the report server 24 are provided with an image DB 21a and a report DB 24a, respectively. Each DB 21a, 24a can search and extract corresponding data based on search keys such as patient ID, patient name, and examination ID. The image server 21 and the report server 24 receive access from the medical department terminal 12 and the report creation terminal 23, and execute processing according to the requested contents such as data distribution and registration.

  The chart server 26 is provided with a chart DB 26a for storing chart data. Similarly to the image DB 21a, the report DB 24a, and the like, the medical record DB 26a is configured to be able to extract corresponding medical record data based on the search key. The medical record server 26 receives access from the medical department terminal 12 and executes processing corresponding to the requested content such as distribution and registration of medical record data.

  The medical record server 26, the image server 21, and the report server 24 are composed of, for example, a server computer in which various server programs are installed on the basis of a personal computer or a workstation, and data storage that constitutes various DBs. Of course, these servers may be configured separately, or may be configured as a single integrated server. Further, only the data storage in which the DB is constructed may be shared among a plurality of servers.

  As shown in FIG. 2, the clinical department terminal 12 is a computer such as a workstation or a personal computer, and includes a main body 31 and a console 32. The console 32 includes a monitor 33 that displays an operation screen and data, and an input device 34 that inputs an operation signal. The input device 34 includes, for example, a keyboard 34a and a mouse 34b. The main body 31 includes a CPU 36, a memory 37, an HDD (hard disk drive) 38, and a communication I / F 39, which are connected via a data bus 40.

  A control program such as an operating system and an electronic medical record program 41 are installed in the HDD 38. The memory 37 is a working memory for the CPU 36 to execute processing. The CPU 36 centrally controls the main body 31 and the console 32 by loading a program stored in the HDD 38 into the memory 37 and executing processing according to the program. The communication I / F 39 is a communication interface that performs communication control for transmitting and receiving data via the LAN 16.

  When the electronic medical record program 41 is activated, the CPU 36 functions as a medical record processing unit 36a and an inspection request processing unit 36b. The medical chart processing unit 36a displays a medical chart editing screen 42, which is an operation screen for displaying and editing medical chart data, on the monitor 33, and accepts an operation signal input from the input device 34 through the medical chart editing screen 42. Then, editing including new creation and update of medical chart data and access to the medical chart server 26 to perform various processes such as acquisition of medical chart data and registration of processed medical chart data. The electronic medical record program 41 is provided with an inspection request function, and the inspection request processing unit 36b executes processing related to the inspection request such as issuing an inspection request and issuing an instruction for associating a plurality of inspection requests.

  The chart edit screen 42 is an example of an operation screen. The chart edit screen 42 displays chart data of the selected patient. On the medical record editing screen 42, a patient basic information display area for displaying basic patient information such as a patient ID and a patient name, and a medical record display area for displaying medical records including the patient's main symptoms, progress, prescription, treatment, etc. Is provided. The chart is edited through the operation of the chart editing screen 42 and the input device 34.

  In addition, the chart editing screen 42 is provided with an operation palette 44 in which various operation buttons for performing operations related to examination are integrated. The operation palette 44 includes, for example, a request button 44a, an inquiry button 44b, and an inspection result button 44c, which are pointed and clicked by the pointer 46 of the mouse 34b, and corresponding operation instructions are respectively provided. Is given to the CPU 36.

  The inquiry button 44b is a button for inquiring the requested information management server 14 about the implementation status and progress status of the requested examination. When an inquiry process is instructed, the inquiry button 44b has been received from the request information management server 14. Request information is distributed. The inspection request processing unit 36b generates an inspection list (see FIG. 6) including the implementation status and progress status based on the distributed request information, and displays it on the monitor 33. The inspection result button 44c is a button for displaying a completed inspection result. When this button is operated, a list of completed inspection results is displayed, and a desired inspection is selected from the list. Thus, the inspection image and the report corresponding thereto are displayed on the monitor 33. The request button 44a is a button for issuing an inspection request.

  As shown in FIG. 3, when the request button 44 a is operated, an inspection request screen 47 is displayed on the monitor 33. In the upper part of the inspection request screen 47, a specification area 48 for specifying the inspection type is provided. The designated area 48 is provided with a tab 48a corresponding to the examination classification, such as “image diagnosis” and “physiology / pathological examination”, and the classification is switched by operating the tab 48a. Yes. When the “image diagnosis” tab 48a is selected, a plurality of designated icons 48b corresponding to a plurality of examination types (CT, CR, MRI, US) belonging to the classification of image diagnosis are displayed.

  A group frame 49 for collecting a plurality of examinations into one group is displayed below the designated area 48. When designating the examination type, the desired designation icon 48b in the designation area 48 is pointed by the pointer 46, and the designated designation icon 48b is dragged to the group frame 49 as indicated by a two-dot chain line arrow. , Put in the group frame 49. Such operations are repeated when a plurality of examinations are designated. FIG. 3 shows a state in which CT inspection and US inspection are designated in the group frame 49 whose group ID (GrID) is “1”.

  The detail input button 51 is a button for inputting a comment such as an inspection request sentence, a message to be sent to the examination department 13, a photographing condition, and the like. When the detail input button 51 is operated, a window for inputting a comment is displayed. A comment is input by the requesting doctor as necessary. As the message to be sent, for example, a message to be communicated from the request source to the request destination, including a special note regarding the patient and transmission of a point for which interpretation is desired, is input.

  In addition, when requesting a group of examinations, it is desirable to request an interpretation result obtained by comprehensively judging each examination image, and further to collect the interpretation result as one report. Enter the instructions as items to be sent. As a specific example of comprehensively judging multiple examinations, patients are suspected of having cirrhosis or liver cancer in their examination results, and in order to determine either of them, we request multiple types of examinations, CT examination and US examination. There are cases. At that time, as described above, a CT examination and US examination designation icon 48b is put in the group frame 49 to designate a plurality of examinations, and the above-mentioned items to be sent are input by operating the detailed input button 51. Issue a request. In this example, an instruction to be combined into one report is input as text, and the instruction is transmitted to the requestee as a report item. Dedicated operation means (such as operation buttons) may be provided for designating. This is convenient because it saves the trouble of inputting the fact as text.

  When the confirmation button 52 is operated, the inspection request processing unit 36b generates inspection request information of inspection requests O1 (CT inspection) and O2 (US inspection) for a plurality of designated inspections, and assigns the same GrID to each. Then, an inspection request set 17 in which both are collected is created. In this way, a plurality of inspection requests O1, O2 are collected into one inspection group. When the request issue button 53 is operated, the inspection request processing unit 36 b transmits the inspection request set 17 to the request information management server 14. The inspection request processing unit 36b issues a plurality of inspection association instructions to the request information management server 14 by grouping the plurality of inspections in this way. The request information management server 14 receives the association instruction and associates and records a plurality of inspection requests O1 and O2 included in the inspection request set 17.

  The form, method, and timing for issuing the association instruction are not limited to the above. For example, in this example, GrID assigned to each inspection request information is used as instruction data for instructing association. However, the data is not limited to GrID, and any data that can identify a plurality of inspection requests to be associated may be used. Further, the instruction data may not be included in the inspection request data, and may be transmitted as data different from the inspection request data. Further, once the inspection request is transmitted, it may be possible to instruct that the inspection request is associated with another inspection request that has already been transmitted. Further, after transmitting the inspection request set of one inspection group, an association instruction may be issued so that a new inspection request is added to the inspection group.

  When requesting one kind of inspection, only one designation icon 48b is put in the group frame 49. In that case, the inspection request processing unit 36b transmits one specified inspection request without assigning the GrID. Even when the number of inspection requests is one, GrID may be assigned to the data. In this way, when adding another inspection request later, it is not necessary to give a new GrID. For example, data handling is standardized (data processing is performed in a plurality of cases and a single case). It can be the same).

  The chart processing unit 36a records such an inspection request history as an inspection record of medical chart data. FIG. 4 is an explanatory diagram showing a schematic configuration of medical chart data. The medical record data includes basic patient data such as the patient name and medical records for each date, and the medical records include examination records representing the examination contents and history as well as examination records representing the examination contents and history. ing. In the inspection request history, for example, a plurality of inspection requests O1 and O2 are recorded together with GrID so that the grouped inspection requests can be identified. Thereby, it becomes possible to identify the belonging relationship between the inspection requests O1 and O2 from the inspection request history. The inspection request O3 that is not grouped is recorded without being assigned a GrID.

  As shown in FIG. 5, the request information management server 14 is a computer such as a workstation or a personal computer, and includes a main body 56 and a console 57. The console 57 includes a monitor and an input device, and is used for managing and setting the request information management server 14. The main body 56 includes a CPU 58, a memory 59, an HDD 61, a communication I / F 62, and a request information DB 18, which are connected via a data bus 63.

  A control program such as an operating system and a request information management program 64 are installed in the HDD 61. The CPU 58 controls the main body 56 and the console 57 in an integrated manner by loading a program stored in the HDD 38 into the memory 59 and executing processing according to the program. The communication I / F 62 is a communication interface that performs communication control for transmitting and receiving data via the LAN 16.

  The CPU 58 functions as a request reception unit 58a, a DB access unit 58b, and a distribution unit 58c by executing the request information management program 64. Upon receiving the inspection request transmitted from the medical department terminal 12, the request reception unit 58a issues an inspection ID for each inspection request one by one, records the reception date and time together with the inspection ID, and requests the inspection. Perform the acceptance process.

  The DB access unit 58b accesses the request information DB 18 to read and write data. The DB access unit 58b writes the inspection request information received by the request receiving unit 58a into the request information DB 18 as one request information record. In addition to items such as reception date and time, inspection ID, requester identification information, inspection type and request content including comments, each request information record is provided with progress information indicating the progress of the inspection. The DB access unit 58b updates each request information record as needed based on the shooting and interpretation progress information notified from the terminal and modality 19 of the imaging room 13a, the report creation terminal 23 of the interpretation room 13b, and the like. Further, the request information record for which imaging and interpretation have been completed includes the storage address of the inspection image and report data recorded based on the notification from the modality 19 and the report creation terminal 23.

  The distribution unit 58 c can distribute the request information stored in the request information DB 18 to the request source in response to a request from a client terminal including the medical department terminal 12 and the report creation terminal 23. When the distribution unit 58c receives a distribution request from the client terminal, the distribution unit 58c searches and extracts the request information corresponding to the content from the request information DB 18 and distributes it to the request source. For example, it is possible to distribute all of the request information records, the request information record corresponding to the search condition, or only the items corresponding to the search condition among the items included in the request information record. The data storage constituting the request information DB 18 may be locally connected to the request information management server 14, or may be connected via a network such as the LAN 16, for example. Furthermore, you may share with the data storage which comprises other DB.

  Each client terminal generates an inspection list representing a list of inspection requests received by the request information management server 14 based on the request information distributed from the distribution unit 58c, and displays the inspection list on the monitor of each terminal. FIG. 6 shows an example of an examination list displayed on the monitor of the client terminal. Items included in the examination list 66 include, for example, reception date / time, examination ID, GrID (examination GrID), patient ID, patient name, examination type, imaging situation, interpretation situation, and the like. Of course, the order of arrangement in the list of these items, the type and number of items displayed in the examination list 66, and the like can be changed as appropriate according to the setting. The detail button 66a is a button for confirming the details of the inspection request. When this button is clicked, the detailed contents of the inspection request are displayed.

  The inspection list 66 is provided with a field for displaying GrID so that a plurality of related inspection requests can be identified. By confirming this GrID, it is possible to easily identify the existence of related inspection requests and the identification of both. For example, in FIG. 5, the same GrID “Gr1” is displayed in the GrID items of the inspection requests with the inspection IDs “CT0012” and “US0026”. Therefore, it is understood that there is a separate examination request related to each examination request only by confirming the item of GrID without collating a plurality of items such as patient name, patient ID, and reception date and time. Further, by examining whether or not the GrIDs are the same, it is possible to specify the related inspection request.

  The shooting state represents the progress of image shooting by the modality 19 and is displayed for each stage such as waiting for reception, during shooting, waiting for shooting, or completion of shooting. Here, “waiting for reception” means a state in which the patient's confidence as the subject has not yet received the examination department 13 after receiving the examination request from the requesting doctor. The interpretation status represents the progress of report creation by the interpreting physician, and is displayed for each stage such as incomplete (incomplete), waiting for interpretation, waiting for completion of related examinations, completion of interpretation, and the like. Here, the waiting for completion of the related inspection means that there are other inspection requests related to the inspection request, and an instruction to comprehensively judge a plurality of related inspection results, or to combine them into one report. When there is an instruction, it means that the imaging corresponding to the inspection request has been completed, but the imaging for other inspections included in the same inspection group has not been completed, and is waiting for completion. . In this example, the imaging of the examination ID “CT0012” has been completed, but the imaging of “US0026” related thereto has not been completed. Therefore, “Reading related examination completion” is displayed in the interpretation status of “CT0012”. Is made.

  As shown in FIG. 7, the report creation terminal 23 is a computer such as a workstation or a personal computer, like the clinical department terminal, and includes a main body 72 and a console 73. The console 73 includes a monitor 74 that displays an operation screen and data and an input device 76 that inputs an operation signal. The input device 76 includes, for example, a keyboard 76a and a mouse 76b. The main body 72 includes a CPU 77, a memory 78, an HDD (hard disk drive) 79, and a communication I / F 81, which are connected via a data bus 82.

  A control program such as an operating system and an interpretation report program 83 are installed in the HDD 79. The memory 78 is a working memory for the CPU 77 to execute processing. The CPU 77 loads the program stored in the HDD 79 into the memory 78 and executes processing according to the program, thereby controlling the main body 72 and the console 73 in an integrated manner. The communication I / F 81 is a communication interface that performs communication control for transmitting and receiving data via the LAN 16.

  The report program 83 is a program for creating and displaying an interpretation report. When the report program 83 is activated, the CPU 77 functions as a report processing unit 77a and a data acquisition unit 77b. The report processing unit 77a displays a report edit screen 84, which is an operation screen for displaying and editing report data, on the monitor 74, and receives an operation signal input from the input device 76 through the report edit screen 84. Then, editing including new creation and update of report data, access to the report server 24, and processing such as acquisition of report data and registration of processed report data are performed.

  The data acquisition unit 77b accesses the request information management server 14, the image server 21, the report server 24, and the medical record server 26 to acquire data in order to refer to various data such as request information, inspection images, reports, and medical records. Execute the process.

  The report edit screen 84 is an example of an operation screen. The report is edited through the operation of the report editing screen 84 and the input device 76. The report editing screen 84 is provided with a patient basic information display area for displaying patient basic information such as a patient ID and a patient name, and a finding input area for inputting an interpretation result including a finding. In the observation input area, a representative key image of particular interest in the inspection image can be inserted and pasted. The key image is a reduced image obtained by reducing the original data of the inspection image. In addition, the reduced image can be edited by inserting an annotation mark in a region of interest in the image (a region that the image interpretation doctor has paid attention to when performing image diagnosis).

  Furthermore, link information (finding link information) between such an annotation mark and a designated portion in the finding (a portion mentioned in the finding regarding the annotation mark) can be given. Such finding link information is recorded in a report file. According to this, when the annotation mark in the key image is pointed with the mouse or the like, the corresponding finding part is identified and displayed, and on the contrary, when the finding part is pointed, the corresponding key image is identified and displayed. Can access the image server to acquire the original image of the key image and display it on the screen.

  The report of this example is an example in which the examination results of a plurality of examinations are combined into one, and the CT examination image (CT image) and the US examination image (US image) are used as key images in the finding input area. Is affixed.

  The report editing screen 84 is provided with an operation palette 86 in which various operation buttons are integrated. For example, the operation palette 86 includes a plurality of screens that can be selectively switched by tabs 86a. Each tab 86a displays, for example, titles such as “edit”, “send”, and “inspection”. The screen is provided with operation buttons related to the respective titles. The “edit” screen is provided with operation buttons relating to an editing operation such as an instruction to insert a key image or an annotation mark, or linking a key image to a finding area. The “transmission” screen is provided with operation buttons for registering a report in the report server 24 and notifying the request information management server 14 of the progress status.

  FIG. 7 shows an example in which the “inspection” screen is selected, and buttons for referring to information related to the inspection are collected on this screen. On this screen, an inquiry button 87a, an image button 87b, and a related examination list button 87c are provided. These operation buttons are pointed and clicked by the pointer 88 of the mouse 76b, whereby an operation instruction corresponding to each is given to the CPU 77. The data acquisition unit 77b executes a corresponding process based on the input operation instruction.

  The inquiry button 87a is a button for inquiring the request information management server 14 about the inspection implementation status and progress status. When an inquiry process is instructed by this button, the data acquisition unit 77b issues a request for distributing accepted request information to the request information management server 14. The data acquisition unit 77b generates an inspection list 66 (FIG. 6) based on the distributed request information, and the generated inspection list 66 is displayed on the monitor 74. The interpretation doctor confirms the examination that needs to be interpreted based on this examination list 66, selects an examination request that has been radiographed and waits for interpretation, acquires detailed information of the examination request, and starts preparing a report.

  The image button 87 b is a button for acquiring an inspection image. When this button is operated, the data acquisition unit 77 b issues a distribution request to the image server 21. The distributed inspection image is displayed on the monitor 74. The interpreting doctor creates a report while observing the examination image. When an image display monitor is provided separately from the report editing monitor 74, the inspection image may be displayed on the image display monitor.

  The related examination list button 87 c is a button for displaying a list of examinations related to the report displayed on the report editing screen 84. When the related examination list button 87c is operated, the data acquisition unit 77b reads the GrID from the acquired examination request information corresponding to the currently displayed report, and the examination request including the GrID (related examination request). Is requested to the request information management server 14. The request information management server 14 distributes the inspection request information to the report creation terminal 23 when there is an associated inspection request, and notifies that fact when there is no inspection request. When the data acquisition unit 77b acquires the related inspection request information, the data acquisition unit 77b displays the list in a list format similar to the inspection list 66, for example. As a result, it is possible to confirm whether or not there is an inspection request related to the currently displayed report. The list for displaying the list of related examinations is displayed by the data acquisition unit 77b by processing the data into a list format based on the data acquired from the request information management server 14, but the request information management server 14 However, the list data generated by performing the processing process may be distributed to the report creation terminal 23, and the report creation terminal 23 may simply perform the display process.

  In addition, when one inspection request is selected from the list of related inspection requests, the data acquisition unit 77b reads out the storage information of the inspection image and the report from the inspection request information, and accesses each storage destination. Obtain inspection images and reports. Then, the acquired inspection image and report are displayed on the monitor 74. Thereby, it becomes possible to easily refer to the data of a plurality of related inspection requests, and the work of combining a plurality of inspection results into one report can be efficiently advanced.

  As described above, information related to related inspection requests (related inspection information) can be confirmed by the related inspection list button 87c. When one inspection request is selected in the inspection list 66, a report is sent from the request information management server 14. You may make it notify related test | inspection information with respect to the creation terminal 23. FIG.

  For example, when the interpretation doctor starts to create a report, the interpretation doctor acquires the examination list 66 from the request information management server 14 through the report creation terminal 23 and confirms the examination request to be interpreted. Then, one inspection request is selected from the inspection list 66, and the request information management server 14 is requested to distribute the request information of the inspection request. When the request information management server 14 receives the distribution request, the request information management server 14 checks whether there is an inspection request related to the inspection request, and if there is a related inspection, notifies the report creation terminal 23 of the related inspection information.

  A message screen 89 shown in FIG. 8 is an example of a notification message of related examination information. This message screen 89 reports that the selected inspection request has an associated inspection request, the progress status of the associated inspection request (incomplete imaging, taking image, etc.), and without waiting for the imaging completion of the associated inspection request. Includes a message prompting you to confirm whether or not to start creating These messages not only inform the interpreting doctor of the existence of related examinations, but also confirm the matters to be sent from the requesting doctor (multiple examinations should be comprehensively judged, reports should be combined into one, etc.). An encouraging effect can be expected.

  Of course, since GrID is included as an item in the inspection list 66, it can be seen that there is a related inspection request by looking at the display, and it is also possible to confirm the items to be sent by looking at the detailed information. However, there are cases where there are many items included in the examination list 66, or there are cases where the items are not displayed. Therefore, it is possible to more reliably notify the related inspection information by actively issuing the guidance message as described above. When the button 89a displaying "Yes" on the message screen 89 is clicked with the mouse, the report can be edited, and when the button 89b displaying "No" is clicked, the report editing of the selected inspection request is cancelled. Is done.

  Such notification processing is executed by the CPU 58 (FIG. 5) of the request information management server 14. When the CPU 58 receives a request for distribution of at least one inspection request information designated by the terminal and distributes the inspection request information, the CPU 58 determines whether or not there is inspection request information related to the inspection request information. If there is an inspection, the guidance message is delivered to the report creation terminal 23. In addition, you may make it display the notification matter from a requesting doctor in the said guidance message.

  In this example, the message notification process until the guidance message is displayed on the monitor of the report creation terminal 23 more specifically includes the following processes. First, the CPU 58 of the request information management server 14 searches for related inspection request information from the request information DB 18 using the GrID as a search key based on the inspection request information for which the distribution request has been received, and determines the presence or absence of the related inspection request. Execute the judgment process. Next, based on the determination result, when there is an associated examination request, a message transmission process is performed to transmit (distribute) the guidance message data to the report creation terminal 23. The report creation terminal 23 that has received the guidance message data generates a message screen 89 based on the data and performs display processing for display on the monitor.

  However, the configuration of the process is not limited to this example. For example, the report creation terminal 23 may execute related inspection request determination processing. In this case, when the operator designates an inspection request through the console 73, the report creation terminal 23 receives input of the designation information. Then, the CPU 77 of the report creation terminal 23 performs the related inspection request determination process when issuing a distribution request for the specified inspection request information to the request information management server 14. For example, based on the data (including a plurality of pieces of inspection request information) that is the basis of the inspection list 66 that has been downloaded in advance, the CPU 77 uses the GrID as a search key to determine whether there is an inspection request related to the specified inspection request. In addition to performing a related inspection request determination process by determining whether or not, a display process for generating and displaying a message screen 89 based on the determination result is performed. The inspection request may not be specified from the inspection list 66 but may be performed by inputting information that can specify the inspection request such as an inspection ID.

  As described above, the sharing of each process of the process (distribution of processes in charge of the request information management server 14 and the report creation terminal 23), the contents of the processes, and the like can be changed as appropriate. What processing is assigned to which device is determined in accordance with the configuration of the entire system. In this example, a guidance message is displayed on the report creation terminal 23. However, such a guidance message may be displayed on a terminal other than the report creation terminal 23 such as the medical department terminal 12. . In that case, the content of the message is changed as appropriate, for example, a message such as “… Do you want to create a report?” Is not displayed and only a message indicating that there is a related examination request is displayed. The

  When the report processing unit 77a saves the report, the report processing unit 77a adds GrID in the case where the inspection request is grouped in addition to the inspection ID for identifying one inspection request in the data of the report. Also record. The saved report is uploaded to the report server 24 and registered. When the report creation is completed, a notification to that effect is transmitted to the request information management server 14. The request information management server 14 updates the interpretation status included in the request information record based on this notification. The report completion notification may be notified to the medical department terminal 12 via the request information management server 14, or may be notified to each of the request information management server 14 and the medical department terminal 12. .

  FIG. 9 is an explanatory diagram showing the correspondence of data related to a plurality of inspection requests associated as described above. Arrows indicate a direct correspondence between the data. First, based on the association instruction issued by the medical department terminal 12, the request information DB 18 stores request information records 91a and 91b for a plurality of examination requests. The request information records 91a and 91b are associated with each other by giving the same GrID (Gr1) together with the respective examination IDs (“CT0012” and “US0026”). The image DB 21a stores inspection images 92a and 92b corresponding to the respective inspection requests. Each inspection image 92a, 92b is assigned an inspection ID to the tag area of each data file. The report DB 24a stores one report file 93 collected based on these inspection images 92a and 92b. In the report file 93, each inspection ID and GrID are recorded.

  Since the inspection ID is recorded in all of the request information record 91, the inspection image 92, and the report file 93, the respective data are directly associated with each other based on the inspection ID. Therefore, it is possible to refer to each other, for example, by referring to the inspection image 92 or the report file 93 corresponding to the request information record 91 or referring to the report file 93 corresponding to the inspection image 92. Moreover, since GrID is recorded in the request information record 91 and the report file 93, both data are directly matched. Therefore, the request information record 91 can be referred to from the report file 93 or vice versa.

  Further, although the GrID is not recorded in the inspection image 92, the inspection images 92a and 92b can be referred to each other because they are indirectly associated with each other through the request information records 91a and 91b. . Of course, GrID may be recorded in the file of the inspection image 92, and in this case, direct reference between the inspection images 92a and 92b becomes possible.

  Hereinafter, the operation of the above configuration will be described with reference to FIG. When the requesting doctor requests the examination department 13 for a plurality of related examinations, the examination department 12 groups the examinations and issues an examination request. GrID is given to the inspection request set 17 together with each inspection request information.

  The request information management server 14 receives the inspection request, and if it includes GrID, it accepts this as an association instruction, and records the inspection request of the same GrID in association with the request information DB 18. When the imaging is executed based on each inspection request and the imaging is completed, an imaging completion notification is notified to the report creation terminal 23 through the inspection list 66. Since the GrID is displayed for a plurality of related examinations in the examination list 66, it is possible to clearly grasp the relationship between the plurality of examination requests.

  Therefore, there is no time and effort to collate and confirm patient IDs and reception dates in order to identify a plurality of related examinations. Even if the interpreting doctor is unaware of the request from the requesting doctor or the requesting doctor forgets to send the request, the inspection information list 18 is associated with a plurality of inspection requests, so the inspection list. 66 and a message screen 89 can clearly confirm a plurality of related inspection requests. As a result, it is also possible to expect an effect of covering an artificial transmission error between departments. This configuration improves business efficiency.

  The interpretation doctor uses the report creation terminal 23 to collect the interpretation results into one report while observing the examination images of the related examination requests. The report creation terminal 23 records and saves the GrID in the report file, registers the data in the report DB 24a, and sends an interpretation completion notification to the request information management server 14. The medical department terminal 12 receives an interpretation completion notification from the request information management server 14 through the examination list 66 and the like. Based on the notification, the requesting doctor accesses the report DB 24a and the image DB 21a from the medical department terminal 12 and acquires the examination result including the report and the examination image.

  In the above embodiment, the example in which the inspection results of a plurality of inspection requests are combined into one report has been described. However, the inspection results may be combined into separate reports. In that case, the correspondence between the data is as shown in FIG. The difference from FIG. 9 is that a plurality of reports are created corresponding to each of a plurality of inspection requests. Each report file 94a, 94b corresponds to CT inspection and US inspection, respectively. In each of the files 94a and 94b, the inspection ID is recorded, and the GrID is recorded in each of the files 94a and 94b. As a result, the files 94a and 94b are directly associated with each other, and can be referred to each other.

  As shown in FIG. 12, link information for referring to the other report file 94b may be recorded in one report file 94a of a plurality of related report files 94a and 94b. In this way, when one report file 94a is displayed on the medical department terminal 12 or the report creation terminal 23, it is possible to refer to the related report file 94b and the corresponding examination image based on the link information. .

  When the report file 94a is opened, the related examination information 96 including the examination ID (US0026) is displayed on the screen of a display terminal capable of displaying reports such as the medical department terminal 12 and the report creation terminal 23. In the related inspection information 96, another report file corresponding to the inspection ID and the storage destination address 97 of the inspection image are embedded. By clicking with the mouse pointer, the storage destination is accessed to acquire the inspection data. can do. Reference processing including such data acquisition and display thereof is executed by the CPU 77 of the medical department terminal 12 or the report creation terminal 23.

  Furthermore, apart from the related examination information 96, the above-described finding link information may be recorded in the report file 94a. For example, as the finding link information, the storage destination address of the examination result of another examination associated with the specific position in the finding of one report file 94a is embedded. In this way, it is possible to refer to the test results related to the specific position within the findings, and to clearly understand the correspondence between the specific part of the findings and other test results. Become.

  The related inspection information 96 is recorded in the report file based on the inspection request information acquired from the request information management server 14 by the report creation terminal 23. When generating the finding link information, the finding position information designated by the interpretation doctor is acquired, and the report creating terminal 23 records it in the report file 94a.

  Note that the request information management server 14 may perform the process of recording the related inspection information 96 in the report file. In this case, for example, when the CPU 58 of the request information management server 14 receives the interpretation completion notification, it determines whether or not there is a related inspection request from the corresponding request information record, and the related inspection request. Is present, the related inspection information 96 is recorded in the report file corresponding to each inspection request.

  In this way, a plurality of inspection requests are associated with each other and recorded in the system (specifically, the request information DB) and managed. References can be made easily. Specifically, it is easier to link information among clinical department terminals that mainly handle electronic medical records, image servers that store images, examination acceptance devices that handle examination acceptance information, and report creation devices, greatly improving operational efficiency. It becomes possible to improve.

  In the above embodiment, the inspection image and the report have been described as the inspection result, but the inspection result may be either the inspection image or the report. As a terminal for displaying these examination results, a medical department terminal and a report creation terminal have been described as examples. However, examination images and reports may be displayed on other terminals.

  In the above embodiment, the function of issuing an instruction for associating a plurality of inspection requests has been described as being incorporated in the medical record program. However, the function may be configured by a program different from the medical record program.

  In the above-described embodiment, the example of CT inspection and US inspection has been described as a combination of related inspection requests. However, the present invention is not limited to this, but CT inspection and CR inspection, CT inspection and MRI inspection, and endoscopy It can be applied to various combinations such as microscopic examination and pathological examination. In addition, as an examination type, an examination in which an image diagnosis is performed has been described as an example. However, the examination is not limited to an image diagnosis. Good. Of course, the number of combinations is not limited to two, and three or more types of requests may be combined. Further, although an example in which a plurality of examination requests of one patient are grouped has been described, a plurality of examination requests of different patients may be grouped.

  In the above embodiment, request information to be recorded in association with each other has been described as an inspection request. However, the present invention is not limited to an inspection request, and can also be applied to other medical service requests. For example, a case where a plurality of related medical examination requests are collectively requested to a medical department, or a case where a plurality of related medical examination requests and examination requests are collectively accounted for medical accounting, etc. can be mentioned. Also in this case, the request information management server receives the association instruction and, based on the instruction, associates a plurality of pieces of request information and stores them in the storage unit. This makes it possible to easily search for related requests and cross-reference them. Similarly to the above-described examination request, the related request may not be related to one patient.

  In the above embodiment, when there is an inspection request associated with the designated inspection request, a message to that effect is displayed on the monitor of the terminal, but this is not limited to the inspection request. It can also be applied to other requests such as medical examination requests.

  In the above embodiment, the request source terminal issues an association instruction. For example, in addition to the request source terminal, a management terminal accessible to the request information management server issues an association instruction. You may enable it to issue from another terminal.

  In the above embodiment, a medical network system constructed in one medical facility has been described as an example. However, a medical facility is not limited to a medical facility existing in one base, but a plurality of geographically dispersed bases. Including medical facilities. Moreover, you may apply to the medical network system which cooperates not only with one medical facility but between several medical facilities. Examples of such a medical network system include, for example, a network system that connects a plurality of medical facilities and an interpretation specialized institution, a clinic that is a small-scale medical facility, and a large-scale medical facility that possesses advanced examination equipment. For example, a network system to connect. As described above, when business cooperation is performed between facilities that are distant from each other, an artificial transmission error is likely to occur, and thus the effect of the present invention becomes more remarkable.

  As shown in the above embodiment, the present invention naturally extends to a program form and further to a storage medium for storing the program.

It is a block diagram of a medical network system. It is explanatory drawing of a medical department terminal. It is explanatory drawing of the operation pallet operated when issuing an inspection request. It is explanatory drawing of the data structure of medical chart data. It is explanatory drawing of a request information management server. It is explanatory drawing of a test | inspection list. It is explanatory drawing of a report preparation terminal. It is an example of the notification message regarding a related test | inspection. It is explanatory drawing of the correspondence of a request information record, an inspection image, and a report file. It is a flowchart explaining the process from inspection request issue to inspection result acquisition. It is explanatory drawing which shows the correspondence of data in case there are two or more report files. It is explanatory drawing of the example which records relevant test | inspection information in a report file.

Explanation of symbols

10 Medical network system 12 Clinical department terminal (requesting terminal)
14 Request information management server (request information management device)
17 Inspection request set 16 LAN
18 Request information DB (request information storage means)
21 Image server (inspection result storage server)
23 Report creation terminal 24 Report server (inspection result storage server)
26 chart server 36, 58, 77 CPU
36b Inspection request processing unit (association instruction issuing means)
42 chart edit screen 58a request reception part (association instruction reception means)
58b DB access part (request information recording means, progress information recording means)
58c Distribution section (distribution means)

Claims (16)

In a medical network system comprising a plurality of terminals including a request source terminal, and a request information management server connected to each terminal via a network and managing request information related to medical care issued by the request source terminal,
Request information storage means for storing the request information;
Association instruction receiving means for receiving an association instruction for associating a plurality of the request information;
A medical network system comprising: request information recording means for associating a plurality of pieces of request information as targets in association with each other based on the association instruction and recording them in the request information storage means.   2. The medical network system according to claim 1, wherein the request information management server includes distribution means for receiving a request for distributing the request information from the terminal and distributing the request information to the requesting terminal. .   3. The medical network system according to claim 2, wherein the request information distributed by the distribution means includes identification information for identifying the plurality of associated request information.   When there is related request information provided in the terminal or the request information management server, and includes related request determination means for determining the presence or absence of request information related to the request information specified by the terminal. 4. The medical network system according to claim 2, wherein a message to that effect is displayed on the display means of the terminal.   5. The medical network system according to claim 2, wherein the terminal is capable of displaying a list of the request information based on the request information distributed by the distribution unit.   The plurality of associated request information is a plurality of examination request information related to a plurality of medical examinations, and an examination result storage server that stores examination results corresponding to each of the examination request information is connected to the network. The medical network system according to any one of claims 1 to 5, wherein   7. The medical network system according to claim 6, wherein the plurality of examination request information is a plurality of examination request information of different types of the same patient.   8. The medical network system according to claim 6, wherein the examination result includes a medical image and / or a report describing the findings.   The terminal includes a data acquisition unit that accesses the inspection result storage server and acquires a plurality of associated inspection results based on the inspection request information distributed by the distribution unit. Item 9. A medical network system according to any one of Items 6 to 8.   The medical network system according to claim 8, wherein the terminal includes a report creation terminal that creates the report.   The medical network system according to claim 6, wherein the message is a message related to the examination request.   The request information management server includes progress information recording means for recording progress information indicating the progress of the inspection for each inspection request information, and the distribution means includes the progress information in the inspection request information. The medical network system according to any one of claims 6 to 11, wherein the medical network system is distributed.   The request source terminal is provided with association instruction issuing means for issuing the association instruction, and the association instruction receiving means receives the association instruction issued by the association instruction issuing means. A medical network system according to any one of 1 to 12.   The request source terminal includes display means for displaying a medical chart operation screen for displaying and editing an electronic medical chart, and the association instruction issuing means performs an issuing process based on an operation from the medical chart operation screen. 14. The medical network system according to claim 13, wherein In a request information management apparatus that is connected to a plurality of terminals including a request source terminal via a network and manages request information related to medical care issued by the request source terminal,
Request information storage means for storing the request information;
Association instruction receiving means for receiving an association instruction for associating a plurality of the request information;
A request information management device comprising: request information recording means for associating a plurality of the request information to be recorded in the request information storage means based on the association instruction. In a request information management method that is connected to a plurality of terminals including a request source terminal via a network and manages request information related to medical care issued by the request source terminal,
An association instruction receiving step for receiving an association instruction for associating a plurality of the request information;
A request information management method comprising: a request information recording step of associating a plurality of the request information as targets based on the association instruction and recording the request information.

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