WO1999021114A1 - System for recording medical, insurance and welfare information - Google Patents

Abstract

A novel information management system for utilizing medical, insurance and welfare information handled in a medical institution such as a hospital, a pharmacy, or a medical examination institute. A write once recording medium is employed for storing information concerning the medical record and carried by a patient. An information writing means for storing medical information on the information recording medium carried by the patient is installed in each medical institute or at each section thereof. Each medical institute or each section thereof can write information on the recording medium carried by the patient or reads information therefrom within a range which the operator is allowed.

Description

 Description System for recording medical, insurance and welfare information

 The present invention relates to a medical information recording system. More specifically, the present invention records information on medical treatment, medication, examinations, health insurance affairs, etc. performed by medical institutions such as hospitals, pharmacies, and laboratories in the form of information such as text, images, and voice. In particular, it is possible for multiple medical institutions to refer to each other's medical treatment and medication history at the same time, and at the same time, to protect the privacy and present information to medical institutions. It relates to a completely new medical information recording system that can respect the will. Background art

 Various types of medical institutions, such as hospitals and pharmacies, have made various attempts to streamline work and expand the use of information assets by using information processing equipment that has been rapidly developed in recent years. In addition, the introduction of various information processing devices to medical institutions has been widespread from the perspective of streamlining medical institutions and the medical insurance system itself. Therefore, in addition to the individual automation of inspection equipment, it is possible to introduce information processing equipment for the output and storage of inspection records, to make the back-office department so-called OA, or to digitize medical records using information processing equipment. It is already being implemented.

 In view of the above situation, various inventions have been proposed in the field of information processing technology. For example, JP-A-60-54550, JP-A-61-161571, JP-A-61-260356, JP-A-62-247463, JP-A-62-269534, and JP-A-5 Japanese Patent Application Laid-Open Nos. 2613, 5-35756, 5-225212, 6-83880, and the like are disclosed.

In other words, Japanese Patent Application Laid-Open No. Sho 60-54550 proposes that slip processing in a hospital be digitized to eliminate duplication of transcription work. Japanese Patent Application Laid-Open No. 61-161571 proposes using a card storing electronic information for authentication of each patient. Special In Japanese Laid-Open Publication No. 61-260356, it is proposed to use a magnetic card for outpatient reception, medical record search, waiting for a turn, and the like. Japanese Patent Laying-Open No. 62-247463 describes that inspection data is stored in a memory card. Japanese Patent Application Laid-Open No. 62-269534 proposes that various procedures in a hospital be processed by a single network system. Japanese Patent Application Laid-Open No. Hei 5-2613 proposes that a plurality of hospitals use a common database by using a network system. Japanese Patent Laying-Open No. 5-35756 proposes to reduce the number of operations in an information processing apparatus used in a hospital. Japanese Patent Application Laid-Open No. 5-225212 proposes storing various kinds of information in an ID field corresponding to each patient. Japanese Patent Laid-Open Publication No. Hei 6-83880 proposes displaying medical information stored in a database so that it can be easily used. By the way, for example, doctors are obliged to record a so-called “medical record”, that is, a medical record, on medical care performed on each patient. Medical records are required to be kept for 5 years, so physicians can refer to patients who have re-examined their medical records, such as their medical history, medication history, and whether or not they have a lentogen test. However, in the event that the hospital visit is changed for various reasons, such as patient relocation, such past medical records are rarely transmitted to other medical institutions. This can be disadvantageous or dangerous for the patient itself, such as duplication of tests, medication, and excessive exposure to X-rays, as well as contributing to the financial pressure on medical insurance.

 Therefore, it is conceivable that a plurality of medical institutions refer to information by applying the above-mentioned invention relating to the use of the information processing apparatus in the medical field. However, actually, the conventional technology has the following problems.

That is, the medical information described in the medical record is information that can be referred only to those who have special qualifications such as doctors. On the other hand, for example, a laboratory technician performs a test while referring to some medical information according to a doctor's inspection instruction, and, for example, a pharmacist prepares a drug according to a doctor's injection instruction. In addition, the medical administration department performs business operations with reference to only items related to billing to patients and so-called receipts to medical insurance organizations, that is, descriptions of medical fee reimbursement statements. In this way, necessary information differs depending on the business of each party. Therefore, the information processing system built by medical institutions must be complicated. Therefore, individual information processing systems may be constructed for each department or institution, but with such a system configuration, a rational system cannot be realized due to duplication of equipment and operations.

 Therefore, it is conceivable to construct a system in which users with different qualifications use one database. However, database systems that are used by multiple medical institutions are extremely difficult to realize because their scales are extremely large. In addition, there are many information processing systems that have already been introduced and are in operation at each medical institution, and considering that their data is not always compatible, a database system that can be used in common by many medical institutions It is actually extremely difficult to construct

 In the medical information, there is information such as the name of the disease, such as cancer, that the notification to the patient is a problem, and at the same time, the patient himself wants to keep it confidential to the doctor due to the human relationship between the doctor and the patient. There is also information to do. In some cases, such as AIDS, a simple response can cause problems in privacy protection. Therefore, it is desirable that the use of medical information for oneself reflects the patient's will, but the information processing system for a medical institution reflects the patient's will and desire for privacy protection. There is no room.

 In addition, doctors are busy in the work of conventional clinics (medical and dental), and even if the medical records are simply digitized, the burden of data input work by the information processing device is extremely burdensome for doctors. large. Also, many doctors are unfamiliar with the operation of information processing devices, and it is difficult to input data into information processing devices while performing medical work. For these reasons, in order to introduce an information processing device to various medical institutions, the data that should be originally input by the doctor is once recorded in a document and then input again by a specialized operator, or the doctor himself or herself outside the medical hours. It was necessary to input data again.

Therefore, the present invention solves the above-mentioned problems of the prior art, and allows a plurality of medical institutions to refer to each other's medical information while respecting the privacy and will of the patient, and to introduce new medical information that is easy to introduce. Its purpose is to provide a recording system. Disclosure of the invention

 According to the present invention, a recordable information recording medium in which records on medical treatment and medication are stored and owned by each patient, respectively; installed in each medical institution or medical department, and utilizing the medical institution or medical department Information writing means for storing usage information on the information recording medium brought by the patient who has taken care of, and information installed at each medical institution or medical department and brought by the patient who used the medical institution or medical department. A medical information recording system comprising: an information reading unit that can read data stored in a recording medium under restrictions corresponding to each of the medical institutions, medical departments, or operators. Is provided.

 The main feature of the medical information recording system according to the present invention is that the medical information itself is stored in a write-once type information recording medium, and the use of this recording medium is left to the patient's own judgment. That is, in this medical information system, the medical information is recorded on an information recording medium which is owned and carried by the patient himself. This information recording medium is a write-once type, and once the medical information is recorded, even if it is corrected by a qualified person, the information including the one before correction is not deleted internally. Each patient can arbitrarily submit such an information recording medium to a medical institution used by the patient, that is, a hospital, a pharmacy, a laboratory, an insurance place, or the like. By reading the contents of this information recording medium, each medical institution can refer to the medical information, such as the symptoms, medical history, presence / absence of the test, and the results of each patient, as well as the medical treatment performed there. Information on medications, tests, etc. can be added.

However, in this medical information system, writing and reading of medical information to and from a recording medium are performed within a range allowed for each medical institution, department, or operator. For example, of medical information, only medical doctors are allowed to write and read medical contents. On the other hand, for example, reception and back-office departments have the ability to read out treatment items and examination items related to fee calculation, and writing is limited to information related to back-office processing. Inspection laboratories or inspection departments can read instructions for inspection items and inspection reports and write inspection results, but cannot access other information. However, such as allergic symptoms to the test drug, Medical information related to the test can be referred to. Further, for example, in a pharmacy, only information on a doctor's medication order can be referred to. Furthermore, there are severe restrictions on reading out items that should be considered with caution regarding the notification of disease names to patients or others, such as cancer and AIDS.

 Further, in the medical information system according to the present invention, the recording medium on which the medical information is recorded is attributed to each patient and carried by the patient. Therefore, even if a medical institution that supports this system is used, the use of the system is left to each patient's will. In addition, even when using medical information, the medical information is referred to under restrictions according to each medical institution, so that the privacy of the patient is not infringed. On the other hand, as long as this medical information recording system is used, the past medical information of each patient is accumulated, so that duplicate examinations, excessive medication, excessive X-ray exposure, etc. can be prevented beforehand. However, efficient medical care becomes possible.

 Further, in the medical information recording system according to the present invention, there is no particular restriction on the information processing system used by each medical institution as long as an interface for the information recording medium owned by the patient is secured. Therefore, in a large hospital, it can be incorporated as a part of the information processing system of the hospital. On the other hand, in small clinics and pharmacies, etc., the system can be incorporated into the system using an inexpensive information processing device such as a personal computer. Can respond. Also, it is not necessary to introduce equipment for network connection between medical institutions, install special software for it, and learn how to operate it. Therefore, it is possible to build a system for sharing medical information among multiple medical institutions without making huge investments like a large-scale network system.

 In addition, large-scale medical institutions such as general hospitals can use this system by arranging read / write units with different limits for each section, such as the medical department, administrative department, and laboratory department. In other words, by introducing this system, it is possible to prevent erroneous entries due to slip posting and re-entry work and to reduce the amount of work, and the delivery of work between departments becomes quick and accurate.

According to a preferred embodiment of the present invention, as a write-once information recording medium carried by a patient, a laser card or a Drex La card (trade name) is used. Type recording media are preferred. This recording medium is a complete write-once type, and once recorded information cannot be changed, the contents are surely preserved. In addition, the storage capacity of several megabytes makes it possible to store not only medical treatment information in text, but also lentogen photographs, image information on the affected area, and conversations of patients during medical interviews. Further, since a relatively simple writing / reading device is provided, it can be used by connecting to various information processing devices.

 Further, according to a further preferred aspect of the present invention, by restricting the use of information in the write / read device (hereinafter, referred to as “drive device”) of the write-once information recording medium, it is possible to reliably restrict the use of medical information. It can be. That is, high security can be realized by mounting the use restriction function as a part of the hardware in the drive device. In addition, since the actual drive device is small and lightweight, more complete security can be realized by removing the drive device itself when not used by qualified persons. Needless to say, it is preferable that the medical information on the recording medium is encrypted by some method.

 Still further, according to another preferred aspect of the present invention, reading and writing of information in each institution or department are performed together with information processing in each institution or department. That is, a doctor can write medical information, a test instruction, a medication instruction, and the like while also filling in a medical record, and the inspection department can record information as a recording operation of a test result. In the back office, the system can be configured to write data at the same time as accounting and insurance processing. With this configuration, no additional work related to recording of medical information is required.

Further, in the above-described system according to the present invention, when a write-once recording medium such as an optical disk is used as a recording medium, in particular, in order to reduce loss of capacity due to update of recording data, It is preferable to write as small as possible. Therefore, it is preferable that each data is separated into unit information, classified according to the content, and stored in a directory corresponding to each classification. On the other hand, since basic information such as the name of the recording medium owner and the insurance number is referred to each time it is accessed, it is stored in the highest level of the file system of the recording medium, that is, the so-called root directory. Is preferred. For example, it is preferable that a file name include a part indicating the data type as an extension so that each data can be classified according to a data type defined according to the information form. Furthermore, a file system that allows both a single recording method, which adds data to past files when updating data, and a history information method, which generates a new independent file, to be appropriately selected according to the purpose. O

 By recording information in accordance with such a file system, when reading data, for example, if you want to extract data for a particular test item in a specific period in a chronological order or at a hospital for paperwork. It is easy to deal with cases where only items such as treatments and tests performed on a single day are to be extracted at once.

 Further, a proposal for an input device in the above system is also included in the scope of the present invention.

That is, according to the present invention, a recordable information recording medium that stores records related to medical treatment, medication, and medical images and is owned and carried by each patient, and is installed in each medical institution or medical department, Information writing means for storing medical information in the information recording medium brought by a patient using the medical institution or medical department; installed in each medical institution or medical department; Information reading means which can read information stored in the information recording medium brought by a patient using the department under the restrictions corresponding to each of the medical institutions, medical departments or operators. Claims: 1. A data input device for a medical information system, comprising: an image display device for displaying a choice of data to be input; The data input device of a medical information system, characterized in that the probable choice next input is configured to be displayed in order. Is provided. This input device is configured so that a doctor unfamiliar with the operation of a so-called information processing device can quickly and accurately operate the input device. The input device displays a highly probable option on a display device, and the selection device is selected by a pointing device. Input is completed only by instructing one of. For this reason, extremely quick input is possible, and omission of input or incomplete description can be prevented. BRIEF DESCRIPTION OF THE FIGURES

 FIG. 1 is a diagram schematically showing a configuration of a medical care information recording system according to the present invention. FIG. 2 is a diagram schematically showing the structure of data stored in a light source used in the medical information recording system shown in FIG.

 FIG. 3 is a diagram schematically showing a configuration of a drive device that can be suitably used in the medical information recording system according to the present invention.

 FIG. 4 is a diagram showing an input screen of examination instruction data in a doctor's terminal device. FIG. 5 is a diagram showing an input screen of examination instruction data in a doctor's terminal device. FIG. 6 is a diagram showing an input screen for examination instruction data in a doctor's terminal device. FIG. 7 is a diagram showing display data on the terminal device of the inspection department.

 FIG. 8 is a diagram showing an input screen of medication instruction data in a doctor's terminal device. FIG. 9 is a diagram showing display data on a terminal device of a pharmacy.

 FIG. 10 is a diagram showing display data on the terminal device of the office department.

 FIG. 11 is a diagram showing display data on the terminal device of the office department.

 FIG. 12 is a diagram showing a configuration example of a directory on a recording medium.

 FIG. 13 is a diagram showing a data structure of information stored in a recording medium.

 FIG. 14 is a diagram illustrating an example of a file name of information stored in a recording medium.

 FIG. 15 is a diagram showing a configuration example of a file system for adding information to be recorded on a recording medium.

 FIG. 16 is a diagram showing a procedure for accessing data on a recording medium.

 FIG. 17 is a diagram showing a procedure for referring to data on a recording medium.

 FIG. 18 is a diagram illustrating an input screen of an input device that can be suitably used in the system according to the present invention.

 FIG. 19 is a diagram showing another screen of the input device.

FIG. 20 is a diagram also showing another screen of the input device. Hereinafter, the force ^s ′ described more specifically with reference to the drawings. The following disclosure is merely an example of the present invention and does not limit the technical scope of the present invention in any way. BEST MODE FOR CARRYING OUT THE INVENTION

 FIG. 1 is a diagram schematically showing a configuration example of a medical information recording system according to the present invention. In the present embodiment, an optical recording card of the Japan Delux (DELA) method is used as a write-once type information recording medium carried by the patient. It goes without saying that the SIOC method can be used for a similar system.

 As shown in the figure, the medical information recording system shown here sells to patients patients a hospital X equipped with a reception a, an office b, a consultation room (, an examination room d, etc., and a medicine prescribed at the hospital X. It is constructed to include a pharmacy Y, a clinic Z separate from hospital X, and a patient Q who owns a card C. At hospital X, reception a, office b, examination room (:, examination room d) Each of them has introduced an information processing device or terminal device Pa to Pd, and a card drive C a to C d device connected to it and equipped with restrictions according to each department. And the clinic Z also have installed personal computers Py and Pz connected to the optical card drive devices Cy and Cc, respectively, provided that the information installed at each of these medical institutions Processing devices or terminal devices Pa to Pd are not necessarily connected by a network. Not a translation. In particular, a personal computer that has been introduced to the pharmacy Y and clinics Z is quite running in a stand-alone.

 FIG. 2 is a diagram schematically showing a data structure stored in a light source used in the above system.

As shown in the figure, the optical card C contains the identification data D p that is always referred to by the user of this system, such as the patient's name, blood type, date of birth, and social insurance number, as well as the reception data D. a, medical office data Db, treatment data Dc, examination data Dd, medication data Dy, etc. are stored as medical care data. Furthermore, here, each medical data of the medical office data Da, the treatment data Dc, the medication data Dz, and the test data Dd is, for each data unit, what kind of data the data is. The headers include Ha to Hd and Hp. Each data is encrypted using algorithms Aa to Ad and Ap specific to the type of the data. Therefore, in order to write or read various kinds of data properly, an algorithm corresponding to each kind of data is indispensable. Note that one data may have multiple attributes. In other words, for example, the treatment items themselves in the medical treatment data are also necessary for fee calculation and insurance claim processing in paperwork. Therefore, the treatment items are described using an algorithm that is compatible with the algorithm Aa in the medical office data. Data that is compatible with such other types of data is represented by multiple headers in the figure for convenience, but the technology that achieves partial compatibility of the encryption algorithm is information processing technology. The detailed description is omitted in this specification.

 FIG. 3 is a diagram schematically showing a configuration example of a drive device of an information recording medium that can be suitably used in the above-mentioned medical information recording system. The drive unit is connected to a general-purpose input / output port of a main unit, which is a general-purpose information processing device or terminal device, using a cable.

 As shown in FIGS. 7A to 7D, the internal configuration of the drive device differs depending on the qualification of the user. That is, the drive device includes a connector 11 for connecting a cable, a communication circuit 12 for transmitting information to a main device to which the drive device is connected, and information recorded on the inserted force. A ROM 15 storing an algorithm for decryption, a decryption circuit 13 for decrypting information with reference to the ROM 15, and a writing / reading device U for reading / writing information from / to a force inserted in the device. Each has.

Here, the content of the ROM 15 mounted on the drive device differs depending on the drive device. That is, in the drive device shown in FIG. 3A, a ROM storing only the algorithm Aa is mounted. Therefore, in this drive device, only the data Da required for the reception work can be written or read. However, data Db-Dd which requires other algorithms Ab-Ad cannot be read and written by this drive device at all. The drive device shown in Fig. 3 (c) implements a ROM that stores algorithms Ab to Ad. Therefore, this drive device can read and write all of the medical treatment data Dc, examination data Dd, and medication data Dz. Similarly, each drive device shown in FIGS. 3 (b) and 3 (d) can handle only data corresponding to the algorithm stored in each ROM. Since the patient identification data D p is referred to in any drive, the algorithm Ap is implemented in all drive devices. However, the identification data D p For this reason, writing is not allowed except when personalizing the force for the first time.The above-mentioned drive device is used by clerks, doctors, pharmacists, laboratory technicians, etc. according to their qualifications. Then, each authorized data can be handled. On the other hand, regardless of the connected main unit, this drive unit can write or read data permitted by the drive unit owner to or from the card. Therefore, by removing and bringing the drive unit from the main unit, it is possible to restrict the use of others while away from home, and at the same time, connect to another main unit to perform work in different places become.

When the patient Q receives medical treatment at the hospital X in the system as described above, first, he submits his optical card C at the reception desk a. Here, the card C of the patient Q is inserted into the drive device C a of the receptionist a, and the administrative data such as the insurance number of the patient Q, whether this patient Q is the first consultation or a re-examination, and whether or not there is a leading doctor. Is read from card C and accepted a. Next, patient Q brings card C and goes to consulting room c. Here, the physician conducts an inquiry while referring to the medical history and the like while inserting the card C of the patient Q into his / her own drive device Cc, and writes findings and instructions for examination. Next, patient Q brings card C to laboratory d to be examined. Here, the laboratory technician inserts the force C of the patient Q into his / her drive device C d and performs a test while referring to the doctor's test instructions and the patient's Q allergic response and X-ray exposure history. Write the inspection result to card C. In practice, the output of inspection results is automated in many inspection devices. Therefore, the writing of inspection data can be automated by interposing an appropriate interface. Also, in the case of examinations that require the physician's own findings, such as Lentogen examination, CT, MRI, and ultrasound echo, if the physician brings his / her drive device C c to the examination room d, The findings can be added as medical information by connecting to the main device installed in the hospital. Patient Q returns to examination room c with card C on which the test results are recorded. Here, the physician performs treatment while referring to the test results from the card C, and writes a record of treatment, a medication instruction, and the like on the card C. Patient Q who has completed the consultation brings card C and brings card C to reception desk a. At reception a, the fee is calculated by referring to the examination items, treatment items, etc. from card C. Office b handles insurance claims processing. In addition, patient Q brings his card C and pharmacy Y go to. At the pharmacy Y, the drug is sold by referring to the doctor's medication order using the drive device Cy there.

 In the above series of card operations, it is preferable to configure the apparatus so that the work of writing information to the card is performed simultaneously with the work for information processing in each department. In other words, it is relatively easy for a doctor's office, for example, to automatically enter the data to be described on the card with appropriate attributes when entering the electronic medical record. That is. Further, at the reception or the office, when data is input to the POS system or the cash register, the office data to be recorded in the force can also be recorded on the card. Furthermore, as already mentioned, the output of various inspection devices can be recorded directly on the card.

 In addition, if the patient goes to a nearby clinic Y at home, the same as that at the hospital X and the pharmacy Y, the doctor Y treats the patient by inserting the patient Q card into his / her drive device. Records and medication records can be referenced, and efficient interviews can be conducted promptly. Although this hospital is small and does not have multiple departments, the drive that can be used as a physician can access office data and examination data, so it is also effective in processing medical affairs. One can use

In this way, By giving you access this medical information recording system, inspection facility at any clinic Z that are not For example Bei, to _c reverse that it is possible to perform the treatment by referring to the advanced testing data, is usually the practice When a patient who visits place Z receives treatment at hospital X, the patient can refer to the medical information known from the conventional medical treatment regarding the medical history and the presence / absence of drug allergy. Interviews can be made efficiently and accurately. Furthermore, even when a patient carrying a light guide is admitted to an emergency hospital due to unforeseen circumstances, prompt and appropriate measures can be taken by referring to the medical information on the light guide.

 In general, only one side of an optical card used for the above applications is used for information recording. Therefore, by writing the name, photo, etc. of the owner of the optical card on the back of the card that is not used for information recording, it is possible to prevent misuse of the card and to handle the card when it is lost.

In addition, in such a system, the data itself is encrypted to increase versatility. It is preferable to record the data in a simple data format such as a list format, for example, in a standardized format such as SGML. FIG. 4 is a diagram showing an examination instruction input screen 100 as an example of an input screen display on the doctor's terminal device. As shown in the figure, the physician selects an appropriate one of the examination type options displayed on the upper left of the screen, and further details of each examination content as shown on the lower left of the screen 101 in FIG. 6 to complete the inspection instruction as shown on the right side of the screen 102 in FIG. All the data entered here is stored in the optical medium, which is the recording medium, and the force ⁵ 'is displayed on the terminal device of the inspection department in which this card is inserted, as shown in screen 103 in FIG. You. That is, here, a screen for inputting the inspection result is displayed at the same time as displaying the inspection items and methods. In addition, on this screen 103, a “doctor comment” column indicating precautions on examination is also displayed. However, here, only information related to the test is displayed, and information such as the disease name is not disclosed to the test department.

 FIG. 8 is a diagram showing input of a medication instruction as another example of the display of the input screen 104 on the doctor's terminal device. As shown in the figure, the doctor selects an appropriate one from the options displayed on the left side of the screen 104, and completes the prescription instruction as shown on the right side of the screen 104. The data thus input is displayed on the terminal device of the pharmacy as shown on a screen 105 in FIG. That is, here, information such as the power s for displaying the drug type, the amount, the taking method, and the like, the name of the patient's disease, and the like are not disclosed.

 FIG. 10 and FIG. 11 show display examples of the terminal device in the office / accounting processing department for a patient who received a medical examination and received the above-mentioned examination or medication instruction. As shown in a screen 106 in FIG. 10, a terminal device such as a receptionist corresponding to a visitor displays only information relevant to the work, such as a patient's share of medical treatment costs. On the other hand, on the terminal device of the accounting department, as shown in a screen 107 in FIG. 11, only the cost required for preparing the medical remuneration bill statement is displayed.

In the series of data entry and its use as described above, the data entry is performed by a specialist related to each task such as a doctor or a laboratory technician. Therefore, as shown in the figure, the contents of the data recorded on the card include the disease name, drug name, Laws, etc. are recorded in technical terms in each field. The data format on the card is preferably stored in a simple data format such as a standard text file in ASCII code. That is, by keeping such a simple data format, a wide range of applications can be realized only by updating the information form conversion function on the reading side.

 On the other hand, at the reception desk, the name of the disease or drug is irrelevant to the work, and the medical fee required for entering the basic data for calculating the medical fee and calculating the patient's co-payment and the medical fee statement You only need to know the unit. Rather, the names of the diseases must be kept confidential to employees in these departments. In the pharmacy, you only need to know the name of the drug. Therefore, in each of these departments, the data on the card is converted and displayed according to the respective departments as shown in the respective drawings with reference to the conversion table mounted on the drive device described above. That is, the display unique to each department is generated by converting each terminal device into display data based on the data initially input by the doctor. Therefore, a single data input by the doctor is recorded on the storage medium carried by the patient.

With the above configuration, each medical department can refer to one piece of medical information recorded on the card in an optimal state. Conversely, information that is not desired to be referenced by other departments is not displayed. Therefore, it is possible to rationalize medical services while achieving both effective use of medical information and protection of privacy. Further, in the system according to the present invention as described above, when a write-once type recording medium such as a light source is used as a recording medium, in particular, in order to reduce loss of capacity due to updating of recording data, It is preferable to write as small as possible. Thus, according to one of the preferred embodiments of the present invention, each data is separated into unit information and then classified according to the content, and as shown in FIG. Is preferably stored. In this case, it is preferable not to create a directory in a layer deeper than that, since unnecessarily increasing the depth of the directory causes a reduction in processing speed, etc. instead. On the other hand, since basic information such as the name of the recording medium owner and the insurance number are referred to every time they are accessed, it is preferable to save the information in the highest level of the file system of the recording medium, that is, in the so-called root directory. . Also, each For example, as shown in Fig. 13, data can be classified according to the data type defined according to its information format.For example, the file name should include a part indicating the data type as an extension in the file name. Is preferred.

 For write-once recording media, there is a single recording method that adds data to past files when updating data, and a history information method that creates a new independent file. However, in the case of the system according to the present invention, it is preferable to use a file system in which both can be appropriately selected according to the purpose. That is, in the file of the history information method, for example, “YYYY MM DD. FID. Extension (where Υ is year, Μ is month, D represents each day). ", Etc., it is possible to search for desired information by file name. FIG. 14 shows file names that can constitute such a file system. Figure 15 shows a list of file names that can be used favorably in the system shown in Figure 1.

 FIG. 16 is a diagram showing an access procedure to an optical card when using data recorded in the above format. As shown in the figure, the application software で used in the information device connected to the optical power drive sends an information disclosure request including the ID and the passcode to the optical power driver B. Send to. In response, the optical driver B responds to the application software A with an approval or denial of access. If the access is approved, the application software A sends a command ③ for information retrieval to the optical power driver B. The description file (2) and the unique information file (2) generated according to this command (3) are transferred according to the write or read processing. When a series of these processes is completed, the optical card driver B returns a response 知 ら notifying the end of the process to the application software A.

In the above series of accesses, for example, when reading data, it is necessary to extract different data at each time. That is, for example, there is a case where it is desired to extract data for a certain inspection item in a specific period in chronological order. In some cases, it may be necessary to collectively extract only the treatments, tests, and other items performed at a hospital for one day for paperwork. In such a case, from the data stored as classified as described above, As shown in Fig. 17, significant data can be extracted by various search items.o In addition, even in the system described above, the data input by the doctor at the clinic can It is the basis for all other medical institutions' operations, including: Therefore, the data that each physician inputs during medical treatment must cover the information obtained by the physician and be accurately transmitted to other departments or institutions.

 The terminal devices Pa to Pd arranged in each department have force drive devices Ca to Cd connected thereto. Also a terminal device? The display units of a to Pd are touch panels 21, and are configured so that a selection operation can be performed by touching an option area displayed on the screen. In addition to this selection operation, a normal input means such as a keyboard and a mouse can be used. On the other hand, the card drive devices Ca to Cd are configured to display stored data in different forms depending on the department in which they are arranged.

 FIG. 18 is a diagram showing an example of the initial display on the liquid crystal panel of the input device as described above. As shown in a screen 108 of the figure, on the liquid crystal panel screen 108, the medical information is displayed on the left side, and options for assisting the input of the doctor are displayed on the right side. Since the display has a touch panel function, the selection can be executed by directly touching the option on the screen 108.

 The display in this figure is for a doctor to start a medical care operation. First, when "Start medical care" is selected, a list of hospitalized patients read from the light source at the reception is displayed. According to a preferred embodiment of the present invention, a patient who has visited for a medical examination and a patient who has visited only for, for example, medication, injection, or examination are distinguished from each other by changing the display color or display type. You. From these patients, the physician selects the next patient to be treated. Patient selection is also made by directly touching the list on the screen, and when the patient is selected, the screen display changes.

 FIG. 19 is a diagram showing a screen displayed after selecting a patient.

As shown in the figure, on this screen 109, a so-called medical record image is displayed on the left side, and options for assisting a doctor's input are displayed on the right side. Also, The past medical history and the data of the past illness stored in the card brought by each patient are also displayed. Here, usually, first of all, an interview is carried out, and when "chief complaint" is selected, the display of options on the right side of the screen 109 changes. That is, as already shown on the screen 104 in FIG. 8, options such as where, how, how much, etc. appear sequentially. Therefore, by selecting these, the entry of the chief complaint in the medical record is completed as shown in the upper right column of the display. For the selection operation, it is preferable to use a display device with a touch panel or the like that can be operated directly. This allows physicians to enter data by simply touching the screen with one hand. Further, according to a preferred embodiment of the present invention, the options appearing at this time are displayed in descending order of the probability of the option selected before. Therefore, it is not only easy to input, but also it is possible to effectively reduce entry errors and omissions.

 Subsequently, a doctor makes a selection of a necessary test or the like according to the result of the above interview. Here, the screen 100 shifts to an inspection item selection screen as shown in FIG. Also, as shown in a screen 101 in FIG. 5, options with a high probability are sequentially displayed also for an instruction such as an inspection method, so that a simple operation such as touching this with a finger or the like can be performed. As shown in the figure, the input of the inspection instruction is also completed. In addition, past inspection results and the like can be referred to as necessary, as shown on a screen 110 in FIG. Similarly, data input for other medical treatments, treatments, and medications can be performed by simple operations.

 With the data thus input and stored, for example, only the billing control item is displayed on the terminal device of the office as shown on a screen 107 in FIG. Therefore, there is no need to enter new data in the billing of fees and the preparation of bills for medical fees to medical insurance institutions, and there is no erroneous transcription due to transcription. In particular, it is not necessary to prepare a new form of the medical reimbursement claim statement, and it can be directly converted to an appropriate format as shown on the screen 106 in FIG.

When performing input operations on each of the screens described above, “medication”, “injection”, “examination”, etc. are performed according to the symptoms and diagnosis results entered in “chief complaint”, “examination”, and “diagnosis”. As for the input of, as shown in each figure, the choices are displayed in descending order of probability. In addition, items that are related to drug prices, such as medications and injections, For example, it is preferable to consider the display from the cheapest one. In addition, it can be configured so that information on side effects of the drug used can be referred to at the same time. If it is desired to enter a description that does not correspond to any of the options, it is possible to use a normal input means such as a keyboard. By installing peripheral devices that can record voice directly, the chief complaint can be recorded without using a keyboard at all. After completing the chief complaint and selecting “Close”, the screen returns to the medical record and initial options screen shown in Figure 19. Therefore, if you select “Remarks” and “Policy”, you can fill out the medical record with the same volume as the chief complaint. In addition, the same input method can be used to create referral letters, prescriptions, and instructions. For the letter of introduction or prescription, a hard copy may be made on the spot, or the content may be transferred to the destination of the document via a LAN or the Internet. .

 As described above, a series of operations as described above can be configured so that a doctor can perform the operation with one hand, so that it is possible to use a stethoscope or the like to immediately enter findings while using or operating the stethoscope. is there. In addition, by configuring so that options can be selected by foot or line of sight, it can be used even in special situations during surgery or treatment. Furthermore, since this input device does not require special operation methods, it can be used immediately by doctors who are not used to operating a computer. (4) Mistakes are unlikely to occur. Industrial applicability

As described in detail above, the data input device according to the present invention can be easily operated even by a doctor unfamiliar with the operation of the information processing device, and can input data quickly and accurately. Therefore, at the same time as reducing the attendant duties of physicians, it is possible to prevent omissions and omissions, and to significantly improve the quality of information in the medical field. In addition, medical information that is converted into electronic data with a certain quality can be used not only for doctors' own medical work, but also for operating clinics and saving labor in accounting. Furthermore, since the description method is unified, the accumulated medical information is analyzed. Thus, the input device according to the present invention includes: Encourage physicians to focus on the core work of health care, make medical work records more accurate, and make a significant contribution to streamlining the overall health care system

Things.

 In the medical care information system according to the present invention, the medical care information is stored in a write-once recording medium owned by the patient, and the use of the medical care information is set in advance in accordance with the qualification of each medical institution. Have been. Therefore, a single medical information can be used by many medical institutions, and the information can be efficiently stored and reused. In addition, it is possible to prevent duplication of examinations, excessive medication, X-ray exposure, etc., and to provide efficient medical treatment, thereby suppressing excessive expenditure on medical insurance. On the other hand, in the medical information recording system according to the present invention, the information recording medium storing the medical information is attributed to the patient's own, and its use is left to the patient's own will. Therefore, each patient's intention and privacy can be fully respected. Also, if you distrust the doctor's diagnosis, you may be able to seek medical treatment at another medical institution without submitting a lightwave at your own risk. In addition, if the patient is willing to become a donor for organ transplantation, this may be recorded. In addition, if there are foods or treatment methods that should be avoided due to religious reasons, etc., it will be possible to respond promptly at the hospital by recording this in advance in this light source.

 Further, in the medical information recording system according to the present invention, the configuration of the information processing system of each medical institution is not particularly limited as long as the interface for the recording medium owned by the patient is secured. . Therefore, it is possible to use the system with a device configuration according to each situation, from large-scale medical institutions with high systemization to small medical institutions such as clinics and pharmacies.

 In this way, the system according to the present invention not only contributes to the rationalization of the operation and management of specific medical institutions, but also protects the privacy of each patient for medical treatment and at the same time is aware of the patient's own judgment and responsibility. And greatly contribute to the rationalization of the healthcare system as a whole.

Claims

 The scope of the claims  1) a write-once type information recording medium in which medical information on medical treatment and medication is stored, and each patient owns and carries it;  Information writing means installed at each medical institution or medical department, and storing medical information in the information recording medium brought by the patient using the medical institution or medical department;  Information stored in the information recording medium, which is installed at each medical institution or medical department and brought by a patient who uses the medical institution or medical department, can be used for each medical institution, medical department or operation. Information reading means that can be read under restrictions according to each A system for recording medical, insurance and welfare information comprising: 2) The system according to claim 1, wherein the medical care information includes at least one information form among characters, images, and sounds. 3) The system according to claim 1 or 2, wherein the information recording medium is a write-once optical power supply. 4) In the system according to any one of claims 1 to 3, the restriction on writing and Z or reading of the medical information is implemented in the driving device of the information recording medium itself. A system characterized by the following.  5) The system according to any one of claims 1 to 4, wherein the medical institution includes different departments of one medical institution. 6) The system according to any one of claims 1 to 5, wherein the operation of writing the medical information is also the operation of writing a medical record by a doctor. 7) The system according to any one of claims 1 to 6, wherein the writing operation of the medical treatment information also serves as a recording operation of test data by a laboratory technician. 8) In the system according to any one of claims 1 to 7, the writing operation of the medical information described above also serves as a data entry operation for business processing and accounting processing by a medical clerk. A system characterized in that: 9) In the system according to any one of claims 1 to 8, a character and / or image representing the owner of the information recording medium is visually observed on at least one surface of the information recording medium. A system characterized by being displayed so that it can be used. 10) The information reading means of each department should be designed so that each medical information is input in a simple information format conforming to the business of each department and output in an information format suitable for the business in each department. An information system for medical institutions, each of which is equipped with an information form conversion function. 11) The medical institution information system according to claim 10, wherein the information form conversion function includes an information form conversion table mounted on the information reading means. 12. The medical institution information system according to claim 11, wherein the contents of the information form conversion table are changeable. 13) In the system according to any one of claims 1 to 12, the information stored in the information recording medium is the personal identification information stored in the highest level and the next level. From the individual information stored by classifying it into multiple directories A system characterized by being stored in a ruffle structure. 14) The system according to claim 13, wherein the information stored in the information recording medium generates a file of a single recording method for adding data to an existing file at the time of updating, and a new file at the time of updating. A system characterized in that both the history information file and the history information file are recorded in a mixed state. 15) The system according to claim 14, wherein the file name of the file includes an instance indicating a classification of content and an extension indicating a type of data of the content. 16) The system according to claim 15, further comprising information on the file name of the file and the date and time when the file was created. System _c 17) in a system according to any one of claims 14 to 16, in which the contents of the previous SL Fairu, characterized in that it is written in SGML format 18) A data input device for a system according to any one of claims 1 to 17;  The data input device is provided with an image display device for displaying choices of data to be input, and the display device is configured to sequentially display the most likely choices to be input next. A data input device for a system. 19. The input device according to claim 18, wherein the information recorded on the recording medium includes at least one of character information, image information, and audio information. 20) The input device according to claim 18 or 17, wherein the information recording medium is a write-once optical power. 21) The input device according to any one of claims 18 to 20, wherein the display device includes a touch panel mounted on a display surface, and an option displayed on the display device. An input device characterized in that input is completed by directly pointing to the input device. 22) The input device according to claim 21, wherein the display device is a liquid crystal panel device or a plasma display device. 23) In the input device according to any one of claims 18 to 22, the option displayed on the display device is determined by referring to the option selected before the option. An input device characterized in that the input device is configured to be operated. 24) In the input device according to any one of claims 18 to 23, the option displayed on the display device is determined by referring to information stored in the information recording medium. An input device characterized in that the input device is configured to be operated. 25) The input device according to any one of claims 18 to 24, wherein if an appropriate option is not extracted, the input device is configured to switch to a general-purpose input mode. Input device. 26. The input device according to claim 25, wherein the input device in the general-purpose input mode includes any one of a keyboard device, a voice input device, and an image input device.