JP2010170332A - Medical business management system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a simple medical business management system which can be introduced at low cost, while solving the cost problem in conventional medical business management systems where a server device and a terminal for recording execution of medical practice are networked. <P>SOLUTION: A receipt computer 1 serving as a server device for accumulating and managing information about medical business and a terminal 6 for recording execution of medical practice, which is installed in a location where medical business is implemented, are made independent of each other without being connected together via a communication line. An RFID card C is used to exchange information between the receipt computer 1 and the execution recording terminal 6. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical work management system whose main purpose is to automatically input a medical practice record into a reception computer at the time of accounting in a medical institution.

  In recent years, the digitization of medical information has been promoted, and as one of them, a medical work management system that manages medical information for the purpose of automatically inputting medical practice records into a receipt computer, a so-called order entry system Electronic medical records are known. The order entry system / electronic medical record is a system in which a medical record for a doctor to record the treatment contents and instructions of a patient is stored as electronic data in a server device installed mainly for each medical institution.

  In addition, there is also known a medical work management system having a traceability system that records when and who performed a medical practice and can extract the information as necessary. In order to perform this function, the traceability system generally uses a system in which information is centrally managed by a server device when a certain input / output is performed by a terminal, and is converted into a database.

  As described above, in the conventional general medical work management system, information is stored in the server device. Therefore, as disclosed in Patent Document 1 and Patent Document 2, the system configuration is the same as that of the server device. It was assumed that a medical practice execution recording terminal installed at a medical service execution place was physically connected by a communication line such as a network.

  However, the implementation record terminals are scattered in a plurality of locations, and in order to centrally manage the input / output of information by these implementation record terminals through the network, infrastructure development such as the wiring of network cables (LAN cables) between each terminal is required.

  In addition, since the implementation record terminal is connected to the server device via the network, it is necessary to take strict measures against computer viruses, and security measures such as checking data for each patient when information is input / output from the implementation record terminal are also available. It is necessary to be strict.

  Even in a database for storing information, it is necessary to take measures for locking the database as a countermeasure when there are simultaneous inputs / updates from a plurality of implementation record terminals.

  Furthermore, since all the cooperative applications of the implementation recording terminal are integrated into one system, it is necessary to update all the systems at the same time as the system evolves.

  For this reason, the conventional medical operation management system has an enormous and complicated system configuration and enormous initial costs and maintenance costs at the time of system introduction. It has become.

Japanese Patent Laid-Open No. 2004-046582 JP 2005-259033 A

  The problem to be solved by the present invention is that a conventional medical business management system in which a server device and a medical practice execution recording terminal are networked solves the problem that the cost is too high, and can be easily introduced at a low cost. To provide a medical service management system.

  The present invention makes a receipt computer as a server device that accumulates and manages information related to medical work and a medical practice execution recording terminal installed at a medical work execution place independent of each other without connecting via a communication line. The information exchange between the receipt computer and the implementation recording terminal is performed by an RFID (Radio Frequency Identification) card.

  That is, the present invention is a medical work management system using an RFID card capable of rewriting information related to medical work, and stores at least patient information and medical practice records as information related to medical work; An issuance reader / writer that acquires patient information from a receipt computer and writes the patient information to an RFID card; and an implementation record terminal that is installed independently of the receipt computer at a medical service implementation location without being connected by a communication line; An implementation record reader / writer that writes an implementation record of a medical practice to an RFID card by operating an implementation record terminal, and an accounting reader that reads the patient information and the implementation record of the medical practice written to the RFID card and transmits them to a receipt computer Also features a writer It is.

  In the present invention, “communication line” is a general term for lines that enable communication regardless of wired or wireless.

  In the medical work management system of the present invention, the implementation record reader / writer can read the patient information written in the RFID card and display the patient information on the implementation record terminal. Accordingly, it is possible to verify that the patient is the correct person by confirming the coincidence between the displayed patient information and the patient information described in the medical record or slip.

  In the medical work management system of the present invention, the implementation record reader / writer writes the implementation record of the medical practice on the RFID card by operating the implementation record terminal, and the person who performed the medical practice displayed on the implementation record terminal The trace information including the implementation date and the implementation location is written on the RFID card, and the accounting reader / writer reads the trace information together with the implementation record of the medical practice written on the RFID card and transmits it to the reception computer. it can. Accordingly, it is possible to accumulate trace information such as the practitioner of the medical practice, the implementation date, and the implementation location, and it is possible to extract the trace information as necessary.

  Furthermore, in the medical work management system of the present invention, the receipt software is incorporated into the receipt computer, and the receipt software receives the medical practice record read from the RFID card by the accounting reader / writer, and performs the received medical practice. A medical fee can be calculated based on the record. As a result, a medical practice record is automatically input to the receipt software, thereby making it possible to increase the efficiency of the calculation of medical fees.

  In the medical work management system of the present invention, the execution record terminal of each medical work execution place is independent of the reception computer regardless of wired or wireless, and does not need to be networked, so the overall system configuration is simplified, The system can be constructed at low cost.

  In addition, since information is exchanged via the RFID card, it is possible to leave no personal information of the patient on the implementation record terminal. Moreover, since the implementation record terminal is separated from the receipt computer in which the patient's personal information and the like are stored, it is not necessary to take security measures against information leakage or the like in the implementation record terminal. Furthermore, the implementation recording terminal can have a minimum hardware configuration that includes only the implementation recording reader / writer.

  In addition, when information is written to the RFID card by the implementation record terminal installed at each medical service implementation location, information such as the implementation location (installation location of the implementation record terminal), the implementer, and the implementation date / time can also be written. . Such information can be used as trace information by reading it at the time of accounting and storing it in a database.

  As described above, in the medical work management system of the present invention, the implementation record and trace information of medical actions required at the time of accounting can be transmitted by the RFID card and stored in the receipt computer, and the conventional large-scale medical work management The same function as the system can be exhibited. Moreover, in the medical work management system of the present invention, as described above, the cost for constructing the network and the cost for security measures do not occur, so the medical work management that exhibits excellent functions safely and at low cost. A system can be constructed.

It is a block diagram of the medical service management system of this invention. It is the schematic which shows the memory area of the memory chip of an RFID card. It is a flowchart of an RFID card issuance process. It is a flowchart of a RFID card reading process. It is a flowchart of a RFID card write process. It is a flowchart of the accounting process by an RFID card.

  Embodiments of the present invention will be described below based on examples shown in the drawings.

  FIG. 1 is a block diagram of a medical service management system according to the present invention.

  In FIG. 1, a communication line (LAN) 2 is installed on the same network as the receipt computer 1, and an issuing reader / writer 3 and an RFID that can write information in the RFID card C via a distributor (HUB). An accounting reader / writer 4 capable of reading information in the card C is connected.

  The receipt computer is a computer that creates a receipt (specific medical fee description). Specifically, software (receipt software) that has patient information management / acceptance functions, input / calculation / output functions of medical practice records, etc. It is an embedded computer.

  In this embodiment, as the receipt computer 1, a computer (PC) in which the Japan Medical Association Standard Receipt Software (ORCA) 1a is installed is used. Since ORCA is open source and the software main body is provided free of charge, it is easy to link with external programs.

  ORCA has an XML-based communication protocol called CLAIM (Claim), which is defined to link ORCA and external programs. This is mainly specified for cooperation with the electronic medical chart system.

  In the receipt computer 1 of FIG. 1, in addition to the ORCA 1a, an issuance processing program 1c having a function of writing data to the RFID card C by controlling the issuance reader / writer 3 and an accounting reader / writer 4 are controlled. An accounting program 1d having a function of reading data written in C is incorporated.

  The issuing reader / writer 3 receives from the ORCA patient information to be written on the RFID card C using the ORCA CLAIM in accordance with the control of the issuing program 1c. Further, the accounting reader / writer 4 transmits to the ORCA the medical practice record written on the RFID card C using the ORCA CLAIM in accordance with the control of the accounting program 1d. These patient information and implementation records are accumulated in the ORCA database 1b.

  The ORCA 1a, the issuance processing program 1c, and the accounting processing program 1d described above may exist on a computer different from the receipt computer 1, respectively.

  An implementation record terminal 6 is installed at each medical service implementation location. The implementation record terminal 6 is installed independently without being connected to the receipt computer 1 at all. The implementation record terminal 6 incorporates an implementation record processing program 6a that can control the implementation record reader / writer 5 to read / write information in the RFID card C.

  The implementation record terminal 6 is a PC having a touch panel display 6c. The touch panel display 6c includes a patient information display unit 6d for displaying patient information and the like, an implementation input item display unit 6e for displaying implementation input items, There is a trace information display section 6f that displays trace information such as the name of a person in charge (implementer) who performs the execution record, and an executed item display section 6g that displays an executed item.

  In such a basic configuration, in the system of the present invention, information is exchanged between the receipt computer 1 and the implementation recording terminal 6 via the RFID card C.

  FIG. 2 is a schematic diagram showing the storage area of the memory chip of the RFID card C. The range that can be freely rewritten in the storage area of the RFID card C is the address 20 to the address FF. Since 4 bytes of data can be stored in one address, a total of 896 bytes can be used.

  The date when the card is issued at address 20 is stored in 8 digits. A patient code for identifying a patient is stored in addresses 21 to 22 in 10 digits. A name for identifying the patient is stored at addresses 23-26. These are patient information for preventing the card from being mixed.

  The address 27 stores the position information of the address where the medical practice record and the trace information are written. The initial value is 30, which is a state in which no execution record and trace information are stored. When one execution record and trace information associated therewith are written, the data is stored at addresses 30-33. The writing position of the next execution record is 34, and 34 is overwritten on the address 27.

  The address 28 stores a security code that identifies the use environment. This is to prevent misidentification of a card that has not been issued properly.

  At addresses 30 to F7, implementation records and trace information necessary for data input to the receipt computer are stored. 16 bytes are allocated to one execution record and trace information. A medical code for identifying the implementation content is stored in the address 30 in four digits. The address 31 stores the number of medical practices in four digits including a decimal point. A code for identifying the practitioner is stored in address 32 in four digits. The address 34 stores a code for identifying the place of implementation and time information in four digits. The information stored at the addresses 30 and 31 is the implementation record, and the information stored at the addresses 32 and 33 is the trace information.

  The issuing process of the RFID card C will be described with reference to FIG. 1, FIG. 2, and FIG. In the case of a first visit patient, the hospital side performs new registration at the receipt computer 1 or a client terminal using the receipt computer 1 as a server. The registered contents are patient name, patient number, insurance card number, etc., and these registered contents are accumulated in the ORCA database 1b by new registration. In the case of revisited patients, no new registration will be made.

  After that, reception registration is performed at the terminal. In the reception registration, the patient number is input on the ORCA reception registration screen, and the patient information (patient number, patient name) accumulated in the ORCA database 1b is displayed on the screen on the terminal. After the display, the RFID card C is set in the issuing reader / writer 3.

  The issuing reader / writer 3 recognizes that the RFID card C is set under the control of the issuing processing program 1c, and requests patient information (patient number, patient name) displayed on the current screen of the terminal by CLAIM. . The issuing reader / writer 3 initializes the RFID card C after receiving the patient information by CLAIM. Specifically, the address 27 is rewritten to the initial value 30, and a specific code is overwritten on the security code of the address 28. Next, the patient information (patient number, patient name) and the current date are overwritten on a predetermined address of the RFID card C.

  The RFID card C issued in this way is transferred to the patient or inserted into the medical chart, and moves with the patient in the hospital.

  Next, the process in the implementation record terminal 6 installed in each medical work execution place will be described. The implementation recording terminal 6 reads / writes information in the RFID card C using the implementation recording reader / writer 5 connected thereto.

  First, reading of information in the RFID card C by the implementation recording terminal 6 will be described with reference to the flowcharts of FIGS. 1, 2, and 4.

  Patient information, implementation input items, trace information, and implemented items are displayed on the display units 6d to 6g of the touch panel display 6c of the implementation recording terminal 6, respectively. In the initial state before reading the RFID card C, the patient information display unit 6d and the performed item display unit 6g are blank. The trace information display section 6f displays the name of the medical service execution place and the current date and time. The implementation input item 6e displays an implementation input item stored in the implementation item DB 6b.

  The person in charge (implementer) who performs the implementation record causes the implementation record reader / writer 5 to read the person-in-charge card T that identifies himself / herself. The read person information (person name) is displayed as trace information on the trace information display unit 6f.

  Next, the RFID card C is set in the implementation recording reader / writer 5. The implementation recording reader / writer 5 reads the security code at the address 28 in FIG. 2 under the control of the implementation recording processing program 6a, and confirms that the card is a legitimate card.

  Subsequently, the implementation recording reader / writer 5 reads the addresses 20 to 26 in FIG. 2 and displays the date, patient code, and patient name on the patient information display unit 6d. By confirming the coincidence between the displayed patient information and the patient information described in the medical record or slip, it is possible to verify that the patient is correct.

  Next, the implementation recording reader / writer 5 reads the address value of the address 27 in FIG. This address value indicates the address position where the execution record and the trace information are written, and the initial value is 30. If the address value is 30, it indicates that no implementation record or trace information has been written. When the address value is other than 30, it indicates that the execution record and the trace information have already been written at another medical work execution place. For example, in the case of the address value 40, it indicates that a total of four data (execution record and trace information) are written in the addresses 30 to 3F at other medical work execution locations. The reader / writer 5 reads them and displays them on the executed item display section 6g. By confirming this performed item display section 6g, it is possible to confirm what kind of treatment has been performed at another medical work execution place.

  Next, a process of writing information to the RFID card C by the implementation recording terminal 6 will be described with reference to the flowcharts of FIGS.

  The person in charge (practitioner) selects a corresponding execution item from the execution input items displayed on the execution input item display unit 6e by touching the touch panel display 6c. If numbers are required, enter numbers.

  The implementation record reader / writer 5 writes the medical code and the input number (quantity) associated with the selected implementation item in the address position indicated by the address 27 as an implementation record in accordance with the control of the implementation record processing program 6a. Further, the person-in-charge information (person-in-charge name), the name of the medical work execution place, and the current date and time displayed on the trace information display unit 6f are written as trace information. The association between the execution item and the medical code is performed by referring to a database that associates the execution item with the medical code, for example.

  Next, the next position information is overwritten on the address 27. For example, when the value of the address 27 is 30, the execution record and the trace information are recorded in the addresses 30 to 33, and thus the value of the address 27 is 34.

  When performing a plurality of execution records, the above is repeated. In this way, writing of the implementation record and trace information is completed.

  After the writing is completed, the RFID card C is removed from the implementation record reader / writer 5 and moved to the next medical service implementation place or accounting together with the patient.

  Next, an accounting process using the RFID card C will be described with reference to FIG. 1, FIG. 2, and FIG.

  During the accounting process, the patient submits the RFID card C to the accounting window where the accounting reader / writer 4 is installed. The accounting person sets the RFID card C in the accounting reader / writer 4.

  The accounting reader / writer 4 recognizes the RFID card C under the control of the accounting processing program 1d, and first reads the security code written in the address 28 to confirm that it is a regular card. Next, the patient code written in the addresses 21 to 22 is read. Next, the address value of the execution record written in the address 27 is read, and the medical codes and quantities of all the execution records written are read. Then, using CLAIM, the patient code, all medical codes, and the quantity are transmitted to ORCA.

  The ordinary accounting process of ORCA will be described. Select “21 medical practice” from the “(M01) business menu” of ORCA, and display the “(K02) clinical practice input” screen. First, a patient number is input and patient information is displayed. Then, a pre-set code called a medical code or an abbreviated code is input to display a medical name. Enter the quantity as required. After the input is completed, by clicking “Register (F12)”, a “(K08) medical practice input-input action confirmation” screen is displayed. By clicking “Register (F12)”, the medical practice is registered in the ORCA database 1b and the medical fee is calculated.

  When the medical service management system of the present invention is applied, data read from the RFID card C by the accounting reader / writer 4 is transmitted to ORCA by CLAIM. After that, on the “(K02) medical practice input” screen of ORCA, click “midway display”. “Intermediate display” is a function for calling data received from an external system such as an electronic medical record of ORCA. When “display halfway” is clicked, a list of data read from the RFID card C is displayed on the ORCA screen. When the corresponding data is selected and “F12 confirmation” is clicked, the screen returns to the “(K02) medical practice input” screen. At this time, the implementation record read from the RFID card C is input as a medical practice. In other words, the operation of inputting patient information and medical practice described in a paper slip or medical record input is automated by the medical work management system of the present invention.

  Although the case where there is one implementation record terminal 6 has been described above, it is possible to perform the same procedure even when a plurality of implementation record terminals 6 are installed, and connection via a communication line is unnecessary. There is no limit.

  The accounting reader / writer 4 also reads the trace information from the RFID card C according to the control of the accounting processing program 1d. The trace information is stored in the trace information DB 1f. This makes it possible to specify the date and time of the past medical practice, the person in charge, and the place of implementation. The terminal that refers to the information in the trace information DB 1f is the receipt computer 1 or a computer (PC) on the same network.

  The medical operation management system of the present invention described above uses an RFID card having a necessary and sufficient memory capacity and rewritable as means for transmitting information regardless of the network. As described above, the storage capacity of the RFID card C in this embodiment is 896 bytes, 36 bytes for patient information, security code, etc., and 16 bytes for one execution record and trace information. It was possible to store record and trace information.

1 Receipt Computer 1a ORCA (Japan Medical Association Standard Receipt Software)
1b ORCA database 1c issuance processing program 1d accounting processing program 1f database for trace information 2 LAN (network)
3 Reader / Writer for Issue 4 Reader / Writer for Accounting 5 Reader / Writer for Implementation Record 6 Implementation Record Terminal (Touch Panel PC)
6a Implementation record processing program 6b Implementation item database 6c Touch panel display 6d Patient information display unit 6e Implementation input item display unit 6f Trace information display unit 6g Performed item display unit C RFID card T Person in charge card

Claims (4)

A medical work management system using an RFID card capable of rewriting information related to medical work,
A receipt computer that accumulates at least patient information and medical practice records as information related to medical services;
An issuance reader / writer that acquires patient information from a receipt computer and writes the patient information to an RFID card;
An implementation record terminal installed independently without being connected to the receipt computer via a communication line at a medical service implementation site;
An implementation record reader / writer that writes an implementation record of medical practice to the RFID card by operating the implementation record terminal;
A medical work management system comprising: an accounting reader / writer that reads patient information written on an RFID card and a medical practice record and transmits it to a receipt computer.   The medical operation management system according to claim 1, wherein the implementation record reader / writer reads patient information written in the RFID card and displays the patient information on the implementation record terminal. The implementation record reader / writer writes the implementation record of the medical practice to the RFID card by operating the implementation record terminal, and also displays the trace information including the performer, implementation date and implementation location of the medical practice displayed on the implementation record terminal. Write on the card,
The medical work management system according to claim 1 or 2, wherein the accounting reader / writer reads the trace information together with the medical action execution record written in the RFID card and transmits the read trace information to the reception computer.   A request for receiving medical software implementation records read from an RFID card by an accounting reader / writer and calculating medical fees based on the received medical activity implementation records. Item 4. A medical work management system according to any one of Items 1 to 3.

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