JP2019012385A - Medical information management apparatus and medical information sharing system - Google Patents

Abstract

To promote efficiency of medical work by making it possible to flexibly change the disclosure range of medical information.SOLUTION: A medical information management apparatus sets a disclosure range for each piece of medical information to medical staff who can refer to the medical information. The medical information management apparatus permits referring to the medical information when it is accessed from login accounts corresponding to the medical staff included in the disclosure range corresponding to the medical information with respect with each piece of the medical information. The medical information management apparatus changes the disclosure range corresponding to a designated medical information in response to the consent of the medical staff who registered the designated medical information when there is a disclosure request from the medical staff not included in the disclosure range corresponding to the designated medical information.SELECTED DRAWING: Figure 15

Description

  The present invention relates to a medical information management apparatus and a medical information sharing system.

  In recent years, with the diversification of medical technology, medical cooperation in which a plurality of medical facilities such as hospitals and clinics having a specific function share medical information and perform examination and treatment of patients in cooperation is becoming widespread. In addition, the importance of home care and nursing care is increasing, and medical information is being shared among medical facilities such as hospitals, clinics, home-visit nursing stations, and nursing care establishments.

For example, in a situation where a patient moves from a hospital, nursing home, home, etc. and a multi-professional staff (medical worker) is involved with the patient, the access authority to the document is managed depending on the affiliation and occupation of the staff at each facility. A multi-facility integrated electronic medical record system has been proposed (see Patent Document 1).
Usually, in such a system, the disclosure range of various types of medical information related to patients is set for each occupation of the medical staff.

Japanese Patent No. 5829347

  However, in an actual medical field, the patient's condition changes day by day, so the medical information required by the medical staff also changes. For this reason, the method of uniformly setting the disclosure range of medical information for each type of occupation of medical staff has a problem that it is not easy to use and the efficiency of medical work cannot be achieved.

For example, when the attending physician asks the attending physician to visit the home patient, a summary describing the patient's medical condition is shared among the doctors. There is a desire to understand the recorded daily conditions (vital signs, appetite, defecation, etc.).
In addition, medical staff other than doctors share their daily status among various occupations and aim to improve the patient's QOL. By grasping the doctor's judgment results such as the patient's name and prescription, You may want to use it for business.

Also, since individual medical information and reference authority (publication range) are not managed one-on-one, once the operation of the system is started, it is difficult to change the reference authority.
In addition, since authority management is often performed for each occupation of a medical worker, it is difficult to manage authority in units of individual medical information.

  The present invention has been made in view of the above-described problems in the prior art, and it is an object of the present invention to promote the efficiency of medical work by allowing the disclosure range of medical information to be flexibly changed.

  In order to solve the above-mentioned problem, the invention described in claim 1 is characterized in that the medical information is stored for each of the first storage means for storing medical information and the medical information stored in the first storage means. For each of the second storage means for storing the public range of referable medical workers and the medical information stored in the first storage means, it corresponds to the medical workers included in the public range corresponding to the medical information Change the disclosure range corresponding to the specified medical information out of the disclosure range stored in the second storage unit and the disclosure control unit that permits the reference of the medical information when accessed from the login account A medical information management device comprising: a changing means that

  According to a second aspect of the present invention, in the medical information management device according to the first aspect, the changing means sets a medical worker who permits or prohibits reference to the designated medical information for each medical worker. Thus, the disclosure range corresponding to the designated medical information is changed.

  According to a third aspect of the present invention, in the medical information management apparatus according to the first or second aspect, the disclosure range registered in advance in the second storage means is set for each occupational category of the medical worker.

  According to a fourth aspect of the present invention, in the medical information management device according to any one of the first to third aspects of the present invention, a third memory for storing a medical worker who registers each piece of medical information in the first storage means. And the specified medical information from the third storage means when there is a request for disclosure of the specified medical information from a login account corresponding to a medical worker who wishes to refer to the specified medical information. And a requesting device for transmitting the specified medical information disclosure request to a notification destination of the acquired medical worker, and the changing unit includes the specified medical device. When the release of the specified medical information is approved in the login account corresponding to the medical worker who registered the medical information, the specified medical information stored in the second storage means To add a medical practitioner who wish to reference of the designated medical information to the public range to respond.

  According to a fifth aspect of the present invention, in the medical information management apparatus according to the fourth aspect, the medical staff who desires to refer to the designated medical information in the disclosure range corresponding to the designated medical information by the changing means. When a person is added, it is provided with a notification means for notifying that the public range corresponding to the designated medical information has been changed to the notification destination of the added medical staff.

  The invention according to claim 6 is the medical information management device according to claim 4 or 5, wherein the disclosure range is changed when the disclosure range corresponding to the designated medical information is changed by the changing means. A publication deadline setting means for setting a publication deadline to be performed, and the publication control means, when there is an access from a login account corresponding to a medical worker added to the publication scope corresponding to the designated medical information, When it is within the set publication deadline, reference to the designated medical information is permitted.

  The invention according to claim 7 is the medical information management device according to claim 4 or 5, wherein when the disclosure range corresponding to the designated medical information is changed by the changing means, the disclosure range is changed. A disclosure count setting means for setting the number of disclosures permitted to permit, and the disclosure control means is accessed from a login account corresponding to a medical worker added to the disclosure range corresponding to the specified medical information In addition, when the number of times the designated medical information is referred to by the added medical worker is less than the set number of times of disclosure, the reference of the designated medical information is permitted.

  According to an eighth aspect of the present invention, in the medical information management device according to any one of the first to seventh aspects, any one of the medical information stored in the first storage unit is specified. 4th storage means which memorize | stores the change schedule information including the information for performing, the target medical worker who permits the reference of said one medical information temporarily, and the open period which permits the reference of said one medical information The changing means includes the target medical worker within a disclosure range corresponding to the one medical information when the disclosure period is reached based on the scheduled change information stored in the fourth storage means. When the disclosure period ends, the target medical worker is deleted from the disclosure range corresponding to the one medical information.

  According to the ninth aspect of the present invention, a medical information management device including a first storage unit that stores medical information and a client terminal used by a medical worker belonging to a medical facility communicate data via a communication network. A medical information sharing system that is connected to the medical information management apparatus, wherein the medical information management apparatus discloses, to each of the medical information stored in the first storage unit, a medical worker who can refer to the medical information. For each of the second storage means for storing the range and the medical information stored in the first storage means, there was an access from a login account corresponding to a medical worker included in the disclosure range corresponding to the medical information. In this case, it corresponds to the specified medical information in the disclosure range stored in the second storage unit and the disclosure control unit that permits reference to the medical information. Comprising changing means for changing the open range, the.

  ADVANTAGE OF THE INVENTION According to this invention, efficiency improvement of a medical service can be promoted by enabling it to change the disclosure range of medical information flexibly.

It is a system configuration figure of a medical information sharing system in an embodiment of the invention. It is a block diagram which shows the functional structure of a medical information management apparatus. It is a figure which shows the example of a facility information table, a user information table, a patient information table, and a medical information table. It is a figure which shows the example of a public occupation initial value table. It is a figure which shows the example of a public request management table. It is a figure which shows the folder structure in a file storage part. It is a figure which shows the occupation which can become a registered user about each medical information, and the occupation which makes a public request temporarily. It is a block diagram which shows the functional structure of a client terminal. It is a ladder chart which shows the information upload process performed by a medical information management apparatus and a client terminal. It is a ladder chart which shows the information registration process performed by a medical information management apparatus and a client terminal. It is a flowchart which shows the medical information reference process performed by the medical information management apparatus. It is a flowchart which shows a reference authority presence determination process. It is an example of a medical information list screen. It is an example of a public request confirmation screen. It is a flowchart which shows the public request | requirement response process performed by a medical information management apparatus. It is an example of a public consent confirmation screen. It is a ladder chart which shows the open occupation type addition process performed with a medical information management apparatus and a client terminal. It is a ladder chart which shows the disclosure prohibition process performed by a medical information management apparatus and a client terminal. It is a flowchart which shows the open range automatic change process performed by the medical information management apparatus in a modification.

  Hereinafter, an embodiment of a medical information sharing system according to the present invention will be described with reference to the drawings. However, the scope of the invention is not limited to the illustrated examples.

[Configuration of medical information sharing system]
FIG. 1 shows a system configuration of a medical information sharing system 100 in the present embodiment.
As illustrated in FIG. 1, the medical information sharing system 100 includes a medical information management device 10 and a client terminal 20 that is used by medical personnel belonging to each medical facility. The medical information management apparatus 10 and the client terminal 20 are connected via a communication network N so that data communication is possible.

  The medical information management apparatus 10 accumulates and manages medical information registered from the client terminal 20. The medical information management apparatus 10 may be a cloud server provided in a cloud environment.

The client terminal 20 is a computer device such as a PC (Personal Computer), a tablet terminal, or a smartphone used by a medical worker belonging to each medical facility. Medical facilities include hospitals and clinics to which doctors (primary physicians, deputy physicians, etc.) belong, visiting nursing stations to which nurses who perform nursing visits to patients, care managers to create patient care plans, and patient visits Examples include nursing care offices where helpers (visiting caregivers) who perform nursing care belong, and dispensing pharmacies where pharmacists belong.
The client terminal 20 refers to the medical information managed by the medical information management apparatus 10 when a medical worker who is engaged in patient examination, treatment, home care / care, etc. registers the medical information in the medical information management apparatus 10. Used for occasions.

[Configuration of medical information management device]
FIG. 2 shows a functional configuration of the medical information management apparatus 10.
As shown in FIG. 2, the medical information management apparatus 10 includes a control unit 11, a communication unit 12, a RAM 13, a clock unit 14, a storage unit 15, and the like, and each unit is connected by a bus 16.

  The control unit 11 is configured by a CPU (Central Processing Unit) and the like, and comprehensively controls the processing operation of each unit of the medical information management apparatus 10. Specifically, the CPU reads various processing programs stored in the storage unit 15 and develops them in the RAM 13 to perform various processes in cooperation with the programs.

  The communication unit 12 includes a network interface and the like, and transmits and receives data to and from an external device connected via a communication network N such as a LAN (Local Area Network), a WAN (Wide Area Network), and the Internet.

  The RAM 13 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 15 in various processes that are executed and controlled by the control unit 11.

  The timer unit 14 has a timer circuit (RTC: Real Time Clock). The timer circuit measures the current date and time and outputs it to the controller 11.

  The storage unit 15 includes an HDD (Hard Disk Drive), a non-volatile semiconductor memory, and the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. For example, the storage unit 15 includes a web server program for realizing a function as a web server that provides various web screens to the web browser by communicating with a web browser mounted on an external device using the HTTP protocol. The application program etc. which operate | move above and provide a medical information sharing service to the user of an external apparatus via a web browser are memorize | stored.

  The storage unit 15 stores a facility information table T1, a user information table T2, a patient information table T3, a medical information table T4, a public job initial value table T5, and a public request management table T6. The storage unit 15 includes a file storage unit 151. The file storage unit 151 stores medical information registered as a file.

  FIG. 3 shows examples of the facility information table T1, the user information table T2, the patient information table T3, and the medical information table T4.

The facility information table T1 is a table for managing facility information related to a medical facility for each medical facility involved in treatment of a patient, home care / care, and the like. In the facility information table T1, a facility ID, a business type, a name, an address, a telephone number, a FAX number, and the like are stored in association with each medical facility.
The facility ID is medical facility identification information.
The business type is the business type of the medical facility (clinic clinic, home-visit nursing station, pharmacy, care support center, care establishment, etc.).
The name is the name of the medical facility.
The address is the address of the medical facility.
The telephone number is the telephone number of the medical facility.
The FAX number is a FAX number of a medical facility.

The user information table T <b> 2 is a table for managing user information regarding users for each user (medical worker) who uses the medical information sharing system 100. In the user information table T2, a user ID, a password, a name, a telephone number, a mail address, a facility ID, a job type, and the like are stored in association with each user.
The user ID is user identification information.
The password is used for user authentication when the user logs in to the system.
The name is the name of the user.
The telephone number is the user's telephone number.
The e-mail address is the user's e-mail address.
The facility ID is a facility ID of a medical facility to which the user belongs.
The job type is the job type of the user (doctor, nurse, pharmacist, care manager, rehabilitation specialist, helper, etc.).

The patient information table T3 is a table for managing patient information regarding a patient for each patient. In the patient information table T3, a patient ID, name, sex, date of birth, address, telephone number, e-mail address, contraindication, allergy, and the like are stored in association with each patient.
The patient ID is patient identification information.
The name is the name of the patient.
The gender is the gender of the patient.
The date of birth is the date of birth of the patient.
The address is the patient's address.
The phone number is the patient's phone number.
The e-mail address is the patient's e-mail address.
Contraindications are contraindications for patients, such as contraindications.
Allergy is information about the patient's allergies.

  The medical information table T4 is a table for managing medical information accumulated and managed in the medical information management apparatus 10. The medical information table T4 includes, for each medical information, a patient ID, a file ID, a file type, an item code, a value, a registered user ID, a registration date, a public job type, a public job type restriction, a public user, and a public user restriction. , Publicly prohibited users and the like are stored in association with each other.

  Medical information includes a file that is registered in the file storage unit 151 as a file and a medical information value that is directly registered in the medical information table T4. In the “file ID” and “file type” of the medical information table T4, information is stored only for medical information registered as a file. The “item code” and “value” of the medical information table T4 store information only for the medical information whose values are registered in the medical information table T4. That is, for the medical information registered as a file, the file storage unit 151 of the storage unit 15 functions as a first storage unit that stores the medical information. On the other hand, for medical information registered as values (characters, numbers, etc.), the storage unit 15 that stores the medical information table T4 functions as a first storage unit that stores medical information.

The patient ID is the patient ID of the patient corresponding to the medical information.
The file ID is file identification information assigned in the system. Here, the file name created by the rule of “facility ID_user ID_registration date / time.extension” is used as the file ID.
The file type is information indicating the type of medical information file (medical information provision form, care plan, etc.).
The item code is a code (standardized code) indicating an item of medical information. As the item code, a code corresponding to each item such as a name of a sickness, a prescription, a vital sign, and a care service is used.
The value is information indicating the content corresponding to the item of medical information, and is represented by letters, numbers, or the like.

The registered user ID is a user ID of a medical worker who has registered medical information (file / value).
The registration date / time is the date / time when the medical information is registered in the medical information management apparatus 10.
The public occupation type is the occupation type of a medical worker (medical doctor, nurse, pharmacist, care manager, rehabilitation specialist, helper, etc.) whose medical information is disclosed. Medical information is disclosed to all users belonging to the occupation set as “Public occupation”.
The disclosure restriction of the public occupation type is information indicating a restriction defined regarding the disclosure of medical information for the public occupation category. For example, a publication time limit (a publication end date, an indefinite period, etc.), a number of times of publication, etc. are set as the publication restrictions on the occupation type. A plurality of public occupations can be registered, and a public restriction is defined for each registered public occupation.
The public user is a user ID of a medical worker whose medical information is disclosed. The public user is used when the medical information is disclosed to medical workers of occupations other than the public occupation.
The public user's public restriction is information indicating a restriction defined for the disclosure of medical information to the public user. As a public user's public restriction, for example, a public deadline (publication end date, indefinite period, etc.), the number of publications, etc. are defined. A plurality of public users can be registered, and a public restriction is set for each registered public user.
The public prohibition user is a user ID of a medical worker who is prohibited from disclosing medical information. Since “prohibited users” are given priority over “public occupations”, they are used when it is not desired to disclose medical information to a part of medical workers corresponding to the public occupations.

The storage unit 15 that stores the medical information table T4 (public job type, public user, and public prohibition user) stores, for each medical information, a public range of medical workers who can refer to the medical information. Functions as a means.
In addition, the storage unit 15 that stores the medical information table T4 (registered user ID) functions as a third storage unit that stores medical workers who have registered the medical information in the storage unit 15.

The public job type initial value table T5 is a table in which initial values of public job types for the job types of medical workers who have registered medical information are defined.
FIG. 4 shows an example of the public job type initial value table T5. In FIG. 4, for each occupation type of a medical worker (registered user) who registered the medical information, the occupation type (initial value) for which the medical information is disclosed is indicated by a check mark. For example, the initial value of the public occupation type of the medical information registered by the doctor is “doctor”, and the initial value of the public occupation type of the medical information registered by the nurse is “nurse” and “care manager”.
The disclosure range registered in advance in the medical information table T4 is set for each occupation type of the medical worker based on the published occupation initial value table T5.

FIG. 5 shows an example of the disclosure request management table T6.
In the disclosure request management table T6, a disclosure request ID, a patient ID, medical information specifying information, a disclosure requester, and the like are stored in association with each disclosure request for medical information.
The publication request ID is identification information given to the publication request.
The patient ID is the patient ID of the patient corresponding to the medical information that is the subject of the disclosure request.
The medical information specifying information is information for specifying medical information that is a target of the disclosure request. When the medical information is a file, the medical information specifying information includes a file type and a registration date / time. Alternatively, as the medical information specifying information, a file ID may be used instead of the file type and the registration date / time. When the medical information is registered as a value in the medical information table T4, the medical information specifying information includes an item code and a registration date and time.
The disclosure requester is a user ID of a medical worker who requests disclosure of medical information.

FIG. 6 shows a folder structure in the file storage unit 151.
A folder (patient ID folder) having a name that matches the patient ID of each patient is created in the lower hierarchy of the root folder.
A medical information file related to the patient corresponding to the patient ID folder is stored in a lower hierarchy of the patient ID folder. A folder may be created for each file type in a lower hierarchy of the patient ID folder, and medical information may be classified and stored in this folder.

  The control unit 11 refers to the user information table T2 in the storage unit 15 when the medical information management apparatus 10 is accessed from the login account (user ID / password) corresponding to each user in the client terminal 20. It is determined whether or not the user is registered in advance. When the combination of the user ID and password input at the client terminal 20 is registered in the user information table T2, the control unit 11 determines that the user corresponding to this user ID is a valid user.

  For each piece of medical information stored in the storage unit 15, the control unit 11 can access the medical information when there is an access from a login account corresponding to a medical worker included in the disclosure range corresponding to the medical information. Allow referrals. That is, the control unit 11 functions as a public control unit.

The control unit 11 changes the disclosure range corresponding to the designated medical information among the disclosure ranges stored in the storage unit 15 (medical information table T4). That is, the control unit 11 functions as a changing unit.
For example, the control unit 11 changes the disclosure range corresponding to the specified medical information by setting, for each medical worker, a medical worker who permits or prohibits reference to the specified medical information.

  The control unit 11 is designated from the storage unit 15 (medical information table T4) when there is a request for disclosure of the designated medical information from a login account corresponding to a medical worker who wishes to refer to the designated medical information. The medical worker who registered the medical information is acquired, and a request for disclosing the medical information designated as the notification destination of the acquired medical worker is transmitted. That is, the control unit 11 functions as a disclosure request unit.

  The control part 11 is memorize | stored in the memory | storage part 15 (medical information table T4), when disclosure of the medical information designated in the login account corresponding to the medical worker who registered the designated medical information is approved. A medical worker who wishes to refer to the specified medical information in the disclosure range corresponding to the specified medical information is added.

  The control unit 11 is designated as a notification destination of the added medical worker when a medical worker who wants to refer to the medical information designated in the disclosure range corresponding to the designated medical information is added. Notify that the disclosure range corresponding to medical information has been changed. That is, the control unit 11 functions as a notification unit.

When the disclosure range corresponding to the designated medical information is changed, the control unit 11 sets a disclosure deadline for changing the disclosure range. That is, the control unit 11 functions as a publication time limit setting unit.
When there is an access from a login account corresponding to a medical worker added to the disclosure range corresponding to the designated medical information, the control unit 11 specifies the designated medical information if it is within the set publication deadline. Allow browsing of

When the disclosure range corresponding to the designated medical information is changed, the control unit 11 sets the number of disclosures permitted to change the disclosure range. That is, the control unit 11 functions as a disclosure number setting unit.
When there is an access from a login account corresponding to a medical worker added to the disclosure range corresponding to the specified medical information, the control unit 11 refers to the specified medical information by the added medical worker. When the number of times is less than the set number of times of disclosure, reference to the designated medical information is permitted. Specifically, a reference number counter (initial value is “0”) that counts the number of times the medical information is referred to is provided in the storage unit 15 for each medical staff and for each medical information. The control part 11 permits the reference of the designated medical information by the added medical worker until the set number of times of disclosure including the current reference.

  FIG. 7 shows examples of job types that can be registered users (●) and job types that make a temporary disclosure request (◯) for each medical information. Of the medical information shown in FIG. 7, the prescription and the test result are medical information whose values are directly registered in the medical information table T4, and the other are the medical information registered as files. The photograph includes a photograph of a patient (including an X-ray photograph) and a photograph of a document. Visit records include vital signs, treatment details, and the like.

Here, a scene assumed as a case where the disclosure range corresponding to medical information is changed will be described.
(1) When a care manager formulates a medical treatment plan for a home patient, medical information is required, and therefore the medical information is temporarily disclosed by the primary doctor (when the medical condition is formulated, when the patient status is changed).
(2) When a doctor other than the primary doctor creates a patient's doctor's opinion, the care manager temporarily releases medical information (only once).
(3) The attending physician of the patient at home receives an inquiry from the nursing or pharmacy and temporarily discloses medical information (for each inquiry, or for a long period for each patient if there are many inquiries).
(4) Disclose medical information temporarily between doctors (provide information such as allergies, contraindications, drugs being administered, etc. when a medical practice is performed by a doctor other than the primary doctor due to pressure sores, decayed teeth, etc.).
(5) When receiving a designation of a medical worker who does not want to disclose medical information about the patient from the patient, the designated medical worker is excluded from the disclosure range.

[Configuration of client terminal]
FIG. 8 shows a functional configuration of the client terminal 20.
As shown in FIG. 8, the client terminal 20 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, a RAM 25, a storage unit 26, and the like. Yes.

  The control unit 21 includes a CPU and the like, and comprehensively controls processing operations of the respective units of the client terminal 20. Specifically, the CPU reads various processing programs stored in the storage unit 26 in accordance with an operation signal input from the operation unit 22 or an instruction signal received by the communication unit 24, expands the program in the RAM 25, and Various processes are performed in cooperation with the program.

The operation unit 22 includes a keyboard having cursor keys, character input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 21 receives operation signals input by keyboard operations or mouse operations. Output to.
When the client terminal 20 is a tablet terminal, a smartphone, or the like, the operation unit 22 includes operation keys such as a power key for turning on / off the power, a touch panel stacked on the display unit 23, and corresponds to each operation key. The operation signal corresponding to the position of the touch operation by the user's finger or the like is output to the control unit 21.

  The display unit 23 includes a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 21. For example, the display unit 23 displays various Web screens based on display data for various Web screens received from the medical information management apparatus 10.

  The communication unit 24 includes a network interface and the like, and transmits and receives data to and from an external device connected via a communication network N such as a LAN, WAN, or the Internet. The communication unit 24 performs wireless communication using a mobile phone line or the like, and transmits / receives data to / from an external device such as the medical information management apparatus 10 connected via the communication network N.

  The RAM 25 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 26 in various processes that are executed and controlled by the control unit 21.

  The storage unit 26 includes an HDD, a nonvolatile semiconductor memory, and the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. For example, the storage unit 26 stores a Web browser program and the like for realizing a Web browser.

[Operation in medical information sharing system]
Next, the operation in the medical information sharing system 100 will be described.

  FIG. 9 is a ladder chart showing information upload processing executed by the medical information management apparatus 10 and the client terminal 20. This process is a process when medical information is registered as a file. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 15, and the processing in the client terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

First, when a URL for accessing the medical information management apparatus 10 is input from the Web browser by the operation unit 22 in the client terminal 20, the control unit 21 passes the communication unit 24 based on the input URL. Then, the medical information management apparatus 10 is accessed.
In the medical information management apparatus 10, display data for displaying a login screen is transmitted from the control unit 11 to the client terminal 20 via the communication unit 12. The display data of various Web screens including the login screen transmitted to the client terminal 20 by the Web server function of the medical information management apparatus 10 includes HTML, style sheets, image data, predetermined processing in the client terminal 20. Includes a script for executing.

  In the client terminal 20, when display data for the login screen is received by the communication unit 24, the login screen is displayed on the display unit 23 by the control unit 21. The login screen includes input fields for user ID and password. When a user ID and a password are input by an operation from the operation unit 22 on the login screen (step S1), the input user ID and password are input by the control unit 21 via the communication unit 24. Sent to.

  In the medical information management apparatus 10, when the user ID and the password are received by the communication unit 12, the control unit 11 performs user authentication (step S2). Specifically, the control unit 11 searches the user information table T2 of the storage unit 15 for a record that matches the user ID input in the client terminal 20, and the password included in the searched record and the client terminal 20 If the entered passwords match, it is determined that the user authentication was successful.

  Next, when a patient list request is transmitted to the medical information management device 10 via the communication unit 24 by an operation from the operation unit 22 at the client terminal 20 (step S3), the control unit 11, display data for displaying the patient list screen is transmitted to the client terminal 20 via the communication unit 12.

In the client terminal 20, when the display data of the patient list screen is received by the communication unit 24, the patient list screen is displayed on the display unit 23 by the control unit 21 (step S4).
When a patient who uploads medical information (file) is selected by an operation from the operation unit 22 on the patient list screen (step S5), the control unit 21 sets a patient ID corresponding to the selected patient to the communication unit 24. Is transmitted to the medical information management apparatus 10 via

Next, in the client terminal 20, a file to be uploaded (medical information) is selected by an operation from the operation unit 22 (step S6).
Next, when a file type is input by an operation from the operation unit 22 (Step S7), the control unit 21 transmits the input file type to the medical information management apparatus 10 via the communication unit 24. The
Next, the selected file is uploaded by the control unit 21 to the medical information management apparatus 10 via the communication unit 24 (step S8).

  In the medical information management apparatus 10, when the patient ID, file type, and file (medical information) of the selected patient are received by the communication unit 12, the control unit 11 assigns a file ID (step S9). Specifically, the control unit 11 acquires the facility ID corresponding to the user ID of the login user who operates the client terminal 20 from the user information table T2 of the storage unit 15, and the current date and time is “registration date and time” from the time measuring unit 14. Get as. Then, the control unit 11 combines the facility ID, the user ID of the login user, and the registration date and time, and changes the file name of the uploaded file to “facility ID_user ID_registration date and time extension” (“00113_10567_20170517”). .pdf "). This file name is used as the file ID.

  Next, the control unit 11 stores the received file in the patient ID folder of the selected patient in the file storage unit 151 of the storage unit 15 (step S10).

  Next, the control unit 11 acquires the job type corresponding to the user ID of the login user (registered user) from the user information table T2 of the storage unit 15, and the public job type corresponding to the registered user job type is the public job type of the storage unit 15. Obtained from the initial value table T5 (step S11).

Next, the medical information table of the storage unit 15 is associated with the uploaded file by the control unit 11 in association with the patient ID, the file ID, the file type, the registered user ID, the registration date and time, the public job type, and the public job type restriction. It is registered at T4 (step S12). Specifically, the control unit 11 stores the patient ID of the patient selected in step S5 in the “patient ID” field. Further, the control unit 11 stores the file ID assigned in step S9 in the “file ID” field, and stores the file type input in step S7 in the “file type” field. In addition, the control unit 11 stores the user ID of the login user who performed the file upload operation in the “registered user ID” field, and the current date and time (uploaded) acquired from the timing unit 14 when the file ID is given. Is stored in the “registration date” field. Further, the public job type acquired in step S11 is stored in the “public job type” field by the control unit 11. Further, the control unit 11 sets “indefinite” as an initial value of “public job restriction”.
This completes the information upload process.

  FIG. 10 is a ladder chart showing information registration processing executed by the medical information management apparatus 10 and the client terminal 20. This process is a process in the case where medical information values (characters, numbers, etc.) are registered in the medical information table T4. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 15, and the processing in the client terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the process of step S21-step S24 is the same as the process of step S1-step S4 of an information upload process (refer FIG. 9), description is abbreviate | omitted.

  In the patient list screen displayed on the display unit 23 of the client terminal 20, when a patient to register medical information is selected by an operation from the operation unit 22 (step S25), the control unit 21 sets the selected patient. The corresponding patient ID is transmitted to the medical information management apparatus 10 via the communication unit 24.

Next, in the client terminal 20, when an item of medical information to be registered (for example, “injury name”) is selected by an operation from the operation unit 22 (step S26), the control unit 21 sets the selected item. A corresponding item code is transmitted to the medical information management apparatus 10 via the communication unit 24.
Next, when a value of medical information to be registered (for example, “cardiovascular disease”) is input by an operation from the operation unit 22 (step S27), the input value is transmitted to the communication unit 24 by the control unit 21. To the medical information management apparatus 10 via

  In the medical information management device 10, when the patient ID, item code, and value (contents of medical information) of the selected patient are received by the communication unit 12, the control unit 11 corresponds to the user ID of the login user (registered user). The job type is acquired from the user information table T2 of the storage unit 15, and the public job type corresponding to the job type of the registered user is acquired from the public job type initial value table T5 of the storage unit 15 (step S28).

Next, the medical information table of the storage unit 15 is associated with the medical information to be registered by the control unit 11 in association with the patient ID, item code, value, registered user ID, registration date and time, public job type, and public job type restriction. It is registered at T4 (step S29). Specifically, the control unit 11 stores the patient ID of the patient selected in step S25 in the “patient ID” field. Further, the control unit 11 stores the item code corresponding to the item selected in step S26 in the “item code” field, and stores the value of the medical information input in step S27 in the “value” field. Further, the control unit 11 stores the user ID of the login user who performed the registration operation of the medical information in the “registered user ID” field, and stores the current date and time acquired from the timing unit 14 in the “registration date” field. . Further, the public job type acquired in step S28 is stored in the “public job type” field by the control unit 11. Further, the control unit 11 sets “indefinite” as an initial value of “public job restriction”.
This completes the information registration process.

  FIG. 11 is a flowchart showing medical information reference processing executed by the medical information management apparatus 10. This processing is realized by software processing through cooperation between the control unit 11 and a program stored in the storage unit 15.

  First, a login process is performed by the control unit 11 in response to an access from the client terminal 20 (step S31). Specifically, the user ID and password input at the client terminal 20 are acquired via the communication unit 12, and user authentication is performed by the control unit 11.

Next, in response to a patient list request from the client terminal 20, the control unit 11 transmits display data for displaying a patient list screen to the client terminal 20 via the communication unit 12.
In the client terminal 20, when the display data of the patient list screen is received by the communication unit 24, the patient list screen is displayed on the display unit 23 by the control unit 21. When a patient who refers to medical information is selected by an operation from the operation unit 22 on the patient list screen, the control unit 21 assigns a patient ID corresponding to the selected patient to the medical information management apparatus via the communication unit 24. 10 is transmitted.
In the medical information management apparatus 10, the patient ID of the patient selected as the reference target is acquired by the control unit 11 via the communication unit 12 (step S32).

  Next, the control unit 11 acquires the job type corresponding to the user ID of the login user who operates the client terminal 20 from the user information table T2 in the storage unit 15 (step S33).

  Next, the control unit 11 extracts information on the selected patient from the medical information table T4 in the storage unit 15 (step S34). Specifically, the control unit 11 extracts a record in which the “patient ID” field is the patient ID of the selected patient from the medical information table T4.

  Next, the control section 11 performs a reference authority presence / absence determination process on the extracted selected patient information (step S35). The reference authority presence / absence determination process is a process of determining whether or not the login user has a reference authority for each piece of medical information of the selected patient.

  In the reference authority presence / absence determination process, as shown in FIG. 12, the control unit 11 sets medical information (processing target record) to be processed from the record of the selected patient extracted from the medical information table T4. (Step S51).

  Next, the control unit 11 refers to the processing target record of the selected patient, and determines whether the user ID of the login user is included in the “publication prohibition user” (step S52).

  When the user ID of the logged-in user is not included in the “prohibited user” (step S52; NO), the control unit 11 refers to the processing target record of the selected patient, and the user ID of the logged-in user is displayed in the “public user”. Is determined (step S53).

  When the user ID of the logged-in user is included in the “public user” (step S53; YES), the control unit 11 refers to the processing target record of the selected patient and satisfies the condition of “public user restriction”. It is determined whether or not (step S54). For example, when the publication time limit is set, the control unit 11 determines whether or not the current date and time acquired from the time measuring unit 14 is within the publication time limit. When the number of times of disclosure is set, the control unit 11 determines whether or not the value of the reference number counter of the login user for the medical information to be processed is less than the number of times of disclosure.

  If the user ID of the login user is not included in “public user” in step S53 (step S53; NO), or if the condition of “public user restriction” is not satisfied in step S54 (step S54). NO), the control unit 11 refers to the processing target record of the selected patient, and determines whether or not the job type of the logged-in user is included in the “public job type” (step S55).

  When the occupation type of the logged-in user is included in the “public job category” (step S55; YES), the control unit 11 refers to the processing target record of the selected patient, and satisfies the condition of “public job limitation”. Is determined (step S56). The method for determining whether or not the condition of “Restriction of Public Job Type” is satisfied is the same as in step S54.

  In step S54, when the condition of “public user restriction” is satisfied (step S54; YES), or when the condition of “public job restriction” is satisfied in step S56 (step S56; YES), The control unit 11 determines that the login user has the reference authority for the processing target record of the selected patient (step S57).

  In step S52, when the user ID of the login user is included in “public prohibition user” (step S52; YES), in step S55, the type of login user is not included in “public job type” (step S55; NO). Or, in step S56, when the condition of “Restriction of Opening of Public Job Type” is not satisfied (step S56; NO), the control unit 11 does not have the reference authority for the login user for the processing target record of the selected patient Is determined (step S58).

  After step S57 or step S58, the control unit 11 determines whether or not the processing has been completed for all information on the selected patient (step S59). If there is unprocessed information in the selected patient information (step S59; NO), the process returns to step S51, other medical information is set as a processing target, and the process is repeated.

  In step S59, when all the information on the selected patient has been processed (step S59; YES), the process returns to FIG.

When the logged-in user has the reference authority for the medical information of the selected patient (step S36; YES), the control unit 11 generates display data for displaying the medical information specifying information normally, and the communication unit 12 Is transmitted to the client terminal 20 via step S37. Here, the normal display is to display the medical information specifying information with black characters or the like in order to clearly indicate that the medical information has the reference authority. Specifically, when medical information is registered as a file, the control unit 11 acquires “file type” and “registration date” from the target record of the medical information table T4, and “file type” and “registration”. Display data for normally displaying “date and time” is generated. On the other hand, when the value of the medical information is registered in the medical information table T4, the “item code” and the “registration date” are acquired from the target record of the medical information table T4 by the control unit 11, and the “item code” is acquired. Display data for normal display of “items” and “registration date” corresponding to is generated.
In the client terminal 20, when the display data is received by the communication unit 24, the medical information specifying information is normally displayed on the display unit 23 by the control unit 21.

In step S36, when the logged-in user does not have reference authority for the medical information of the selected patient (step S36; NO), the control unit 11 generates display data for displaying the medical information specifying information in a halftone manner. Then, it is transmitted to the client terminal 20 via the communication unit 12 (step S40). Here, the halftone display is to display medical information specifying information in gray letters or the like in order to clearly indicate that the medical information has no reference authority. Specifically, when medical information is registered as a file, the control unit 11 acquires “file type” and “registration date” from the target record of the medical information table T4, and “file type” and “registration”. Display data for half-tone display of “date and time” is generated. On the other hand, when the value of the medical information is registered in the medical information table T4, the “item code” and the “registration date” are acquired from the target record of the medical information table T4 by the control unit 11, and the “item code” is acquired. Display data for halftone display of “items” and “registration date” corresponding to is generated.
In the client terminal 20, when display data is received by the communication unit 24, the medical information specifying information is displayed on the display unit 23 in halftone by the control unit 21.

  In FIG. 11, in order to simplify the description, in step S <b> 36, the process branches to step S <b> 37 or step S <b> 40 depending on the presence or absence of reference authority for the medical information of the selected patient. The presence / absence of reference authority is determined for each piece of medical information of the selected patient, and is displayed on the display unit 23 of the client terminal 20 in a state where medical information with reference authority and medical information without reference authority are mixed. Is done.

  FIG. 13 shows an example of a medical information list screen 231 displayed on the display unit 23 of the client terminal 20. On the medical information list screen 231, medical information specifying information 31 to 34 of the patient A is displayed. The medical information specifying information 31 to 34 includes a combination of “file type” and “registration date” of medical information or a combination of “item” and “registration date”. The medical information specifying information 32 and 33 are displayed in black characters because the login user has reference authority. On the other hand, the medical information specifying information 31 and 34 is displayed in gray letters because the login user does not have the reference authority.

After step S <b> 37, in the medical information management apparatus 10, the control unit 11 determines whether or not the medical information specifying information of the medical information with reference authority is clicked on the client terminal 20 by the operation from the operation unit 22. (Step S38).
When the medical information specifying information of the medical information having the reference authority is clicked (Step S38; YES), the control unit 11 displays data for displaying the medical information corresponding to the clicked medical information specifying information. Is generated and transmitted to the client terminal 20 via the communication unit 12 (step S39). Specifically, when medical information is registered as a file, the control unit 11 corresponds to the clicked medical information specifying information (combination of “file type” and “registration date”) in the medical information table T4. A “file ID” is acquired from the record, a file is read from the file storage unit 151 of the storage unit 15 based on the acquired “file ID”, and a display for displaying medical information based on this file Data is generated. On the other hand, when the value of the medical information is registered in the medical information table T4, the control unit 11 adds the clicked medical information specifying information (combination of “item” and “registration date”) in the medical information table T4. “Value” is acquired from the corresponding record, and display data for displaying “item” and “value” is generated.
In the client terminal 20, when display data is received by the communication unit 24, medical information is displayed on the display unit 23 by the control unit 21. That is, when there is an access from a login account corresponding to a medical worker included in the disclosure range corresponding to the medical information, reference to the medical information is permitted.

  In the medical information management apparatus 10, the control unit 11 adds “1” to the reference number counter of the login user for the displayed medical information.

After step S <b> 40, in the medical information management apparatus 10, the control unit 11 determines whether or not the medical information specifying information of the medical information without reference authority is clicked by the operation from the operation unit 22 on the client terminal 20. (Step S41).
When the medical information specifying information of the medical information without reference authority is clicked (step S41; YES), the control unit 11 displays a disclosure request confirmation screen for the medical information corresponding to the clicked medical information specifying information. Display data is generated and transmitted to the client terminal 20 via the communication unit 12 (step S42).
In the client terminal 20, when display data is received by the communication unit 24, a public request confirmation screen is displayed on the display unit 23 by the control unit 21.

  FIG. 14 shows an example of a disclosure request confirmation screen 232 displayed on the display unit 23 of the client terminal 20. The publication request confirmation screen 232 includes a “Yes” button B1 and a “No” button B2. The “Yes” button B1 is a button that is pressed when requesting a medical information registrant to disclose medical information. The “No” button B2 is a button that is pressed when the medical information registrant is not requested to disclose the medical information.

  Next, in the medical information management apparatus 10, the control unit 11 determines whether or not a disclosure request is instructed by an operation from the operation unit 22 at the client terminal 20 (step S43). Specifically, when it is determined by the control unit 11 that the “Yes” button B1 on the disclosure request confirmation screen 232 has been pressed on the client terminal 20, it is determined that the disclosure request has been issued, and the “No” button B2 Is determined to have been pressed, it is determined that a public request has not been instructed.

  When a public request is instructed (step S43; YES), a public request ID is given by the control unit 11, and the public request ID, patient ID, medical information specifying information, public requester, etc. are associated and stored. Registered in the disclosure request management table T6 of the unit 15 (step S44). Specifically, the control unit 11 stores the patient ID of the patient selected as the reference target in the “patient ID” field. In addition, the control unit 11 stores the medical information identification information (file type and registration date or item code and registration date) of the medical information designated as the disclosure target in the “medical information identification information” field. Further, the control unit 11 stores the user ID of the login user in the “public requester” field.

Next, a public request mail is transmitted to the registered user by the control unit 11 (step S45). Specifically, the control unit 11 acquires “registered user ID” from the target record of the medical information table T4 (the record corresponding to the medical information specifying information clicked in step S41), and corresponds to the “user ID”. The “mail address” to be acquired is acquired from the user information table T2, and a public request mail is transmitted to the registered user's mail address via the communication unit 12. The disclosure request mail includes a patient, medical information specifying information, a disclosure requester, and the like. In addition, the public request mail describes a URL that can specify the public request ID.
The registered user confirms the publication request mail on the client terminal 20.

  In step S38, when the medical information specifying information of the medical information with reference authority is not clicked (step S38; NO), after step S39, in step S41, the medical information specifying information of the medical information without reference authority is not clicked. (Step S41; NO) When the disclosure request is not instructed in Step S43 (Step S43; NO), or after Step S45, the medical information reference process ends.

  FIG. 15 is a flowchart showing a public request response process executed by the medical information management apparatus 10. This process is a process when the user who has received the disclosure request mail accesses the medical information management apparatus 10 from the client terminal 20, and is software by cooperation between the control unit 11 and the program stored in the storage unit 15. Realized by processing.

  First, in the client terminal 20, when the URL described in the publication request mail is selected by the operation of the user (registered user) who has received the publication request mail, the control unit 21 performs communication based on the selected URL. The medical information management apparatus 10 is accessed via the unit 24. This URL includes a publication request ID, and the medical information management apparatus 10 identifies which publication request is related to access from the client terminal 20.

  In the medical information management apparatus 10, when there is an access from the client terminal 20 by the operation of the user who has received the disclosure request mail (step S61), the control unit 11 causes the login screen to be displayed on the client terminal 20 via the communication unit 12. Display data for displaying is transmitted, and a login process is performed (step S62). Specifically, the user ID and password input at the client terminal 20 are acquired via the communication unit 12, and user authentication is performed by the control unit 11.

Next, the control unit 11 records (patient ID, medical information specifying information, disclosure requester) corresponding to the disclosure request ID from the disclosure request management table T6 of the storage unit 15 based on the disclosure request ID included in the URL. ) Is acquired, and display data for displaying the name, facility name, occupation, target patient, and medical information specifying information of the requester of disclosure is generated (step S63). Specifically, the control unit 11 uses the user information in the storage unit 15 whose name (name of the public requester), facility ID, and job type corresponding to the public requester (user ID) included in the record corresponding to the public request ID. Obtained from table T2. Further, the control unit 11 acquires a name (facility name) corresponding to the facility ID from the facility information table T1 of the storage unit 15. In addition, the control unit 11 acquires the name (target patient) corresponding to the patient ID included in the record corresponding to the disclosure request ID from the patient information table T <b> 3 in the storage unit 15.
In the client terminal 20, when display data is received by the communication unit 24, each information is displayed on the display unit 23 by the control unit 21.

  FIG. 16 shows an example of a public consent confirmation screen 233 displayed on the display unit 23 of the client terminal 20. The public consent confirmation screen 233 is a screen for instructing the user B (publication requester) whether or not to accept the public about the medical information “medical care information provision form (2017.04.10)” of the patient A. It is. The public consent confirmation screen 233 includes a “publish” button B11 and a “not open” button B12. The “publish” button B11 is a button that is pressed when a medical information registrant approves the disclosure of medical information to a requester of disclosure. The “do not disclose” button B12 is a button that is pressed when the registrant of medical information does not consent to the disclosure requester to disclose the medical information.

  Next, it is determined by the control unit 11 whether or not there is an instruction to accept the release of the medical information requested to be released by the operation from the operation unit 22 at the client terminal 20 (step S64). . Specifically, when it is determined by the control unit 11 that the “Publish” button B11 on the release permission confirmation screen 233 is pressed on the client terminal 20, the release of the medical information requested for release is approved. If it is determined that there is an instruction to do so, and it is determined that the “do not release” button B12 is pressed, it is determined that there is no instruction to approve the release of the medical information requested to be published.

When there is an instruction to accept the release of the medical information requested to be released (step S64; YES), the client terminal 20 operates the operation unit 22 to limit the release (release time limit, release date). The control unit 21 transmits the input disclosure restriction to the medical information management apparatus 10 via the communication unit 24.
In the medical information management apparatus 10, when the public restriction is acquired via the communication unit 12 (step S65), the control unit 11 applies the public user and the public user to the target record of the medical information table T4 in the storage unit 15. Public restrictions are set (step S66). Specifically, the control requester 11 stores the disclosure requester (user ID) in the “public user” field of the target record of the medical information table T4 and inputs it in the “public user restriction” field at the client terminal 20. Stored public restrictions are stored. That is, when the release of the medical information is approved in the login account corresponding to the medical worker who registered the medical information for which the release request has been made, the release requester is added to the release range corresponding to the medical information.

  Thereafter, in the medical information management apparatus 10, when access is made from the login account corresponding to the disclosure requester, when the “public user disclosure restriction” condition is satisfied (when the disclosure request period is satisfied, the disclosure requester For example, when the number of times medical information targeted for publication is referred to is less than the number of times of publication, the medical information targeted for publication is disclosed to the publication requester as having reference authority.

In step S64, when there is no instruction for accepting the release of the medical information requested to be released (step S64; NO), or after step S66, the control unit 11 sends the result to the release requester by e-mail. (Step S67). Specifically, the control unit 11 acquires “mail address” corresponding to “public requester (user ID)” from the user information table T2.
If the release is approved, the control unit 11 changes the release range corresponding to the medical information requested to be released and can be referred to by the release requester. Is sent to the e-mail address of the public requester.
When the publication is not accepted, the control unit 11 notifies the publication requester's e-mail address via the communication unit 12 that the publication range corresponding to the medical information requested to be published has not been changed. Is done.
Thus, the public request response process ends.

  FIG. 17 is a ladder chart showing a public job type addition process executed by the medical information management apparatus 10 and the client terminal 20. This process is a process of adding a public job category to the public information disclosure range. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 15, and the processing in the client terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the processing of step S71 and step S72 is the same as the processing of step S1 and step S2 of the information upload processing (see FIG. 9), description thereof is omitted.

  Next, in the medical information management device 10, the control unit 11 extracts information registered by the login user from the medical information table T4 in the storage unit 15 (step S73). Specifically, the control unit 11 extracts a record in which the “registered user ID” field is the user ID of the login user from the medical information table T4.

Next, display data for displaying the medical information list screen is generated by the control unit 11 based on the extracted information, and transmitted to the client terminal 20 via the communication unit 12. The medical information list screen displays a list of medical information registered by the login user.
In the client terminal 20, when the display data is received by the communication unit 24, the control unit 21 displays a medical information list screen on the display unit 23 (step S74).

  In the medical information list screen displayed on the display unit 23 of the client terminal 20, when medical information for changing the disclosure range is selected by an operation from the operation unit 22 (step S75), the control unit 21 selects the selected medical information. Information indicating medical information is transmitted to the medical information management apparatus 10 via the communication unit 24.

In the medical information management apparatus 10, when information indicating the medical information selected by the communication unit 12 is received, the control unit 11 acquires a record corresponding to the selected medical information from the medical information table T <b> 4 in the storage unit 15. Display data for displaying the currently set open range for the selected medical information is generated based on the open job type, open user, and open prohibited user included in the record, and the communication unit 12 Is transmitted to the client terminal 20 via.
In the client terminal 20, when the display data is received by the communication unit 24, the control unit 21 displays the disclosure range currently set for the selected medical information on the display unit 23 (step S76). .

When a public job type to be added is selected by the operation from the operation unit 22 in the client terminal 20 (step S77), the control unit 21 sends the selected public job type to the medical information management apparatus 10 via the communication unit 24. Sent.
Next, by the operation from the operation unit 22, the disclosure restriction (publication time limit, number of publications, etc.) of the public occupation to be added is input (step S 78), and the input publication restriction is input by the control unit 21 via the communication unit 24. To the medical information management apparatus 10.

In the medical information management device 10, when the public job type to be added and the disclosure restriction of the public job type are received via the communication unit 12, the control unit 11 handles the selected medical information in the medical information table T 4 of the storage unit 15. The public job type and the public restriction of the public job type are added to the record to be executed (step S79).
Thus, the public job type addition process is completed.

  When the medical information management apparatus 10 is accessed from a login account corresponding to a medical worker belonging to the added public job after the public job addition process, the condition of “Restriction of Public Jobs” is satisfied ( When it is within the publication period, the medical information that is subject to change of the scope of disclosure is deemed to have reference authority when the number of times the relevant medical information is referred to by the relevant medical worker is less than the number of times of publication) Published.

  FIG. 18 is a ladder chart showing a disclosure prohibition process executed by the medical information management apparatus 10 and the client terminal 20. This process is a process of excluding a specific medical worker from the disclosure range of medical information. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 15, and the processing in the client terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the processing from step S81 to step S86 is the same as the processing from step S71 to step S76 of the public job type addition processing (see FIG. 17), description thereof will be omitted.

  Next, in the client terminal 20, when a disclosure-prohibited user is selected by an operation from the operation unit 22 (step S 87), the user ID of the selected disclosure-prohibited user is transmitted via the communication unit 24 by the control unit 21. It is transmitted to the medical information management apparatus 10.

In the medical information management device 10, when the user ID of the public-prohibited user is received via the communication unit 12, the control unit 11 applies the record corresponding to the selected medical information in the medical information table T 4 in the storage unit 15. A public prohibition user is set (step S88). Specifically, the control unit 11 stores the user ID of the selected disclosure prohibited user in the “publication prohibited user” field of the target record of the medical information table T4.
Thus, the disclosure prohibition process ends.

  After access prohibition processing, in the medical information management device 10, when access is made from a login account corresponding to a medical worker set as a prohibition user, the medical information for which the disclosure range is changed is not disclosed. .

As described above, according to the present embodiment, it is possible to promote the efficiency of medical work by allowing the disclosure range of medical information to be flexibly changed as necessary. Since the disclosure range can be changed for each medical information, even after the operation of the system is started, a medical worker who can refer to the medical information can be changed according to the situation.
Specifically, a medical worker who is permitted or prohibited to refer to medical information can be set for each medical worker.

Also, when there is a request for disclosure of the medical information from a login account corresponding to a medical worker who wishes to refer to certain medical information, the medical information is disclosed to the notification destination of the medical worker who has registered the medical information. Since the request is transmitted, it is possible to request the medical worker who registered the medical information to change the disclosure range.
After that, when medical information disclosure is accepted in the login account corresponding to the medical worker who registered the medical information, a medical worker who wants to refer to the medical information is added to the disclosure range corresponding to the medical information. It is possible to give a reference authority to a medical worker who wishes to refer to medical information.

  In addition, when a medical worker who wants to refer to medical information is added to the disclosure range corresponding to the medical information, the disclosure range corresponding to the medical information is notified by notifying the notification destination of the added medical worker. Can be communicated to medical personnel who wish to refer to medical information.

In addition, by setting the expiration date, it is possible to temporarily permit a change in the disclosure range corresponding to the medical information.
Also, by setting the number of times of disclosure, it is possible to permit a change in the range of disclosure corresponding to medical information while providing an upper limit number of times.

[Modification]
Next, a modified example will be described. Note that illustration and description of the same configuration and processing as those in the above embodiment will be omitted, and description will be made centering on differences from the above embodiment.

  The change schedule information is stored in the storage unit 15 of the medical information management apparatus 10. The scheduled change information includes information for specifying any one of the medical information stored in the storage unit 15 (target medical information), and the target medical staff that temporarily permits reference to the target medical information. And a public period for permitting reference to the target medical information. That is, the storage unit 15 functions as a fourth storage unit.

  Based on the change schedule information stored in the storage unit 15, the control unit 11 adds the target medical worker to the disclosure range corresponding to the target medical information when the disclosure period is reached, and the disclosure period ends. In this case, the target medical worker is deleted from the disclosure range corresponding to the target medical information.

  The medical worker can register the scheduled change information by specifying the target medical worker and the disclosure period for the medical information registered by the medical worker himself / herself from the client terminal 20.

  FIG. 19 is a flowchart showing a disclosure range automatic change process executed by the medical information management apparatus 10. This process is a process for changing the disclosure range of medical information based on preset change schedule information, and is realized by software processing in cooperation with a program stored in the control unit 11 and the storage unit 15. The

  First, the control unit 11 determines whether or not the current date and time is acquired from the timing unit 14 and the disclosure period included in the scheduled change information stored in the storage unit 15 has come (step S91). If it is before the public period (step S91; NO), the process returns to step S91.

  When the disclosure period is reached (step S91; YES), the control unit 11 adds the target medical worker included in the scheduled change information to the disclosure range corresponding to the target medical information included in the scheduled change information. (Step S92). Specifically, the control unit 11 adds the user ID of the target medical worker to the “public user” field of the record corresponding to the target medical information in the medical information table T4 of the storage unit 15. Here, the “public user restriction” is set to “indefinite” or “end date of public period”.

  Next, the control unit 11 acquires the current date and time from the time measuring unit 14, and determines whether or not the publication period included in the change schedule information has ended (step S93). If the publication period has not ended (step S93; NO), the process returns to step S93.

When the publication period ends (step S93; YES), the control unit 11 deletes the target medical worker included in the scheduled change information from the disclosure range corresponding to the target medical information included in the scheduled change information. (Step S94). Specifically, the control unit 11 deletes the user ID of the target medical worker from the “public user” field of the record corresponding to the target medical information in the medical information table T4 of the storage unit 15, The setting in "is also canceled.
The disclosure range automatic change processing is thus completed.

  According to the modified example, in addition to the same effects as those of the above-described embodiment, by setting the scheduled change information in advance, the disclosure range corresponding to the medical information is changed according to the period when the medical information is required. be able to.

  In addition, when there is a plan to change the disclosure range of medical information regularly (once every three months, etc.), a plurality of disclosure periods may be set and the disclosure range automatic change process may be repeated.

  Note that the descriptions in the above-described embodiments and modifications are examples of the medical information sharing system according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each device constituting the system can be changed as appropriate without departing from the spirit of the present invention.

  For example, when “public user” is set in the medical information table T4 and the public deadline (other than indefinite) is set in the “public user public restriction”, the medical deadline has passed. The corresponding “public user” and “public user restriction” may be deleted from the information table T4. The same applies to “public occupation” and “public occupation restriction”.

  Further, whether or not information can be acquired may be defined as “public job restriction” and “public user restriction” in the medical information table T4. The information acquisition availability is information indicating whether or not there is an authority for information acquisition. Specifically, for medical information registered as a file, the availability of information acquisition corresponds to the availability of download. When the download permission is set to “No”, the medical worker belonging to “Public occupation” or the medical worker corresponding to “Public user” refers to the contents of the file on the client terminal 20 on the screen. I can, but I can't download the file. For the medical information whose value is directly registered in the medical information table T4, the availability of information acquisition corresponds to the availability of copying. When the copy permission is set to “No”, the medical staff belonging to “Public occupation” or the medical staff corresponding to “Public user” displays the content (value) of the medical information in the client terminal 20. You can refer to it on the screen, but you cannot copy and paste values.

  As a computer-readable medium for storing a program for executing each process, a portable recording medium such as a CD-ROM can be applied in addition to an HDD and a nonvolatile semiconductor memory. A carrier wave may be applied as a medium for providing program data via a communication line.

DESCRIPTION OF SYMBOLS 10 Medical information management apparatus 11 Control part 12 Communication part 14 Timekeeping part 15 Storage part 20 Client terminal 21 Control part 22 Operation part 23 Display part 24 Communication part 26 Storage part 100 Medical information sharing system 151 File storage part N Communication network T1 Facility information Table T2 User information table T3 Patient information table T4 Medical information table T5 Public job initial value table T6 Public request management table

Claims (9)

First storage means for storing medical information;
Second storage means for storing, for each of the medical information stored in the first storage means, a public range of medical personnel who can refer to the medical information;
Permit access to each medical information stored in the first storage means when accessed from a login account corresponding to a medical worker included in the disclosure range corresponding to the medical information. Public control means to
Changing means for changing the disclosure range corresponding to the specified medical information among the disclosure ranges stored in the second storage unit;
A medical information management device comprising:   The change means changes a disclosure range corresponding to the specified medical information by setting a medical worker who permits or prohibits reference to the specified medical information for each medical worker. The medical information management device described in 1.   The medical information management apparatus according to claim 1, wherein the disclosure range registered in advance in the second storage unit is set for each occupation type of a medical worker. Third storage means for storing medical personnel who registered each of the medical information in the first storage means;
The specified medical information is registered from the third storage means when there is a request for disclosure of the specified medical information from a login account corresponding to a medical worker who wishes to refer to the specified medical information. A public request means for acquiring a medical worker and transmitting the specified medical information public request to a notification destination of the acquired medical worker;
With
The change means stores the designation stored in the second storage means when the designated medical information is approved for release in a login account corresponding to a medical worker who has registered the designated medical information. The medical information management apparatus according to any one of claims 1 to 3, wherein a medical worker who wishes to refer to the designated medical information is added to a disclosure range corresponding to the medical information that has been specified.   When a medical worker who wants to refer to the designated medical information is added to the disclosure range corresponding to the designated medical information by the changing means, the designation is made as the notification destination of the added medical worker The medical information management apparatus according to claim 4, further comprising notification means for notifying that the disclosure range corresponding to the medical information that has been changed has been changed. When the disclosure range corresponding to the designated medical information is changed by the changing unit, the disclosure unit includes an expiration date setting unit that sets an expiration date for changing the disclosure range,
The public control means, when there is an access from a login account corresponding to a medical worker added to the public scope corresponding to the designated medical information, and within the set publication deadline, The medical information management apparatus according to claim 4, wherein the medical information is allowed to be referred to. When the disclosure range corresponding to the designated medical information is changed by the changing unit, the disclosure number setting unit for setting the number of disclosures permitted to change the disclosure range,
The public control means, when accessed from a login account corresponding to a medical worker added to the public range corresponding to the specified medical information, the specified medical care by the added medical worker The medical information management apparatus according to claim 4 or 5, wherein when the number of information references is less than the set number of times of disclosure, reference to the designated medical information is permitted. Information for identifying any one of the medical information stored in the first storage means, a target medical worker who temporarily permits reference to the one medical information, and the one A fourth storage means for storing change schedule information including a publication period permitting reference to medical information;
The changing means adds the target medical worker to the disclosure range corresponding to the one medical information when the disclosure period is reached based on the change schedule information stored in the fourth storage means. The medical information management device according to any one of claims 1 to 7, wherein when the disclosure period ends, the target medical worker is deleted from a disclosure range corresponding to the one medical information. A medical information sharing system in which a medical information management device including first storage means for storing medical information and a client terminal used by a medical worker belonging to a medical facility are connected to be able to perform data communication via a communication network Because
The medical information management device includes:
Second storage means for storing, for each of the medical information stored in the first storage means, a public range of medical personnel who can refer to the medical information;
Permit access to each medical information stored in the first storage means when accessed from a login account corresponding to a medical worker included in the disclosure range corresponding to the medical information. Public control means to
Changing means for changing the disclosure range corresponding to the specified medical information among the disclosure ranges stored in the second storage unit;
Medical information sharing system with