JP4759296B2 - Medical office processing equipment - Google Patents

Description

  The present invention relates to a medical office processing apparatus, and more particularly to a medical office processing apparatus having an editing function for creating a receipt.

  2. Description of the Related Art Conventionally, there has been proposed a medical office processing apparatus that discriminates the type of detailed data and edits the data according to a condition corresponding to the type difference (see, for example, Patent Document 1).

Japanese Patent No. 2842589

  However, the conventional medical office processing apparatus does not have a function of adding a comment to each receipt data when requesting a receipt. The addition of comments to the receipt data is optional but required, and a function that allows easy addition of comments has long been desired.

  Therefore, an object of the present invention is to provide a medical office processing apparatus having a function capable of easily adding a comment to the receipt data.

As a means for solving the above problems, the present invention provides:
Medical office equipment,
Auto-created standard text that consists of standard format, standard text comment information, and setting value calculation method, or semi-automatic text that can automatically create non-set values included in standard text, and receipt data. A fixed sentence that is set for each medical practice and has a data insertion location corresponding to each patient's medical record data, and an SQL sentence that allows the corresponding data to be taken from the patient's medical record data into the fixed sentence Storage means comprising a fixed phrase comment master that stores
And Table shows means,
Based on whether or not the setting value can be automatically created by referring to the standard sentence comment master based on the created receipt data, it is determined whether or not the standard sentence can be automatically created or semi-automatically created, If it is determined that automatic creation is possible, the corresponding fixed sentence and SQL sentence are called, the corresponding data is called from the patient's chart data based on the SQL sentence, and the number of examination days stored in the chart data To determine the number of times of the medical practice, call a fixed sentence according to the determined number of medical practices from the storage means, and insert the setting value calculated based on the setting value calculation method automatically create a comment by, while creating receipts are attached to the receipt data, if judged to be created semi-automatically, a fixed sentence except the set value, set And control means for creating a receipt by the input field value is displayed on the display means, to complete the input of the set value,
It is set as the structure provided with.

With this configuration, when a receipt is output, a comment can be automatically attached to the receipt data, and it is possible to realize efficient receipt generation without the need for input. Even when the setting value cannot be automatically determined, other items can be automatically created, and the fixed text can be created by taking in the inputted setting value.

When the batch creation button in the receipt creation screen is operated in a state where the receipt creation screen is displayed on the display means, the control means creates a plurality of patient receipt data at one time. If there is an automatically added comment in the receipt data, it can be recognized at a glance by displaying it so that it can be distinguished from other receipt data, and the efficiency of the input work can be improved. This is preferable.

If it is determined that the fixed sentence data or fixed sentence semi-automatically generated data corresponding to the created receipt data is not in the fixed sentence comment master, the control means displays a free format screen on the display means, and allows manual input. Good.

  With this configuration, a fixed sentence can be set for each medical practice, and the data to be inserted into the fixed sentence with the SQL sentence can be automatically taken from the medical record data, so the comment that must be created based on the patient-specific data Can be obtained automatically.

  According to the present invention, the standard text can be automatically created by referring to the standard text comment master based on the receipt data, so that it is possible to easily attach a comment to the receipt without the need for input. It becomes.

  Embodiments according to the present invention will be described below with reference to the accompanying drawings.

  FIG. 1 shows a medical paperwork apparatus according to this embodiment. This device includes a display device 1 such as a liquid crystal display, an input device 2 such as a keyboard / mouse, a storage device 3 such as a hard disk, and a central processing unit (CPU) 4 for input / output control. Reference numeral 5 denotes an electronic medical record terminal capable of transmitting and receiving data to and from the medical office processing apparatus.

  On the display device 1, a reception work screen shown in FIG. 2 is displayed as an initial screen. The reception work screen includes a work menu bar 10, a function menu bar 11, a patient ID (identification) input area 12, a received patient list 13, a patient notice list 14, a patient notice information detail list 15, a patient reservation information calendar 16, and a work notice panel. 17 and a status bar 18.

  The business menu bar 10 is used for switching to any of reception business, accounting business, reservation business, survey business, and setting business.

  The function menu bar 11 includes a patient ID search button, a new patient reception button, an emergency patient reception button, a cancel button, and a new reservation button on the upper side, and a patient information input button, an inquiry information input button, and medical information on the left side. An input button, a survey button, and a chart reference button are provided, and an up button, a down button, and a table update button are provided on the right side.

  When the new patient acceptance button is operated, a patient insurance information registration screen shown in FIG. 3A is displayed. Here, when the type of insurance is selected in the basic information field displayed as the screen selection tab, the display on the lower side is switched to the display corresponding to the selected insurance, so the insurer number, the patient burden rate, etc. are input. When the insurer number of the patient is input, it is determined whether or not the insurer information is registered. If it is determined that the insurer information is registered, the information is taken in, the burden rate is calculated based on the age calculated from the date of birth of the patient, and the calculated value is displayed in the burden rate input unit. On the other hand, if it is determined that the insurer information is not registered, the insurance master registration screen shown in FIG. 3B is displayed, and the trader name, burden rate, etc. are entered. By entering a trader name on this insurance master registration screen, setting for each trader is possible. In addition, since the burden rate can be set, it is possible to flexibly respond to legal revisions.

  When the input on the patient insurance information registration screen in FIG. 3A is completed, the screen switches to the examination information registration screen shown in FIG. 3C. The examination information registration screen includes a patient information display unit and a examination information input unit. In the examination information input section, input of the department, doctor, etc. is performed. In addition, in the priority calculation instruction management fee column of the examination information registration screen, instruction management fees listed as described later are displayed in a pull-down manner. The examination information registration screen can also be displayed by operating the patient information input button.

  When the new reservation button is operated, the screen is switched to the reservation accounting screen shown in FIG. 3D, and the accounting patient display list, that is, the list of patients waiting for the accounting after the examination is displayed. In addition, the buttons displayed on the left side are switched to an accounting button, a reservation button, and a chart reference button. When the accounting button is operated, the charge amount is calculated according to the contents recorded in the electronic medical record. When the reservation button is operated, a reservation calendar is displayed, and it is possible to make a reservation while looking at the examination reservation status of the doctor in charge. When the medical chart reference button is operated, the electronic medical chart of the patient is displayed in a separate window, and the description content can be referred to and used.

  When the examination information input button is operated, the examination information registration screen shown in FIG. 3E is displayed in a separate window.

  When the survey button is operated, the survey screen shown in FIG. 3F is displayed, and it is possible to easily search and refer to desired data from already registered data for the patient.

  When the medical chart reference button (the button in FIG. 3A in which the medical chart is simplified and the character “karte” is displayed) is operated, the medical chart reference screen shown in FIG. 3G can be displayed separately from the reception screen. By this, for example, when operating the examination information input button to enter the confirmation of the doctor who consulted, the judgment of the first visit / revisit, or the time zone of the examination, the contents displayed on the chart reference screen displayed at the same time This makes it possible to easily work by copying or the like. The medical chart reference screen includes a patient information display section, a medical chart information display section, and a display switching operation section.

  The patient ID input area 12 is used to directly input a patient ID using a keyboard or the like when the examination ticket cannot be read by a scanner.

  The reception patient list 13 includes columns of reception number, priority classification, reception time, waiting time, name, age, gender, state, memo, first / re, payment, temperature measurement, blood pressure, urinalysis, patient information, and inquiry information. It is configured. The receipt number is automatically assigned sequentially when the patient ID search button or the like is clicked on the function menu bar 11. In the priority classification, a display indicating the degree of urgency when the patient is examined is performed. For example, “urgent” is displayed in the case of an emergency patient. In the reception time, the system time when the reception input is completed is displayed. The reservation time is displayed in parentheses next to the reception time. In the waiting time, a result obtained by subtracting the reception time from the system time is displayed. When the waiting time exceeds a preset time, it is highlighted by changing the character color or the like. The name is displayed in both reading and kanji. When the maiden name is registered, that is, when there is a record in which the patient ID matches and the patient's surname Kana is different, the maiden name is displayed in parentheses. The age is calculated from the system date and the date of birth entered, and is displayed in the form of ** years and ** months. However, less than one month after birth will be displayed in days. The gender is displayed with different character colors for men and women. Status displays the current patient status. Specifically, any one of waiting for reservation, waiting for medical examination, during medical examination, waiting for payment, waiting for reservation, or completion of payment is displayed. These displays are all displayed with different character colors. The contents entered on the examination information input screen are displayed in the memo. In the first / re-visit, whether it is a first visit or a re-examination is displayed. In the payment, the self-payment category is converted into a name and displayed. For insurance, the burden rate is displayed in parentheses (). In case of own expense, the multiplication rate is displayed in parentheses. In the temperature measurement, blood pressure, and urinalysis, the results of the previous examination are displayed as they are. Blood pressure and urinalysis results are highlighted when they exceed the normal range. In the patient information, a circle is displayed only when the input of patient information is completed. In the inquiry information, a circle is displayed only when the input of the inquiry information is completed.

  The patient notification list 14 includes information about the patient selected in the accepted patient list 13. Specifically, it includes items such as an insurance card confirmation list, a reservation confirmation list, a non-accrual list, and a patient table / comment. By clicking and selecting any item (a check is put in the check column), the content corresponding to the clicked item is displayed in the patient notification information detailed list 15. Further, the patient notification list 14 changes the patient's burden rate based on, for example, the patient's age calculated from today's date and the patient's date of birth, and the burden rate registered on the patient information registration screen. If it is determined whether or not it has been changed, an alarm for warning that effect is displayed in red. Note that this display is deleted by changing the burden rate of the patient whose warning is displayed to an appropriate one.

  The patient notification information detailed list 15 is composed of detailed information for the item selected in the patient notification list 14. When the insurance card confirmation list is selected, a part of the description contents of the insurance card is displayed in a list. Specifically, items of type, insurer number, symbol-number, delivery date, expiration date, relationship, and burden are displayed. If you double-click the line where these items are displayed, the detailed contents of the insurance card will be displayed in a separate window. In addition to the items described above, detailed data including the establishment name, location, date of qualification acquisition, date of final confirmation, insured person, remote place certificate, and high medical expenses are displayed.

  The patient reservation information calendar 16 is displayed on the lower right side of the reception work screen and can be switched in units of one month. In the displayed calendar, the past visit date is highlighted for the patient selected in the accepted patient list 13. By clicking on the past visit date, the reception time and the contents of the reception memo are displayed. In addition, the patient reservation information calendar 16 may be provided with a button on the reception work screen, and may be popped up when this button is clicked.

  The business notification panel 17 can display a notification message for each of the entire system and the window business. By clicking the edit button, it is possible to display the editing screen in a separate window and edit the display contents. The notification message input for the entire system is displayed on all connected terminals (in this case, the electronic medical chart terminal 5 corresponds). In addition, the notification message input for the window service is displayed only on the display device 1.

  The status bar 18 displays supplementary explanations on operations, system operating conditions, system date, and system time.

  As the input device 2, a mouse, a keyboard, a pen device, or the like can be used. When using a pen device, the display is configured with a touch panel.

  The storage device 3 stores various master files and various tables.

  The master file includes a medical practice master, a medicine master, a material price master, a disease name code conversion master, a guidance fee calculation master, a fixed sentence comment master, and the like.

  In the medical practice master, for example, data relating to a medical practice such as injecting a patient is stored.

  The drug master stores data related to the drug (drug), for example, drug name, drug price, unit name code, unit quantity, and the like.

  The material price master stores the price of a material used for a procedure or the like, for example, the price of a film or the like used for X-ray photography.

  The disease name code conversion master includes “International Statistical Classification of Diseases and Related Health Problems, Tenth Revison (ICD-10)” established by the World Health Organization (WHO). Code numbers (ICD-10 codes) and receipt computer codes are stored in a one-to-one correspondence.

  The instruction fee calculation master includes a disease name, an instruction fee and a score that can be calculated, and a calculation condition. FIG. 3G shows a part of data registered in the instruction fee calculation master.

  In the fixed form comment master, a fixed form, fixed form comment information, and a setting value calculation method are registered. These are stored in association with receipt data, which will be described later, and are automatically given to certain receipt data. However, manual input is possible for data that does not have data for automatic assignment.

  The various tables include a reception table, a medical record table, a medical record analysis result table, a patient information table, a calculation result history table, and the like.

  The CPU 4 reads each data stored in the storage device 3 based on the input signal from the input device 2, performs reception work at the medical record analysis unit, and performs accounting work at the calculation control unit.

  Next, the operation of the medical paper processing apparatus will be described separately for reception work and accounting work.

  (Reception Work) In the reception work, a predetermined input is performed by clicking a button corresponding to the type of patient on the reception work screen. The types of patients referred to here mean emergency patients, new patients, and revisited patients.

  In the case of an emergency patient, the patient is clicked on the emergency patient acceptance button and a patient record is added to the accepted patient list 13. The fields of the patient record (here, the reception number, priority classification, and reception time) are automatically input as follows. In other words, the reception number is automatically assigned according to today's reception order. In this case, the emergency letter is highlighted in red. In addition, since it is an emergency patient, you may make it give the earliest number among patients waiting for a medical examination. In the priority classification, the letter “Urgent” is displayed in red. The current system time is input as the reception time. And these input data are reflected in the electronic medical record installed in the terminal which a doctor uses.

  In the case of a new patient, the new patient acceptance button is clicked to display the patient insurance information registration screen shown in FIG. 3A in a separate window. Since the basic information registration screen is initially displayed on the patient information registration screen, the patient's name, date of birth, etc. are input. The age is automatically calculated and displayed from the date of birth and today's date. Subsequently, the main insurance tab is selected to display a screen for inputting main insurance information. FIG. 3 shows a state in which after entering basic information, a screen for entering main insurance information is displayed and an insurer number is entered. If there is already registered data with the entered insurer number, the data registered in the other items is automatically displayed. A value calculated from the age of the patient is automatically entered in the item of burden rate. On the other hand, if there is no registered data, the insurance master registration screen shown in FIG. 3B is displayed, and the insurer information and the burden rate are set. The burden rate is set according to the age difference. When the registration button is operated to close the insurance master registration screen, the registration contents are displayed on the patient insurance information registration screen. In the burden rate column, a corresponding burden rate is displayed from the age of the patient and the burden rate by age set on the insurance master registration screen. In addition, if the image button is operated, the insurance card image data can be captured using a scanner or the like. The image data of the insurance card can be used when confirming the contents of the insurance card thereafter. As a result, even if there is an input mistake or the like, there is no need to check with the patient. When the input on the patient insurance information registration screen shown in FIG. 3A is completed, the registration button is operated to close this screen and return to the reception screen shown in FIG.

  If patient insurance information is registered in this manner, the type of insurance and the self-pay rate are displayed in the payment column of the list. Further, at the time of reception from the next time, it is determined whether or not the self-pay rate is appropriate from the date of today and the date of birth of the patient. For example, if the burden rate is set to 20% under 5 years old, the burden rate needs to be 30% when the patient exceeds 5 years old. Is displayed in red. However, the burden rate may be automatically changed without displaying such a warning, and a display indicating that the burden rate has been changed from the previous time may be displayed in the patient information detail display column.

  In the case of a revisit patient, if there is no examination ticket, the patient ID button is clicked to display the patient ID search screen shown in FIG. If the patient's name, date of birth, telephone number, etc. are known, the patient ID can be specified by inputting and searching for the corresponding location. If only the name does not match between the patient specified by inputting the telephone number and the patient currently accepted, it is determined that the surname has been changed due to marriage or the like, and the maiden name is displayed in parentheses. It is also possible to display a list of registered patient data by clicking the search button. In the initial state, the patient names are displayed in the order of the Japanese syllabary, and the patient ID can be specified using a search formula if necessary.

  If there is an examination ticket, the patient ID is specified by reading the examination ticket with a scanner. However, if the examination ticket cannot be read by the scanner, the patient ID is directly input.

  If the patient ID is specified, the registered patient data is called to determine whether or not three months have passed since the previous examination. If 3 months have passed, it will be treated as the first visit, and if it has not passed, it will be treated as a reexamination on the condition that the return date for the disease name has not been entered. In this case, the calendar is displayed in a separate window so that the visit history can be seen at a glance. That is, on the day when the patient visits, the display is distinguishable from other days, and the visit time pops up when the mouse is moved on that day.

  In the case of the first visit, ask the patient to fill out a questionnaire and enter the contents. The input contents are registered as questionnaire information and reflected in the electronic medical record. If there is an insurance card, enter the details. If your family name is listed on your insurance card, enter it at the same time. Thereby, for example, if someone in the family comes to the clinic, it is possible to respond even if you do not bring your health insurance card. If the patient has been examined before, the insurance card registration data is searched from the patient ID and the like.

  When the acceptance is completed by the above input work and the input data of the questionnaire is registered together with the patient ID, the patient data is displayed in a list in the order of acceptance. The examination will be conducted in the order of acceptance. In this case, the examination order can be changed by selecting the patient name (row) and changing the reception order.

  (Accounting Business) In the accounting business, as shown in FIG. 5, based on the data read from the reception table, the medical record table, and the disease name code conversion master, the code conversion processing shown in FIG. 6 and the receipt calculation shown in FIG. Logic, partial contribution creation processing shown in FIG. 8, and invoice data creation processing shown in FIG. 9 are performed.

  In the code conversion process, as shown in FIG. 6, first, data required for calculating the medical fee score is read from the reception table and the medical record table (step S1). Here, based on the reception date (date data and time data) read from the reception table and the patient ID, for example, from the medical record table, among the data recorded in the medical record, for example, the disease name and the prescription drug name are read. . The read data is code-converted based on the data read from the disease name code conversion master (step S2). In the code conversion, the ICD-10 code read from the medical record table is converted into a receipt computer code. Then, the data converted by the code conversion process is stored in the medical record analysis result table (step S3). The above is a common process regardless of whether or not the method for calculating the medical reward points has been changed due to revision or the like. By making it possible to execute common processes all together, it is possible to easily and quickly respond to revisions only by changing only the changed parts.

  In the receipt calculation logic, as shown in FIG. 7A, corresponding data from the first day of this month to the present is read from the data stored in the medical record analysis result table based on the patient ID and the reception date data ( Step S10). Then, based on the read data, the medical treatment master, the pharmaceutical product master, and the material price master are referred to, and the medical fee calculation process is performed (step S11). Subsequently, the calculation result is stored in the calculation result history table (step S12).

  In the medical fee calculation process, depending on the diagnosis category, initial examination fee, re-examination fee, guidance fee, home fee, medication fee, injection fee, treatment fee, surgery fee, anesthesia fee, examination fee, diagnostic imaging fee, rehabilitation fee, etc. Processes such as calculation.

  For example, in the instruction fee calculation process, as shown in FIG. 7B, a computable instruction fee list selection process is performed with reference to the instruction fee calculation master based on the patient disease name data and the calculation past data. The processing result is displayed in the priority calculation instruction management fee column of the examination information registration screen shown in FIG. 2F. In the case of a patient who has not calculated a tuition fee in the past, the tutor fee calculation data with the highest score is displayed as a result of the selectable tuition fee list selection process. Display instruction fee calculation data. In addition, the priority calculation instruction management fee column can be displayed in a pull-down manner as shown in FIG. 7C. In the former case, the priority calculation instruction management fee column is displayed in descending order of the score, and in the latter case, the instruction fee is displayed in the order from the closest calculation time. The processing result is stored as instruction request data and displayed as a message on a medical chart examination screen displayed on the electronic medical chart terminal as shown in FIG. 7D. Only when the doctor gives guidance to the patient based on this message and writes in the electronic medical record, billing at the receipt computer is possible.

  In the computable instruction fee list selection process, all the corresponding data are listed by sequentially collating with the instruction fee calculation master for all disease name codes described in the patient's electronic medical record. Then, the listed data is sorted in descending order of the score.

  For example, for a patient who is 20 years old, a doctor who specializes in internal medicine and pediatrics names stomach cancer (main disease name), hypertension (main disease name), HIV infection, epilepsy, malignant rheumatoid arthritis, and lupus erythematosus. If it is collated with the instruction fee calculation master, the virus disease instruction fee 2, the epilepsy instruction fee, and the specific disease treatment instruction fee (clinic) are listed in the order of high score. The childhood malignant tumor patient guidance management fee for gastric cancer (main disease name) is excluded because the patient is 20 years old. Moreover, malignant rheumatoid arthritis is excluded because it is not the main disease name. Furthermore, the reason why the dermatology specific disease guidance management fee (1) is excluded is that the doctor in charge specializes in internal medicine and pediatrics.

  Further, in the dosage calculation process, as shown in the flowchart of FIG. 10, the drug fee, the dispensing fee, the prescription fee, the hepatotoxic addition, and the dispensing fee are calculated, and the decreasing fee is calculated for the drug fee (step S20). To S25).

  In the medicine fee calculation, as shown in the flowchart of FIG. 11, all medicine data for a certain patient are sorted by taking method identification number (the same number is given to the same taking method) (step S30). ), After initializing the memory, that is, the serial number of the medication method identification number, the drug price, and the internal medicine type (step S31), until the last line (all drug data is completed) (step S32), Each drug data is read (step S33). Based on the read drug data, the drug price is calculated by multiplying the unit price of the drug by the quantity (step S34). When there are a plurality of medicine data and the manner of taking is different among the medicines, the same taking method identification number is set as one group, and calculation is performed for each group (steps S35, S36, S37). After calculating the total drug price for each group (step S38), the drug fee score is calculated for all drugs prescribed to the patient (step S39). In addition, about the internal medicine, the number of types is stored as internal medicine kind data (step S40).

  In the calculation of the drug fee score in step S39, as shown in the flowchart of FIG. 12, it is determined whether or not the total drug price exceeds 15 yen (step S50). If it exceeds 15 yen, 5 is subtracted from the total drug price. Then, the value obtained by dividing by 10 is rounded up to the point of one agent (step S51), and when it is 15 yen or less, it is uniquely set to 1 point (step S52). If the score for one drug is calculated in this way, the drug charge is calculated by multiplying the number of doses (step S53). Here, it is determined whether or not the medicine to be prescribed is an internal medicine (step S54), and if it is an internal medicine, the number of types of internal medicine is calculated (step S55).

  In the calculation of the number of internal medicines, as shown in the flowchart of FIG. 13, it is determined whether or not the total medicine price exceeds 205 yen in the same medicine unit among the medicines prescribed for a certain patient (step S60). . That is, when the usage is the same, it is determined whether or not the number of prescriptions is more than necessary for the medicine of the same taking method with 205 yen as a guideline, thereby preventing unauthorized charges. If the total price of drugs with the same medication method exceeds 205 yen, the number of drug types is determined as it is (step S61), and if it is 205 yen or less, it is determined as one type (step S62).

  In the prescription fee calculation, the number of points given is changed depending on whether there are seven or more internal medicines, whether the patient is less than 3 years old, or whether the patient has a specific disease.

  In the case of narcotic addition, if any of narcotics, psychotropic drugs, stimulants and poisons is included, the score is added.

  In the base fee calculation, the score to be added is changed depending on whether or not the pharmacist is working full time.

  In the decreasing point calculation, as shown in the flowchart of FIG. 14, the total is calculated for all internal medicines that are not temporary medication (step S70). Then, it is determined whether or not the number of internal medicines is seven or more (step S71). If the number is seven or more, it is determined whether or not the number of diminishing points has not been calculated for the same prescription (step S72). If there are more than 7 types of internal medicine and the number of decreasing points has not been calculated, 0.9 is added to the total of the drug charges, and the first decimal place is rounded off (step S73). Subsequently, the sum of the drug charges is subtracted from the value obtained in step S73, and the value is set as the drug charge decrement point (step S74).

  Specifically, the case of prescribing A to G drugs (all internal medicines) shown in the following table for a certain patient X will be described. In this case, A to C and D to G are all the same, and the prescription is 4 days.

  Based on the drug price for one drug for each drug, the total drug price for the AG drugs prescribed this time is calculated. For example, in the case of A drug, the price for one tablet is 9.7 yen, so the price for two tablets prescribed is 19.4 yen. In the same manner, when the drug prices of the A to C drug and the D to G drug are summed in the same manner, they are 248.6 yen and 250.5 yen, respectively. Therefore, based on this total, in step S51, the drug price for one drug is calculated, and 25 points are obtained for both. Therefore, since the prescription is for 4 days, the total is 100 points. Since all the A to G drugs are internal medicines, the number of internal medicine types is calculated in step S55. That is, the total price of medicines is 248.6 yen and 250.5 yen, which exceeds the judgment standard of 205 yen, so the number of prescriptions is judged to be 3 and 4 kinds. Hereinafter, a dispensing fee, a prescription fee, a hepatotoxic addition fee, and a dispensing basic fee are calculated and added in order to obtain 148 points (the score calculation is well known in the art and will not be described). . And as mentioned above, since there are (3 + 4) 7 types of internal medicines, the decreasing points are -10 points obtained by multiplying 100 points calculated in step S51 by 0.9 and subtracting 100, The medical treatment reward score obtained by calculating the drug fee is 138 points.

  Further, in the injection fee calculation process, as shown in the flowchart of FIG. 15, a drug fee calculation process (step 200) and a technique fee calculation process (step S201) are executed. Since the medicine fee calculation process is as described above, the technique fee calculation process will be described below.

  As shown in the flowchart of FIG. 16, the procedure fee calculation process sorts all procedure data by procedure identification number (step S210), sequentially reads the data (steps S211 and S212), and relates to the operation. A check is made (steps S213 and S214). If there is a relevance to surgery, score calculation is not performed. If there is no relevance to the operation, it is determined whether or not it is an infusion (step S215). If it is a drip injection, a drip technique fee is calculated (step S216), and if it is not a drip injection, various injection charges are calculated (step S217). In addition, narcotic injection addition calculation (step S218), precise continuous infusion injection addition calculation (step S219), and biological preparation injection addition calculation (step S220) are performed.

  In the calculation of the drip technique, as shown in the flowchart of FIG. 17, first, the already calculated drip technique on the same date is canceled (step S230). Then, it is determined whether or not the patient is under 6 years old (step S231). If the patient is under 6 years old, it is determined whether or not the total amount of infusion per day is 100 ml or more (step S232). If the total amount of infusion per day is 100 ml or more, the infusion technique fee is 95 points (step S233), and if it is less than 100 ml, 47 points (step S234). Then, it is determined whether or not the baby is added on the same date (step S238). If the baby is not added, 21 points are added (step S239). On the other hand, if the patient is 6 years old or older, it is determined whether or not the total amount of daily infusion is 500 ml or more (step S235). If the total amount of infusion per day is 500 ml or more, the infusion technique fee is 95 points (step S236), and if it is less than 500 ml, 47 points (step S237).

  For example, if a patient Y (28 years old) receives an infusion of drug A as shown in the following table and receives an infusion of drug B after the procedure fee has been calculated, as shown in the following table: The procedure fee is calculated as follows.

  That is, 47 points of the drip technique fee are canceled in step S230 and the age is 28, so the process proceeds from step S231 to step S95. Since the total amount of infusion is 600 ml, the process proceeds to step S237, and 95 points are obtained as the infusion technique fee.

  As described above, in the calculation of the drip technique fee, not only whether or not the patient is an infant under 6 years old but also a case where the drip is performed a plurality of times on the same date is considered. In particular, when instilling a plurality of times, the previous infusion technique is always canceled, the total amount is calculated again, and the score is calculated. Therefore, it is possible to appropriately calculate the medical fee score.

  Returning to FIG. 5, in the partial contribution creation process, as shown in FIG. 8, data for one day of the corresponding patient is extracted from the data stored in the calculation result history table (step S <b> 100). Subsequently, based on the public expenditure information included in the extracted data (medical remuneration points), a target public expenditure selection process is performed in which the target public expenditure is selected with reference to the public expenditure matrix (step S101). In the selection process, first, the public expenditure with the highest priority is selected. Subsequently, a public expense that can be combined with the selected public expense is selected. Then, the public expenses that were not selected are eliminated. Next, patient information (burden rate and contribution limit) is extracted from the extracted data (step S102). Further, for the public expense selected in step S101, a public expense calculated based on the burden ratio and a public expense calculated based on the burden ratio limit amount are obtained (step S103). Then, a low amount is selected from the obtained calculation results (step S104) and stored in the calculation result history table (step S105).

  Specifically, the case where the partial contribution creation process is performed will be described with reference to FIG. 22 in which a part of the public expenditure matrix is extracted. For example, when a certain patient satisfies three conditions of 27 “old man”, 11 “tuberculous 35”, and 51 “specific disease”, 27 “old man” having a high priority is selected. Then, 10% of the self-pay for 27 “old man” is calculated (for example, 1000 yen). In addition, 27 “old people” can be combined with 11 “tuberculosis 35” and 51 “specific disease” from the public expenditure matrix. In 11 “tuberculosis 35” and 51 “specific disease”, 11 “tuberculosis 35” has a high priority, so the self-pay 0 yen is adopted. Finally, the self-payment of 1,000 yen calculated for 27 “old man” and the self-payment of 0 yen calculated for 11 “tuberculosis 35” are compared. It becomes unnecessary.

  In the partial contribution creation process, the contribution is calculated according to the contribution rate set on the patient insurance information registration screen shown in FIG. 3A. However, the contribution rate is appropriate from the date of birth and today's date of the patient. Judge whether or not. When it is determined that the burden rate is inappropriate, the fact is displayed on the patient notification list 14 displayed on the reception screen shown in FIG. In FIG. 2, the burden rate is changed due to the patient's age being excluded from the child burden rate target, and the burden rate correction (current (20%) → general (30%)) is displayed in the patient notification list 14. An example is shown.

  Returning to FIG. 5 again, in the invoice data creation process, as shown in FIG. 9, the data for one month of the corresponding patient is extracted from the calculation result history table (step S110), and the extracted data (medical fee score) (Partial contribution) and the format (code) for the invoice are converted (step S111). If the patient receives one or more visits in the same month in addition to this time, the bill data processed so far is extracted from the calculation result history table (step S112). Subsequently, the data code-converted in step S111 is charged for one month, and a difference from the invoice data extracted in step S112 is calculated (step S113). Then, the calculated result is stored in the calculation result history table as current invoice data (step S114).

  When the accounting process is completed and payment is made, the accounting reservation screen shown in FIG. 18 is displayed by clicking on the accounting business button on the acceptance service screen shown in FIG. Here, when the accounting button is clicked, as shown in FIG. 19, the account is switched to a settlement screen in which the settlement tab is clicked, and all the settlement items for today are displayed in a list. In addition, on the right side of the screen, insurance points and billing details for all settlement items are displayed, and calculation results processed as described above are displayed in the corresponding items. In the lower part of the screen, a billing column is displayed showing the amount of medical care that has been receivable from the patient in the past, such as the date of examination, reception time, and department, and on the right side, the amount of receivable displayed in the billing column is displayed. Billed amount, the deposit amount deposited this time, and the change for the deposit amount. Here, even a part of the payment for the accounts receivable can be dealt with. In this case, the change is displayed as a minus sign.

  When the accounting card tab is clicked, as shown in FIG. 20, the account is switched from the settlement screen to the accounting card screen, and a list of items required for calculating the medical fee is displayed for each month to which today belongs. . The displayed contents can be printed by clicking the print button.

  Further, when the payment is completed and the next medical appointment is made, the reservation screen shown in FIG. 21 is displayed by clicking the reservation button on the reception work screen shown in FIG. On the appointment screen, a calendar is displayed, and the examination time is divided into four time zones for each examination date, and is displayed in different colors except for the time zone when there is no examination. However, the setting of this time zone can be changed freely. For example, it can be set in two time zones of morning and afternoon. When you click on the date you want to reserve, the reservation status is listed on the right side of the calendar. When you click on the time you want to make a reservation, a reservation acceptance screen pops up, so you can click the registration button to complete the reservation.

  Further, when the accounting process is completed and the created medical fee remuneration statement (receipt) is output, a comment can be added as follows.

  That is, as shown in the process flow of FIG. 23, since the receipt data created by the receipt creation process based on the patient insurance data, the patient disease name data, and the patient accounting data is stored in the storage device 3, this receipt Read data one by one. Then, it is determined whether or not there is data (standard sentence automatic creation data) that can be automatically created in the standard sentence comment master. If there is fixed phrase automatic creation data, the fixed phrase comment information and the setting value calculation method are read and stored as receipt data again. Thereby, a comment is automatically input.

  Specifically, when the collective creation button is operated on the receipt creation screen shown in FIG. 24, receipt data is created for all displayed patients, and a standard sentence comment is automatically added. When the comment editing button is operated, the comment editing accounting card screen shown in FIG. 25 is opened, and the result of automatic addition processing of the fixed phrase comment is displayed in addition to the created receipt data. If there is a fixed phrase automatically added, the background color is green so that it can be distinguished from other items.

  When requesting a receipt, you are requested to comment on all items, though optional. Therefore, for items that cannot be automatically created, a comment can be created by moving the cursor to each item (fixed sentence item) on the receipt creation screen shown in FIG.

  That is, when the cursor is moved to an item, it is determined whether or not there is data (fixed sentence semi-automatically generated data) that can create a fixed sentence by inputting only a set value in the fixed phrase comment master. If there is semi-automatically created fixed sentence data, the input items are automatically displayed on the input screen in the fixed format. Therefore, if a set value is input, a comment is automatically created according to a fixed format. In FIG. 24, when a date (○ month and ○ day) is input as a set value for the child specific disease counseling fee, the child specific first counseling ○ month ○ day is automatically created as a comment. If neither the fixed sentence automatic creation data nor the fixed sentence semi-automatic creation data is prepared in the fixed sentence comment master, a free format screen is displayed. Therefore, it is possible to arbitrarily input on the free format screen using a keyboard or the like. However, in this way, the comment created based on the semi-automatically generated fixed sentence text or on the free format screen has a blue background so that it can be distinguished from the automatically created comment.

  Further, the process of automatically adding the fixed phrase comment may be performed as follows using, for example, SQL (Structured Query Language).

  That is, for example, as shown in FIG. 26 and FIG. 28, the fixed sentence comment master can be inserted into the receipt computer code based on the chart data out of the fixed sentence and the contents included in the fixed sentence. An SQL statement for calling the contents from the chart data is stored in association with each other.

  FIG. 30 shows a receipt comment list for the fixed sentence registered in the fixed sentence comment master. As shown in the receipt comment list, each medical practice has an appropriate fixed phrase. For example, if the medical practice is “ercitonin injection”, the standard sentence is “use ercitonin because of pain in osteoporosis, start date of use XX year XX month XX day”. If the medical practice is “albumin quantitative precision measurement (urine) (TIA method)”, different standard sentences (standard comment strings) are used for the first time and the second and subsequent times. And if it is the first time, an inspection implementation date will be inserted in a fixed sentence, and the last implementation date will be inserted after the 2nd time. Therefore, in the case of the first time, the standard comment comment master uses the standard comment in the receipt comment list, that is, “This time: first time: XX month XX day implementation”, and the SQL sentence is inspected from the chart data. The date can be inserted. In the case of the second and subsequent times, the current sentence will be used as the standard sentence (previous: Heisei XX year XX month XX day), and the SQL sentence will be the number of inspections. , And the date of the previous examination are insertable contents.

  In the example of FIG. 26, based on the receipt computer code “160037510” set for the medical practice “Elsitonin injection”, the standard sentence comment master is referred to and the standard sentence and the SQL sentence are specified. The SQL statement has, for example, the contents shown in FIG. 27, and the oldest date is selected from the medical treatment dates stored in the medical record data (described as “MIN (RsptYMD)” in the SQL statement).

  Further, in the example of FIG. 28, the routine is set for the medical treatment “albumin quantitative precision measurement (urine) (TIA method)”, and the standard sentence comment master is referred to based on the receipt computer code “160004810”. Identify the sentence. The SQL sentence has the content shown in FIG. 29, for example, and changes the fixed sentence to be selected based on the number of times this medical practice (examination) is performed. That is, in the SQL statement, “DECODE (COUNT (DISTINCT RsptYMD)” is described. By this, the examination date (number of examinations) stored in the chart data is counted, and if the number of examination days is 1, It is judged as the first time, and the test date is inserted using “This time: XX month XX day implementation” as a standard sentence, and if the number of inspection days is 2 or more, it is judged as the second or later, As a standard sentence, “This time, the XXth inspection (previous: Heisei XX year XX month XX day)” is used, and the number of inspection days and the previous inspection date are inserted.

  In this way, by simply associating the fixed sentence and the SQL sentence corresponding to this fixed sentence with the receipt computer code, the contents of the chart data specific to each patient can be taken into the fixed sentence. And, in the receipt creation process, if the receipt computer code of the standard sentence comment master is stored in association with the patient ID as the receipt data, when creating the receipt, regardless of the difference in the chart data for each patient, It is possible to automatically create a comment by incorporating the contents.

It is a block diagram which shows the structure of the medical paperwork apparatus which concerns on this embodiment. 3 is a reception work screen displayed as an initial screen on the display device of FIG. 1. It is a figure which shows the patient insurance information registration screen displayed by operating a new patient reception button on the screen of FIG. It is a figure which shows the insurance master registration screen displayed when it is judged with the screen of FIG. 3A that insurer information is not registered. It is a figure which shows the examination information registration screen displayed when the input in the patient insurance information registration screen of FIG. 3A is completed. It is a figure which shows the reservation accounting screen displayed by operating a new reservation button on the screen of FIG. It is a figure which shows the examination information registration screen displayed by operating the examination information input button on the screen of FIG. It is a figure which shows the investigation screen displayed by operating a survey button on the screen of FIG. It is a figure which shows the medical chart reference screen displayed by operating a medical chart reference button on the screen of FIG. It is a figure which shows a part of data registered into the instruction fee calculation master. It is a patient ID search screen displayed by clicking a patient ID button on the screen of FIG. It is a flowchart which shows accounting work. It is a flowchart which shows the code conversion process of FIG. It is a flowchart which shows the receipt calculation logic of FIG. It is a processing flowchart which shows instruction fee calculation. It is a figure which shows the state which made the pull-down display of the priority calculation instruction | indication management fee column of the examination information registration screen shown to FIG. 2F. It is a figure which shows the medical chart medical examination screen displayed on the terminal for electronic medical charts. It is a flowchart which shows the partial contribution creation process of FIG. It is a flowchart which shows the invoice data creation process of FIG. It is a flowchart which shows the dosage calculation process performed by the medical treatment reward score calculation process of the receipt calculation logic of FIG. It is a flowchart which shows the medicine fee calculation process performed by the dosage calculation process of FIG. It is a flowchart which shows the medicine fee score calculation performed by the dosage calculation process of FIG. It is a flowchart which shows the internal medicine type number calculation performed by the dosage calculation process of FIG. It is a flowchart which shows the decreasing point calculation performed by the dosage calculation process of FIG. It is a flowchart which shows the injection fee calculation process performed by the medical treatment reward score calculation process of the receipt calculation logic of FIG. It is a flowchart which shows the technique fee calculation process performed by the injection fee calculation process of FIG. It is a flowchart which shows the drip technique fee calculation process performed by the injection fee calculation process of FIG. It is an accounting reservation screen displayed by clicking an accounting operation button on the reception operation screen shown in FIG. 19 is a settlement screen displayed by clicking an accounting button on the accounting reservation screen shown in FIG. FIG. 20 is a list of items required for calculating a medical fee score displayed by clicking the accounting card tab on the checkout screen shown in FIG. 19. It is a reservation screen displayed by clicking the reservation button on the reception work screen shown in FIG. It is a chart which shows a public expenditure matrix. It is a processing flowchart which shows a comment addition function. It is a figure which shows a receipt creation screen. It is a figure which shows the accounting card screen for comment edit displayed by operating a comment edit button on the receipt creation screen shown in FIG. It is a processing flowchart which shows a comment addition function. It is an example of a SQL sentence in FIG. It is a processing flowchart which shows another comment addition function. It is an example of the SQL sentence in FIG. 27 is a chart showing a receipt comment list used in the comment addition function of FIG. 26. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Display apparatus 2 ... Input device 3 ... Memory | storage device 4 ... Central processing unit (CPU)
10 ... Business menu bar 11 ... Function menu bar 12 ... Patient ID input area 13 ... Accepted patient list 14 ... Patient notification list 15 ... Patient notification information detailed list 16 ... Patient reservation information calendar 17 ... Business notification panel 18 ... Status bar

Claims (3)

Auto-created standard text that consists of standard format, standard text comment information, and setting value calculation method, or semi-automatic text that can automatically create non-set values included in standard text, and receipt data. A fixed sentence that is set for each medical practice and has a data insertion location corresponding to each patient's medical record data, and an SQL sentence that allows the corresponding data to be taken from the patient's medical record data into the fixed sentence Storage means comprising a fixed phrase comment master that stores
And Table shows means,
Based on whether or not the setting value can be automatically created by referring to the standard sentence comment master based on the created receipt data, it is determined whether or not the standard sentence can be automatically created or semi-automatically created, If it is determined that automatic creation is possible, the corresponding fixed sentence and SQL sentence are called, the corresponding data is called from the patient's chart data based on the SQL sentence, and the number of examination days stored in the chart data To determine the number of times of the medical practice, call a fixed sentence according to the determined number of medical practices from the storage means, and insert the setting value calculated based on the setting value calculation method automatically create a comment by, while creating receipts are attached to the receipt data, if judged to be created semi-automatically, a fixed sentence except the set value, set And control means for creating a receipt by the input field value is displayed on the display means, to complete the input of the set value,
A medical paper processing apparatus characterized by comprising: When the batch creation button in the receipt creation screen is operated in a state where the receipt creation screen is displayed on the display means, the control means creates a plurality of patient receipt data at one time. 2. The medical office processing apparatus according to claim 1, wherein if there is an automatically added comment in the receipt data, it is displayed so as to be distinguishable from other receipt data .   If it is determined that the fixed sentence data or fixed sentence semi-automatically generated data corresponding to the created receipt data is not in the fixed sentence comment master, the control means displays a free format screen on the display means, and allows manual input. The medical paperwork apparatus of Claim 1 or 2 characterized by the above-mentioned.