JP5265299B2 - Medical information management system - Google Patents

Description

  The present invention relates to a medical information system that manages medical information as electronic data.

Conventionally, a medical information management system for managing electronic medical information such as an electronic medical record is known. In such a system, information necessary for diagnosis such as medical charts and test results is digitized and managed in an integrated manner, and a doctor performs diagnosis of a patient's medical condition, treatment such as surgery based on such information. In such a system, a technique for electronically managing the operation reservation status electronically, facilitating the operation management, and reducing the labor of doctors, nurses, etc. is known (for example, Patent Document 1). .
JP 2007-72925 A

  In such a system, further improvement in work efficiency is desired in surgical management. Particularly in the field of ophthalmology, there are many relatively short-time operations such as cataract operations, and a plurality of operations are often performed on the same day. However, it is difficult to perform an efficient operation according to the case and the condition of the operation eye if the reservation of the operation is confirmed in the order of reception, so after grasping multiple operation items to be performed on the same day, It is necessary to adjust so that an efficient surgical plan can be made in view of the contents of the surgical operation.

  In view of the above-described problems of the prior art, it is an object of the present invention to provide a medical information management system that can efficiently prepare a surgical plan for performing a plurality of operations on the same day and improve work efficiency. .

  In order to solve the above problems, the present invention has the following configuration.

In order to solve the above problems, the present invention has the following configuration.
(1) storage means for storing patient information including, as elements , personal information of a plurality of patients and a plurality of medical information for each patient ;
An operation reservation means for reserving operation schedules of the plurality of patients, wherein a plurality of the patient information corresponding to the same operation day and the reservation time is undetermined are displayed on the screen as undetermined information, and the same operation Surgical reservation means for displaying a plurality of the patient information corresponding to the day and the reservation time fixed as the fixed information separately from the unconfirmed information;
An input means for transmitting a signal for setting the unconfirmed information displayed by the surgery reservation means as the confirmed information;
A rule setting means for setting a sorting rule by determining a priority between the elements of the patient information;
Reserving individual patient information by using the patient information stored in the storage means based on the signal from the input means and the rule so that reservation times of a plurality of patient information to be determined information do not overlap. Reservation time determination means for determining the time within the same operation date and making the confirmed information;
A medical information management system comprising:

  According to the present invention, an operation plan for performing a plurality of operations on the same day can be efficiently established, and work efficiency can be improved.

  Embodiments of a medical information management system (electronic medical record system) according to the present invention will be described below with reference to the drawings. In the present embodiment, a medical information management system in the ophthalmic field will be described as an example. FIG. 1 is a diagram showing an outline of a medical information management system. A medical information management system according to an embodiment of the present invention digitizes medical information and collectively manages it with a server, and is constructed by connecting a plurality of clients in a hospital via a communication line such as a LAN.

  The configuration of this system will be described below. The management server 10 has a server body 11. The server main body 11 includes a CPU 12 that is mounted on the main body and is responsible for main arithmetic processing (determination and calculation) of the medical information management system, and a storage unit (storage means) that is mounted on the main body and stores all data of the medical information management system. A hard disk 13 is provided. All data in the system is centrally managed by the management server 10. Each client 20 connected to the management server 10 to be described later displays various types of examination data, inputs / outputs data, schedules a patient's surgery, and the like. The hard disk 13 stores a medical information management system program 14.

  The client (terminal) 20 is connected to the management server 10 via the hub 15. The client 20 includes the following. Clients for receiving procedures for receiving patients, examination clients for managing patient examination data, medical examination clients for recording, managing and browsing medical records, appointments for patient surgery, etc. It is an accounting client that bills a patient for medical expenses, makes payments, and makes appointments for the next medical examination. In practice, the reception client and the accounting client may be shared.

  Each client 20 has a personal computer (hereinafter abbreviated as a PC) connected to the management server 10 in its main body. Such a commonly used PC can be used as a medical information processing apparatus that manages and browses patient information and the like. The PC 21 serving as the client 20 includes a monitor (output means) 22 for displaying various work screens to be described later, a keyboard 23 and a mouse 24 as input means (operation means). The management server 10 and each client 20 are connected via a hub 15 by a LAN cable 25. In this way, the management server 10 and each client 20 form a network (here, LAN). Further, the PC 21 stores a control unit 21a that controls execution of the client program of the system and various processes (determination, storage, calling, etc.), display, and the like, and a client program of the system, data, and the like. It has a hard disk 21b. The client program of this system is read by the aforementioned program 14 to the hard disk 21b and executed by the controller 21a. In cooperation with the client 20 and the management server 10, a server / client system is constructed as if medical information stored in the hard disk 13 is virtually managed, viewed, and changed on the PC 21. Accordingly, the program 14 is executed by the CPU 12 and the control unit 21a, which are execution means. By executing this program, the medical information management system is integrated and controlled.

  In the examination client, the PC 21 is connected to one or more various examination devices 30, and patient examination data obtained by the various examination devices 30 is stored in the hard disk 21b. Examples of the inspection device 30 include a tonometer, a refractive power measuring device, a corneal shape measuring device, an ultrasonic diagnostic device (an axial length measuring device), and a slit lamp that images the fundus of a subject's eye in the ophthalmic field. A microscope etc. are mentioned. The inspection data stored in the hard disk 21b is sent to the hard disk 13 of the management server 10 by the control unit 21a of the PC 21. At this time, in the PC 21, the inspection result sent from each inspection device 30 is determined for each port. Then, the control unit 21a provides the server with identification information (object ID), examination date information and examination time, patient identification information (patient ID), etc. for identifying the examination item corresponding to the examination result. Send inspection data (including inspection items, inspection results, etc.) to the 10th side. When the inspection data is manually input to the inspection client 20 (PC 21), the control unit 21a specifies the patient identification information and the inspection result in the inspection result by designating the patient and the inspection item on the screen. Date information, object ID, etc. are assigned.

  In the examination client, the PC 21 is connected with a printer 35 as output means and a scanner 36 as take-in means. The printer 35 is used for printing (outputting) document data related to a later-described operation on paper. The printer 35 outputs information in the hard disk 13 or information in the hard disk 21b by operating the PC 21. The scanner 36 is used for taking a document printed on paper and digitizing it. The information captured by the scanner 36 is temporarily stored in the hard disk 21b and sent to the hard disk 13 by the control unit 21a.

  In the above description, the server 10 and the client 20 are connected by the LAN cable 25 and the medical information management system is constructed by the LAN. However, the present invention is not limited to this, and other communication lines can be used. For example, hospitals may be connected to each other via an internet line and used for centralized medical information management and telemedicine between hospitals. Further, the construction of the network need not be limited to the connection of the LAN cable 25. A wireless LAN system using radio waves that do not affect medical devices, for example, a wireless LAN system using PHS or the like may be constructed and used. In this embodiment, a server and a plurality of clients are connected by a communication line to form a network. However, the present invention is not limited to this, and in a single system in which a server function and a client function are integrated. Can also be applied.

  Next, an outline of a flow of medical treatment for a patient using the above-described medical information management system will be described. Although detailed explanation is omitted, a doctor, a nurse, a medical office worker (medical affairs) or the like who is a user notifies the CPU 12 of authentication information stored in the hard disk 13 in advance from the login screen of each client 20. To log into the system. The logged-in user uses the client 20 (server 10) to perform medical procedures such as patient reception, examination, medical care, and accounting. The authentication information includes information that can be used by the user in the system, such as authority. For example, when the department to which the user belongs is “reception”, detailed patient information in the medical record cannot be viewed, and only personal information such as the patient's name can be viewed. Patient information mentioned here refers to personal information such as patient's name, gender, address, patient ID (patient identification information), and medical treatment such as patient's disease name, past illness, examination data, medical record description, and surgical eye information. Information.

  First, when a user whose department is “reception” logs in to the system using the reception client 20, a reception window (not shown) is activated. In the reception window, a patient list in which patients who have been subjected to reception processing are registered in order, a patient status indicating a patient state (advancing degree of medical treatment such as examination, medical examination, treatment) is displayed. Similarly, if the department is a user of “Examination (Ophthalmology)”, “Diagnosis (Ophthalmology)”, or “Accounting”, each window is activated.

  When a user whose department is medical (reception) logs in, a reception window (not shown) is activated. At the reception desk, patients who come to the hospital are registered in the medical information management system, and procedures for receiving medical care such as examinations and medical examinations are taken. The patient is additionally registered in the patient list, and the medical care received by the patient is registered.

  The patient is then advanced to the examination. When a user whose department is “inspection” (inspection engineer, nurse or doctor belonging to ophthalmology) logs in to this system, an inspection window (not shown) is activated. The inspector who is the user knows the examination items received by the patient by selecting the patient to be examined from the patient list in the examination window.

  Taking in test data will be described by taking precision intraocular pressure measurement as an example. As described above, the inspection client 20 takes in the inspection data (intraocular pressure value) from the tonometer into the inspection client 20 by operating the inspection window. At this time, examination data such as an intraocular pressure value is stored in the hard disk 21b, and an object ID is assigned to each examination data by the control unit 21a and stored in the hard disk 13 of the server 10. Further, the inspection data storing operation is used as a trigger to transfer each inspection data to the medical record, and the medical record information to which the inspection data is transferred is stored in the hard disk 13. Similarly, the refraction value obtained by the refraction examination, the corneal curvature obtained by the corneal curvature radius measurement, the axial length obtained by the ultrasonic diagnostic apparatus, the anterior segment and the posterior segment obtained by the slit lamp examination The slit image is transferred to the medical chart as appropriate by the doctor.

  Next, the patient who has completed the examination enters the examination room. When a user (physician) having the right of examination logs into the examination client 20, the examination window is activated. A doctor selects a patient to be examined from a patient list (not shown) to display a medical chart.

  The doctor opens the chart and diagnoses and treats the patient's disease name based on the chart description, examination data, and the like. Here, it is assumed that the doctor diagnoses the patient's disease name as “cataract” from the examination data and performs “cataract surgery” at the next visit (described later). The configuration and operation of the operation reservation will be described later.

  The examination is completed by proceeding with the examination of the patient by the procedure as described above and finally saving the medical record. Upon completion of the examination, the control unit 21a sends each examination item to be billed via the CPU 12 to the accounting client 20, and further calculates a medical cost to be charged to the patient.

  In accounting, a user whose department is medical (accounting) logs in to the accounting client 20 and performs an accounting process by looking at the patient's medical expenses calculated based on the examination, medical practice, etc. charged to the patient. When the patient pays medical expenses, the patient's series of medical care is completed.

  Next, a series of flows on the system related to patient surgery will be described. Here, the determination of the operation in the examination, the reservation of the operation, the preparation before the operation, and the operation will be described in order. The medical information management system according to the present invention has a surgery management program for managing the patient's surgery status (surgery reservation, preoperative examination, surgery execution, etc.) based on the patient information managed by the server 10. The surgery management program is included in the program 14 described above.

  Hereinafter, the screen configuration of the medical information management system will be described in order. The operation of the medical information management system described below is performed by moving the cursor displayed on each work screen with a pointing device such as the mouse 24 and selecting (clicking) a button or icon on the screen. Similarly, the cursor is moved to select an input field, and operations are performed by inputting characters and codes using a character input device such as a keyboard. A reader device may be used for inputting characters and codes. Examples thereof include an acquisition device (reader) such as a card, an IC chip, and a barcode, a biometric device for biometric authentication, and the like.

  First, the configuration of a medical examination screen (electronic medical chart screen) for creating a medical chart and determining a patient's technique will be described. FIG. 2 is a diagram illustrating a screen configuration of a diagnosis window 600 displayed when a doctor logs in to the diagnosis client 20. In the examination window 600, a navigator button 601 is a launcher that is displayed in common on the medical information management system and changes functions corresponding to each screen such as reception, examination, examination, and accounting. The patient information display unit 490 displayed above the examination window 600 is a column in which information on a patient selected from a patient list (not shown) is displayed. The patient information display unit 490 displays a part of the personal information of the selected patient. In the examination window 600, a medical chart 640 describing the medical information, examination data, etc. of the patient is displayed.

  As described above, this patient is diagnosed with “cataract”, and the doctor's disease name is described as “cataract” in the medical chart 640 (see FIG. 2). The description of the disease name is performed by selecting a disease name or inputting characters using an input means in a disease name registration window (not shown) activated by selecting “Register disease name” with the navigator button 601. When the disease name is registered, medical information in which the disease name code of the disease name (here, cataract) is associated with the patient ID of the patient is created on the medical chart 640 and stored in the hard disk 13 by the control unit 21a.

  After the patient's name is determined, the surgery or procedure to treat the patient is determined. As described above, the surgery is determined as “cataract surgery” by surgery registration (not shown) of the navigator button 601, and the surgery content (surgery information such as the surgery name here) is created on the medical chart 640 and the surgery content. Is stored in the hard disk 13. Then, in accordance with the determination of the operation, the operation document set selection window 850 shown in FIG. 3 is activated. Although details will be described later, the surgical document set selection window 850 displays a surgical document set in which document data required for a predetermined surgery performed on a patient is combined. Here, a plurality of surgical document sets are displayed in a list. Note that the sequence of surgical document sets may be set so as to be in order of frequency of use on the user side. In the present embodiment, the document set name is displayed in the window. However, the present invention is not limited to this, and as a surgical content at first glance, when selecting a surgical document set such as an operation, a surgical procedure, a disease name, etc. The name which can be judged should just be displayed. Further, the contents of surgery are not limited to those stored in the hard disk 13 as data. Information determined by a user such as a doctor is also included in the operation content. In the surgical document selection window 850 of the present embodiment, a plurality of surgical document sets corresponding to the patient's surgery can be displayed, and one surgical document set corresponding to the patient's surgical content is selected from the plurality of surgical document sets. Selected. When a surgical document set is selected, a selection signal is generated, and the surgical document set is associated with the patient information of the patient selected on the window by the control unit 21a and the surgical content, and stored in the hard disk 13. .

  The surgical document set is a collection of documents prepared corresponding to a predetermined operation (operation content), and has at least two types of documents required for performing the operation. Patterns with different surgical contents are prepared for each type of document, and one surgical document set is obtained by combining these documents according to the surgical contents. Accordingly, a plurality of surgical document sets are prepared in accordance with the surgical contents. Here, the document refers to document data (file) that is electronically stored and managed. The surgical document set includes, for example, preoperative records, surgical records, manuals, and consent form template data (template). The preoperative record is a document that describes information for confirming the condition of the patient before the operation, and includes personal information and medical information of the patient. Specifically, examination data, surgical eye information, past disease information, infection information, and the like are described (details will be described later). For example, in cataract surgery, pre-operative records describe the presence or absence of a patient's infection, the operating eye (the eye performing the operation), the astigmatic axis angle of the patient's eye, and the like. The intraoperative record is a document that describes information on a patient during surgery, surgical instrument, and information on a surgical apparatus (setting information and usage information). For example, in cataract surgery, information such as the incision position, the setting of the cataract surgery device, and the amount of physiological saline used as a perfusate is described in the intraoperative record. The manual is a document for explaining the contents of the operation to the patient. The manual includes diagrams and text explaining the contents of the surgery. The consent form is a document for declaring that the patient has consented to the operation. The consent form is provided with a text for confirming whether or not to agree on the contents of a predetermined operation and a patient signature column. In addition, when the patient's signature is entered, the contents are understood (approved) for the manual and consent form.

  At least one document in the surgical document set includes at least one of an image, examination data having text data, medical information such as patient chart information, and patient personal information, and is output on the monitor 22 of the client 20 ( Information (numerical values, characters, etc.) can be input as text data for the displayed document. For example, a document in which information such as preoperative records and intraoperative records is input as text data such as numerical values is in the above format. In the present embodiment, medical record information data can be electronically written in preoperative recording and intraoperative recording. In addition, at least one document in the surgical document set is output on the monitor 22 and has a format in which information cannot be input to the document (text data cannot be input). For example, a consent document that requires a patient's handwritten signature and a document such as a manual that does not require input of other information are in the above format. Specifically, it is a document in a format in which necessary information such as a signature is written on a sheet of paper, and is a document stored as an image.

  In addition, a plurality of documents are set as one surgical document set, and these documents are stored in the hard disk 13 by the control unit 21a (described later). In addition, the surgical document set is stored in the hard disk 13 in correspondence with the patient ID (patient information) by the control unit 21a, similarly to the chart information. Such a document is attached to the medical record by storage. The printed document is captured by the scanner 36. Specifically, a document to be captured is set in the scanner 36 and a document capture window (not shown) is operated to output the captured document as image data on the monitor 22. When saving the captured document, the patient ID and the captured document are associated with each other by specifying the patient and the document type (document name, etc.), and the document type is specified. Are stored in the hard disk 21b. The stored document is stored in the hard disk 13 by the control unit 21a. By this operation, the captured document is attached to the patient's chart. The control unit 21a may determine the document type from the image data captured by the scanner based on the printed document information. For example, identification information that can be identified as an image such as a barcode is printed on the document, and the control unit 21a determines the identification information.

  Such a document set differs depending on hospitals, and each document is prepared individually from each hospital. For example, inspection items required for preoperative recording of cataract surgery are greatly different from inspection items required for preoperative recording of vitreous surgery. In addition, in the manual, the contents to be explained differ greatly depending on the operation. Furthermore, if the apparatuses and instruments used for the operation are different in each hospital, the input fields for information required for intraoperative recording and the like are different. For this reason, a document is prepared for every operation and every hospital. In other words, a specific document needs to be prepared for each operation, and has a plurality of patterns.

  The setting of the operation document set, that is, the setting of the document used individually in accordance with the predetermined operation, and the setting of the combination of each document are performed by the operation document set setting in which a setting screen (not shown) is activated from the diagnosis window 600. This is performed in the window 860 (see FIG. 4). The operation document set setting window 860 includes an operation selection field 861 for selecting an operation or an operation method, and a document setting field 862 for selecting and setting each document corresponding to the selected operation. The operation selection column 861 selects a predetermined operation from a pull-down menu. In the document setting field 862, documents with respective document names are displayed as thumbnails. When a document is selected in the document setting field 862, a text editor (not shown) is activated. A text is created by a text editor, which is a document creation means, and items to be input on the document, for example, fields for taking in personal information of patients and medical information from a medical record are created (details will be described later). In addition, a diagram necessary for a document is created by capturing an image and using a drawing tool on a text editor. By preparing such a document for each operation and selecting the OK button in the operation document set setting window 860, the setting of each document and operation document set is confirmed by the control unit 21a, and the contents are stored in the hard disk 13. Remembered. Further, by associating related documents (with the same operation name) and storing them in the hard disk 13, a predetermined surgical document set can be obtained. By repeating this operation, a surgical document set corresponding to the surgical content is stored in the hard disk 13.

  In the above description, the operation document set is selected after the operation content is determined. However, the present invention is not limited to this. The operation document set may be configured to correspond to the patient information as the operation content is determined. For example, the operation information setting operation of setting the operation name of the patient to the medical record is set to the selected patient information as the operation information for recognizing the operation to be performed on the patient. The surgical document set is stored in the hard disk 13 in correspondence with the surgical information. A signal for setting at this time may be used as a selection signal for selecting one from the plurality of surgical document sets described above. Specifically, “cataract”, “cataract surgery”, and the like are input to the medical chart, and the set signal is used. In this case, the configuration is not limited to using a window for selecting a surgical document set. Further, the operation of the patient may be determined by selecting the surgical document set.

  Once the patient's surgery or procedure is determined, a surgery appointment is made. When an operation reservation is selected using the navigator button 601, an operation reservation window 900 is activated as a separate window. FIG. 5 is a diagram showing a screen configuration of an operation reservation window (reservation screen) 900. In the present embodiment, it is assumed that the surgery reservation window 900 is displayed on the monitor 22 of the examination client 20, and the doctor reserves the surgery for the patient. In addition, medical office work etc. may perform the appointment of surgery in the accounting client 20.

  The operation reservation window 900 includes a calendar 910 that displays a list of operation reservation dates in a predetermined period, a temporary reservation list (unconfirmed reservation list) 920 that displays a temporary reservation status of a specific operation day, and a specific operation date. A main reservation list (final reservation list) 930 for displaying the main reservation status is included. Here, in the reservation lists 920 and 930, lists of patients on the same operation day are displayed. The reservation lists 920 and 930 are displayed side by side on the surgery reservation window 900 so that the reservation status can be easily understood. When a specific operation date in the calendar 910 is selected, the status of the selected operation date is displayed in the reservation lists 920 and 930. In the reservation lists 920 and 930, patient information such as a patient ID, a patient name, an operation name, and a surgical eye is displayed.

  In the calendar 910, the guideline of the number of reserved patients on each operation day is displayed in different colors so that the reservation status can be easily understood. For example, the background is colored white when there is no patient appointment, green when there are a few (2, 3), yellow when the number is medium, and red when there are many (surgical number limit) . Such a display is performed by the control unit 21a referring to the reservation information in the hard disk 13. In addition, since the standard of color coding differs depending on each hospital, the number of people, colors, etc. are set in a setting window (not shown). Moreover, it is good also as a structure which informs a user of the reservation condition of a specific surgery day by the ratio of the number of reservation patients and the tolerance of a specific surgery day.

  The addition (input) of a patient to the provisional reservation list 920 is performed by the above-described surgery determination. Here, it is a state (indeterminate state) in which only the operation date is determined. The addition (input) to the main reservation list 930 is performed by dragging a patient (pointing to at least one patient) selected on the temporary reservation window 920 and dropping it on the main reservation list 930. By this operation, the operation time is determined together with the patient's operation date. In the list display on the reservation list 930, the patients are arranged in the order of surgery (in chronological order). Further, the patients displayed as a list on the reservation list 930 are rearranged and displayed based on a predetermined distribution rule (reservation confirmation reference information). In this embodiment, the patient in the reservation list 930 cannot be dragged and dropped into the provisional reservation list 920. When a patient on the main reservation list 930 is temporarily reserved, the patient is deleted from the main reservation list 930 using a delete button on the window and added to the temporary reservation list 920 again. Through such a procedure, mistakes are less likely to occur in patient appointments. Such a setting can be changed by a setting window (not shown).

  Here, the distribution rule will be described. The distribution rule is information used for determining the operation order of a plurality of patients on the same operation day, and has an element of patient information as a reference element. The elements of patient information include, for example, surgery (or operative method), operative eye information (for example, left and right eye information, astigmatic axis angle information of the operative eye), presence / absence of infection, and operation time (difficulty of operation) is there. The distribution rule has at least one of these elements, and has priority information for setting the priority between the elements. Distributing patients according to these factors has the following advantages. For example, by setting the order of surgery (operative method), it is not necessary to confirm the surgery every time the patient to be operated changes, thereby improving work efficiency. In the case of the surgical eye, it is not necessary for the operator to move for each patient, and the work efficiency can be improved. Also, in the case of the astigmatic axis angle of the patient, it is not necessary to change the position of incision for each patient, and the working efficiency is improved. When an incision is made around the cornea, an incision is formed according to the astigmatic axis so as not to cause postoperative astigmatism. Specifically, it means that an incision is formed with a surgical knife or the like at a location where the curvature of astigmatism is high, and the incision is formed in a corneal ring at a position orthogonal to the astigmatism axis. For this reason, if the astigmatic axis angle of the surgical eye is different for each operation, it is necessary to change the incision position, and the operator needs to move for each operation. On the other hand, as described above, the operation efficiency is improved by rearranging the operation order according to the astigmatic axis angle of the surgical eye. Moreover, the risk of infection to other patients can be reduced by making a patient with an infection last in the same operation day. Moreover, by rearranging every operation time, a difficult operation can be performed later, the operation flow can be smoothed, and the work efficiency can be improved.

  FIG. 6 is a view showing a distribution rule setting window 940. The distribution rule setting window 940 includes an element list 941, a reference list 942, and an edit button 943. Here, an element refers to an item corresponding to patient information, and refers to, for example, a surgery or a surgical method, a surgical eye, an astigmatic axis angle, and the like. In the element list 941, elements corresponding to the elements of the patient information are prepared. In the reference list 942, elements of the element list 941 added by the edit button 943 or drag and drop are displayed. Elements displayed in the reference list 942 have a higher priority in order from the top. Elements displayed in the reference list 942 are rearranged by the edit button 943 or the like, and the priority order thereof is changed. Further, the element is deleted by the edit button 943. Further, as the rearrangement order for each item displayed in the reference list 942, ascending order and descending order are set by pull-down of the element list 942. The ascending order and descending order are not limited to numerical values. For example, in the case of a surgical eye, the order of “right” and “left” is set in ascending order, and in the case of an infectious disease, “none” and “yes” are set in ascending order.

  By selecting the OK button in the distribution rule setting window 940, the distribution rule information is confirmed (updated) and stored in the hard disk 13 by the control unit 21a. At this time, the elements in the reference list 942 are set as information used for the distribution rule, and the priority information between the elements is determined by the arrangement order (ascending order) of the elements.

  Next, patient distribution based on distribution rule information will be described. When at least one patient selected in the temporary reservation list 920 of FIG. 5 is added to the main reservation list 930, the main reservation is confirmed. Note that the actual appointment refers to the confirmation of the operation time, and when another patient is added to the appointment, the operation time of the patient that has been confirmed earlier may be changed. The control unit 21a of the client 20 reads out the distribution rule information in the hard disk 13 based on the final reservation confirmation signal and also reads out the patient information of the patient in the main reservation list 920. The control unit 21a compares each element of the distribution rule information with the patient information of each patient, and rearranges the operation order of each patient. Moreover, the priority order of the items of the distribution rule information is compared, and the operation order of each patient is rearranged according to the element having the higher priority order. In this manner, the control unit 21a stores the result of rearranging the operation order of each patient in the hard disk 13 as reservation confirmation information. In addition, the operation order of the patient is displayed in the main reservation list 930. At this time, the control part 21a determines each operation time so that the operation time of each patient may not overlap. Specifically, the control unit 21a calls up the surgical or surgical element of the patient information and also calls up a predetermined standard of operating time information, and based on these, determines the operating time of the patient. In this way, the operation order of each patient can be assigned within the same operation and displayed in the operation reservation window 900.

  When the patient's operation date and operation time are determined, the pre-operative record is entered (pre-operative examination), the patient is explained the contents of the operation, and the patient's consent is obtained. Here, there is no preoperative examination, and preoperative records are created from medical chart information.

  As described above, a description printed by the printer 35 of the client 20 is used for the description of the operation content. At this time, an instruction corresponding to the selected patient information is selected from the surgical document selection list 950 (described later) selected and activated by the navigator button 601 of the examination client 20. When the client 20 prints the manual from the printer 35, the control unit 21a calls the operation name of the patient information of the patient from the hard disk 13 based on the output selection signal, and the operation document selected from the operation text set corresponding to this operation life. Call (instructions). Information corresponding to the element of the patient information is output to the called manual. Here, the patient ID, which is the patient's personal information, is output in the manual. Also, information necessary for management such as date is output. Then, the control unit 21a prints a manual in which patient information is output from the printer 35. As described above, a manual in which necessary items such as a title are described is captured by the scanner 36 and stored in the hard disk 13 in correspondence with patient information (patient ID). The consent form is processed in the same way.

  FIG. 7 is a diagram showing a preoperative record (surgery preparation / instruction) displayed by selecting a surgical document selection list 950 for calling a predetermined document from the surgical document set. The operative ship record 960 is a document that records an instruction of an inspection necessary before an operation, designation of an instrument required at the time of an operation, precautions, and the like. The surgical document selection list 950 is a window for generating a signal for calling a predetermined document from the surgical document set corresponding to the patient information of the patient. Based on the document selection signal on the surgical document selection list 950, the control unit 21a calls the document (preoperative record) corresponding to the currently selected patient information from the hard disk 13 and displays it on the monitor 22.

  Here, designation of an intraocular lens necessary for cataract surgery will be described. The preoperative record 960 includes a patient information display column 961 such as a patient name and an operating eye, an IOL prescription column 962 for determining the power of an intraocular lens, a check column for displaying an instrument used for an operation, preoperative check items 963. These fields are edited by the text editor described above. On the screen of the client 20, a preoperative record 960 and a patient chart 640 are displayed. When the preoperative record 960 is displayed, the examination data 640a or the like displayed on the medical chart 640 is selected, and dragged and dropped onto the preoperative record 960, the selected examination data is input to the preoperative record 960. Here, examination data necessary for prescribing the IOL such as the axial length and kerato value of the patient described in the chart 640 is used. The IOL calculation formula is incorporated in the surgery management program, and when the examination data of the examination data 640a is input to the preoperative record 960, the control unit 21a calculates the frequency of the IOL suitable for the patient from the examination data. The frequency is displayed in the IOL prescription column 962. In this way, IOL prescription necessary for the patient's surgery is performed.

  Note that the description displayed on the chart 640 is electronically protected so that it cannot be edited or deleted. Therefore, the description of the chart 640 is only viewed (referenced). Here, the selected inspection data 640a is converted into text data by being dragged and dropped onto the preoperative record 960, and the numerical value of the inspection data can be edited. Specifically, the control unit 21a copies the patient's chart information in the hard disk 13 to the preoperative record 960 by drag and drop operation, and the protection is canceled for the copied information. Moreover, the control part 21a preserve | saves the information of the preoperative record 960 in the hard disk 13 as individual patient information. By performing such processing, the degree of freedom in inputting preoperative records can be improved. For example, when there is unfavorable data obtained by examination before surgery, a part of the data can be excluded according to the judgment of the doctor. In the above description, the IOL prescription is calculated using the drag and drop of the chart information as a trigger, but the present invention is not limited to this. It is good also as a structure which determines an IOL prescription after editing information required for an IOL prescription after dragging and dropping medical chart information on preoperative recording. For example, an IOL calculation button is provided in the IOL prescription column, and the IOL prescription is determined by selecting the calculation button.

  In this way, a preoperative record is created. By storing the preoperative record 960 with the OK button, the control unit 21a stores the information displayed in the preoperative record 960 and the patient information in the hard disk 13 in association with each other. In addition, intraoperative records are similarly created and stored. It should be noted that by storing the intraoperative record, it is assumed that the patient information displayed in the reservation list 830 has been implemented, assuming that the patient's surgery has been performed.

  As described above, surgical documents in a series of surgery can be managed as a set. Data can be input from patient information (medical chart information). This simplifies the management of documents prepared for each operation. In addition, the labor of inputting (filling in) patient information into each document is reduced, and the work efficiency of surgery and the like is improved. An operation plan for performing a plurality of operations on the same day can be made efficiently.

  In addition, since the order of the patient's operation on the same operation day is distributed based on the patient information in the actual reservation of the patient, the efficiency of the operation can be improved. As an example, if the right eye is operated first and then the left eye is operated, the doctor needs to change the standing position with respect to the patient only once in the operation on the same day. A decrease in work efficiency due to changing the position can be suppressed. The same applies to the astigmatic axis angle.

  Here, the patient rearrangement based on the distribution rule will be exemplified. FIG. 8 is a flowchart of patient rearrangement. Here, there are three elements of the distribution rule: surgery, presence / absence of infection, and surgical eye, and priority among each element is surgery / presence / absence of infection and surgical eye. Here, in surgery, priority is given to cataract surgery, priority is given to the absence of infection in the presence or absence of infection, and priority is given to the right eye in the operation eye. In the flowchart, the criterion for each element is determined by Y / N, and is arranged according to the priority order. Here, after the determination is made based on the surgical element, the presence / absence of an infectious disease and the surgical eye are determined, and the determination of each element is connected in the form of a tree (here, a binary tree). These three elements, the patient information of the added patient in the reservation list 930, are called in order, and the surgery order of each patient is assigned.

  Below, CPU12 shows the step for distributing a patient's order. In step 11 from the start (hereinafter, step is abbreviated as S), the patient's surgery is determined. Here, it is determined whether the operation is a cataract operation based on the patient information of the patient. If it is determined in S11 that the cataract operation (Y) is performed, the process proceeds to S21 in which the presence or absence of an infection is determined. If it is determined that the cataract surgery is not performed (N), the process is divided into steps (not shown) for determining the presence or absence of an infectious disease different from S21. Next, in S21, the presence or absence of an infectious disease is determined based on the patient information of the patient. In S21, if it is determined that there is no infection (Y), the operation is determined to be S31, and if it is determined that there is an infection (N), the operation is determined to be S32 (different from S31). In S31 and S32, it is determined from the patient information whether the patient's operative eye is the right eye. If the operating eye is determined to be the right eye (Y) in S31, the order is 1, and if it is determined to be the left eye (N), the order is 2, and if the operating eye is determined to be the right eye (Y) in S32, the order is 3, If it is determined that the left eye (N), the order is 4. In the case of a patient who is determined not to have a cataract operation in S11, the presence or absence of an infectious disease and the operation eye are determined in the same manner as described above, and the order 5 to 8 is assigned.

  Based on the above steps, the order of each patient is assigned. In addition, when a some patient is distributed in the same order, it distributes to a patient with order 1A, 1B, ..., 1Z. After assigning the order to the patient, the control unit 21a associates the order with the patient and stores it in the hard disk 13. Then, the control unit 21a rearranges the patients based on the sorted order, and displays them in the reservation list 930. At this time, as described above, the operation time is allocated so that the operation time of each patient does not overlap. Further, the control unit 21 a stores information to be displayed on the reservation list 930 in the hard disk 13. In this way, the reservation time is determined by the distribution rule of the control unit 21a and the hard disk 13. As described above, based on a predetermined distribution rule, the surgical order of patients is distributed.

  In the embodiment described above, the temporary reservation list and the main reservation list are displayed side by side. However, the present invention is not limited to this. The temporary reservation list and the main reservation list may be switched and displayed. In this case, the patient is input by selecting the patient displayed in the provisional reservation list and sending it to the main reservation list using the main reservation button or the like. In this embodiment, a plurality of patients are selected from the temporary reservation list and input to the reservation list. However, the present invention is not limited to this. You may enter the patient of a temporary reservation list into this reservation list one by one. In this case, every time a patient is added (input) to the reservation list, the operation order is sorted. The addition of patients to the reservation is not limited to drag-and-drop. By selecting the reservation button or the like, the patient selected in the provisional reservation list or all patients in the provisional reservation list are added to the reservation list. A configuration may be added. Moreover, although it was set as the structure by which the allocation of an operation reservation is performed by input operation in which a patient is added to this reservation, it is not restricted to this. After adding a patient to this reservation list, the structure which a control part performs distribution by selecting a distribution button may be sufficient. In this case, the doctor can determine the order of the patient's surgery without depending on the distribution rule.

  In the present embodiment described above, each document corresponding to a predetermined operation (operation content) is prepared in advance and each document is set as a set. However, the present invention is not limited to this. A document template may be prepared for different surgical contents, in other words, the document may be shared. For example, a consent document or the like in which the content of the document does not change so much between operations even if the surgery is different is configured so that only the operation name of the patient to be output in the document is different. As a result, even when the surgery is different, the document can be used in common and the storage capacity of the system can be suppressed.

  In the above-described embodiment, the document (data) of the surgical document set is configured such that text data can be input and input cannot be performed when the document set is stored in the hard disk of the server. This is not a limitation. When calling the document to the monitor, the control unit of the client may select whether or not text data can be input to the document. In this case, the document format information is stored in the hard disk of the server, and when the document is displayed on the monitor, the control unit of the client refers to the format information to select the document format.

It is a figure which shows the outline | summary of the medical information management system of this invention. It is a figure which shows an examination window. It is a figure which shows a surgery document set selection window. It is a figure which shows a surgery document set setting window. It is a figure which shows the screen structure of a surgery reservation window. It is a figure which shows a distribution rule setting window. It is a figure which shows the preoperative record (operation preparation and instructions). It is a flowchart of a patient rearrangement.

Explanation of symbols

10 management server 12 CPU
13 Hard disk 20 Client 21 PC
21a Control unit 21b Hard disk 30 Inspection device 600 Examination window 601 Navigator button 640 Medical record 850 Surgery document selection window 860 Surgery document set setting window 900 Surgery reservation window 950 Surgery document selection list

Claims (1)

Storage means for storing patient information including, as elements , personal information of a plurality of patients and a plurality of medical information for each patient ;
An operation reservation means for reserving operation schedules of the plurality of patients, wherein a plurality of the patient information corresponding to the same operation day and the reservation time is undetermined are displayed on the screen as undetermined information, and the same operation Surgical reservation means for displaying a plurality of the patient information corresponding to the day and the reservation time fixed as the fixed information separately from the unconfirmed information;
An input means for transmitting a signal for setting the unconfirmed information displayed by the surgery reservation means as the confirmed information;
A rule setting means for setting a sorting rule by determining a priority between the elements of the patient information;
Reserving individual patient information by using the patient information stored in the storage means based on the signal from the input means and the rule so that reservation times of a plurality of patient information to be determined information do not overlap. Reservation time determination means for determining the time within the same operation date and making the confirmed information;
A medical information management system comprising: