JP7100382B2 - Drug management system - Google Patents

Description

Application of Article 30, Paragraph 2 of the Patent Law Exhibition date: November 29, 2019 Exhibition name: 2019 Medical Quality and Safety Society Academic Meeting Venue: Kyoto International Conference Center (Sakyo Ward, Kyoto City, Kyoto Prefecture)

The present invention relates to a drug management system.

When performing treatment or surgery in a medical institution such as a hospital, it is required to supply various drugs used in the field of treatment or surgery without mistakes and without delay, and to replenish after use. Doctors and nurses in charge of treatment and surgery are also required to accurately record and report the type and number of drugs used. In addition, the management of the drugs used is also important from the perspective of hospital management.

However, in treatment and surgery, it may happen that the presence or absence of the use of the drug is not properly controlled and the drug is not properly replenished to the treatment / surgery site due to the wrong drug or the wrong storage location. As a technique for solving such a problem, for example, a drug management system as described in Patent Document 1 has been proposed. However, conventional systems, including the system of Patent Document 1, are systems that manage drugs depending on the input of operators (doctors, nurses, etc.). For this reason, it has been difficult to appropriately control whether or not a drug is used in the field of treatment or surgery without depending on the input of the operator.

Japanese Patent Publication No. 2014-513839

It is an object of the present invention to provide a drug management system that enables appropriate control of the presence or absence of drug use without depending on the input work of an operator.

In order to solve the above-mentioned problems, the drug management system according to the present invention may be arranged with a mounting table for mounting a tray for storing the drug and a mounting table configured to be able to store the tray and below the above-mentioned table. A tray storage cart configured, an image pickup unit that images the tray placed on the above-mentioned table, and a drug use identification unit that identifies the drug used based on the image captured by the image pickup unit. And prepare. The tray includes a plurality of division chambers partitioned by the medicine to be stored, and each of the division chambers includes an identification code attached to a position where the medicine to be stored can be identified and imaged by the imaging unit. ..

INDUSTRIAL APPLICABILITY According to the present invention, it is possible to provide a drug management system that enables appropriate control of the presence or absence of drug use without depending on the input work of an operator.

It is a schematic diagram which shows the whole structure of the drug management system 1 which concerns on 1st Embodiment. It is a perspective view of the drug management cart 10. It is a perspective view of a tray cart 30. It is a perspective view of the medicine tray 40. An example of the identification label 42 is shown. An example of the usage pattern of the medicine tray 40 will be described. Another example of the usage pattern of the medicine tray 40 will be described. An example of the usage pattern of the drug management cart 10 will be described. An example of the usage pattern of the handheld computer 60 will be described. It is a flowchart explaining the operation of the drug management system 1. An example of the screen display of the drug management system 1 will be described. It is a functional block diagram of the drug management system 1. It is a schematic diagram which shows the whole structure of the drug management system 1 which concerns on 2nd Embodiment. It is a schematic diagram which shows the whole structure of the drug management system 1 which concerns on 3rd Embodiment. It is a schematic diagram which shows the whole structure of the drug management system 1 which concerns on 4th Embodiment.

Hereinafter, the present embodiment will be described with reference to the accompanying drawings. In the attached drawings, functionally the same elements may be displayed with the same number. The accompanying drawings show embodiments and implementation examples in accordance with the principles of the present disclosure, but these are for the purpose of understanding the present disclosure and are never used for the limited interpretation of the present disclosure. is not. The description of the present specification is merely a typical example, and does not limit the scope of claims or application examples of the present disclosure in any sense.

In this embodiment, the description is given in sufficient detail for those skilled in the art to implement the present disclosure, but other implementations and embodiments are also possible and do not deviate from the scope and spirit of the technical idea of the present disclosure. It is necessary to understand that it is possible to change the structure and structure and replace various elements. Therefore, the following description should not be construed as limited to this.

[First Embodiment]
The drug management system 1 according to the first embodiment will be described with reference to FIGS. 1 to 4. FIG. 1 is a schematic view showing the overall configuration of the drug management system 1. The drug management system 1 includes a drug management cart 10, 10A, computers 20, 20A, a tray cart 30, a drug tray 40, a server computer 50, and a handheld computer 60, 60A.

The drug management cart 10 is arranged, for example, in the operating room where the drug is used. That is, the drug management cart 10 is arranged in the vicinity of the operating table 5 or the like in the operating room, and controls drug management (identification of unused drugs and used drugs). The drug management cart 10A similar to the drug management cart 10 is placed in a room (for example, a central control room) different from the operating room and connected to the computer 20A. The drug management carts 10 and 10A together with the computers 20, 20A, the server computer 50, and the like constitute a drug management system. The server computer 50 may be installed in the central control room as shown in FIG. 1, or may be installed in a room different from the central control room, for example, a special server room or the like.

As shown in the enlarged perspective view of FIG. 2, the drug management cart 10 includes, as an example, a leg portion 11, a mounting table 12, a support column 13, a camera 14, monitors 15 and 16, and a lighting device 17. Be prepared. The legs 11 are the base of the drug management cart 10, preferably having wheels on the bottom surface, and may be configured to be slidable on the floor surface. The mounting table 12 is fixed to a support column 13 extending from the leg portion 11, and a drug tray 40 can be mounted on the upper surface thereof.

The medicine tray 40 is stored in the tray cart 30, and is transported from the central control room to the operating room in a state where the medicine necessary for surgery or the like is loaded, and then is taken out from the tray cart 30 and moved onto the mounting table 12. Will be done. The tray cart 30 is configured to be movable to a position directly below the mounting table 12, whereby the doctor or the nurse can move the medicine tray 40 onto the mounting table 12 without a heavy burden.

The support column 13 is configured to extend from the leg portion 11 substantially perpendicular to the upper surface (main plane) of the mounting table 12. The support column 13 is configured so that the camera 14 can be fixed above the upper surface of the mounting table 12, for example, 70 cm to 80 cm above. In FIG. 1, there is only one camera 14, but a plurality of cameras may be provided in one drug management cart 10. Further, although not shown, a depression angle adjusting mechanism may be provided so that the depression angle of the camera 14 can be adjusted. Further, the camera 14 may be mounted on an XY drive mechanism (not shown) and configured to be movable in the XY direction. Further, instead of making the camera 14 movable, the mounting table 12 may be configured to be movable in the XY directions. As a result, even if the entire view of the medicine tray 40 cannot be captured by one camera, one medicine tray 40 can be imaged by one camera by appropriately changing the positional relationship between the medicine tray 40 and the camera 14. It will be possible.

The monitors 15 and 16 are held by an arm extending from the support column 13, and display an image captured by the camera 14, an analysis result thereof, and other information presented to the user as an image. In FIG. 1, two monitors 15 and 16 are provided, but the number of monitors is not limited to two. The lighting device 17 is a light source that emits illumination light that illuminates the mounting table 12.

The drug management cart 10 is connected to the computer 20. The computer 20 executes data processing related to the data acquired from the drug management cart 10, and transfers the processed data to the server computer 50 placed in the central control room.

The tray cart 30 is a cart that can store the drug tray 40 for storing the drug in a plurality of stages. The medicine tray 40 stored in the tray cart 30 is taken out from the tray cart 30 and placed on the upper surface of the mounting table 12, so that the medicine tray 40 is imaged by the camera 14. This imaging information is used for drug management as described below.

As shown in FIG. 3, the tray cart 30 has a housing 31 having an open front surface and a sliding member extending rearward (in the depth direction) from the front surface of the housing 31 and formed in a plurality of stages in the height direction. 32 is provided. The medicine tray 40 has, for example, a housing and a fringe portion F projecting laterally from the housing, and the fringe portion F is inserted into the tray cart 30 so as to enter the upper side of the sliding member 32. As a result, the plurality of drug trays 40 can be stored in the tray cart 30 in a plurality of stages.

The handheld computers 60 and 60A are provided with a camera (not shown) separate from the camera 14 inside, and are held by operators (doctors, assistants, nurses, pharmacists, hospital staff, etc.) so that the drug tray 40 can be imaged. It is composed.

As shown in FIG. 4, the medicine tray 40 has a plurality of division chambers 41 for storing medicines, and the medicine tray 40 is divided into a plurality of division chambers 41. The division chamber 41 is divided according to the medicine used, and each division chamber 41 is provided for each different type of medicine. Even for the same drug, different division chambers 41 may be provided one by one. The split chamber 41 may be physically independent of the main body (housing) of the medicine tray 40 and may be configured to be removable from the main body, or may be integrally configured. Considering that various agents have different sizes and shapes, the split chamber 41 is also prepared in various shapes and sizes.

Further, an identification label 42 including an identification code for identifying the type of the drug is attached to the bottom surface of the division chamber 41. The identification code included in the identification label 42 may be, for example, a so-called one-dimensional bar code, a two-dimensional bar code (QR code (registered trademark)), or a color code (cameleon code (registered trademark)) as shown in the figure. good. The identification label 42 may additionally include information such as the name of the drug in addition to the color code (see FIG. 5).

In the divided chamber 41, a drug corresponding to the identification label 42 attached to the bottom surface thereof is arranged, for example, by the hand of a staff member in the central control room. FIG. 6 shows a state in which various drugs are arranged in the corresponding divided chamber 41. When the drug is placed in the dividing chamber 41, the identification label 42 is concealed by the drug and cannot be confirmed from above. The state in which the identification label 42 is concealed by the drug indicates that the drug has not been used yet and remains in the drug tray 40.

It should be noted that some drugs, such as drip bags and general anesthesia / sedative agents, have a capacity and size of several hundred ml or more and are heavy in weight. For such a large drug, a large split chamber 41A as shown in FIG. 7 is arranged. Although not shown, the same identification label 42 as described above is also attached to the bottom surface of the dividing chamber 41A.

The usage mode of this drug management system 1 will be described with reference to FIGS. 8 to 11. 8 and 9 are schematic views illustrating the usage mode of the system, and FIG. 10 is a flowchart illustrating the operation of the system. Further, FIG. 11 is an example of a screen display displayed on a computer display (display unit) when the system is in operation.

When treatment or surgery is performed in this drug management system 1, the staff of the central control room (FIG. 1) places the drug necessary for the treatment on the drug tray 40, stores it in the tray cart 30, and then stores the drug. The tray cart 30 is transported to the operating room. The transported tray cart 30 is received by a doctor or a nurse in the operating room, and treatment or surgery is started.

When performing treatment or surgery, the doctor or nurse moves the drug tray 40 on which the drug to be used is placed onto the mounting table 12 (step S11 in FIG. 10) as appropriate, as shown in FIG. Treatment or surgery is initiated using the drug (step S12). When the medicine is taken out from the medicine tray 40 for use, the identification label 42 corresponding to the taken out medicine can be imaged by a camera 14 or the like. The drug tray 40 may be placed in a position different from the mounting table 12 during treatment or surgery, and may be left in the tray cart 30 so that only the drug can be taken out as needed. May be. If the drug tray 40 is placed in a different position, or if the drug tray 40 is left in the tray cart 30, the drug tray 40 is moved to the loading table 12 after the end of treatment or surgery. ..

For example, at the timing when the treatment or surgery is completed, the camera 14 or the handheld computer 60 images the drug tray 40 from above and acquires an image of the drug tray 40 (step S13). In the drug tray 40, there is also a drug tray 40 containing a large drug (for example, a drip bag, a general anesthesia / sedative agent, etc.) as shown in FIG. Such a medicine tray 40 is heavy, and it is a burden for the operator to move it on the mounting table 12. Therefore, such a drug tray 40 can be imaged by the handheld computer 60 instead of being imaged by the camera 14.

As shown in FIG. 9, the handheld computer 60 can be brought close to the medicine tray 40, and the upper surface of the medicine tray 40 can be imaged by the built-in camera. In this case, the used medicine can be confirmed without moving the medicine tray 40 onto the mounting table 12.

By analyzing the identification label 42 in the image of the medicine tray 40 captured by the camera 14 or the handheld computer 60, the type and number of medicines used can be specified (step S14). As shown in FIG. 11, when the color chart in the identification label 42 is extracted by the used drug specifying unit 22 and the used drug is specified, the mark M can be displayed on the display in that portion. .. Information about the identified used drug is transferred to, for example, a server computer 50 (step S15). In addition, some identification labels 42 may not be recognized even though the corresponding drug has been used. In this case, the operator (doctor or nurse) may check the display to see if there is a split room 41 in which the drug is taken out and emptied, but the mark M is not displayed. can. When such a misrecognition occurs, it is possible to change the position of the camera 14 or change the lighting, and perform imaging again by the camera 14. Alternatively, it is possible to operate the computer 20 to correct the data so as to correct such misrecognition.

After the drug is used in the operating room, it is returned to the tray cart 30 on which the drug tray 40 containing the used drug is placed, or to, for example, the central control room after the treatment or surgery is completed. The worker in the central control room puts the drug tray 40 returned from the operating room on the mounting table 12 of the drug management cart 10A placed in the central control room, and puts the drug tray 40 on the drug management cart 10A as in the operating room. The drug tray 40 is imaged using the camera 14 or the handheld computer 60A. The image of the identification label 42 is extracted from the captured image of the drug tray 40. The extracted identification label 42 and the corresponding drug information are transferred to the server computer 50.

The server computer 50 thus uses the data of the identification label 42 extracted from the image of the drug tray 40 after the surgery to be placed in the drug management cart 10 placed in the operating room and the drug management placed in the central management qualities. Obtained from both carts 10A. Then, the information of both is compared, and a match / mismatch is determined. Mismatches can result from false positives, doctor or nurse work mistakes, management mistakes in the central control room, and more. Doctors, nurses, workers in the central control room, etc. can perform confirmation work again when a discrepancy is detected.

A drug management system realized by a drug management computer program stored in the computer 20 will be described with reference to the functional block diagram of FIG. The computer 20 acquires an image by the image processing unit 21 of the drug tray 40 imaged by the camera 14 or the handheld computer 60, and executes predetermined image processing. Specifically, the image processing unit 21 extracts the image of the identification label 42 from the image of the drug tray 40. Further, the identification label database 70 is a storage unit that stores the color chart included in the identification label 42 in association with the information about the corresponding drug.

The drug-using identification unit 22 identifies the drug used by comparing the image of the identification label 42 extracted from the image of the drug tray 40 with the identification label stored in the identification label database 70. When information on the type and number of the drugs used is acquired, the information can be transmitted to the server computer 50 or the like by the data transmission / reception control unit 23 and displayed on the display by the display control unit 24.

As described above, according to the drug management system of the first embodiment, the drug tray 40 is provided with an identification label 42 for each division chamber 41, and this is imaged by an imaging unit such as a camera 14. Can manage the drugs used. If a drug is appropriately used from the drug tray 40 moved onto the mounting table 12 for treatment or surgery, the identification label 42 is imaged and the presence or absence of the drug is specified. Therefore, according to the first embodiment, it is possible to provide a drug management system that enables appropriate control of the presence or absence of drug use without depending on the input work of the operator.

[Second Embodiment]
The drug management system 1 according to the second embodiment will be described with reference to FIG. FIG. 13 is a schematic view showing the overall configuration of the drug management system 1 of the second embodiment. In FIG. 13, the same components as those in FIG. 1 are designated by the same reference numerals as those in FIG. 1, and therefore duplicate description will be omitted below.

The drug management system 1 of the second embodiment does not include the drug management cart 10 in the operating room, but only the drug management cart 10A placed in the central control room. The operating room is provided with a cart 10B for simply placing the drug tray 40 taken out from the tray cart 30. The cart 10B includes a leg portion 11B and a mounting table 12B. The doctor can place the drug tray 40 on the mounting table 12B and perform the operation.

After the surgery is completed, the handheld computer 60 can sequentially image the drug tray 40 using the drug, and the image pickup information can be sent to the server computer 50 via the computer 20. Instead of this, the tray cart 30 may be returned to the central control room as it is without performing imaging by the handheld computer 60 or the like in the operating room. When the tray cart 30 after the operation is returned to the central control room, the worker in the central control room sequentially takes out the medicine tray 40 from the tray cart 30 and places it on the mounting table of the medicine management cart 10A. Then, the drug tray 40 is imaged by the camera of the drug management cart 10A, and the drug used is specified in the same manner as in the first embodiment. When the imaging is performed by the handheld computer 60 in the operating room, it is also possible to compare the analysis result by the drug management cart 10A with the analysis result by the handheld computer 60. As described above, according to the second embodiment, it is possible to provide a drug management system that enables appropriate control of the presence or absence of drug use without depending on the input work of the operator. can.

[Third Embodiment]
The drug management system 1 according to the third embodiment will be described with reference to FIG. FIG. 14 is a schematic view showing the overall configuration of the drug management system 1 of the third embodiment. In FIG. 14, the same components as those in FIG. 1 are designated by the same reference numerals as those in FIG. 1, and therefore duplicate description will be omitted below.

The drug management system 1 of the third embodiment includes an additional tray cart 30A in addition to the tray cart 30. This additional tray cart 30A is a cart for storing a drug tray 40A that mainly stores a particularly large and heavy drug MDb (for example, a drip bag, a general anesthesia / sedative agent, etc.).

Since the medicine stored in the medicine tray 40 stored in the tray cart 30 is small, the weight of the medicine tray 40 is small. Therefore, the drug tray 40 of the tray cart 30 can be moved to the mounting table 12 of the drug management cart 10 before the start of the operation, during the operation, or after the operation, and can be imaged by the camera 14 at a predetermined timing. On the other hand, since the medicine tray 40A stored in the tray cart 30A is heavy, it is not moved to the mounting table 12 of the medicine management cart 10 and can be imaged by the handheld computer 60 at the timing after the operation is completed. After the surgery is complete, the tray carts 30 and 30A are both returned to the central control room. The medicine tray 40 and the medicine tray 40A are imaged by the camera 14 of the medicine management cart 10A or the handheld computer 60A.

[Fourth Embodiment]
The drug management system 1 according to the fourth embodiment will be described with reference to FIG. FIG. 15 is a schematic view showing the overall configuration of the drug management system 1 of the fourth embodiment. In FIG. 15, the same components as those in FIG. 1 are designated by the same reference numerals as those in FIG. 1, and therefore duplicate description will be omitted below.

The drug management system 1 of the fourth embodiment additionally corresponds to the case where the drug MDb is delivered by hand from the central control room (urgently) by, for example, the staff NS. When additionally delivering the drug MDb from the central control room to the operating room, the staff NS delivers the identification label card 42B together with the drug MDb to the operating room. The identification label card 42B is a card with an identification label as shown in FIG. The fourth embodiment is different from the above-described embodiment in that the identification label card 42B is provided.

Generally, when an operation or the like is performed, a shortage of the drug may be found after the start of the operation, and the drug may be delivered to the operating room by the staff later. The fourth embodiment includes an identification label card 42B to deal with such a case.

When delivering the deficient drug MDb to the operating room, the staff NS brings the identification label card 42B together with the drug MDb and hands the drug MDb and the identification label card 42B to the doctors in the operating room as a pair. The operating room doctor, nurse, and assistant mount the identification label card 42B together with the drug MDb in the empty space of the drug tray 40. Instead of storing in the medicine tray 40, the medicine MDb may be placed in a tray different from the medicine tray 40. It is preferable that the drug MDb is placed on the identification label card 42B, and before use, the drug MDb is placed so that the identification label card 42B is not visible when viewed from above. When the transported drug MDb is used, the identification label card 42B can be imaged by the camera 14, and it can be detected that the drug MDb has been used.

[others]
The present invention is not limited to the above-described embodiment, and includes various modifications. For example, the above-described embodiment has been described in detail in order to explain the present invention in an easy-to-understand manner, and is not necessarily limited to the one including all the described configurations. Further, it is possible to replace a part of the configuration of one embodiment with the configuration of another embodiment, and it is also possible to add the configuration of another embodiment to the configuration of one embodiment. Further, it is possible to add / delete / replace a part of the configuration of each embodiment with another configuration.

1 ... Drug management system, 5 ... Operating table, 10, 10A ... Drug management cart, 11 ... Legs, 12 ... Stand, 13 ... Support, 14 ... Camera, 15, 16 ... Monitor, 17 ... Lighting device, 20 ... Computer, 21 ... Image processing unit, 22 ... Drug identification unit used, 23 ... Data transmission / reception control unit, 24 ... Display control unit, 30 ... Tray cart, 31 ... Housing, 32 ... Sliding material, 40 ... Drug tray, 41 ... split room, 41A ... split room, 42 ... identification label, 50 ... server computer, 60 ... handheld computer, 70 ... identification label database, F ... fringe part, M ... mark.

Claims (4)

A mounting table for mounting trays for storing medicines,
A tray storage cart configured to store the tray and to be placed below the above-mentioned stand.
An image pickup unit that captures an image of the tray placed on the above-mentioned stand, and
A drug-using identification unit for specifying the drug used based on the image captured by the imaging unit is provided.
The tray has a plurality of divided chambers partitioned by the medicine to be stored.
Each of the division chambers includes an identification code attached to a position that identifies the drug to be stored and can be imaged by the imaging unit.
The identification code is concealed by the drug when the drug is placed in the split chamber, while the identification code is placed in the split chamber so that when the drug is taken out of the split chamber, the image pickup unit can take an image. Attached to each
The used drug specifying unit identifies the used drug based on the image of the identification code that can be imaged by taking out the drug.
A drug management system characterized by that. The drug management system according to claim 1, wherein the used drug specifying unit displays a predetermined mark at a position of the divided chamber related to the used drug on the display unit. The drug management system according to claim 1, wherein the image pickup unit is arranged so that the tray placed on the above-mentioned table can be imaged from a direction perpendicular to the main plane of the above-mentioned table. The drug management system according to claim 1, further comprising a hand-held imaging unit configured to be capable of imaging the tray in addition to the imaging unit.

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