WO2013191580A1

WO2013191580A1 - Medical information resource system

Info

Publication number: WO2013191580A1
Application number: PCT/RU2013/000171
Authority: WO
Inventors: Владимир Леонидович ГЛОТКО
Original assignee: Общество С Ограниченной Ответственностью Торгово-Производственная Фирма "Энергобаланс"
Priority date: 2012-06-22
Filing date: 2013-03-05
Publication date: 2013-12-27

Abstract

The invention relates to medicine. The medical information resource system comprises: computerized workstations for attending physicians, which workstations are equipped with input/output devices and are connected over a network to a controller for controlling a message from a query input subsystem for a query relating to a medicinal preparation, or to a unit for a diagnosis which is made by the attending physician, which is connected to an information unit for information relating to nonspecific and specific treatment standard forms and to an information unit for information relating to treatment methods and procedures, an information unit for general information relating to medicinal preparations, a unit for displaying the activities of medicinal preparations, an information unit for information relating to the application of medicinal preparations, an information unit for information relating to contraindications, and also a unit containing information relating to the chemical composition of medicinal preparations and relating to the release forms of said medicinal preparations.

Description

Drug Reference System

Technical field

The invention relates to medicine and can be used in outpatient and inpatient care as an automated information-intellectual reference system for selecting, comparing, analyzing the possibilities of prescribing diagnostic drugs among themselves and for complaints, symptoms, syndromes, instrumental and laboratory conclusions, differential diagnoses and prescribed forms of treatment in any ratio on-line.

State of the art

Attempts to solve health problems in terms of timely information support or the introduction of statistical programs attracted various forms of automation. Some of these attempts were in the form of a telephone library of answers to medical questions. Other attempts have been made to provide doctors with automated means of assistance for use in examining a patient. These methods involved static procedures or algorithms based on their conditions for quick diagnosis and the choice of treatment method using a computer and taking into account the information laid down in it and the algorithm of its operation: the task was to automatically establish a diagnosis by the machine itself using a set of typical patient input data, and not a human doctor. Such developments operate according to the algorithm of conducting interviews with the patient to collect the necessary and sufficient set of patient data to a degree of saturation corresponding to at least one of the medical diagnostic scenarios included in the computer. This scheme of building a computer on the basis of a set of medical diagnostic scenarios provides for the participation of the doctor only at the stage of entering data about the patient and ultimately leads to the formation of a “convenient” consciousness that everything can be adjusted to one of the scenarios. The participation of the doctor as a specialist and as the main participant in the diagnosis is not considered in this system of medical care.

This drawback is eliminated in the new clinical information system, which contains computerized workplaces of the attending physician, equipped with input / output devices and connected via a network to the message controller with a subsystem for inputting primary information about each patient, which includes a unit for entering general patient data, a block for entering information about the patient’s medical history, a block for entering information about clinical trials conducted by the attending physician in relation to the patient, a block for entering information about the result instrumental and laboratory studies, a unit for entering information about methods and methods of treatment and a unit for reflecting the diagnosis made by the attending physician, for the attending physician to differentiate clinical and instrumental laboratory data for establishing a diagnosis, the specified subsystem for inputting primary information through the exchange bus is communicated with the information subsystem support performed with the function of demonstrating information and reference material on the display of the computerized workplace of the attending physician, information corresponding to the type of information entered into the subsystem for inputting primary information about each patient, and including a block with information on general directories associated with a block for entering general data on a patient, a block with information on disease groups containing matches for patient complaints related with a block for entering information about the anamnesis with patient complaints, a block with information on clinical trials associated with a block for entering information about clinical trials, a block with information about instrumental and oratorio studies related to the unit to enter information on the results of instrumental and laboratory tests, the unit of information on the forms and standards of non-specific specific treatment standards nonspecific and specific treatment associated with the unit for entering information about methods and methods of treatment, and the unit of information for established diagnoses associated with the unit for reflecting the diagnosis made by the attending physician, the specified input subsystem for inputting primary information is connected via a common bus to a common medical database, the unit intellectual-analytical and statistical information processing, by the automated information processing unit, which are communicated in the mode of information exchange with each other, and the formation unit medical reporting, while the block of intellectual and analytical and statistical processing of information is made with the possibility of realizing the function of mathematical and analytical processing of patient data at the current time in terms of the patient’s clinical condition, the dynamics of the disease and treatment results, the automated information processing block is implemented functions of providing pharmacological data and real-time real-time comparison and analysis of data yields for different pharmacological groups of drugs among themselves, and includes a database connected with each other through an exchange bus with information about pharmacological drugs and a database with information about the compatibility of drugs and their action (RU Na 103209, G06Q 50/00, publ. October 29, 2010).

This system was selected as a prototype in terms of matching the differential mechanism of the matrix, connecting all components of the system in a common selection mode, for which the following criteria were selected: accurate (T) (specific, pathognomonic, obligate); reliable (D) (very common, almost always present); probable (B) (common, sensitive); denial (O) (contradictory, incompatible, antagonist, indicating the impossibility of the presence of a given sign (symptom) in a given disease). A feature of this system is the automated search and reference (semantic) support for the entered term during registration, differential comparison and maintenance of clinical or other data. The system provides informational and intellectual support for the medical diagnostic process, providing the clinician with support in the form of:

- providing the results of differentiation in the form of preliminary diagnoses upon receipt of many clinical criteria

- issuance of general and specific symptoms and syndromes according to the diagnoses (pre-installed updated guide with the possibility of operational replenishment);

issuing the most reliable indicators of laboratory and instrumental studies according to the diagnoses (pre-installed updated directory with the possibility of operational replenishment by the Customer’s personnel);

- compilation of the standard patient examination forms with a variety of differential diagnoses, highlighting the most appropriate and rational research methods (elements of the directory / templates are generated by the medical institution independently, or a basic directory is being formed, further work with which is done by staff)

- compiling forms of the predominantly, interconnected and most appropriate treatment of the patient with a variety of differential diagnoses (elements of the directory / templates are formed by the clinicians of the medical institution on their own, or the base directory is formed with further work with the directory by the staff)

The components of the subsystems (blocks) operate among themselves according to the algorithm of related fields, according to which each input feature corresponds to a set of related or response features, the selection of which is determined by the probabilistic scheme by which each the additional feature entered narrows down the field of related or responsive features related to the first feature entered. The method of single conjugate fields provides the possibility of differentiating several units of diseases quantitatively by the frequency of occurrence of identified signs with those available in variants of one group of diseases.

For such an intellectually functioning system, informational pharmacological support is important for medical specialists in prescribing pharmacological, homeopathic, herbal and other forms of drugs in the medical diagnostic process on-line. This support in the form of an independent (autonomous) system or system intended for integration into automated medical information systems should be built using coupled field algorithms to provide an automated analysis of indications, contraindications, compatibility, dosage, side effects of drug interactions, pharmacological, homeopathic, plant, mineral and other forms of drugs among themselves, as well as in any ratio with symptoms, syndrome s, the instrumental laboratory findings, differential diagnoses, and other methods of therapeutic effects in on-line mode.

Disclosure of invention

The present invention is aimed at achieving a technical result, which consists in increasing the efficiency and reliability of the results by implementing the process of differentiation and analysis of the registered clinical data (indicators of the patient’s clinical condition, these are complaints and specialist examinations, as well as laboratory and instrumental data) for clinical matrices, for providing advisory and specialized support in the field of pharmacology The specified technical result is achieved by the fact that the medicinal information and reference system contains computerized workstations of attending physicians equipped with input / output devices and connected via a network to a message controller with a request input subsystem related to the medicinal product, or to a diagnosis unit established by the attending physician related with a block of information about the forms of standards of non-specific and specific treatment standards of non-specific and specific treatment and with a block of information about dogs and methods of treatment, a block of general information related to drugs containing for each drug its synonyms and description, a block for reflecting the actions of drugs, containing for each drug information about the active substance, clinical and pharmacological action and pharmacological group, information block on the use of drugs, containing for each drug information on the use, indications and dosage, a block of information on contraindications x, reflecting for each drug side effects in indicating their symptoms and syndromes with respect to the anatomical object, as well as a block with information about the chemical composition of drugs and their release form, with the information in each block presented in the form of fields, in each of which the specified information in the form of digital data is entered through a centralized input device, and the fields are interconnected by means of a differential diagnostic matrix made with a logical selection function from each th block of information of the fields which coincide with the information of reference in the corresponding user's request, or in accordance with established diagnosis of the attending physician and the chosen method or a method of treatment of the block of information forms standards nonspecific and specific treatment of nonspecific and specific treatment standards, and These features are significant and are interconnected with the formation of a stable set of essential features sufficient to obtain the desired technical result.

Description of the figures of the drawings

The present invention is illustrated by a specific example of execution, which, however, is not the only possible, but clearly demonstrates the possibility of achieving the desired technical result.

In FIG. 1 shows a block diagram of a medicinal information and reference system for providing information about drugs.

The best embodiments of the invention

According to the present invention, there is considered an automated information-intellectual reference system for selecting, comparing, analyzing the possibilities of prescribing diagnostic drugs among themselves and for complaints, symptoms, syndromes, instrumental-laboratory findings, differential diagnoses and prescribed forms of treatment in any ratio on-line .

The peculiarity of such a system is that it can function as an autonomous system, which allows you to input the data into the search apparatus either by the name of the drug or by the treatment method or other initial data. Such a system can be integrated into a general clinical research system, for example, into that described in RU -N ° 106013. In this clinical information system, the results related to the diagnosis are structured related to the choice of treatment method and pharmacological support of this treatment method. Such a well-known system includes a database of diagnoses regarding which the differential diagnostic matrix performs the function of logical selection in the drug system from the general database of information about drugs RU2013 / 000171

8 information about a specific medicinal product with a reflection of its relationship with other drugs prescribed in the complex for the implementation of the method or method of treatment chosen by the attending physician.

The medicinal information and reference system (Fig. 1) contains a database of medicinal preparations 1, to which three subsystems are connected via a common bus. The first subsystem is the communication through the controller with the clinical research system 2, in particular, referring to the example of the implementation of such a system from RU N2 106013, then with the block of the diagnosis established by the attending physician associated with the block of information about the forms of non-specific and specific treatment standards for non-specific and specific treatment and with a block of information about the methods and methods of treatment. When establishing a diagnosis and choosing a treatment method, the attending physician receives a complete picture of the list of medicines used for this method and their relation to each other for the possibility of choosing a set of drugs that will not have mutual suppression. The second subsystem 3 is an information and reference part containing the following blocks: block 4, containing information on the pharmacological actions of drugs, presented in the form of a set / ditch of text materials or files, block 5 of drug indications, which is associated with block 6 of the clinical description of the patient of the system clinical studies 2, block 7 information on the use of drugs, presented in the form of a set / ditch of text materials or files, block 8 information on dosages of the use of drugs of drugs, presented in the form of sets of text materials or files, block 9 with information about side effects related to the consequences of the use of drugs, and block 10 with information about contraindications for drugs.

The blocks included in the second subsystem 3 are connected through the controller with the device / you 11 input information from various sources. Block 4 is replenished with text documents from medical directories 12, related, including to diagnoses and pathogenesis, block 5 is replenished with documents from medical directories 13 for clinical symptoms and information on diagnoses in accordance with ICD-X 14, block 7 and block 8 are replenished with text documents from medical directories 15, which describe the use and dosage of the use of drugs, block 9 and block 10 are updated with information from source 13.

The third subsystem 16 is a comparative analytical part, which includes block 17 with information about pharmacological preparations that are incompatible with each selected drug, presented in the form of sets of text materials or files, block 18 with information about pharmacological drugs that weaken one of actions 19 of each individual selected drug, presented in the form of sets of text materials or files, block 20 with pharmacological information x drugs that enhance one of the actions 21 of each individual selected drug, presented in the form of sets of text materials or files, and block 22 of general information related to drugs, containing for each drug its synonyms and description, which is a database of pharmacological information .

Saturation and replenishment of information in blocks 17, 18, 20 is carried out through an input device from medical directories 23 in pharmacology, known by digitizing text materials and presenting them in a machine-readable form. Each block of the second and third parts, in fact, is a database with their constant replenishment, corresponding to the pace of the emergence of new drugs and descriptions of them for use.

In the General case, the medicinal information and reference system (Fig. 1) contains a block reflecting the actions of drugs, containing for each drug information about the current substance, clinical and pharmacological action and pharmacological group, a block of information on the use of drugs, containing for each drug information on the use, indications and dosage, a block of information on contraindications, reflecting side effects for each drug, indicating their symptoms and syndromes with respect to to the anatomical object, as well as a block with information about the chemical composition of drugs and their release form.

The medicinal information and reference system can be an autonomously working system, the replenishment of which is carried out centrally in the remote access mode, such as the work of the information and legal systems "Grant" and "Code".

The information in each block is presented in the form of fields, in each of which the specified information in the form of digital data is entered through a centralized input device or through separate input devices. The indicated fields are interconnected by means of a differential diagnostic matrix performed with the function of logical selection from each block of information from the fields that match the information entered in the corresponding user request or in accordance with the diagnosis established by the attending physician and the selected treatment method or method from the information block on the forms of standards for non-specific and specific treatment standards for non-specific and specific treatment. The functioning of such a matrix is described in RU JV ° 106013. This matrix allows you to raise all the information related to the use of this drug from the blocks when entering the name of the drug. And when clarifying the request in accordance with the diagnosis, this information becomes directed and shows the picture of the use of the pharmacological agent specifically for the chosen treatment method and taking into account previous practice and personal indications of the patient. Information about the drug is formalized in the system according to the sections of data ratios in any language group:

1. general information (synonyms and description): synonyms (language and name) and description

2. action (active substance, pharmacological group, clinical and pharmacological action): active substance (name); pharmacological group (name); clinical and pharmacological action (name, anatomical object, description);

3. application (indication, compatibility, dosing);

- indication (diagnosis, symptom, syndrome, anatomical object);

compatibility (drug, group, type of compatibility, interaction);

- dosing (diagnosis, symptom, syndrome, age group, dose, unit);

4. contraindications and side effects:

- contraindications (diagnosis, symptom, syndrome, anatomical object, pharmacological group, drug, degree of contraindications);

- side effects (symptom, syndrome, anatomical object);

5. chemical composition, form of the drug:

- chemical composition (form of the preparation, name of the form, substance, unit of measure, content);

- form of the preparation (form of the preparation, name of the form).

Below is the structure of the fields on the example of one of the drugs

Pharmacology Botox

a drug

(register

th name)

International botulinum name for type A toxin

Synonyms of Botux, boxing,

Active Gemmagluti substance NIN- type A botulinum toxin complex

Pharmacology muscle relaxant es th group you

Class CLASS VI. diseases DISEASES

NERVOUS

SYSTEMS

(G00-G99)

By Nervous, anatomical muscular system exposure

Clinical Neurology, Pharmacological Psychiatry

action

Pharmacological Miorelaxan action t,

botulinum toxin A

Pharmacokineti blocks transmission

ADC at synapses

Ampoule Forms Tablets Creams, suppositories capsule capsules and ampoules of the drug, gels, ly

ointment powders

Diagnoses Spasmodic torticollis, hemifascial spasm,

Grow Syndromes Syndrome Symptom Diagnosis

Indications

s paralytic groups

strabismus,

Symptoms of local muscle spasm

Dosage and Administration Diagnosis Symptom Symptom Age

reception s

groups

Adverse diagnosis Syndrome symptom

is an autonomously working system, then communication with it is carried out through computerized workplaces of attending physicians, which are equipped with input / output devices for generating a request and receiving a response in the form of information displayed on the monitor screen, and messages connected via the network to the controller with the request input subsystem, related to the drug. If this medicinal information and reference system is integrated into the clinical system, then its connection is made with the unit of diagnosis established by the attending physician, associated with the unit of information about the forms of standards for non-specific and specific treatment of the standards of non-specific and specific treatment and with the unit of information about the methods and methods of treatment.

The drug system of FIG. 1 provides an automated analysis of indications, contraindications, compatibility, dosage, side effects of drug interactions of pharmacological, homeopathic, herbal, mineral and other forms of drugs with each other, as well as in any ratio with symptoms, syndromes, instrumental and laboratory findings, differential diagnoses and other methods of therapeutic effects on-line.

The system allows in an automated online mode:

- to analyze the prescribed medications according to indications, contraindications, compatibility, dosage, side effects, on identified complaints, medical history, symptoms, syndromes, instrumental and laboratory findings, differential diagnoses, nutritional supplements, food, drinks and other methods of medical treatment in it online mode;

- to compare many drugs with each other and at the same time with the main and concomitant diagnoses on-line;

- analyze drug interactions according to indications, contraindications, compatibility, side effects, dosage, etc. in on-line mode;

conduct drug comparisons on the action (interaction) of pharmacological preparations with biological and non-pharmacological methods of treatment on-line;

- search for drugs by symptom, syndrome, diagnosis, group of diseases and / or diagnoses, by clinical and pharmacological action, anatomical object, etc. in on-line mode;

- prompt, upon request, the method of interaction of drugs, clinical (laboratory) changes and body reactions to the drug, clarify the change in individual characteristics of the dosage of drugs on-line;

- when introducing complaints, anamnesis, symptoms of a clinical examination, differential diagnoses, determine the occurrence of possible reactions of interaction of drugs prescribed by different specialists (strengthening and / or weakening, neutralization active substances), side effects (development of clinical symptoms and syndromes) on-line;

- warn medical doctors about the incompatibility of prescribed drugs with each other and with diagnoses and symptoms (syndromes) detected on-line;

- warn specialist doctors about contraindications when prescribing drugs, according to the patient’s diagnoses previously issued by other specialists on-line;

- prompt the ratio in time of taking several drugs on-line;

- take into account age-related characteristics when prescribing several drugs with the main and concomitant diagnoses on-line;

- when prompted, get data on the characteristics of the reception, dosage and storage of drugs on-line.

Claims

Claim

A medicinal information and reference system, characterized in that it contains computerized workstations of attending physicians equipped with input / output devices and connected via a network to a message controller with a query input subsystem related to a medicinal product, or to a unit established by the attending physician with a diagnosis associated with the unit information about the forms of standards of non-specific and specific treatment standards of non-specific and specific treatment and with a block of information about methods and methods of treatment, b ok general information related to drugs, containing for each drug its synonyms and description, a unit for reflecting the actions of drugs, containing for each drug information on the active substance, clinical and pharmacological action and pharmacological group, a block on the use of drugs, containing for each drug information on the use, indications and dosage, a block of information on contraindications, reflecting for each side effects in the indication of their symptoms and syndromes in relation to the anatomical object, as well as a block with information about the chemical composition of the drugs and their release form, while the information in each block is presented in the form of fields, each of which contains the specified information in the form of digital data entered through a centralized input device, and the fields are interconnected by means of a differential diagnostic matrix made with the function of logical selection from each block of information from the field d, which coincide with the information provided in the corresponding request of the user or in accordance with the diagnosis established by the attending physician and the selected treatment method or method from the block of information about the forms of non-specific and specific treatment standards of non-specific and specific treatment standards.