JP5359542B2 - Medical office support program, medical office support apparatus, and medical office support method - Google Patents

Description

  The present invention relates to a medical office support program, a medical office support apparatus, and a medical office support method, and more particularly, to a medical office support program, a medical office support apparatus, and a medical office support method that handle a patient's weight as information.

  In medical practice, especially when the patient is a child, weight is important information. For example, when prescribing, drugs and doses that can be prescribed based on body weight are determined. Accordingly, in medical institutions, the weight of the examinee is entered in a medical reception receipt form or an inquiry form (medical chart) issued from the reception.

  In addition, the technique which displays the graph which overlap | superposed the measured patient's weight and the standard growth curve is conventionally known (for example, refer patent documents 1 and 2).

JP 2003-61934 A JP 2008-232777 A

  When the examinee is a child, the weight change rate during a predetermined period is large, so it is desirable to measure the weight at each visit. However, there is a problem that measuring the weight of a child at each medical examination is a difficult task for parents and the like. It should be noted that simply omitting the child's weight measurement has been problematic in view of the impact on medical care.

  One embodiment of the present invention has been made in view of the above points, and a medical office work support program, a medical office work support apparatus, and a medical office work support apparatus that can reduce the number of times a patient is measured without significantly affecting medical care. The purpose is to provide a medical office support method.

In order to solve the above-mentioned problem, according to an embodiment of the present invention, a computer includes a previous weight extracting unit that extracts a weight of a previously measured patient from a measurement information storage unit that stores a weight of the previously measured patient; Standard weight extraction means for extracting the standard weight corresponding to the age of the examinee on the visit date of the patient from the standard weight information storage means storing the standard weight for each age, the weight of the examinee measured last time, and the current visit date When the difference between the patient's standard weight and the patient's standard weight exceeds a threshold, the output means adds a predetermined message to the output and outputs the message . If it is not within a predetermined range from the standard weight of the examinee on the measurement date, it is a medical office work support program that outputs a message prompting weight measurement in addition to the output .

  In addition, what applied the component, the expression, or arbitrary combinations of the component of one Embodiment of this invention to a method, an apparatus, a system, a computer program, a recording medium, a data structure, etc. is also effective as an aspect of this invention. .

  As described above, according to an embodiment of the present invention, it is possible to reduce the number of times a patient is measured for weight without greatly affecting medical care.

It is a system configuration diagram of an example of a medical office work support system of the present embodiment. It is a hardware block diagram of an example of the computer system which implement | achieves a client. It is a processing block block diagram of the reception machine as an example of a client. It is a process block block diagram of the medical chart input machine as an example of a client. It is a processing block block diagram of an example of a measurement frequency control part. It is a flowchart showing the processing procedure of the reception machine. It is a block diagram of an example of a consultation information table. It is a block diagram of an example of a measurement information table. It is a block diagram of an example of a standard height / weight table. It is a graph of an example of a standard growth curve. It is a block diagram of an example of a threshold value table. It is a block diagram of an example of a message table. It is an image figure of an example of the reservation information screen containing the message which prompts a measurement. It is an image figure of an example of the medical treatment reception slip containing the message which urges measurement. It is a flowchart showing the processing procedure of the medical chart input machine. It is an image figure of an example of the medical chart screen after selecting the examinee including the message for prompting the measurement. It is an image figure of an example of a medical chart input screen.

  Next, modes for carrying out the present invention will be described based on the following embodiments with reference to the drawings.

  FIG. 1 is a system configuration diagram of an example of a medical office support system according to the present embodiment. In the medical office support system 1 of FIG. 1, a plurality of clients 10 and a database (DB) server 12 are connected via a network 14 such as a LAN so that data communication is possible. The client 10 corresponds to a reception machine and a chart input machine, which will be described later. The DB server 12 manages information of various tables such as a consultation information table, a measurement information table, a standard height / weight table, a message table, and a threshold table, which will be described later. The DB server 12 provides information on each table based on a request from the client 10, and updates information on each table based on a request from the client 10.

  FIG. 2 is a hardware configuration diagram of an example of a computer system that implements a client. As shown in FIG. 2, the hardware of the client 10 is realized by a computer system, for example. The client 10 in FIG. 2 includes an input device 21, an output device 22, a drive device 23, an auxiliary storage device 24, a main storage device 25, an arithmetic processing device 26, and an interface device 27 that are connected to each other via a bus B.

  The input device 21 is a keyboard or a mouse. The input device 21 is used for inputting various signals. The output device 22 is a display device, a printer device, or the like. The output device 22 is used to display or print various windows and data. The interface device 27 is a modem, a LAN card, or the like. The interface device 27 is used for connecting to the network 14.

  The medical office work support program of this embodiment is at least a part of various programs for controlling the client 10. The medical office work support program is provided by distributing the recording medium 28 or downloading it from the network 14.

  The recording medium 28 on which the medical office support program is recorded is information such as a CD-ROM, a flexible disk, a magneto-optical disk, etc., a recording medium for recording information optically, electrically or magnetically, a ROM, a flash memory, etc. Various types can be used such as a semiconductor memory that electrically records data.

  When the recording medium 28 on which the medical office support program is recorded is set in the drive device 23, the medical office support program is installed from the recording medium 28 into the auxiliary storage device 24 via the drive device 23. The medical office support program downloaded from the network 14 is installed in the auxiliary storage device 24 via the interface device 27.

  The auxiliary storage device 24 stores the installed medical office support program and also stores necessary files, data, and the like. The main storage device 25 reads and stores the medical office support program from the auxiliary storage device 24 when the medical office support program is activated. The arithmetic processing unit 26 implements various processing blocks as will be described later in accordance with a medical office support program stored in the main storage device 25.

  FIG. 3 is a processing block configuration diagram of a reception machine as an example of a client. The receiving machine 10A in FIG. 3 includes a reception processing unit 31 and a measurement frequency control unit 32. The reception processing unit 31 and the measurement frequency control unit 32 are realized by the arithmetic processing device 26 executing a medical office work support program. The measurement frequency control unit 32 is a subroutine called from the reception processing unit 31, for example.

  FIG. 4 is a processing block configuration diagram of a medical record input machine as an example of a client. The chart input machine 10B of FIG. 4 has a chart input processing unit 41 and a measurement frequency control unit 42. The chart input processing unit 41 and the measurement frequency control unit 42 are realized by the arithmetic processing unit 26 executing a medical office work support program. The measurement frequency control unit 42 is a subroutine called from the chart input processing unit 41, for example.

  Note that the measurement frequency control unit 32 of the receiving machine 10A and the measurement frequency control unit 42 of the medical chart input machine 10B have similar processing blocks. Here, as an example, a processing block of the measurement frequency control unit 32 of the receiving machine 10A will be described.

  FIG. 5 is a processing block configuration diagram of an example of the measurement frequency control unit. The measurement frequency control unit 32 of FIG. 5 includes a previous weight extraction unit 51, a standard weight extraction unit 52, a weight comparison unit 53, a threshold excess determination unit 54, and a message addition unit 55. Details of the processes of the previous weight extraction unit 51, the standard weight extraction unit 52, the weight comparison unit 53, the threshold excess determination unit 54, and the message addition unit 55 shown in FIG. 5 will be described later.

  FIG. 6 is a flowchart showing the processing procedure of the accepting machine. Proceeding to step S1, the previous weight extraction unit 51 obtains the patient ID read from, for example, the examination ticket of the examinee at the time of accepting the medical treatment. The previous weight extraction unit 51 searches for a past consultation date from the consultation information table 60 as shown in FIG. 7 using the patient ID as a key.

  FIG. 7 is a configuration diagram of an example of a consultation information table. The consultation information table 60 shown in FIG. 7 includes patient ID, consultation date, consultation time, entrance / exit classification, clinical department, ward, hospital room, clinical classification, comment, update date, update time, and updater as items.

  Further, the previous weight extraction unit 51 searches past measurement information from the measurement information table 70 as shown in FIG. 8 using the patient ID as a key. FIG. 8 is a configuration diagram of an example of the measurement information table. The measurement information table 70 in FIG. 8 includes patient ID, measurement date, measurement time, measurement item, measurement result, update date, update time, and updater as items. The previous weight extraction unit 51 extracts the weight of the examinee who has recently measured (previous measurement) from the retrieved past measurement information.

  In step S2, the standard weight extraction unit 52 extracts the standard weight corresponding to the age of the examinee from the standard height / weight table 80 as shown in FIG. The age of the examinee referred to here is the age of the previous measurement date and the current consultation date. FIG. 9 is a configuration diagram of an example of a standard height / weight table. The standard height / weight table 80 in FIG. 9 has items of age, month, category, and standard value. The standard height / weight table 80 in FIG. 9 is created from standard growth curves 90 and 91 as shown in FIG.

  FIG. 10 is a graph of an example of a standard growth curve. FIG. 10 includes a standard growth curve 90 for weight and a standard growth curve 91 for height. FIG. 10 includes growth curves with SD values of −2SD, −1SD, + 1SD, and + 2SD for the standard growth curve 90 for body weight and the standard growth curve 91 for height, respectively. SD is a standard deviation.

  In step S3, the weight comparison unit 53 determines the weight of the examinee measured last time, the standard weight corresponding to the age of the previous measurement day of the examinee (hereinafter referred to as the standard weight of the measurement day), and the current visit date of the examinee. The standard weight corresponding to the age of the month (hereinafter referred to as the standard weight on the visit date) is compared. In step S4, the weight comparison unit 53 determines whether or not the weight of the examinee measured last time is within a predetermined range from the standard weight on the measurement day (for example, the SD value is within −2SD to + 2SD).

  A point 92 in FIG. 10 represents an example in which, for example, a weight of 10 kg is measured last time for a patient who is 1 year and 9 months old. When the body weight of the examinee previously measured is 10 kg, it is determined that the weight is within a predetermined range from the standard weight on the measurement day. Further, a point 93 in FIG. 10 represents an example in which the body weight measured last time of the examinee who is 1 year and 9 months old is 15 kg. When the body weight of the examinee previously measured is 15 kg, it is determined that it is not within the predetermined range from the standard weight on the measurement day.

  When it is determined that the previously measured patient weight is within the predetermined range from the measurement day standard weight, the threshold excess determination unit 54 proceeds to step S5, and the last measured patient weight and the consultation day standard weight It is determined whether the difference between the two exceeds a threshold value. The threshold value is acquired from, for example, a threshold value table 100 as shown in FIG. FIG. 11 is a configuration diagram of an example of the threshold value table. Although the threshold value table 100 of FIG. 11 represents the threshold value in kilograms (kg), it may be expressed as an SD value or the like.

  For example, when the standard weight is 11.6 kg at 2 years and 0 months, 12.1 kg at 2 years and 3 months, 12.7 kg at 2 years and 6 months, and the threshold value is 1 kg, the determination in step S5 is performed as follows. Is called. Assume that the weight of the examinee measured at the age of 2 years and 0 months was 11.5 kg (-0.1 kg).

  When the same examinee visits at the age of 2 years and 3 months, the threshold excess determination unit 54 compares the weight of the examinee 11.5 kg measured last time with 12.1 kg which is the standard weight of 2 years and 3 months. Since the difference between the weight of the examinee measured last time and the standard weight of 2 years and 3 months is −0.6 kg, the threshold value excess determination unit 54 determines that the threshold value 1 kg is not exceeded.

  When the same examinee visits at the age of 2 years and 6 months, the threshold excess determination unit compares the 11.5 kg body weight of the examinee measured last time and the standard weight of 2 years and 6 months, which is 12.7 kg. Since the difference between the weight of the examinee measured last time and the standard weight of 2 years and 6 months is −1.2 kg, the threshold excess determination unit 54 determines that the threshold exceeds 1 kg.

  When it is determined that the difference between the weight of the examinee measured last time and the standard weight of the visit date corresponding to the age of the examinee does not exceed the threshold value, the message adding unit 55 proceeds to step S6, and no message is added. Is notified to the reception processing unit 31. The reception processing unit 31 displays a reservation information screen on the output device 22. In addition, the reception processing unit 31 proceeds to step S <b> 7 and issues a medical reception receipt form from the output device 22.

  On the other hand, if it is determined that the difference between the weight of the examinee measured last time and the standard weight of the consultation date corresponding to the age of the examinee exceeds the threshold, the message adding unit 55 proceeds to step S8. If it is determined in step S4 that the previously measured patient's weight is not within the predetermined range from the standard weight on the measurement day, the message adding unit 55 proceeds to step S8.

  In step S8, the message adding unit 55 acquires the message contents from the message table 110 as shown in FIG. FIG. 12 is a configuration diagram of an example of a message table. The message table 110 in FIG. 12 includes a message ID and message content as items. The message table 110 in FIG. 12 is an example in which the message content for the accepting machine 10A is different from the message content for the medical record input machine 10B.

  For example, the message content of the message ID “M001” is used for the accepting machine 10A. The message content of the message ID “M002” is used for the chart input machine 10B. The message adding unit 55 notifies the reception processing unit 31 of the acquired message content (message for prompting measurement). In this example, the message prompts the body weight measurement. However, the message may simply indicate that the previous measurement value is not within the predetermined range from the measurement standard weight.

  The reception processing unit 31 displays on the output device 22 a reservation information screen including a message for prompting the measurement notified from the measurement frequency control unit 32. FIG. 13 is an image diagram of an example of a reservation information screen including a message for prompting measurement. The reservation information screen 120 shown in FIG. 13 includes a message 121 that prompts measurement. Therefore, operators such as the examiner and the guardian who are operating the receiving machine 10A can understand that height and weight measurements are necessary.

  In step S <b> 9, the reception processing unit 31 issues a medical treatment reception slip including a message for prompting the measurement notified from the measurement frequency control unit 32. FIG. 14 is an image diagram of an example of a medical reception slip including a message for prompting measurement. A medical reception slip 130 shown in FIG. 14 includes a message 131 that prompts measurement. Therefore, the examinee, the guardian, the hospital staff, and the like who see the medical treatment receipt form 130 can understand that height and weight measurement are necessary.

  FIG. 15 is a flowchart showing the processing procedure of the chart input machine. Since the measurement frequency control unit 42 of the medical record input device 10B has the same processing blocks as the measurement frequency control unit 32 of the receiving device 10A as described above, description will be made using the processing blocks of FIG.

  Proceeding to step S11, the previous weight extraction unit 51 acquires the patient ID read from the reservation information, for example, when selecting the examinee (patient). The previous weight extraction unit 51 searches for a past consultation date from the consultation information table 60 as shown in FIG. 7 using the patient ID as a key.

  Further, the previous weight extraction unit 51 searches past measurement information from the measurement information table 70 as shown in FIG. 8 using the patient ID as a key. The previous weight extraction unit 51 extracts the weight of the examinee who has recently measured (previous measurement) from the retrieved past measurement information. In step S12, the standard weight extraction unit 52 extracts the measurement date standard weight and the consultation date standard weight corresponding to the age of the examinee from the standard height / weight table 80 as shown in FIG. In step S13, the weight comparison unit 53 compares the weight of the examinee measured last time with the measurement date standard weight and the consultation date standard weight corresponding to the age of the examinee.

  In step S14, the weight comparison unit 53 determines whether or not the weight of the examinee measured last time is within a predetermined range from the standard weight on the measurement day (for example, the SD value is within −2SD to + 2SD). When it is determined that the weight of the examinee measured last time is within the predetermined range from the standard weight on the measurement day, the threshold excess determination unit 54 proceeds to step S15, and the weight of the examinee measured last time and the standard weight on the consultation date are determined. It is determined whether the difference exceeds a threshold value. The threshold is acquired from, for example, a threshold table 100 as shown in FIG.

  If it is determined that the difference between the weight of the examinee measured last time and the standard weight of the visit date does not exceed the threshold value, the message adding unit 55 proceeds to step S16 and notifies the medical record input processing unit 41 that no message is added. Notice. The chart input processing unit 41 displays a chart screen after selecting the examinee on the output device 22.

  On the other hand, if it is determined that the difference between the weight of the examinee measured last time and the standard weight of the visit date exceeds the threshold, the chart input processing unit 41 proceeds to step S17. If it is determined in step S14 that the previously measured patient's weight is not within the predetermined range from the standard weight on the measurement day, the chart input processing unit 41 proceeds to step S17.

  In step S17, the message adding unit 55 acquires the message contents from the message table 110 as shown in FIG. The message adding unit 55 notifies the chart input processing unit 41 of the acquired message content (message for prompting measurement). The chart input processing unit 41 displays on the output device 22 a chart screen 140 after selection of the examinee including a message for prompting the measurement notified from the measurement frequency control unit 42.

  FIG. 16 is an image diagram of an example of a medical record screen after selection of a examinee including a message for prompting measurement. The chart screen 140 after selecting the examinee shown in FIG. 16 includes a message 141 that prompts measurement. The message 141 for prompting the measurement is made conspicuous by, for example, highlighting or displaying it in a different color from other characters. Therefore, an operator such as a hospital staff who is operating the chart input machine 10B can understand that height and weight measurement are necessary.

  When the operator presses the button 142 on the chart screen 140 after selecting the examinee, the chart input processing unit 41 proceeds to step S18 and displays a chart input screen 150 as shown in FIG. FIG. 17 is an image diagram of an example of a chart input screen. The chart input screen 150 shown in FIG. 17 displays a character string 151 representing height and weight on the screen.

  The character string 151 representing height and weight is made conspicuous, for example, by highlighting or displaying it in a different color from other characters. The medical record input screen 150 may display a message prompting the measurement notified from the measurement frequency control unit 42. Therefore, a hospital staff or the like who sees the chart input screen 150 can understand that height and weight measurement is necessary.

  In this example, whether or not the previously measured patient's body weight can be applied to this visit is determined from comparison of the measured day standard body weight corresponding to the patient's age based on the standard growth curve and the visit day standard body weight By doing so, the weight measurement interval can be shortened when the growth is remarkable, and the weight measurement interval can be lengthened other than the time when the growth is remarkable. For this reason, in the present embodiment, the number of times the patient's weight is measured can be reduced without greatly affecting the medical treatment.

  The present invention is not limited to the specifically disclosed embodiments, and various modifications and changes can be made without departing from the scope of the claims. The previous weight extracting means described in the claims corresponds to the previous weight extracting section 51, the standard weight extracting means corresponds to the standard weight extracting section 52, the output means is the weight comparing section 53, and the threshold excess determining section 54. , Message adding unit 55, reception processing unit 31, and chart input processing unit 41.

DESCRIPTION OF SYMBOLS 1 Medical office support system 10 Client 10A Reception machine 10B Chart input machine 12 Database (DB) server 14 Network 21 Input device 22 Output device 23 Drive device 24 Auxiliary storage device 25 Main storage device 26 Arithmetic processing device 27 Interface device 28 Recording medium 31 Reception processing unit 32 Measurement frequency control unit 41 Medical record input processing unit 42 Measurement frequency control unit 51 Previous weight extraction unit 52 Standard weight extraction unit 53 Weight comparison unit 54 Overthreshold determination unit 55 Message addition unit 60 Medical examination information table 70 Measurement information table 80 Standard height / weight table 90 Standard growth curve for weight 91 Standard growth curve for height 92, 93 points 100 Threshold table 110 Message table 120 Reservation information screen 121, 131, 141 Message 130 Medical reception Vote 140 Chart screen after selecting examinee 142 Button 150 Chart input screen 151 Character string representing height and weight B Bus

Claims (3)

Computer
Previous weight extraction means for extracting the weight of the last measured patient from the measurement information storage means for storing the weight of the last measured patient;
A standard weight extraction means for extracting a standard weight corresponding to the age of the examinee on the current consultation date from a standard weight information storage means storing a standard weight for each age;
When the difference between the weight of the examinee measured last time and the standard weight of the examinee on this visit date exceeds the threshold, it functions as an output means that adds a predetermined message to the output and outputs it ,
The output means adds a message for prompting weight measurement to the output and outputs the weight if the weight of the examinee measured last time is not within a predetermined range from the standard weight of the examinee on the previous measurement date. . Previous weight extraction means for extracting the weight of the last measured patient from the measurement information storage means for storing the weight of the last measured patient;
A standard weight extraction means for extracting a standard weight corresponding to the age of the examinee on the current consultation date from a standard weight information storage means storing a standard weight for each age;
And examinees weight measured last time, when the difference between the normal weight of the testee during the current visit date exceeds the threshold value, possess and output means for outputting the added output a predetermined message,
The output means is a medical office support apparatus that outputs a message prompting weight measurement to the output if the weight of the examinee measured last time is not within a predetermined range from the standard weight of the examinee on the previous measurement date . A medical office support method executed by a computer,
The computer is
A previous weight extraction step of extracting the weight of the last measured patient from the measurement information storage means storing the weight of the last measured patient;
A standard weight extraction step for extracting a standard weight corresponding to the age of the examinee on the current consultation date from a standard weight information storage means storing a standard weight for each age;
An output step of adding a predetermined message to the output and outputting when the difference between the weight of the examinee measured last time and the standard weight of the examinee on the current visit date exceeds a threshold ;
In the output step, if the weight of the examinee measured last time is not within a predetermined range from the standard weight of the examinee on the previous measurement date, a medical office support method for adding and outputting a message prompting weight measurement to the output .

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