JP5870764B2 - Electronic medical record device - Google Patents

Description

  The present invention relates to an electronic medical chart apparatus.

  In recent years, digitization of documents such as electronic medical records and receipts has been progressing in medical facilities. The electronic medical record stores, manages and manages the information such as the patient's medical condition and prescription described in the paper medical chart in an electronic form. In the electronic medical record, medical record information is recorded, examination order information is issued, medical accounting system (receipt computer) is notified of treatment and prescription contents.

  In order to simplify the operation in the electronic medical record, for example, when the pointer is positioned on any of the plurality of display buttons corresponding to various medical items, the display of the display button where the pointer is positioned is changed to the display button. A technique for switching to display of display buttons corresponding to other medical items associated in advance has been proposed (see Patent Document 1).

JP 2005-250846 A

  However, in the above prior art, only the function related to the designated medical care item is displayed, and finally, the user has to select a desired medical care item from the function. In addition, when generating examination order information for an X-ray imaging apparatus or an ultrasonic diagnostic apparatus, it is necessary to adjust the imaging region and various parameters, which places a heavy burden on the user.

  Further, at the time of comparative interpretation, it is desirable that the shooting conditions and image processing conditions of both images to be compared are the same. In this way, even when it is desired to generate inspection order information under the same imaging conditions and the same image processing conditions as in the past inspection image, the imaging conditions and image processing conditions must be set with reference to the past inspection order information. It was a complicated task.

  The present invention has been made in view of the above problems in the prior art, and an object of the present invention is to reduce a user's operation burden in generating inspection order information.

  In order to solve the above-mentioned problem, the invention according to claim 1 is directed to medical chart information including examination-related images and / or examination items created for each patient, examination-related images for each examination, and / or Storage means for storing examination order information associated with the examination item, past medical chart information of the patient to be examined is acquired from the storage means, and a first screen including the acquired past medical chart information is displayed. And a second screen for inputting the current chart information of the patient to be examined is displayed on the display means, and is included in the past chart information displayed on the first screen by the pointing device. When an inspection-related image or inspection item is dragged and dropped onto the second screen, the inspection order information associated with the inspection-related image or inspection item is An electronic device comprising: control means for acquiring from the storage means, generating the same inspection order information as the acquired inspection order information, and transmitting the generated inspection order information to the inspection apparatus corresponding to the generated inspection order information. It is a medical chart device.

  According to a second aspect of the present invention, in the electronic medical chart apparatus according to the first aspect, the inspection device is an X-ray image photographing device, and the inspection order information includes an imaging region, the number of images, an imaging condition, an image Processing conditions are included.

  According to a third aspect of the present invention, in the electronic medical chart apparatus according to the first aspect, the inspection apparatus is an ultrasonic diagnostic apparatus, and the inspection order information includes an imaging region, an imaging condition, and an image processing condition. It is.

  According to a fourth aspect of the present invention, in the electronic medical chart apparatus according to the third aspect, the imaging conditions include a probe, a focus, and a dynamic range.

  According to a fifth aspect of the present invention, in the electronic medical chart apparatus according to any one of the first to fourth aspects, the control means is related to examinations included in past medical chart information displayed on the first screen. When an image or an inspection item is dragged and dropped onto the second screen, the display means displays the same inspection order information as the inspection order information associated with the inspection-related image or inspection item, and the display means A change instruction from the operation means for the inspection order information displayed on the screen is accepted.

  ADVANTAGE OF THE INVENTION According to this invention, the operation burden of the user in the production | generation of inspection order information can be reduced.

It is a system configuration figure of a diagnostic system. It is a block diagram which shows the functional structure of an electronic medical chart apparatus. It is a flowchart which shows the electronic medical chart assistance process performed in an electronic medical chart apparatus. It is an example of a medical chart information display screen. It is an example of a medical chart information display screen. It is an example of an inspection order information confirmation screen.

[Configuration of diagnostic system]
Embodiments of an electronic medical chart apparatus according to the present invention will be described below with reference to the drawings.
FIG. 1 shows a system configuration of the diagnostic system 1.
As shown in FIG. 1, the diagnosis system 1 includes a modality 10, an electronic medical chart device 20, and a medical image server 30, and each device is a communication network such as a LAN (Local Area Network). The data communication is possible via N1.
The diagnostic system 1 is connected to an analyzer 40 installed in the inspection company 2 via a communication network N2 such as the Internet so that data communication is possible.

The modality 10 captures a region to be diagnosed by a patient and digitally converts the captured image to generate image data. Further, the modality 10 generates incidental information attached to the image data based on the inspection order information and information input at the time of imaging. The incidental information includes patient information (patient ID, patient name, gender, age, date of birth, etc.), imaging conditions (modality type, imaging site, imaging direction, various parameters, etc.) and the like.
For example, the modality 10 attaches additional information to the image data, and generates DICOM-compliant image data in a DICOM file format that conforms to the DICOM (Digital Image and Communications in Medicine) standard.
As the modality 10, an X-ray imaging apparatus such as a CR (Computed Radiography) apparatus, an ultrasonic diagnostic apparatus (US), or the like is applicable.

  The electronic medical record device 20 is a computer device having an electronic medical record creation function and an image viewer function. The electronic medical chart device 20 generates medical record information recording medical practice for each patient and medical treatment, and issues examination order information.

  The medical image server 30 stores and manages the image data generated in the modality 10. As the medical image server 30, a PACS (Picture Archiving and Communication System) or the like is applicable. In response to an image data acquisition request from an external device, the medical image server 30 transmits the requested image data to the external device.

  The analyzer 40 analyzes (tests) a sample such as blood or urine collected from a patient, and generates test data as an analysis result. The analyzer 40 transmits the generated inspection data to the electronic medical chart apparatus 20 via the communication network N2. The inspection company 2 analyzes the sample brought in from each medical facility by the analyzer 40 in response to an inspection request from each medical facility, and provides inspection data as an analysis result.

In addition, the number of each apparatus which comprises the diagnostic system 1 is not specifically limited.
Further, the DICOM standard is generally used as a communication method in the diagnostic system 1, and DICOM MWM (Modality Worklist Management) and DICOM MPPS (Modality Performed Procedure Step) are used for communication between devices.

[Configuration of electronic medical chart device]
FIG. 2 shows a functional configuration of the electronic medical chart apparatus 20.
As shown in FIG. 2, the electronic medical chart apparatus 20 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, a RAM 25, a storage unit 26, and the like. ing.

  The control unit 21 includes a CPU (Central Processing Unit) and the like, and comprehensively controls processing operations of the respective units of the electronic medical chart apparatus 20. Specifically, the CPU reads various processing programs stored in the storage unit 26 in accordance with an operation signal input from the operation unit 22 or an instruction signal received by the communication unit 24, expands the program in the RAM 25, and Various processes are performed in cooperation with the program.

  The operation unit 22 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 21 receives operation signals input by key operations or mouse operations on the keyboard. Output to.

  The display unit 23 includes a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 21.

  The communication unit 24 includes a network interface and the like, and transmits and receives data to and from external devices connected via the communication networks N1 and N2. For example, the communication unit 24 transmits the inspection order information to the modality 10 and the analyzer 40. In addition, the communication unit 24 receives image data obtained by imaging a patient with the modality 10 and examination data generated by analysis by the analyzer 40.

  The RAM 25 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 26 in various processes that are executed and controlled by the control unit 21.

  The storage unit 26 includes an HDD (Hard Disk Drive), a non-volatile memory, and the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. Specifically, the storage unit 26 stores an electronic medical chart support processing program P1, medical chart information, inspection order information, and the like.

  The electronic medical chart support processing program P1 is a program for realizing a function of generating medical chart information or issuing inspection order information.

The medical record information is information indicating the progress of medical treatment of the patient in the medical facility, and includes information such as a disease name, examination content, and prescription. Medical chart information is created for each patient and each visit. The medical chart information includes an examination-related image and / or an examination item for each examination.
The inspection related image is an image related to an inspection (imaging, analysis, etc.) performed based on the inspection order information. Examples thereof include image data of medical images (including thumbnail images) obtained by photographing with the modality 10, and graphs and tables showing examination data (analysis results) generated by the analyzer 40.
The inspection item is information indicating an inspection performed based on the inspection order information. Examples of examination items include X-ray simple imaging, ultrasonic examination, blood examination, urine examination, and the like.

  The inspection order information is information for requesting imaging in the modality 10 and analysis in the analyzer 40. The inspection order information is associated with an inspection-related image and / or inspection item for each inspection included in the medical chart information.

The inspection order information for the modality 10 includes the type of modality, the imaging region, the number of images, imaging conditions, image processing conditions, and the like.
For example, the examination order information for the X-ray imaging apparatus includes imaging regions (chest front, chest side or abdomen), the number of images, imaging conditions (irradiation dose, voltage, etc.), image processing conditions (frequency enhancement processing and gradation). Processing, etc.). In the X-ray imaging apparatus, imaging is performed according to the set imaging conditions, and the final diagnostic image is obtained by performing image processing on the captured images according to the set image processing conditions.

  The inspection order information for the ultrasonic diagnostic apparatus includes an imaging region, imaging conditions (probe used for inspection, focus, dynamic range, TGC, etc.), image processing conditions (speckle noise suppression processing, enhancement processing, etc.), and the like. . In the ultrasonic diagnostic apparatus, imaging is performed according to the set imaging conditions, and image processing is performed on the captured image according to the set image processing conditions.

  The inspection order information for the analyzer 40 includes inspection contents, inspection conditions, and the like.

The control unit 21 acquires past medical record information of the patient to be examined from the storage unit 26 and causes the display unit 23 to display a past medical record screen as a first screen including the acquired past medical record information.
The control unit 21 causes the display unit 23 to display the current chart screen as the second screen for inputting the current chart information of the patient to be examined.

  When the inspection-related image or the inspection item included in the past medical chart information displayed on the past medical chart screen is dragged and dropped on the current medical chart screen by the pointing device of the operation section 22, the control section 21 Inspection order information associated with inspection-related images or inspection items is acquired from the storage unit 26, inspection order information identical to the acquired inspection order information is generated, and the generated inspection order information is converted into the generated inspection order information. It transmits to a corresponding test | inspection apparatus (modality 10, analyzer 40).

  Specifically, when the examination-related image or examination item is dragged and dropped from the past chart screen to the current chart screen, the control unit 21 examines the examination-related image or examination item that has been dragged and dropped. The item is displayed on the current chart screen of the display unit 23. Then, based on the operation from the operation unit 22, the control unit 21 causes the display unit 23 to display the same inspection order information as the inspection order information associated with the inspection-related image or the inspection item. The control unit 21 receives a change instruction from the operation unit 22 for the inspection order information displayed on the display unit 23. The control unit 21 changes the inspection order information based on the change instruction, and transmits the changed inspection order information to the inspection device corresponding to the inspection order information.

[Operation of electronic medical record system]
Next, the operation in the electronic medical chart apparatus 20 will be described.
FIG. 3 is a flowchart showing an electronic medical chart support process executed in the electronic medical chart apparatus 20. This processing is realized by software processing in cooperation with the control unit 21 and the electronic medical record support processing program P1 stored in the storage unit 26.

  First, when a patient to be examined is designated by an operation from the operation unit 22 by the user, the control unit 21 stores past medical record information (for example, medical record information at the previous medical examination) from the storage unit 26. The acquired medical record screen including the acquired historical medical record information is displayed on the display unit 23, and the current medical record screen for inputting the current medical record information of the patient to be examined is displayed on the display unit 23. (Step S1).

FIG. 4 shows an example of a chart information display screen 231 displayed on the display unit 23.
The chart information display screen 231 includes a past chart screen 51 and a current chart screen 52. The past medical chart screen 51 includes examination-related images 53 and 54, diagnostic information 55 and 56, and examination items 57 and 58. Here, the examination-related image 53 is an image taken by “ultrasonic examination” indicated by the examination item 57. The examination-related image 54 is an image taken by “chest X-ray photography” indicated by the examination item 58.

  The user operates the pointing device of the operation unit 22 to select an inspection-related image or an inspection item included in the past medical chart information displayed on the past medical chart screen, which is related to the examination to be performed again. Drag and drop from the medical chart screen to the current medical chart screen (step S2). However, the examination-related images or examination items on the past chart screen continue to be displayed on the past chart screen even after being dragged and dropped.

  When the examination-related image or the inspection item included in the past medical chart information displayed on the past medical chart screen is dragged and dropped on the current medical chart screen by the pointing device of the operation unit 22, the control section 21 Inspection order information associated with the drag-and-drop inspection related image or inspection item is acquired from the storage unit 26, and inspection order information identical to the acquired inspection order information is generated (step S3).

  Next, the control unit 21 displays the inspection-related image or the inspection item corresponding to the inspection item dragged and dropped on the current chart screen of the display unit 23 (step S4). Here, the inspection order information generated in step S3 is associated with the inspection item added to the current chart screen by the control unit 21.

  For example, in the medical chart information display screen 231 shown in FIG. 4, the examination related image 53 or the examination item 57 included in the past medical chart information displayed on the past medical chart screen 51 is dragged and dropped on the current medical chart screen 52. In this case (arrows A1 and A2 shown in FIG. 4), the control unit 21 corresponds to the examination related image 53 and the examination item 57 on the current chart screen 52 as shown in the chart information display screen 232 of FIG. An inspection item 59 “ultrasonic inspection A mode” is added.

  Here, when the inspection item displayed on the current chart screen is double-clicked by operating the pointing device of the operation unit 22 (step S5; YES), the inspection-related image dragged and dropped in step S2 or The same inspection order information as the inspection order information associated with the inspection item is displayed on the display unit 23 (step S6).

  For example, in the medical chart information display screen 232 shown in FIG. 5, when the examination item 59 displayed on the current medical chart screen 52 is double-clicked by the pointing device of the operation unit 22, the control unit 21 displays the information shown in FIG. The inspection order information confirmation screen 233 shown is displayed on the display unit 23. The examination order information confirmation screen 233 includes a patient name display column 61, an age display column 62, a gender display column 63, a date of birth display column 64, a probe setting unit 65, a site setting unit 66, a gain setting unit 67, and a focus setting unit. 68, an edge enhancement setting unit 69, a noise reduction setting unit 70, a dynamic range setting unit 71, a TGC setting unit 72, and an OK button 73.

The patient name display column 61, age display column 62, gender display column 63 and date of birth display column 64 are acquired from the examination order information associated with the examination related image 53 or examination item 57 of the past medical chart screen 51. The patient's name, age, gender, and date of birth are displayed.
The past medical chart screen 51 is displayed on the probe setting unit 65, the part setting unit 66, the gain setting unit 67, the focus setting unit 68, the edge enhancement setting unit 69, the noise reduction setting unit 70, the dynamic range setting unit 71, and the TGC setting unit 72. The imaging conditions in the ultrasonic examination that are the same as the contents of the examination order information associated with the examination-related image 53 or the examination item 57 are displayed, and the setting contents and setting values can be changed by the operation from the operation unit 22. It has become.
The OK button 73 is a button that is pressed after confirming the details of the inspection order information on the inspection order information confirmation screen 233 or after changing the setting content or setting value. When the OK button 73 is pressed, the control unit 21 closes the inspection order information confirmation screen 233 and returns to the medical record information display screen 232 shown in FIG.

  When the control unit 21 receives a change instruction from the operation unit 22 for the inspection order information displayed on the display unit 23 (step S7; YES), the inspection order information is changed based on the change instruction ( Step S8).

  After step S8, when the inspection item displayed on the current chart screen is not double-clicked in step S5 (step S5; NO), or the operation unit for the inspection order information displayed on the display unit 23 in step S7 If there is no change instruction from the control unit 22 (step S7; NO), the control unit 21 determines whether or not there is an instruction to transmit the inspection order information by the operation from the operation unit 22 (step S7). S9).

  If there is an instruction to transmit the inspection order information (step S9; YES), the control unit 21 causes the inspection order information to correspond to the inspection order information (modality) via the communication unit 24. 10 and the analyzer 40) (step S10). Specifically, when the inspection order information is for requesting photographing at the modality 10, the inspection order information is transmitted to the modality 10. If the inspection order information is for requesting analysis by the analyzer 40, the inspection order information is transmitted to the analyzer 40.

For example, in the medical chart information display screen 232 shown in FIG. 5, when the order transmission button 60 is pressed by an operation from the operation unit 22, the control unit 21 sets an inspection item 59 “ultrasonic inspection A mode”. Corresponding inspection order information (the inspection order information identical to the inspection order information associated with the inspection-related image 53 or the inspection item 57. If the inspection order information is changed in step S8, the inspection order after the change Information.) Is transmitted to the modality 10 (ultrasound apparatus).
This completes the electronic medical record support process.

  As described above, according to the electronic medical chart apparatus 20 in the present embodiment, the examination-related image or the examination item included in the past chart information is dragged and dropped on the current chart screen, thereby relating to the past examination. Inspection order information identical to the inspection order information can be easily generated. As described above, since the inspection order information can be generated by an intuitive interface, it is possible to reduce a user's operation burden in generating the inspection order information.

  Further, by using the same inspection order information as in the past, it is not necessary to set the shooting conditions and image processing conditions, and the user's labor can be simplified. For example, the operation can be easily performed when issuing inspection order information for requesting photographing of an image for comparative interpretation.

  Further, by displaying the same inspection order information as the inspection order information associated with the inspection-related image or inspection item dragged and dropped from the past medical chart screen to the current medical chart screen, the user can The contents of the inspection order information can be confirmed and the contents can be changed.

  Note that the description in the above embodiment is an example of the electronic medical chart apparatus according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each part constituting the apparatus can be changed as appropriate without departing from the spirit of the present invention.

  For example, when the image is dragged in the above-described drag operation, parameters necessary for determining the image are transmitted, and when an examination item is dragged, only patient information is transmitted to the examination apparatus side. It is good. Furthermore, parameters for specifying trimming, rotation, and the like can be included in the parameters necessary for determining the image.

  In addition, when an examination-related image or examination item included in past chart information is dragged and dropped from a past chart screen to the current chart screen, examination order information associated with the examination-related image or examination item is transmitted. The inspection order information may be transmitted to the inspection apparatus corresponding to the inspection order information without waiting for an instruction to do so.

  In the above description, an example in which an HDD or a non-volatile memory is used as a computer-readable medium storing a program for executing each process is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave may be applied as a medium for providing program data via a communication line.

DESCRIPTION OF SYMBOLS 1 Diagnosis system 2 Inspection company 10 Modality 20 Electronic medical record apparatus 21 Control part 22 Operation part 23 Display part 24 Communication part 25 RAM
26 Storage Unit 30 Medical Image Server 40 Analyzer 51 Past Medical Record Screen 52 Current Medical Record Screen 53, 54 Examination Related Images 55, 56 Diagnostic Information 57, 58 Examination Item 59 Examination Item 60 Order Send Button 231 Medical Record Information Display Screen 232 Information display screen 233 Inspection order information confirmation screen N1 communication network N2 communication network P1 Electronic medical record support processing program

Claims (5)

Storage means for storing medical chart information including examination-related images and / or examination items for each examination created for each patient, and examination order information associated with the examination-related images and / or examination items for each examination When,
For obtaining past medical chart information of a patient to be examined from the storage means, displaying a first screen including the obtained past medical chart information on the display means, and inputting current medical chart information of the patient to be examined When the second screen is displayed on the display means, and an examination-related image or examination item included in the past medical chart information displayed on the first screen is dragged and dropped onto the second screen by the pointing device. The inspection order information associated with the inspection-related image or the inspection item is acquired from the storage unit, the inspection order information identical to the acquired inspection order information is generated, and the generated inspection order information is generated. Control means for transmitting to the inspection device corresponding to the inspection order information;
An electronic medical chart device comprising: The inspection apparatus is an X-ray imaging apparatus,
The inspection order information includes an imaging region, the number of images, imaging conditions, and image processing conditions.
The electronic medical chart apparatus according to claim 1. The inspection apparatus is an ultrasonic diagnostic apparatus,
The inspection order information includes an imaging region, imaging conditions, and image processing conditions.
The electronic medical chart apparatus according to claim 1. The imaging conditions include probe, focus, and dynamic range.
The electronic medical chart apparatus according to claim 3. The control means responds to the inspection-related image or the inspection item when the inspection-related image or the inspection item included in the past medical chart information displayed on the first screen is dragged and dropped to the second screen. The inspection order information identical to the attached inspection order information is displayed on the display means, and a change instruction from the operation means for the inspection order information displayed on the display means is received.
The electronic medical chart apparatus as described in any one of Claim 1 to 4.

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