JP7187802B2 - RECOMMENDED ACTION NOTIFICATION PROGRAM, RECOMMENDED ACTION NOTIFICATION METHOD, AND INFORMATION PROCESSING APPARATUS - Google Patents

Description

The present invention relates to a recommended action notification program, a recommended action notification method, and an information processing apparatus.

BACKGROUND ART Clinical Decision Support (CDS) systems that output information to assist doctors in making medical decisions such as disease diagnosis and treatment selection are known (see, for example, Patent Document 1). ).

Japanese Patent Publication No. 2012-523877

The CDS system described above may have a function of notifying medical professionals such as doctors and laboratory technologists of recommended medical practices (hereinafter referred to as recommended treatment). When the medical staff is notified of the recommended action during medical care of the target patient, the medical staff decides whether or not to implement the recommended action, and if it decides to implement the recommended action, treats the target patient based on the recommended action. By using such functions, any healthcare professional can provide the same quality of medical service to the target patient.

Here, the notification information including the recommended action described above is generated when all of the plurality of condition information representing the condition of the target patient described in the electronic medical record satisfy the plurality of condition information each setting the notification conditions. . In particular, this notification information is not generated during medical care, but is generated before medical care by nighttime processing that is executed at night or early in the morning. The reason for this is that the process of collating all of the multiple status information and the multiple condition information is enormous. For example, if the collation process is performed at the timing when the electronic medical chart is displayed during medical treatment, the display of the electronic medical chart may be delayed. Because there is

In this way, the following problems arise due to the fact that the notification information is generated before the time of medical treatment. For example, the subject patient may have undergone an examination on the day of the medical examination when the notification information was generated, and the examination value may have improved. The improved test values are reflected in the electronic chart within a short period of time (eg, 2 to 3 hours) by the work of medical personnel (eg, laboratory technicians). Therefore, when another medical worker (for example, a doctor) treats the target patient after the examination, the medical worker treats the target patient based on the electronic medical record reflecting the improved test values.

However, the notification information is generated based on the electronic medical chart before the improved test values are reflected in the electronic medical chart. For this reason, another medical practitioner is notified of the recommended action, but since the patient's condition has improved at the time of the consultation when the recommended action is notified, it is necessary to treat the target patient according to the recommended action. There is a problem that the

Therefore, in one aspect, it is an object to provide a recommended action notification program, a recommended action notification method, and an information processing apparatus capable of notifying a recommended action according to a patient's condition.

In one embodiment, the recommended action notification program includes a plurality of status information representing the patient's condition described in the electronic medical record of each of the plurality of patients, a plurality of condition information respectively representing the conditions for notifying the recommended action, for each of the plurality of patients, and based on the result of the first verification process, a plurality of specific state information that satisfies all of the plurality of condition information among the plurality of state information is stored, and when a display command to display the electronic medical record of one of the plurality of patients is received, it is determined whether there is exclusion information that excludes the notification of the recommended action, and if there is the exclusion information , performing a second collation process for respectively collating the exclusion information and the status information corresponding to the exclusion information among the latest plurality of status information, and as a result of the second collation process, the correspondence to the exclusion information is performed. If the status information to be sent satisfies all of the exclusion information, the recommended action is notified, the electronic medical record corresponding to the display command is displayed, and as a result of the second collation process, the status corresponding to the exclusion information is determined. causing a computer to execute a process of displaying the electronic medical record corresponding to the display instruction without notifying the recommended action if the information does not satisfy at least part of the exclusion information, wherein the exclusion information is the recommended action; It is characterized in that it is information generated based on a plurality of state information saved when the implementation of the treatment based on the treatment is discontinued.

A recommended action can be notified according to the patient's condition.

FIG. 1 is a diagram showing an example of an electronic medical record system. FIG. 2 is an example of the hardware configuration of an electronic medical record server. FIG. 3 is an example of a block diagram of an electronic medical record server. FIG. 4 is a diagram for explaining the relationship of various types of information managed by the electronic medical record server. FIG. 5A is an example of rule information. FIG. 5B is an example of condition information. FIG. 5C is an example of exclusion information. FIG. 6A is an example of notification information. FIG. 6B is an example of state information. FIG. 7 is a flow chart showing an example of the first process. FIGS. 8A to 8D are diagrams for explaining an example of the first matching process. FIG. 9 is a flow chart showing an example of the second process. FIG. 10 is an example of a recommended action notification screen. FIG. 11 is a flow chart showing an example of the third process. FIG. 12 is a flow chart showing an example of the fourth process. FIG. 13 is an example of a cancellation reason selection screen. FIG. 14 is a flow chart showing an example of the fifth process. FIGS. 15A and 15B are examples of diagrams in which a part of exclusion information is extracted. FIGS. 16A to 16D illustrate an example of the second matching process.

Hereinafter, the form for carrying out this case will be described with reference to the drawings.

FIG. 1 is a diagram showing an example of an electronic medical record system ST. The electronic medical chart system ST includes an electronic medical chart display terminal 100 , an electronic medical chart server 200 as an information processing device, and a notification condition setting terminal 300 .

As the electronic medical chart display terminal 100 and the notification condition setting terminal 300, for example, there is a stationary personal computer (PC). A portable PC or smart device may be used as the electronic medical chart display terminal 100 and the notification condition setting terminal 300 . Examples of smart devices include smartphones and tablet terminals. Although one electronic medical chart display terminal 100 and one notification condition setting terminal 300 are shown in FIG. good too.

Here, the electronic medical chart display terminal 100, the electronic medical chart server 200, and the notification condition setting terminal 300 are all installed within the facilities of a medical institution (for example, a hospital) H. FIG. For example, the electronic medical record display terminal 100 is installed in an examination room X of a medical institution H. FIG. The electronic chart server 200 is installed in the server room Y of the medical institution H. FIG. The notification condition setting terminal 300 is installed in the information management room Z of the medical institution H or the like. The electronic medical chart display terminal 100, the electronic medical chart server 200, and the notification condition setting terminal 300 are connected to each other via the communication network NW. The communication network NW is, for example, a Local Area Network (LAN). The communication method in the communication network NW may be wired or wireless.

The electronic medical record server 200 may be installed in a facility outside the medical institution H, such as a data center. That is, the electronic medical record server 200 may be of a cloud type instead of an on-premise type. In this case, for example, the Internet is used as the communication network NW.

The electronic medical record display terminal 100 executes various processes in accordance with commands from medical staff. For example, when a medical staff designates a patient ID, which is patient identification information, and issues an electronic medical chart display command to the electronic medical chart display terminal 100, the electronic medical chart display terminal 100 displays the patient ID on the electronic medical chart server 200. Send orders. Further, when the electronic medical chart display terminal 100 receives the electronic medical chart including the patient ID transmitted from the electronic medical chart server 200 based on the display command, the electronic medical chart display terminal 100 displays the received electronic medical chart. Thereby, the medical staff can enter a plurality of status information representing the patient's status in the electronic medical record of the patient identified by the patient ID. In addition, the electronic medical record display terminal 100 displays various screens, and the details of the screens displayed by the electronic medical record display terminal 100 will be described later.

The electronic medical chart server 200 manages electronic medical charts for each of a plurality of patients. The electronic medical record includes, as written information, the above-described patient ID and multiple pieces of status information, as well as various information (for example, attribute information such as date of birth and gender). When the electronic medical chart server 200 receives a display command including the patient ID described above, the electronic medical chart server 200 identifies an electronic medical chart corresponding to the patient ID included in the received display command, and transmits the electronic medical chart to the electronic medical chart display terminal 100 . Further, the electronic medical chart server 200 collates a plurality of status information described as information described in the electronic medical chart with a plurality of condition information each setting notification conditions for recommended treatment for each patient, and all of the plurality of status information generates notification information including recommended actions when corresponding multiple condition information is satisfied. In addition, the electronic medical chart server 200 executes various processes such as generating exclusion information for excluding recommended treatment notifications from notification targets. Details of the processes executed by the electronic medical chart server 200 will be described later.

The notification condition setting terminal 300 executes various processes in accordance with the instructions of the information manager who belongs to the information management room Z. FIG. For example, when the information manager issues a setting command to the notification condition setting terminal 300 to set notification conditions for recommended actions, the notification condition setting terminal 300 generates condition information in which notification conditions are set, and transmits the condition information to the electronic medical record server 200 . do. Therefore, when the information manager gives multiple setting commands to the notification condition setting terminal 300, the electronic chart server 200 manages multiple pieces of condition information.

Details of the electronic medical record server 200 described above will be described below.

FIG. 2 shows an example of the hardware configuration of the electronic medical record server 200. As shown in FIG. As shown in FIG. 2, the electronic chart server 200 includes at least a Central Processing Unit (CPU) 200A, a Random Access Memory (RAM) 200B, a Read Only Memory (ROM) 200C and a network I/F (interface) 200D. . The electronic medical record server 200 may include at least one of a Hard Disk Drive (HDD) 200E, an input I/F 200F, an output I/F 200G, an input/output I/F 200H, and a drive device 200I, if necessary. The CPU 200A to the drive device 200I are interconnected by an internal bus 200J. That is, the electronic medical record server 200 can be realized by a computer.

An input device 710 is connected to the input I/F 200F. The input device 710 includes, for example, a keyboard and a mouse. A display device 720 is connected to the output I/F 200G. The display device 720 is, for example, a liquid crystal display. A semiconductor memory 730 is connected to the input/output I/F 200H. Examples of the semiconductor memory 730 include Universal Serial Bus (USB) memory and flash memory. The input/output I/F 200H reads programs and data stored in the semiconductor memory 730 . The input I/F 200F and the input/output I/F 200H are provided with USB ports, for example. The output I/F 200G has, for example, a display port.

A portable recording medium 740 is inserted into the drive device 200I. Examples of the portable recording medium 740 include removable discs such as Compact Disc (CD)-ROM and Digital Versatile Disc (DVD). The drive device 200I reads programs and data recorded on the portable recording medium 740 . The network I/F 200D has, for example, a LAN port. Network I/F 200D is connected to communication network NW described above.

The programs stored in the ROM 200C and HDD 200E are temporarily stored in the RAM 200B described above by the CPU 200A. The program recorded on the portable recording medium 740 is temporarily stored in the RAM 200B by the CPU 200A. By executing the stored programs, the CPU 200A implements various functions described later, and also executes various processes described later. Note that the program may be in accordance with the flow chart described later.

FIG. 3 is an example of a block diagram of the electronic medical record server 200. As shown in FIG. In particular, FIG. 3 shows the functional configuration of the essential parts of the electronic medical chart server 200 . The electronic medical record server 200 includes an electronic medical record storage unit 201, a condition information storage unit 202, a notification information storage unit 203, and an exclusion information storage unit 204, as shown in FIG. The electronic medical record server 200 also includes a state information first storage unit 205 , a state information second storage unit 206 , a state information third storage unit 207 , and a cancellation information storage unit 208 . Furthermore, the electronic medical record server 200 includes a communication section 209 and a processing section 210 .

In addition, the electronic medical record storage unit 201, the condition information storage unit 202, the notification information storage unit 203, the exclusion information storage unit 204, the status information first storage unit 205, the status information second storage unit 206, the status information third storage unit 207, And the cancellation information storage unit 208 can be realized by the RAM 200B or the HDD 200E described above. The communication unit 209 can be implemented by the network I/F 200D described above. The processing unit 210 can be realized by the CPU 200A described above.

The electronic medical chart storage unit 201 stores electronic medical charts for each of a plurality of patients. As described above, the electronic medical chart includes information such as patient IDs and multiple pieces of status information. For example, information such as test values indicating test results of a prothrombin INR test (hereinafter referred to as INR) and whether or not the patient is hospitalized is described in the electronic medical record as status information. Condition information storage unit 202 stores a plurality of condition information transmitted from notification condition setting terminal 300 . A notification condition for notifying a recommended action is set for each condition information. For example, the condition information includes a notification condition such as whether the inspection value representing the INR inspection result is 5 or higher, or a notification condition such as being hospitalized.

The notification information storage unit 203 stores a plurality of pieces of notification information each including a recommended action. Notification information is generated by the processing unit 210 and stored in the notification information storage unit 203 . Note that the process of generating notification information by the processing unit 210 will be described later. The exclusion information storage unit 204 stores exclusion information for excluding notification of recommended measures from notification targets. The exclusion information is generated by the processing unit 210 and stored in the exclusion information storage unit 204 . Note that the exclusion information may be generated by the notification condition setting terminal 300 based on an instruction from the information manager and transmitted to the electronic medical record server 200 by the notification condition setting terminal 300 . Thereby, the electronic medical chart server 200 manages the exclusion information.

The first state information storage unit 205 stores state information at the time of determining whether or not the state information satisfies the condition information. The state information second storage unit 206 stores state information at the time of implementation of specific treatment based on the recommended treatment. The third state information storage unit 207 stores state information when a specific treatment based on the recommended treatment is stopped. The state information at the time of determination, the state information at the time of execution, and the state information at the time of cancellation are all extracted from the information described in the electronic medical record by the processing unit 210, and stored in the first state information storage unit 205 and the second state information storage unit 206. , and state information third storage unit 207, respectively. The discontinuation information storage unit 208 stores discontinuation information indicating the reason for discontinuing the specific treatment based on the recommended treatment. The cancellation information is transmitted from the electronic medical record display terminal 100 and stored in the cancellation information storage unit 208 by the processing unit 210 .

The communication unit 209 controls communication among the electronic medical chart server 200 , the electronic medical chart display terminal 100 and the notification condition setting terminal 300 . For example, the communication unit 209 receives a display command, cancellation information, and the like transmitted from the electronic medical record display terminal 100 and outputs them to the processing unit 210 . For example, the communication unit 209 receives electronic medical charts and notification information output from the processing unit 210 and transmits them to the electronic medical chart display terminal 100 .

Upon receiving the display command output from the communication unit 209 , the processing unit 210 extracts the electronic medical record corresponding to the display command from the electronic medical record storage unit 201 based on the received display command, and outputs the electronic medical record to the communication unit 209 . The display command includes a patient ID that can identify the patient. In addition, the processing unit 210 executes a first collation process for collating the plurality of status information and the plurality of condition information for each patient, and when all the plurality of status information satisfy the plurality of condition information, the notification information is generated and stored in the notification information storage unit 203 . In addition, the processing unit 210 stores the state information at the time of determination, the state information at the time of execution, and the state at the time of cancellation from the first state information storage unit 205, the second state information storage unit 206, and the third state information storage unit 207, respectively. Information is acquired, and based on the acquired state information, exclusion information is generated and stored in the exclusion information storage unit 204 . In addition, the processing unit 210 executes various types of information processing, and the details of the information processing executed by the processing unit 210 will be described later.

FIG. 4 is a diagram for explaining the relationship of various types of information managed by the electronic medical record server 200. As shown in FIG. All of the state information at the time of determination, the state information at the time of execution, and the state information at the time of cancellation are associated with the notification information described above. Moreover, all of the above-described condition information, exclusion information, and notification information are associated with rule information. Rule information is a unit for managing CDS rules. Rule information is managed by the electronic chart server 200 . For example, the electronic medical record server 200 may be provided with a rule information storage unit (not shown), and the rule information storage unit may store the rule information.

Furthermore, the details of the rule information, condition information, exclusion information, notification information, and status information described in FIG. 4 will be described with reference to FIGS. do. FIG. 5A is an example of rule information. FIG. 5B is an example of condition information. FIG. 5C is an example of exclusion information. FIG. 6A is an example of notification information. FIG. 6B is an example of state information.

The rule information is managed by a rule information management table T1, as shown in FIG. 5(a). The rule information management table T1 includes a rule ID field, a rule name field, and a version number field as constituent elements. Identification information for uniquely managing rule information is registered in the rule ID field. The name of rule information is registered in the rule name field. The version number of the CDS rule is registered in the version number field.

The condition information is managed by a condition information management table T2, as shown in FIG. 5(b). The condition information management table T2 includes a rule ID field, a condition name field, a condition content (item) field, and a condition content (condition) field as components. Identification information common to the identification information registered in the rule ID field of the rule information management table T1 is registered in the rule ID field. This associates the rule information with the condition information. A condition name, which is the name of the condition information, is registered in the condition name field. An item name, which is the name of an item in the electronic medical record, is registered in the condition content (item) field. Conditions applied to the items of the electronic medical record are registered in the condition content (condition) field. Therefore, the condition information shown in FIG. 5(b) represents the condition that the INR test result is 5 or higher. In this way, various condition information is managed by a plurality of condition information management tables T2.

Exclusion information is managed by an exclusion information management table T3, as shown in FIG. 5(c). The exclusion information management table T3 includes, as components, a rule ID field, an exclusion condition name field, an exclusion condition content (item) field, and an exclusion condition content (condition) field. That is, the data structure of exclusion information is the same as that of condition information. Identification information common to the identification information registered in the rule ID field of the rule information management table T1 is registered in the rule ID field. This associates the rule information with the exclusion information. The name of exclusion information is registered in the exclusion condition name field. The exclusion condition content (item) field registers the name of the item to be compared with the status information included in the electronic medical record. In the exclusion condition content (condition) field, the condition of the item to be checked against the status information included in the electronic medical record is registered. Therefore, the exclusion information shown in FIG. 5(c) represents the condition that the warfarin prescription has not been discontinued. In this way, various types of exclusion information are managed by a plurality of exclusion information management tables T3.

The notification information is managed by a notification information management table T4, as shown in FIG. 6(a). The notification information management table T4 includes a rule ID field, a notification ID field, a determination date/time field, a patient ID field, a recommended treatment field, a status field, and an update date/time field as components.

Identification information common to the identification information registered in the rule ID field of the rule information management table T1 is registered in the rule ID field. This associates the rule information with the exclusion information. Identification information for uniquely managing notification information is registered in the notification ID field. The determination date and time field registers the date and time when it is determined whether or not a plurality of pieces of state information satisfy a plurality of pieces of condition information. Identification information for uniquely managing a patient is registered in the patient ID field. A character string of a recommended action to be notified to a medical worker is registered in the recommended action field. A recommended action is determined in advance according to the contents of the condition information.

The status of notification information is registered in the status field. For example, when a specific action according to the recommended action included in the notification information is performed, "completed" is registered as the status. For example, when the implementation of a specific treatment according to the recommended treatment included in the notification information is canceled, the status is registered as canceled. For example, if the execution of a specific action according to the recommended action included in the notification information is put on hold, the unprocessed status is maintained. The update date and time of the status are registered in the update date and time field. In this way, various pieces of notification information are managed by a plurality of notification information management tables T4.

The state information is managed by a state information management table T5 as shown in FIG. 6(b). The state information management table T5 includes a rule ID field, a notification ID field, a save date/time field, a state save time field, a condition name field, a condition content (item) field, and a condition content (value) field as constituent elements. Identification information common to the identification information registered in the rule ID field of the rule information management table T1 is registered in the rule ID field. This associates the rule information with the state information. Identification information common to the identification information registered in the notification ID field of the notification information management table T4 is registered in the notification ID field. This associates the notification information with the state information. The date and time when the state information was saved is registered in the saved date and time field.

The timing at which the state information was saved is registered in the state save time field. For example, when the state information is saved when the implementation of a specific action according to the recommended action is stopped, as shown in FIG. . For example, when the state information is saved when a specific action according to the recommended action is performed, the time when the state is saved is registered as the timing in the save state field. For example, when the state information is saved when it is determined whether or not the state information satisfies the condition information, the time of determination is registered as the timing in the field when the state is saved. As shown in FIG. 6(b), since the time of cancellation is registered in the field at the time of saving the state, the state information shown in FIG. 6(b) represents the state information of the time of cancellation.

The condition name of the condition information applied to the state information is registered in the condition name field. The item name of the condition information applied to the state information is registered in the condition content (item) field. In this way, by including the condition name and item name of the condition information in the state information, the condition information to be compared with the state information is specified. A value corresponding to the item name registered in the condition content (item) field is registered in the condition content (value) field. The values include numerical values such as test values, dates, symbols, and character strings. Therefore, the status information shown in FIG. 6B indicates that the value of the INR test result was 6. In this way, a variety of state information with different state saving times are managed by a plurality of state information management tables T5.

Next, the operation of the electronic medical record server 200 will be described.

First, the first process executed at night or early in the morning will be described with reference to FIGS. 7 and 8. FIG. FIG. 7 is a flow chart showing an example of the first process. FIGS. 8A to 8D are diagrams for explaining an example of the first matching process. When the processing unit 210 detects a match between the current time and a preset processing start time (for example, at night such as 1:00 am or early morning such as 4:00 am), the processing unit 210 executes the first process. As shown in FIG. 7, the processing unit 210 acquires a plurality of pieces of condition information from the condition information storage unit 202 (step S101). After the processing of step S101 is completed, the processing unit 210 acquires the written information of the electronic medical record from the electronic medical record storage unit 201 (step S102).

When the processing of step S102 is completed, the processing unit 210 starts loop processing (step S103). More specifically, the processing unit 210 designates any one patient ID from among the acquired description information and executes subsequent processing. First, the processing unit 210 executes a first matching process (step S104). The first matching process is a process of matching a plurality of pieces of status information included in the specified patient ID description information with each of a plurality of pieces of acquired condition information. More specifically, as shown in FIGS. 8(a) to 8(d), the first matching process is based on the common condition name and condition content item, and the condition of the condition content of the condition information and the condition of the status information. This is the process of matching with the value of the content.

After the process of step S104 is completed, the processing unit 210 stores the state information in the first state information storage unit 205 (step S105). Thereby, the state information first storage unit 205 stores a plurality of pieces of state information at the time of determination. In particular, when all of a plurality of pieces of condition information are satisfied, the processing unit 210 stores all of the collation target state information in the state information first storage unit 205 . Therefore, if all of the plurality of condition information are not satisfied, the processing unit 210 does not store the state information to be collated in the first state information storage unit 205, designates the next patient ID, and starts the loop processing again. . That is, the processing unit 210 stores state information about at least some of the plurality of patients in the state information first storage unit 205 . When saving the state information, the processing unit 210 generates a notification ID, and stores a plurality of pieces of state information including the generated notification ID, the rule ID of the condition information, and the time of saving the state in the state information first storage unit 205. save.

After the process of step S105 is completed, the processing unit 210 then generates notification information (step S106). More specifically, the processing unit 210 generates recommended notification information according to condition information to be collated. When generating the notification information, the processing unit 210 generates the notification information including the notification ID of the status information, the rule ID of the condition information, the patient ID described in the electronic medical record, and the like. In this case, the status of the notification information becomes unprocessed. When the process of step S106 is completed, the processing unit 210 saves the notification information in the notification information storage unit 203 (step S107) and designates the next patient ID. Then, when the processing unit 210 finishes executing the processing from steps S104 to S107 described above for all patient IDs, the loop processing ends (step S108), and the first processing ends.

By the first processing described above, the notification information storage unit 203 stores notification information whose status is unprocessed. That is, the notification information storage unit 203 stores notification information for which the recommended treatment has not yet been notified to the medical staff. On the other hand, the state information first storage unit 205 stores a plurality of pieces of state information representing the state of the patient at the time of determination.

Next, with reference to FIGS. 9 and 10, a description will be given of the second processing that is performed when a medical professional treats a patient to be treated.

FIG. 9 is a flow chart showing an example of the second process. FIG. 10 is an example of a recommended action notification screen. The processing unit 210 executes the second processing upon receiving the command of the medical staff. More specifically, as shown in FIG. 9, the processing unit 210 waits until receiving a display command (step S201: NO). When the processing unit 210 receives the display command (step S201: YES), it acquires notification information from the notification information storage unit 203 (step S202). More specifically, when the medical staff designates the patient ID of the patient to be medically treated immediately before or at the start of medical treatment of the patient to be medically treated, and instructs the electronic medical record display terminal 100 to display the electronic medical record including the designated patient ID, The electronic medical chart display terminal 100 transmits a display command including the patient ID to the electronic medical chart server 200 . The processing unit 210 of the electronic medical chart server 200 receives a display command including the patient ID, and the processing unit 210 attempts to acquire notification information including the patient ID before transmitting the electronic medical chart including the patient ID.

After the process of step S202 is completed, the processing unit 210 then determines whether or not there is notification information in the notification information storage unit 203 (step S203). When the processing unit 210 determines that there is no notification information (step S203: NO), the electronic medical chart is displayed on the electronic medical chart display terminal 100 (step S209), and the second process ends. That is, the notification information storage unit 203 does not necessarily store notification information including the patient ID of the patient to be treated. is displayed on the electronic medical record display terminal 100 . That is, the medical staff is not notified of the recommended treatment, and the medical staff conducts normal medical treatment for the patient to be treated and performs operations to enter various information in the electronic medical record.

On the other hand, if the processing unit 210 determines that there is notification information (step S203: YES), then the processing unit 210 acquires exclusion information from the exclusion information storage unit 204 (step S204). More specifically, the processing unit 210 attempts to acquire exclusion information. When the processing of step S204 is completed, the processing unit 210 then determines whether or not there is exclusion information in the exclusion information storage unit 204 (step S205). If the processing unit 210 determines that there is no exclusion information (step S205: NO), it displays a recommended action notification screen on the electronic medical chart display terminal 100 (step S210), and ends the second process.

More specifically, the processing unit 210 outputs notification information to the communication unit 209 , and the communication unit 209 transmits the notification information to the electronic medical chart display terminal 100 . When receiving the notification information, the electronic medical record display terminal 100 displays a recommended action notification screen as shown in FIG. 10 based on the received notification information. In particular, since the recommended action notification screen includes the recommended action, the healthcare professional may decide whether to perform a specific action (e.g., discontinue the prescription) according to the recommended action included in the recommended action notification screen. Decide whether or not

When performing a specific treatment, the medical staff presses the action execution button BT1 included in the recommended treatment notification screen with the pointer Pt. When stopping the implementation of a specific treatment, the medical staff presses the treatment stop button BT2 included in the recommended treatment notification screen with the pointer Pt. When suspending the execution of a specific treatment, the medical staff presses the suspension button BT3 included in the recommended treatment notification screen with the pointer Pt.

Here, the exclusion information described in the processing of steps S204 and S205 may or may not be generated based on the button operation by the medical staff. Therefore, the case where exclusion information is not generated at this time and there is no exclusion information in the process of step S205 will be described. Processing when exclusion information is generated and there is exclusion information in the processing of step S205 will be described later in detail.

Next, with reference to FIG. 11, the third process executed when the action execution button BT1 shown in FIG. 10 is pressed will be described.

FIG. 11 is a flow chart showing an example of the third process. The third process is executed when the medical staff presses the treatment execution button BT1 so that the medical staff will now perform a specific treatment according to the recommended treatment. More specifically, as shown in FIG. 11, the processing section 210 first determines whether or not the treatment execution button BT1 has been pressed (step S301). For example, when the treatment stop button BT2 or the hold button BT3 is pressed, the processing unit 210 determines that the treatment execution button BT1 was not pressed (step S301: NO), and ends the third process.

On the other hand, when the processing unit 210 determines that the treatment execution button BT1 has been pressed (step S301: YES), it acquires the written information of the electronic medical record (step S302), and selects a plurality of status information from the acquired written information. The status information is saved in the second storage unit 206 (step S303). Thereby, the state information second storage unit 206 stores a plurality of pieces of state information at the time of implementation. Therefore, if the information described in the electronic medical chart has not been updated, the current value "not discontinued" corresponding to the condition content (item) "prescription of warfarin", which is one of the status information of the electronic medical chart, is stored.

After the process of step S303 is completed, the processing unit 210 then updates the notification information stored in the notification information storage unit 203 (step S304). More specifically, the processing unit 210 updates the status of the notification information for which the recommended action notification screen is displayed from unprocessed to completed. As a result, when one medical worker performs a procedure, the content is shared with another medical worker.

When the process of step S304 is completed, the processing unit 210 then determines whether or not an order to expand the electronic medical record has been issued (step S305). For example, when the medical staff presses the button BT4 for expanding the electronic medical chart (see FIG. 10) using the pointer Pt, the processing unit 210 determines that the expansion of the electronic medical chart has been commanded (step S305: YES). . In this case, the processing unit 210 displays the electronic medical chart including the patient ID included in the display command on the electronic medical chart display terminal 100 (step S306), and ends the third process. On the other hand, for example, when the medical staff presses the button BT5 for closing the recommended action notification screen (see FIG. 10) using the pointer Pt, the processing unit 210 determines that the development of the electronic medical chart has not been commanded (step S305: NO), in this case, the processing unit 210 skips the processing of step S306 and ends the third processing.

Next, a fourth process executed when the treatment stop button BT2 shown in FIG. 10 is pressed will be described with reference to FIGS. 12 and 13. FIG.

FIG. 12 is a flow chart showing an example of the fourth process. FIG. 13 is an example of a cancellation reason selection screen. The fourth process is executed when the medical staff presses the treatment stop button BT2 to stop performing a specific treatment according to the recommended treatment. That is, since the patient's condition has changed before the medical examination, it is no longer necessary to treat the target patient according to the recommended treatment. As a result, the medical staff presses the treatment stop button BT2. Due to this, the fourth process is executed. In addition, if the patient's condition changes before the medical examination, for example, if the prescription of warfarin has not been discontinued, the prescription of warfarin will change at a stage prior to the medical examination (for example, at the examination stage). It has changed to a state of being suspended.

Here, as shown in FIG. 12, the processing unit 210 first determines whether or not the treatment stop button BT2 has been pressed (step S401). For example, when the treatment execution button BT1 or the hold button BT3 is pressed, the processing unit 210 determines that the treatment stop button BT2 is not pressed (step S401: NO), and ends the fourth process.

On the other hand, when the processing unit 210 determines that the treatment stop button BT2 has been pressed (step S401: YES), the processing unit 210 displays a stop reason selection screen on the electronic medical record display terminal 100 (step S402). As a result, as shown in FIG. 13, the electronic medical record display terminal 100 displays a cancellation reason selection screen. The medical staff identifies the reason for discontinuing the implementation of a specific treatment according to the recommended treatment by performing an operation of selecting at least one of a plurality of selection fields Bx1 included in the discontinuation reason selection screen with the pointer Pt. do. In addition, when the medical staff determines that the reason for discontinuing the specific treatment according to the recommended treatment cannot be selected from the plurality of selection fields Bx1, the pointer Pt is used to select the selection field Bx2. An operation is performed to input the reason for canceling in the column Bx3.

Returning to FIG. 12, the processing unit 210 determines whether or not the confirmation button BT6 has been pressed (step S403). For example, when the close button BT7 is pressed, the processing unit 210 determines that the confirmation button BT6 was not pressed (step S403: NO), and ends the fourth process.

On the other hand, when the processing unit 210 determines that the confirmation button BT6 has been pressed (step S403: YES), the processing unit 210 saves the cancellation information in the cancellation information storage unit 208 (step S404). The discontinuation information is information indicating the reason for discontinuing the execution of a specific treatment based on the recommended treatment, such as reason 1 and reason 5. The information entered in the input field Bx3 may be saved as the cancellation information. Thereby, the suspension information storage unit 208 stores the suspension information.

When the process of step S404 is completed, the processing unit 210 then acquires the written information of the electronic medical record (step S405), and stores a plurality of pieces of status information from the acquired written information in the third status information storage unit 207 (step S405). step S406). As a result, the third state information storage unit 207 stores a plurality of pieces of state information at the time of cancellation. Therefore, if the electronic medical record is updated at a stage prior to the consultation, and the value "not discontinued" corresponding to "warfarin prescription" changes to the value "discontinued," the status information in the electronic medical record The current value "discontinued" corresponding to the condition content (item) "prescription of warfarin", which is one of the above, is stored.

After the process of step S406 is completed, the processing unit 210 updates the notification information stored in the notification information storage unit 203 (step S407). More specifically, the processing unit 210 updates the status of the notification information for which the recommended action notification screen is displayed from unprocessed to canceled. When the processing of step S407 is completed, the processing unit 210 displays the electronic medical chart including the patient ID included in the display command on the electronic medical chart display terminal 100 (step S408), and ends the fourth process. After that, the medical staff treats the target patient and writes various information on the electronic chart.

Next, with reference to FIGS. 14 and 15, the fifth process executed at night or early in the morning will be described. Note that the fifth process may be executed when the above-described first process is completed, or may be executed in parallel with the first process.

FIG. 14 is a flow chart showing an example of the fifth process. FIGS. 15A and 15B are examples of diagrams in which a part of exclusion information is extracted. When the processing unit 210 detects a match between the current time and a preset processing start time (for example, at night such as 2:00 am or early morning such as 5:00 am), the processing unit 210 executes the fifth process. As shown in FIG. 14, the processing unit 210 acquires a plurality of pieces of condition information from the condition information storage unit 202 (step S501). After the processing of step S501 is completed, the processing unit 210 starts loop processing (step S502). More specifically, the processing unit 210 designates any one rule ID from among the acquired condition information and executes subsequent processing.

First, the processing unit 210 acquires notification information including the designated rule ID from the notification information storage unit 203 (step S503). When the processing of step S503 is completed, the processing unit 210 further starts loop processing (step S504). More specifically, the processing unit 210 designates any one notification ID from the obtained notification information, and executes subsequent processing.

First, the processing unit 210 acquires a plurality of pieces of state information including the specified notification ID from the first state information storage unit 205 (step S505). That is, the processing unit 210 acquires a plurality of pieces of state information at the time of determination. After the process of step S505 is completed, the processing unit 210 acquires a plurality of pieces of state information including the designated notification ID from the state information second storage unit 206 (step S506). That is, the processing unit 210 acquires a plurality of pieces of state information during execution. After the process of step S506 is completed, the processing unit 210 acquires a plurality of pieces of state information including the designated notification ID from the state information third storage unit 207 (step S507). That is, the processing unit 210 acquires a plurality of pieces of status information at the time of cancellation.

When the process of step S507 is completed, the processing unit 210 determines whether or not all notification IDs have been specified. If it is determined that all notification IDs have not been specified, the next notification ID is specified. , the above-described steps S505 to S507 are repeated. On the other hand, when the processing unit 210 determines that all the notification IDs have been specified, it ends the loop processing regarding the notification IDs (step S508).

When the process of step S508 is completed, the processing unit 210 then generates exclusion information (step S509). More specifically, first, the processing unit 210 compares the acquired three types of multiple status information, that is, multiple status information at the time of determination, multiple status information at the time of implementation, and multiple status information at the time of cancellation. In particular, the processing unit 210 compares the three types of state information having common items of condition name and condition content. Note that the three types of state information to be compared have a common rule ID. Then, based on the comparison result, the processing unit 210 determines that the value of the state information at the time of execution has not changed from the value of the state information at the time of determination, and the value of the state information at the time of cancellation is equal to the value of the state information at the time of determination. Identify the combination of condition name and condition content item that is being changed from the value of . That is, the processing unit 210 identifies a combination of items of the condition name and the condition content based on the difference in the value of the state information. Finally, the processing unit 210 selects condition information including a combination of the specified condition name and condition content items from among the plurality of condition information acquired in the process of step S501, and specifies the selected condition information as exclusion information. do. Through such processing, the processing unit 210 generates exclusion information. When a large number of combinations of condition names and condition contents are specified, the processing unit 210 specifies a predetermined number of combinations in order to minimize the number of second matching processes described later.

Therefore, in the three types of status information that commonly include the condition name "discontinued prescription" and the condition content item "warfarin prescription", if the value "discontinued" is included in the status information at the time of discontinuation, If the state information at the time of determination includes the value "not discontinued", the processing unit 210 specifies the condition name "discontinued prescription" and the condition content item "warfarin prescription". For this reason, the processing unit 210 identifies the condition information including the condition name “discontinued prescription” and the condition content item “warfarin prescription” as exclusion information. In this case, the processing unit 210 generates exclusion information as shown in FIG. 15(a).

In addition, in the three types of status information that commonly include the condition name "hospitalization" and the condition content item "hospitalization status", if the value "not in hospital" is included in the status information at the time of cancellation, includes the value "hospitalized", the processing unit 210 specifies the condition name "hospitalized" and the condition content item "hospitalized state". Therefore, the processing unit 210 identifies the condition information including the condition name “hospitalization” and the condition content item “hospitalization state” as exclusion information. In this case, the processing unit 210 generates exclusion information as shown in FIG. 15(b).

After the processing of step S509 is completed, the processing unit 210 stores the exclusion information in the exclusion information storage unit 204 (step S510). When the process of step S510 is completed, the processing unit 210 determines whether or not all rule IDs have been specified. If it is determined that all rule IDs have not been specified, the next rule ID is specified. , the above-described steps S503 to S510 are repeated. On the other hand, when the processing unit 210 determines that all rule IDs have been specified, it ends the loop processing regarding the rule IDs (step S511), and ends the fifth processing.

Next, with reference to FIG. 9 and FIG. 16 described above, the processing when there is exclusion information in the processing of step S205 will be described.

FIGS. 16A to 16D illustrate an example of the second matching process. First, as shown in FIG. 9, in the processing of step S205, when the processing unit 210 determines that there is exclusion information (step S205: YES), it acquires the description information of the electronic medical record (step S206), and performs the second verification. Processing is executed (step S207). The second matching process is a process of matching a plurality of pieces of status information included in the written information of the electronic medical record with the acquired exclusion information. More specifically, as shown in FIGS. 16(a) to 16(d), the second collation process is based on the common condition name and condition content item, and the condition of the condition content of the exclusion information and the condition of the status information. This is the process of matching with the value of the content. All of the plurality of pieces of state information to be collated in the second collation process are the latest (or most recent) state information. Therefore, the value may not change between the time of judgment and the time of medical treatment, and the value may change due to an update of the electronic medical record due to an examination or the like.

Here, if there is no exclusion information corresponding to the state information, the processing unit 210 cannot compare the state information and the exclusion information, as shown in FIGS. 16(c) and 16(d). That is, the processing unit 210 may perform the second matching process only on the status information for the acquired exclusion information. In this way, the processing unit 210 does not have to execute the second collation processing for all the status information, so the processing load at the time of displaying the electronic medical chart is reduced, and the delay in displaying the electronic medical chart can be suppressed.

When the process of step S207 is completed, the processing unit 210 then determines whether or not the value of the condition information of the state information satisfies the condition of the condition information of the exclusion information (step S208). More specifically, the processing unit 210 determines whether all the values of the condition information of the status information satisfy all the conditions of the condition information of the exclusion information.

When the processing unit 210 determines that the value of the condition information of the state information does not satisfy the condition of the condition content of the exclusion information (step S208: NO), it executes the processing of step S209. For example, as shown in FIG. 16(a), if the condition of the exclusion information includes the condition "not canceled", the condition of the status information includes the value "discontinued". If there is, the processing unit 210 determines that the value of the conditional content of the status information does not satisfy the condition of the conditional content of the exclusion information. Similarly, as shown in FIG. 16(b), when the exclusion information condition includes the condition "hospitalized", the condition information includes the value "not hospitalized". If there is, the processing unit 210 determines that the value of the conditional content of the status information does not satisfy the condition of the conditional content of the exclusion information.

In this way, when the latest status information in the information described in the electronic medical record has already been updated at the time of medical treatment, etc., when receiving the display order of the electronic medical record, the recommended action is notified to the medical staff. you don't have to. In this case, the processing unit 210 displays the electronic medical chart on the electronic medical chart display terminal 100 without displaying the recommended action notification screen.

On the other hand, when the processing unit 210 determines that the value of the condition information of the state information satisfies the condition of the condition content of the exclusion information (step S208: YES), the processing unit 210 executes the process of step S210. For example, if the condition of the exclusion information includes the condition "not canceled", the condition of the status information includes the value "not canceled", and the condition of the exclusion information If the condition "hospitalized" is included and the condition content of the status information includes the value "hospitalized", the processing unit 210 changes the condition of the condition content of the exclusion information to the condition of the status information. Judge that the value of the condition content is satisfied.

In this way, when receiving an electronic medical chart display order, etc., if the latest state information in the information described in the electronic medical chart has not been changed since the time of judgment, the recommended action is notified to the medical staff. There is a need. In this case, the processing unit 210 displays the recommended treatment notification screen on the electronic medical chart display terminal 100, ends the second process, and displays the electronic medical chart by the above-described third process or fourth process.

As described above, according to the present embodiment, the electronic medical record server 200 includes the processing unit 210 . The processing unit 210 collates, for each of the plurality of patients, a plurality of status information representing the patient's condition described in the electronic medical record of each of the plurality of patients and a plurality of condition information respectively representing the conditions for notifying the recommended treatment. A first matching process is performed. Based on the result of the first matching process, the processing unit 210 stores a plurality of pieces of state information satisfying all of the pieces of condition information among the pieces of state information. When the processing unit 210 receives a display command to display the electronic medical record of any one of a plurality of patients, the processing unit 210 determines whether or not there is exclusion information that excludes the notification of the recommended treatment.

If there is exclusion information, the processing unit 210 performs a second matching process of matching the exclusion information with the status information corresponding to the exclusion information among the plurality of stored status information. If the status information corresponding to the exclusion information satisfies all of the exclusion information as a result of the second collation processing, the processing unit 210 notifies the recommended action and displays the electronic medical record corresponding to the display command. On the other hand, if the status information corresponding to the exclusion information does not satisfy at least part of the exclusion information as a result of the second collation processing, the processing unit 210 displays the electronic medical record corresponding to the display command without notifying the recommended action. do. In particular, the exclusion information mentioned above is information generated based on a plurality of saved status information when the action based on the recommended action is discontinued. Thereby, it is possible to notify the recommended treatment according to the patient's condition.

Although the preferred embodiments of the present invention have been described in detail above, the present invention is not limited to the specific embodiments, and various modifications can be made within the spirit and scope of the present invention described in the claims.・Changes are possible. For example, in FIG. 16 described above, the processing unit 210 compares two items of exclusion information with two pieces of status information corresponding to these items of exclusion information. A piece of state information corresponding to the exclusion information is collated.

Note that the following notes are further disclosed with respect to the above description.
(Additional remark 1) A plurality of condition information representing the patient's condition described in the electronic medical record of each of the plurality of patients and a plurality of condition information representing the conditions for notifying the recommended treatment are collated for each of the plurality of patients. performing a first collation process, based on the result of the first collation process, storing a plurality of pieces of state information satisfying all of the plurality of condition information among the plurality of pieces of state information; When a display command to display any electronic medical record is received, it is determined whether or not there is exclusion information that excludes the notification of the recommended action, and if there is the exclusion information, the exclusion information and the saved A second matching process is performed for matching the status information corresponding to the exclusion information in the status information, and as a result of the second matching process, the status information corresponding to the exclusion information satisfies all of the exclusion information. If so, the recommended action is notified, the electronic medical record corresponding to the display command is displayed, and as a result of the second collation process, the status information corresponding to the exclusion information satisfies at least part of the exclusion information. If not, display the electronic medical record corresponding to the display command without notifying the recommended action, causing the computer to execute processing, and the exclusion information is the case where the implementation of the action based on the recommended action is discontinued A recommended action notification program characterized by being information generated based on a plurality of state information stored in a.
(Appendix 2) The process compares a plurality of status information items saved when the action based on the recommended action is stopped and a plurality of state information items saved based on the result of the first verification process. The recommended action notification program according to appendix 1, wherein the exclusion information is generated based on the result.
(Additional remark 3) A plurality of status information representing the patient's condition described in the electronic medical record of each of the plurality of patients and a plurality of condition information representing the conditions for notifying the recommended treatment are collated for each of the plurality of patients performing a first collation process, based on the result of the first collation process, storing a plurality of pieces of state information satisfying all of the plurality of condition information among the plurality of pieces of state information; When a display command to display any electronic medical record is received, it is determined whether or not there is exclusion information that excludes the notification of the recommended action, and if there is the exclusion information, the exclusion information and the saved A second matching process is performed for matching the status information corresponding to the exclusion information in the status information, and as a result of the second matching process, the status information corresponding to the exclusion information satisfies all of the exclusion information. If so, the recommended action is notified, the electronic medical record corresponding to the display command is displayed, and as a result of the second collation process, the status information corresponding to the exclusion information satisfies at least part of the exclusion information. If not, the computer executes a process of displaying the electronic medical record corresponding to the display instruction without notifying the recommended action, and the exclusion information is the case where the implementation of the action based on the recommended action is discontinued A recommended action notification method, wherein the information is generated based on a plurality of state information stored in a.
(Appendix 4) A plurality of condition information representing the patient's condition described in the electronic medical record of each of the plurality of patients and a plurality of condition information representing the conditions for notifying the recommended treatment are collated for each of the plurality of patients. performing a first collation process, based on the result of the first collation process, storing a plurality of pieces of state information satisfying all of the plurality of condition information among the plurality of pieces of state information; When a display command to display any electronic medical record is received, it is determined whether or not there is exclusion information that excludes the notification of the recommended action, and if there is the exclusion information, the exclusion information and the saved A second matching process is performed for matching the status information corresponding to the exclusion information in the status information, and as a result of the second matching process, the status information corresponding to the exclusion information satisfies all of the exclusion information. If so, the recommended action is notified, the electronic medical record corresponding to the display command is displayed, and as a result of the second collation process, the status information corresponding to the exclusion information satisfies at least part of the exclusion information. If not, the processing unit displays the electronic medical record corresponding to the display command without notifying the recommended action, and the exclusion information indicates that the treatment based on the recommended action is suspended. An information processing apparatus characterized in that the information is generated based on a plurality of pieces of state information stored when the state information is stored.
(Supplementary Note 5) The processing unit stores a plurality of state information items stored when the action based on the recommended action is stopped, and a plurality of state information items stored based on the result of the first verification process. The information processing apparatus according to appendix 4, wherein the exclusion information is generated based on the comparison result.

ST electronic medical chart system 100 electronic medical chart display terminal 200 electronic medical chart server 201 electronic medical chart storage unit 202 condition information storage unit 203 notification information storage unit 204 exclusion information storage unit 205 first state information storage unit 206 second state information storage unit 207 state information Third storage unit 208 Cancellation information storage unit 209 Communication unit 210 Processing unit 300 Notification condition setting terminal

Claims (4)

A first collation for collating a plurality of condition information respectively representing conditions of the patients described in the electronic medical charts of the plurality of patients and a plurality of condition information respectively representing conditions for notifying the recommended treatment for each of the plurality of patients do the processing,
storing a plurality of specific state information that satisfies all of the plurality of condition information among the plurality of state information based on the result of the first matching process;
When receiving a display command to display the electronic medical record of one of the plurality of patients,
Determining whether there is exclusion information that excludes notification of the recommended action,
if there is the exclusion information, performing a second matching process of comparing the exclusion information with the latest status information corresponding to the exclusion information among the plurality of status information;
as a result of the second verification process, if the status information corresponding to the exclusion information satisfies all of the exclusion information, notifying the recommended action and displaying the electronic medical record corresponding to the display command;
If the status information corresponding to the exclusion information does not satisfy at least part of the exclusion information as a result of the second collation process, the electronic medical record corresponding to the display command is displayed without notifying the recommended action. ,
let the computer do the work,
The exclusion information is information generated based on a plurality of saved state information when the implementation of the recommended action is discontinued.
A recommended action notification program characterized by: The processing is based on a result of comparing a plurality of pieces of status information saved when the implementation of the treatment based on the recommended treatment is stopped and a plurality of pieces of specific state information saved based on the results of the first verification process. to generate the exclusion information;
The recommended action notification program according to claim 1, characterized by: A first collation for collating a plurality of condition information respectively representing conditions of the patients described in the electronic medical charts of the plurality of patients and a plurality of condition information respectively representing conditions for notifying the recommended treatment for each of the plurality of patients do the processing,
storing a plurality of specific state information that satisfies all of the plurality of condition information among the plurality of state information based on the result of the first matching process;
When receiving a display command to display the electronic medical record of one of the plurality of patients,
Determining whether there is exclusion information that excludes notification of the recommended action,
if there is the exclusion information, performing a second matching process of comparing the exclusion information with the latest status information corresponding to the exclusion information among the plurality of status information;
as a result of the second verification process, if the status information corresponding to the exclusion information satisfies all of the exclusion information, notifying the recommended action and displaying the electronic medical record corresponding to the display command;
If the status information corresponding to the exclusion information does not satisfy at least part of the exclusion information as a result of the second collation process, the electronic medical record corresponding to the display command is displayed without notifying the recommended action. ,
A computer performs the processing,
The exclusion information is information generated based on a plurality of state information saved when the treatment based on the recommended treatment is discontinued.
A recommended action notification method characterized by: A first collation for collating a plurality of condition information respectively representing conditions of the patients described in the electronic medical charts of the plurality of patients and a plurality of condition information respectively representing conditions for notifying the recommended treatment for each of the plurality of patients do the processing,
storing a plurality of specific state information that satisfies all of the plurality of condition information among the plurality of state information based on the result of the first matching process;
When receiving a display command to display the electronic medical record of one of the plurality of patients,
Determining whether there is exclusion information that excludes notification of the recommended action,
if there is the exclusion information, performing a second matching process of comparing the exclusion information with the latest status information corresponding to the exclusion information among the plurality of status information;
as a result of the second verification process, if the status information corresponding to the exclusion information satisfies all of the exclusion information, notifying the recommended action and displaying the electronic medical record corresponding to the display command;
If the status information corresponding to the exclusion information does not satisfy at least part of the exclusion information as a result of the second collation process, the electronic medical record corresponding to the display command is displayed without notifying the recommended action. ,
Having a processing unit that executes processing,
The exclusion information is information generated based on a plurality of saved state information when the implementation of the recommended action is discontinued.
An information processing device characterized by:

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