This application is based upon and claims the benefit of priority from Japanese Patent Application No. 2021-181011, filed on Nov. 5, 2021; the entire contents of which are incorporated herein by reference.
Embodiments disclosed in the present specification and drawings generally relate to a medical information processing apparatus and a medical information processing system.
In a hospital, for example, when a physician checks the medical treatment information of a target patient, the period for which the medical treatment information of the target patient is displayed is different depending on a disease of the target patient, the purpose of referring to the medical treatment information, and the like. For example, when a physician wants to check the effect of treatment on a target patient, the physician sets a display period so that the physician can compare the past medical treatment information and the current medical treatment information, and in case of emergency, the physician sets the display period so that the physician can check the most recent medical treatment information. Thus, when checking each piece of medical treatment information of the target patient, the physician needs to set the display period for each piece of medical treatment information. However, it takes time and efforts for physicians to set the display period.
A medical information processing apparatus according to an embodiment includes a processing circuitry. The processing circuitry acquires operation information of a medical worker for medical treatment information of a target patient or operation information of a medical worker for the medical treatment information of a similar patient who is similar to the target patient. Based on the operation information, the processing circuitry calculates the concordance rate between a period for which the medical treatment information of the target patient or the medical treatment information of the similar patient is referred to and the period for which the medical treatment information of the target patient is displayed. The processing circuitry performs display of information about the concordance rate.
One embodiment of the medical information processing apparatus is described below in detail with reference to the drawings. Note that in the example to be described below, a medical information processing system 1 includes an electronic medical record server incorporating a function of the medical information processing apparatus. In the medical information processing system 1 illustrated in
The medical information processing system 1 illustrated in
The HIS server manages information generated in the hospital. The information generated in the hospital includes patient information, examination order information, and the like. When the examination order information is input from the terminal 10, for example, the HIS server sends the input examination order information and the patient information specified by the examination order information to the RIS server. The RIS server manages examination appointment information related to radiological examination services. The medical image diagnosis device is a device that, for example, performs examinations on the basis of the examination appointment information sent from the RIS server. For example, a clinical technologist performs an examination by, for example, photographing a patient using the medical image diagnosis device, and the medical image diagnosis device generates medical images in performing the examination.
The medical images are, for example, X-ray computed tomography (CT) images, X-ray images, magnetic resonance imaging (MRI) images, nuclear medicine images, and ultrasound images. The medical image diagnosis device converts the generated medical images into a format compliant with the Digital Imaging and Communication in Medicine (DICOM) standard, for example. In other words, the medical image diagnosis device generates medical images to which DICOM tags are added as supplementary information. The supplementary information includes, for example, patient ID, examination ID, device ID, image series ID, etc., and is standardized according to the DICOM standard. The medical image diagnosis device sends the generated medical images to the PACS server. The PACS server, for example, receives the patient information sent from the HIS server and manages the received patient information. For example, the PACS server has a storage circuitry for managing the patient information, receives the medical images sent from the medical image diagnosis device, and stores the received medical images in its own storage circuitry by associating these images with the patient information.
The terminals 10 to 30 are used by the medical workers involved in the medical treatment of the patient. For example, the terminals 10 to 30 are used by physicians. The terminals 10 to 30 include, for example, personal computers (PCs), tablet PCs, personal digital assistants (PDAs), and mobile terminals. The terminals 10 to 30 have a viewer (software) installed therein to display medical images on their own displays.
The electronic medical record server 100 is incorporated into the electronic medical record system 2 together with the HIS server, as described above. The electronic medical record server 100 is communicably connected to the terminals 10 to 30 and the like through a network. The electronic medical record server 100 and the terminals 10 to 30 are connected to an in-hospital local area network (LAN) installed in, for example, a hospital, send information to a predetermined device, and receive information sent from the predetermined device. For example, the electronic medical record server 100 is realized by a computer apparatus such as a workstation or a personal computer.
The electronic medical record server 100 has a processing circuitry 110 and a storage circuitry 120. The electronic medical record server 100 is not limited to the structure described above and the storage circuitry 120 may not be incorporated in the electronic medical record server 100 as long as the electronic medical record server 100 can access the storage circuitry 120 on the network.
The storage circuitry 120 is connected to the processing circuitry 110 and stores various kinds of information therein. Specifically, the storage circuitry 120 stores therein patient information received from each system. For example, the storage circuitry 120 is realized by a semiconductor memory element such as a random-access memory (RAM) or a flash memory, a hard disk, an optical disc, or the like.
The processing circuitry 110 controls components of the electronic medical record server 100. For example, the processing circuitry 110 performs a processing function 111, a monitoring function 112, an acquiring function 113, a calculating function 114, and a controlling function 115. Here, for example, each function performed by the processing function 111, the monitoring function 112, the acquiring function 113, the calculating function 114, and the controlling function 115, which are the components of the processing circuitry 110, is recorded in the storage circuitry 120 in the form of a computer program executable by a computer. The processing circuitry 110 is a processor that reads out each computer program from the storage circuitry 120 and executes the computer program to realize the function corresponding to the computer program. In other words, the processing circuitry 110 that has read out each computer program has each function illustrated in the processing circuitry 110 in
The processing function 111 performs the function of the electronic medical record system. Specifically, the processing function 111 stores electronic medical records in the storage circuitry 120 that record the patient information such as prescriptions, nursing records, and specimen examinations performed on the patient.
The patient information includes basic information and medical treatment information of the patient. The basic information includes patient ID, name, date of birth, gender, blood type, height, weight, and the like. As the patient ID, identifier information that uniquely identifies the patient is set. The medical treatment information of the patient includes information such as numerical values (measurement values) and medical treatment records, as well as information indicating the date and time of the recording. For example, the medical treatment information of the patient includes prescriptions for medicines by physicians, nursing records by nurses, specimen examinations in the laboratory department, and arrangements for meals during hospitalization. For example, the prescriptions are recorded in the electronic medical records by the physicians, and the nursing records are recorded in the electronic medical records by the nurses.
The monitoring function 112, the acquiring function 113, the calculating function 114, and the controlling function 115 perform the functions of the medical information processing apparatus of the electronic medical record server 100. A display application (computer program) is implemented in the medical information processing apparatus, and the display application can be read out by the terminals 10 to 30. The processes of the monitoring function 112, the acquiring function 113, the calculating function 114, and the controlling function 115 are described later.
The storage circuitry 120 has, as databases (hereinafter simply referred to as “DBs”), a medical treatment information DB 121 and an operation information DB 122. The medical treatment information DB 121, for example, corresponds to a storage circuitry of the HIS server and stores therein the medical treatment information of the patient or the electronic medical record that records the medical treatment information of the patient. The information stored in the operation information DB 122 is described later.
The term “processor” in the above description includes, for example, a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (e.g., simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)), and other circuits. If the processor is a CPU, for example, the processor reads out and executes a computer program saved in the storage circuitry 120 to realize the function. On the other hand, if the processor is an ASIC, for example, the computer program is incorporated directly into the circuitry of the processor instead of saving the computer program in the storage circuitry 120. Each processor in this embodiment is not limited to the case where each processor is configured as a single circuit, but may also be configured as a single processor by combining a plurality of independent circuits to realize the functions. Furthermore, a plurality of components in
The overall structure of the medical information processing system 1 including the electronic medical record server 100 according to the present embodiment has been described. With such a structure, the electronic medical record server 100 prevents the oversight of medical treatment information that needs to be checked.
In a hospital, for example, when a physician checks the medical treatment information of a target patient, the period for which the medical treatment information of the target patient is displayed is different depending on a disease of the target patient, the purpose of referring to the medical treatment information, and the like. For example, when a physician wants to check the effect of treatment on a target patient, the physician retrieves each piece of medical treatment information of the target patient, and in order to compare the past medical treatment information and the current medical treatment information of the target patient, sets the period from the date and time of the medical treatment to be compared to the current date and time as the display period. Moreover, in the case of an emergency, the physician sets the most recent period as the display period in order to check the most recent medical treatment information of the target patient. If the physician is young or inexperienced, for example, such a physician may set the long display period.
In addition, the period for which the medical treatment information of the target patient is displayed is different depending on the type of medical treatment information. For example, if the physician wants to check the medical treatment information of vital data, blood test results, or the like of the target patient, or other specimen examinations, the physician sets the period from the date and time of the previous medical treatment to the current date and time as the display period in order to compare the previous medical treatment information and the current medical treatment information of the target patient. In addition, the display period may be set long when the physician wants to check the information about the target patient's tumor or the like.
Thus, when checking each piece of medical treatment information of the target patient, the physician needs to set the display period for each piece of medical treatment information. However, it takes time and efforts for physicians to set the display period.
Therefore, the electronic medical record server 100 in this embodiment performs the following process to prevent the oversight of the medical treatment information that needs to be checked. First, in the electronic medical record server 100 according to this embodiment, the acquiring function 113 acquires the operation information of the medical worker for the medical treatment information of the target patient. Based on the acquired operation information, the calculating function 114 calculates the concordance rate between the period for which the medical treatment information of the target patient is referred to and the period for which the medical treatment information of the target patient is displayed, and the controlling function 115 performs display of information about the concordance rate.
Here, for example, if the acquiring function 113 cannot acquire the operation information of the medical worker for the medical treatment information of the target patient, the acquiring function 113 acquires the operation information of the medical worker for the medical treatment information of a similar patient whose disease and the like are similar to those of the target patient. In this case, based on the acquired operation information, the calculating function 114 calculates the concordance rate between the period for which the medical treatment information of the similar patient is referred to and the period for which the medical treatment information of the target patient is displayed, and the controlling function 115 performs display of information about the concordance rate. As an example, description is made of a case in which the operation information of the medical worker for the medical treatment information of the target patient is acquired.
At step S101 in
Here, for example, the operation information includes the time for which the physician refers to the medical treatment information and the history when the physician accessed the medical treatment information as the contents of the operations by the physician. The time for which the physician refers to the medical treatment information includes click operations and a gazing time by eye tracking. For example, each of the terminals 10 to 30 includes a camera to capture images of a physician operating the terminal, and at step S101, the monitoring function 112 analyzes the images captured by the camera to measure the physician's line of sight (eye tracking) to collect the gazing time by the eye tracking.
At step S102 in
First, the process of the electronic medical record server 100 according to the first embodiment is described with reference to
At step S110 in
At step S111 in
At step S112 in
At step S113 in
At step S114 in
Here, as illustrated in
Next, the process by the electronic medical record server 100 according to the first embodiment will be described with specific examples.
In the example in
The precision corresponds to, for example, an index expressing how much medical treatment information referred to by the physician is included in the acquired medical treatment information of the patient. For example, the precision is the ratio of the value “R”, which is the number of pieces of medical treatment information referred to in the medical treatment information included in the display candidate period, to the value “N”, which is the number of pieces of medical treatment information included in the display candidate period in the acquired medical treatment information, and is calculated by Precision=R/N. For example, the value “R” represents the number of reference determinations “◯” as the number of pieces of medical treatment information referred to by the physician out of the value “N”. The value “N” is an example of “first value” and the value “R” is an example of “second value”.
The recall corresponds to, for example, an index expressing how comprehensively the medical treatment information referred to by the physician is displayed. For example, the recall is the ratio of the value “R” to the value “C,” which is the number of pieces of medical treatment information referred to in the acquired medical treatment information, and is calculated by Recall=R/C. For example, the value “C” represents the number of reference determinations “◯” in the acquired medical treatment information. The value “C” is an example of “third value”.
To increase the recall (Recall=R/C), R may be increased by extending the display candidate period, i.e., by increasing N. In this case, however, the precision (precision=R/N) will decrease. Thus, since there is a trade-off relation between the recall and the precision, the calculating function 114 calculates the F value, which is the harmonic mean of the precision and the recall, as the concordance rate. The F value is calculated by F=(2×precision×Recall)/(precision+Recall)=2R/(N+C).
Here, the calculating function 114 calculates the F value in a plurality of display candidate periods and determines the display period on the basis of the display candidate period with the maximum F value. In the example in
For example, the calculating function 114 calculates, by item, the F value on the basis of the operation information. In the example in
The calculating function 114 determines the display candidate period “2020/4/10 to 2020/7/10” including the date with the maximum F value in the medical treatment information “medicine A” to “medicine D” in the item “medicine administration date” to be the display period. In this example, the period from the surgery followed by the discharge from the hospital to the current date is determined to be the display period.
The calculating function 114 is also applicable to examinations using medical images, and determines the two dates “2020/3/18” and “2020/6/20” when the F value becomes local maximum (peak) in the item “CT image” to be the display period. In this example, the date before the surgery and the date after the discharge are determined to be the display period.
Thus, the calculating function 114 determines the appropriate display period that the physician may want to check for different types of medical treatment information.
Here, the controlling function 115 of the electronic medical record server 100 selects one or more items to be displayed on the terminal 10 of the physician. For example, the physician operating the terminal 10 may select the items, or the items referred to more frequently by the physician may be selected first. Alternatively, the selected items are obtained by input of information such as the target patient's disease into a learned model obtained by machine learning. For example, based on result data expressing the items that the physicians selected, items that were referred to very frequently by physicians are specified, and a learned model is generated by learning using the result data. The controlling function 115 specifies the items by input of information such as the target patient's disease into the learned model.
The controlling function 115 then causes the terminal 10 of the physician to display, by selected item, the medical treatment information for the display period determined by the calculating function 114. In the example in
As a first modification, the calculating function 114 may determine the period with the most frequent reference to be an important period in the determined display period, and the controlling function 115 may perform display in a larger granularity in the important period in the display period determined by the calculating function 114. For example, the calculating function 114 determines the display candidate period “2020/6/10 to 2020/7/10” with the maximum F value in the medical treatment information “Ca” and “white blood cell” in the item “specimen examination” to be the display period. Here, the calculating function 114 determines the period in which the physician refers to the medical treatment information “Ca” and “white blood cell” frequently in the display period “2020/6/10 to 2020/7/10” determined by himself/herself to be the important period. For example, the frequency of reference exceeds the set frequency in the period “2020/6/30 to 2020/7/10” in the display period “2020/6/10 to 2020/7/10”. In this case, the calculating function 114 determines the period “2020/6/30 to 2020/7/10” to be the important period, and the controlling function 115, as illustrated in
In the embodiment described above, the calculating function 114 determines the display candidate period with the maximum F value to be the display period, but in a second modification, the calculating function 114 may determine the display candidate period that includes the date with the maximum F value to be the display period. In the example in
In the second modification, the calculating function 114 adjusts the start, but in a third modification, the calculating function 114 may adjust both the start and the end. In the example in
In the third modification, the calculating function 114 determines the past period including the date with the maximum F value to be the display period. In a fourth modification, the calculating function 114 determines the past period including the date with the local maximum (peak) F value and the period including the date with the local maximum F value and the current date to be the display period. In the example in
As a fifth modification, the calculating function 114 may determine the display period in accordance with the relevance of the sub-items. For example, as expressed in the left part of
On the other hand, if the relevance of the sub-items is low because the temporal variation of the sub-items “Ca” and “white blood cell” and the temporal variation of the sub-items “γ-GTP” and “CEA” are not similar as the medical treatment information, for example, the calculating function 114 does not select the display period. In this case, as illustrated in the right part of
As a sixth modification, the calculating function 114 may determine the display period using the frequency of reference (views) as well as the length of period. For example, as illustrated in
As described above, in the electronic medical record server 100 in the first embodiment, the acquiring function 113 acquires the physician's operation information for the medical treatment information of the target patient or the physician's operation information for the medical treatment information of the similar patient who is similar to the target patient. Based on the operation information, the calculating function 114 calculates the F value, which is the concordance rate between the period for which the medical treatment information of the target patient or the medical treatment information of the similar patient is referred to and the period for which the medical treatment information of the target patient is displayed, and the controlling function 115 performs display of the information about the F value. Specifically, the calculating function 114 determines the period starting from the date when the F value is maximum and ending at the current date to be the display period, and the controlling function 115 performs the display of the medical treatment information for the display period determined by the calculating function 114. Alternatively, the calculating function 114 determines the period including the date when the F value is maximum to be the display period, and the controlling function 115 performs the display of the medical treatment information for the display period determined by the calculating function 114. Thus, the electronic medical record server 100 according to the first embodiment can prevent the oversight of the medical treatment information that needs to be checked.
In a second embodiment, the acquiring function 113 specifies the medical treatment scene of the target patient and acquires the physician's operation information for the medical treatment information of the target patient according to the specified medical treatment scene. For example, the medical treatment scene includes information about the target patient's disease. The information about the disease includes the name of the disease, the site of the disease, the treatment method, and the like. For example, the medical treatment scene includes a medical treatment phase, which is a period of time sectioned for each event. Examples of the medical treatment phase include a period from the initial consultation to hospitalization, a period from the hospitalization to a surgery, and a period from the surgery to discharge.
In the second embodiment, the acquiring function 113 can acquire the physician's operation information (action data) according to the medical treatment scene. For example, the acquiring function 113 acquires the medical treatment information of the target patient at step S110. Furthermore, at step S110, the acquiring function 113 acquires the medical treatment information of a similar patient who was in the medical treatment scene similar to the medical treatment scene specified at step S200, and who was treated by the physician in charge of the target patient. Then, the acquiring function 113 acquires the operation information about the operation performed on the similar patient by the physician in charge of the target patient at step S111. The similar patient may be one or more patients. The calculating function 114 determines the display period for the target patient on the basis of the operation information of the operation performed on the similar patient at step S112. For example, the calculating function 114 determines the display period for the target patient by applying the period determined for the similar patient to the target patient. Thus, the calculating function 114 can determine the display period according to the preference of the physician in charge of the target patient.
Alternatively, the similar patient targeted in the above example may be the similar patient who was in the medical treatment scene similar to the medical treatment scene specified at step S200, and who was treated by the physician in charge of the target patient and a physician with the same attribute as that of the physician. Thus, the calculating function 114 can determine the display period according to the preferences of the group to which the physician in charge of the target patient belongs.
Alternatively, the similar patient targeted in the above example may be the similar patient who was in the medical treatment scene similar to the medical treatment scene specified at step S200 and treated by a physician of any attribute. Here, the attributes include young, experienced, and specialist physicians. For example, the calculating function 114 determines the display period of the experienced physician, so that the controlling function 115 can provide educational information to younger physicians about what period of time the experienced physicians refer to in making their diagnosis. In other words, by comparing the display period of a younger physician with that of an experienced physician, the younger physician can find out points to be improved. In addition, since the calculating function 114 determines the display period of the specialist physician, the controlling function 115 can provide the point of view that only the specialist physician can provide.
In the second embodiment, the medical department may be used as the attribute. For example, if the target patient has an urgent disease, the acquiring function 113 acquires the medical treatment information and the operation information for the similar patient with the urgent disease at step S111, so that the calculating function 114 can determine the display period suitable for the patient with the urgent disease at step S112. For example, a display period for displaying the most recent medical treatment information is determined for the target patient with the urgent disease. On the other hand, if the target patient has a chronic disease, the acquiring function 113 acquires the medical treatment information and the operation information for the similar patient with the chronic disease at step S111, so that the calculating function 114 can determine the display period suitable for the patient with the chronic disease at step S112. For example, for the target patient with the chronic disease, the long display period is determined for displaying the medical treatment information.
In addition, in the second embodiment, depending on the medical treatment scene, the operation information according to the patient's condition can be acquired. For example, if the target patient has a sudden symptom, the acquiring function 113 acquires the medical treatment information and the operation information for the similar patient who had the sudden symptom at step S111, so that the calculating function 114 can determine the display period suitable for the patient with the sudden symptom at step S112. For example, for the target patient with the sudden symptoms, the display period for displaying the most recent medical treatment information is determined.
In addition, in the second embodiment, the operation information in accordance with the patient's location can be acquired depending on the medical treatment scene. For example, if the target patient is an outpatient, the acquiring function 113 acquires the medical treatment information and the operation information for the similar patient during the outpatient treatment at step S111, so that the calculating function 114 can determine the display period suitable for the outpatient at step S112. For example, for outpatients, the long display period is determined for displaying the medical treatment information. On the other hand, if the target patient is hospitalized, the acquiring function 113 acquires the medical treatment information and the operation information for the similar patient in the medical treatment during the hospitalization at step S111, so that the calculating function 114 can determine the display period suitable for the hospitalized patient at step S112. For example, for the hospitalized patient, the display period for displaying the most recent medical treatment information is determined.
Thus, the electronic medical record server 100 according to the second embodiment can determine the display period in accordance with the medical treatment scene.
A physician may refer to pieces of medical treatment information in combination. For example, a physician administers medicine to a target patient in consideration of the patient's symptoms, and checks the effectiveness and side effects of the medicine. In view of this, in a third embodiment, the calculating function 114 calculates the F value by combining the medical treatment information of the target patient acquired by item, and determines the display period using the calculated F value.
Here, as illustrated in
Thus, the electronic medical record server 100 according to the third embodiment can determine the display period considering the combination of the medical treatment information.
A physician may want to check the past symptoms and treatment history of the target patient or similar patients whose diseases and other conditions are similar to those of the target patient. In view of this, in a fourth embodiment, by determining the display target period using the past action patterns, the calculating function 114 determines the display period in the determined display target period. In this case, the physician may determine the display target period, or the acquiring function 113 may determine the display target period. For example, the display target period is the period for which the medical treatment information was referred to very frequently in the past according to the click operations, eye tracking, the access history, or the like.
Thus, the electronic medical record server 100 according to the fourth embodiment can determine the display period in consideration of the past symptoms and treatment history of the target patient or the similar patient.
Each component of each device illustrated in the first embodiment to the fourth embodiment is conceptual in terms of function, and does not necessarily have to be physically configured as illustrated in the drawings. In other words, the specific form of dispersion and integration of the devices is not limited to that illustrated in the figure, but can be configured by functionally or physically dispersing or integrating all or some of them in arbitrary units according to various loads and usage conditions. Furthermore, all or any part of each processing function performed by each device can be realized by a CPU and a computer program analyzed and executed by the CPU, or by hardware using wired logic.
The methods described in the first embodiment to the fourth embodiment can also be realized by executing a computer program prepared in advance on a computer such as a personal computer or workstation. This computer program can be distributed via the Internet or other networks. This computer program can also be recorded on a computer-readable non-transitory recording medium, such as a hard disk, flexible disk (FD), CD-ROM, MO, or DVD, and executed by being read out from the recording medium by a computer.
According to at least one of the embodiments described above, medical treatment information that needs to be checked can be prevented from being overlooked.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel embodiments described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the embodiments described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.
Number | Date | Country | Kind |
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2021-181011 | Nov 2021 | JP | national |