This application is based upon and claims the benefit of priority from the prior Japanese Patent Application No. 2004-220268, filed Jul. 28, 2004, the entire contents of which are incorporated herein by reference.
1. Field of the Invention
The present invention relates to a medical practice information management system for managing a medical practice such as blood transfusion operated for a patient and a medical practice operation assistance terminal such as mobile information terminal for use in the system.
2. Description of the Related Art
Various medical practices are provided for a patient in a hospital. Various systems are developed for assisting such medical practices.
As such a system, a system disclosed by a below noted patent document 1 configures a subsystem installed close to a hospital section (simply “section” hereinafter unless otherwise noted), where a medical practice is carried out, and enables to input information about the operation being completed through the subsystem.
[Patent document 1] Japanese patent application publication No. 2002-252064 “Hospital information system”
The system disclosed by the patent document 1 makes it possible to grasp a progress of medical practice, et cetera, in real time or semi-real time by installing a subsystem close to a section where the medical practice is carried out. Among medical practices, however, some are desired to be responsive to an order change relating to the medical practice for example as a result of referring to the medical practice prior to carrying out such as blood transfusion.
The challenge of the present invention is to provide a medical practice information management system and medical practice operation assistance terminal which make it possible to reflect an operation of medical practice in real time or semi-real time and respond to a content change thereof.
In a first aspect of the present invention, a medical practice information management system, for managing medical practice information through a medical practice information management apparatus exchanging data with one or more number of medical practice operation assistance terminals, wherein the medical practice information management apparatus comprises a medical practice storage unit for storing a medical practice carried out for a patient and a plurality of items constituting the aforementioned medical practice by correlating the former with the latter, a search unit for searching the stored medical practice based on information contained by a received acquisition request if the acquisition request for the stored medical practice is received, and a transmission unit for transmitting information about the search result performed by the search unit back to a sender of the acquisition request; and the medical practice operation assistance terminal comprises a medical practice acquisition unit which is capable of transmitting an acquisition request of a medical practice to the medical practice information management apparatus, and acquiring the medical practice(s) related to the acquisition request; a judgment unit comparing identifier of the readout item of a medical practice and identifier of the item specified among the displayed items of the acquired medical practice(s); and an acquisition decision maker unit for deciding whether or not the medical practice acquisition unit is to be activated with the specified item as search condition in accordance with a category of the specified item constituting the medical practice, if a readout identifier information identifies with the identifier information of the specified item.
In a second aspect of the present invention, a medical practice operation assistance terminal, capable of accessing a data base for managing information relating to a medical practice carried out for a patient, comprises a medical practice acquisition unit which is capable of transmitting an acquisition request of a medical practice to a data base storing information relating to medical practice(s), and acquiring the medical practice(s) related to the acquisition request; a judgment unit comparing identifier of the readout item of a medical practice and identifier of the item specified among the displayed items of the acquired medical practice(s); and an acquisition decision maker unit for deciding whether or not the medical practice acquisition unit is to be activated with the specified item as search condition in accordance with a category of the specified item constituting the medical practice, if a readout identifier information identifies with the identifier information of the specified item.
In a third aspect of the present invention, a medical practice information management method, in the method for managing medical practice information by a medical practice information management apparatus exchanging data with one or more number of medical practice operation assistance terminals, comprises the steps of the medical practice information management apparatus searching for a medical practice carried out for a patient within a data base accessible from a medical practice information management apparatus which stores the medical practice together with a plurality of items constituting the medical practice based on information contained by a received acquisition request, if the acquisition request for the stored medical practice is received from any one of the one or more number of the medical practice operation assistance terminals, and responding back to a transmitter of the acquisition request with information about the search result; and the medical practice operation assistance terminal acquiring a search result by making the medical practice information management apparatus search, by transmitting thereto an acquisition request relating to the stored medical practice, a plurality of items constituting the stored medical practice by a prescribed search condition contained by the acquisition request, displaying a list of acquired items constituting a medical practice or information based on acquired items constituting the medical practice in a display of the medical practice operation assistance terminal, comparing identifier information for identifying readout item constituting a medical practice with a responsible item within the medical practice specified as a part of the item list screen, and deciding whether or not the medical practice acquisition unit is to be activated as a specified item as search condition in accordance with a category of the specified item constituting a medical practice if readout identifier information identifies with identifier information contained by the specified item.
In a fourth aspect of the present invention, a medical practice operation assistance method, in the method for a computer assisting when carrying out a medical practice for a patient, comprises the steps of displaying in a screen a list of items constituting a medical practice acquired from a data base or information based on an acquired list constituting the medical practice in response to an acquisition request transmitted to an apparatus managing a data base which stores the medical practice and a plurality of items constituting the aforementioned medical practice by correlating the former with the latter; comparing identifier information about an item constituting a medical practice specified as a part of the item list screen with identifier information about an item constituting a medical practice which has been read out by way of an input unit; and deciding whether or not the acquisition request is to be transmitted to a management apparatus managing the data base so as to have each item constituting a medical practice stored in the data base searched by the specified item as search condition in accordance with a category of the specified item constituting a medical practice, if readout identifier information identifies with identifier information about the specified item.
In a fifth aspect of the present invention, a storage medium storing a program for making a computer manage information about a medical practice, wherein the program makes the computer carry out the steps of changing an operation status of a corresponding item within a storage unit of the computer which stores a medical practice carried out for a patient and a plurality of items constituting the medical practice by correlating the former with the latter to an “operation completed” based on a received information about “operation completed” which indicates that a prescribed item constituting the medical practice has been carried out; acquiring a search result by searching a medical practice stored by a storage unit of the computer by using a search condition contained by a received acquisition request for the medical practice or a search condition obtained from the acquisition request; and transmitting an acquired search result to an apparatus which is a transmitter of an acquisition request.
In a sixth aspect of the present invention, a storage medium storing a program for making a computer assist in carrying out a medical practice for a patient, wherein the program makes the computer carry out the steps of displaying, in a screen, a list of items constituting a medical practice acquired from the data base, or information based on acquired items constituting the medical practice in response to an acquisition request transmitted to an apparatus managing a data base which stores the medical practice and a plurality of items constituting the aforementioned medical practice by correlating the former with the latter; comparing identifier information about an item constituting a medical practice specified as a part of the item list screen with identifier information about an item constituting a medical practice which has been read out by way of an input unit; and deciding whether or not the acquisition request is to be transmitted to a management apparatus managing the data base so as to have each item constituting a medical practice stored in the data base searched by a specified item as search condition in accordance with a category of the specified item constituting the medical practice, if readout identifier information identifies with identifier information about the specified item.
The present invention enables a carried-out medical practice to be reflected to the data base storing the medical practice in real time or semi-real time. Furthermore, information relating to the specified item constituting the medical practice can be obtained by way of the acquisition decision maker unit prior to carrying out the medical practice, and therefore it is possible to respond to a content change thereof (i.e., order).
The following is a detailed description of the preferred embodiment of the present invention while referring to the accompanying drawings.
The medical services information management system 1 is installed in a medical facility such as a hospital and comprises an intra-hospital information management system 2 including an intra-hospital information management apparatus (not shown herein) capable of accessing a data base (not shown herein) which manages information relating to various medical practices carried out within the medical facility (i.e., hospital) and one or more number of subsystems 4A and 4B, respectively, which are connected with the intra-hospital information management system 2 by way of a network 3 for example and capable of renewing respective pieces of information relating to medical practices registered in the data base by accessing the data base within the intra-hospital information management system 2 by way of the network 3.
The above described data base stores each item constituting a medical practice created based on the inputted medical practice carried out for a patient by relating thereto.
Note that the present embodiment is configured to enable some of the subsystem, such as a server apparatus 5 constituting the subsystem 4A to access the data base, but can be configured differently so as to enable a server apparatus (i.e., intra-hospital information management apparatus), for example, constituting the intra-hospital information management system 2 to access the data base directly.
In
Meanwhile, the server apparatus 5 is enabled to receive, by way of a receiving unit 24, “operation completed” information for indicating that a prescribed item within the medical practice has been carried out. In this event, an operation status change unit 26 changes the operation status of the relating item of the medical practice to “operation completed” based on the “operation completed” information.
Furthermore, the server apparatus 5 is enabled to receive, by way of a receiving unit 24, an acquisition request for a medical practice. In this event, a search unit 25 searches for a medical practice stored by the medical practice storage unit 31 by a search condition either contained by the received acquisition request or created based thereon to acquire a search result which is then transmitted to a transmitter of the search condition by a transmission unit 23.
Note that each PC terminal 6 subordinate to the server apparatus 5 has an operation assistance function for a medical practice.
The operation assistance function for a medical practice is largely categorized into the function of transmitting “operation completed” information to an apparatus managing the data base 30 so as to reflect the “operation completed” information thereon for indicating that an item within the medical practice for which the apparatus is responsible has been carried out, and that of querying whether or not a responsible item of the medical practice is to be carried out in terms of the above described sequence of operation.
In
Incidentally, the input unit 41 is constituted by, for example, an identifier code reader for reading out an identifier code such as OCR printed on a medium as a subject of reading.
Respective items constituting a medical practice are largely categorized into practices requiring to be carried out on the patient's side and practices not requiring as such. For example, considering the case of blood transfusion (simply “transfusion” hereinafter unless otherwise noted) as an example of medical practice, the transfusion itself belongs to the former category, while a cross matching test, et cetera, belong to the latter.
In relation with
Note that a stationary PC terminal 6 is usually used for the subsystem 4A, while a mobile information terminal (e.g., personal digital assistant; PDA) 8 is usually used for the subsystem 4B. The mobile information terminal allows a hand carry up to the patient's side, thereby enabling information relating to a medical practice carried out on the patient's side, such as a transfusion, to be reflected in the above described data base 30 in real time. Note also that an access point 10, used for the PDA 8 communicating with a server 7 which is included in the subsystem 4B to assist an operation of medical practice, is desirably installed in the neighborhood of the patients' room.
In
Note that the transmission unit 53 and receiving unit 57 is comprised by a wireless LAN card 11 shown by
Also note that the server 7 included in the subsystem 4B mainly transfers the above described “operation completed” information or query information to an apparatus in need of the information or an apparatus having information so as to enable its own apparatus to be capable of answering such query.
The following description deals with the case of carrying out a transfusion as a medical practice. Let it describe an example case of transfusion.
First, a physician issues a transfusion order to a transfusion department within the hospital as follows: “Make ready with three MAP (Mannitol Adenine Phosphate) s and one FFP (Fresh Frozen Plasma) for a surgery for the patient A.”
Over at the transfusion dept., a responsible person places an order on the blood center, et cetera, for the specified formulation to obtain it, as well as registers the transfusion order with the data base 30 shown by
The obtained formulations from the manufacturer bear identifier numbers as follows:
MAP 12-3456-7890
MAP 12-3456-1112
MAP 12-3456-2222
FFP 12-3456-2000
A cross-matching of these formulations with the sampled blood is then conducted to produce a result as follows:
MAP 12-3456-7890: Passed a cross-matching
MAP 12-3456-1112: Passed a cross-matching
MAP 12-3456-2222: Failed a cross-matching
FFP 12-3456-2000: A cross-matching not required
A decision is made based on the cross-matching result for carrying out a transfusion of the passed two MAPs and one not-required FFP.
An ensuing transfusion for the patient A in the patient's room (or surgical unit or hematological medicine dept.) obtains a result as follows:
MAP 12-3456-7890: 100% transfused
MAP 12-3456-1112: Not transfused due to a side effect
FFP 12-3456-2000: 100% transfused
As shown by
The “order registration” is set as “complete” automatically when the transfusion order is registered, while the other items will be treated as “complete” when the operation status change unit 26 shown by
The received “operation completed” information contains criteria items, i.e., the practician, operation date & time, contents of operation items. And the criteria for dealing as “operation completed” or not is judged either based on whether or not respective data are entered for the above noted criteria items, i.e., practician, operation date & time, contents of operation items, or by referring to each “operation completed” flag which is attached to each of the above described criteria items.
The “instruction received” is treated as “complete” when an apparatus (not shown in
The “specimen label issue” is treated as “complete” when a PC terminal 6 installed in the section issuing a specimen label for example transmits information about “a specimen label issued” to an apparatus managing the data base when issuing the specimen label as identifier information for identifying the transfusion order.
The “blood sampling” is treated as “complete” when a PC terminal 6 installed in the responsible section transmits a message about putting the blood sample taken from the patient into the test tube bearing the issued specimen label to an apparatus managing the data base.
The “cross-matching” is treated as “complete” when a PC terminal 6 installed in the responsible section for example transmits a message about carrying out a cross-matching of the drawing blood sample with each of formulations obtained from the respective manufacturers and obtaining all the results to an apparatus managing the data base.
The “transfusion start” is treated as “complete” when a PDA 8 transmits a message about starting a transfusion for the patient to an apparatus managing the data base.
The “transfusion end” is treated as “complete” when a PDA 8 transmits a message about ending a transfusion for the patient, which has already started, to an apparatus managing the data base.
When a responsible practician, such as a physician, who has issued a transfusion order canceling the transfusion order, she or he “cancels” it. The “cancellation” is carried out by a terminal of the responsible section transmitting the “cancellation” information to an apparatus managing the data base 30. And the apparatus managing the data base 30 receives the information and then the operation status change unit 26 shown by
When a responsible practician, such as a physician, who has issued a transfusion order aborting the transfusion order, she or he “aborts” it. The “abortion” is carried out by a terminal of the responsible section transmitting the “abortion” information to an apparatus managing the data base 30. And the apparatus managing the data base 30 receives the information and then the operation status change unit 26 shown by
Incidentally, the “cancellation,” and “abort” among the above described do not have any sequence of operation in relation with other items, as with the other items.
Each item constituting a medical practice order, such as a transfusion order, is created as a work schedule data at the time of registration. The work schedule data is created as a file in an XML structure for example, with a content of tag indicated by <progress> in the file being changed from “scheduled” to “operation completed” when the item is carried out.
In
A tag <instruction content> indicates a route and transfusion speed for the transfusion. And an <object material> specifies a kind of transfusing formula, such as MAP, FFP, et cetera.
The work schedule data shown by the second column of
In
In
Once the transfusion order is registered, the system gives identifier information thereto for identifying the transfusion order. Then a specimen label containing the identifier information is outputted (i.e., issued). The issued specimen label is then attached to a test tube in which will be put the sampled patient's blood. Information about the specimen label being issued is sent either from the server apparatus or PC terminal within the transfusion management system to the server apparatus therein as “operation completed” information. The operation status change unit 26 shown by
In
Having received the transfusion order acquisition request, the server apparatus within the transfusion management system searches in the data base using a search condition for a medical practice either contained by the transfusion order acquisition request or created by a server apparatus within the transfusion management system, and acquires the search result.
The search condition maybe, for example, all items respectively constituting medical practices which are scheduled in a prescribed time after the clock time when the server apparatus within the transfusion management system received. Furthermore, it is also possible to narrow down the overall items constituting the medical practices scheduled to carry out by identifying a section which the apparatus transmitting the transfusion order acquisition request belongs to.
Incidentally, if a transmitter does not specify a search condition, the usual method is to acquire all the items constituting the medical practices around the clock time at which the acquisition request has been made, in consideration of the transmitting section; whereas, if the transmitter specifies a search condition so as to acquire data relating to transfusion order, such an acquisition request can be considered as a “transfusion order acquisition request”.
The acquired search result is then received over at the mobile terminal (i.e., PDA) by way of a server apparatus within the hospital information system, followed by the display & specification unit 55 shown by
Referring to
A responsible person such as a medical staff selects (i.e., specifies) an item relating to a blood sampling carried out for the patient from this point on, from among a list of not done items displayed in the screen of the mobile terminal.
By this specifying, the screen displays a message prompting to read a patient ID printed on the patient wrist band by using the input unit (e.g., identifier code reader) so that the medical staff reads it out according to the message. The judgment unit 54 shown by
If identification is made, the screen then displays a message prompting to let the input unit read an identifier ID identifying a transfusion order printed on the specimen label on the specimen container, the medical staff carries out the readout according to the message. The judgment unit 54 shown by
Incidentally, when selecting (i.e., specifying) an item corresponding to the blood sampling carried out for the patient from this point on, from a list of not done items displayed in the screen of the mobile terminal, an item processing decision maker unit not shown by
Following the blood sampling, a cross-matching is carried out, which will be done in a section where the server apparatus or PC terminal of the transfusion management system is installed or nearby the section.
That is, a required formulation is delivered, a cross-matching is done by using the formulation and the sampled blood of the patient, a cross-matching result is registered in the data base upon finishing it and a formulation label to be attached onto each formulation pack is issued (i.e., outputted) at the same time for the registration. Note that the registration method for the cross-matching result is the same as in the case of the above described blood sampling.
Now turning to the sequence chart shown by
In
A medical staff such as a nurse selects the items applicable to carrying out a transfusion for the transfusion order, such as a transfusion MAP, prior to carrying out a transfusion for the patient as per the transfusion order.
When an item applicable to carrying out a transfusion is selected (i.e., specified) (assumption here is that the list which has been already acquired through the above described “transfusion order” acquisition request contain items applicable to carrying out a transfusion as shown by
On the other hand, if all the preceding items are completed, the screen display changes to prompt reading out identifier information indicating a patient ID which is printed on the patient wrist band (S104).
As the medical staff reads the identifier information out of the patient wrist band, the judgment unit 54 shown by
If the patient ID included in the selected transfusion MAP does not identify with the readout patient ID, the screen displays a message warning a false identification of patient (S106). On the other hand, if the patient ID included in the selected transfusion MAP identifies with the readout patient ID, the screen displays a message to prompt to read out identifier information (ID) of blood formulation, which is attached to the formulation pack (S107).
As the medical staff reads the identifier information (of the blood formulation) out of the label attached to the formulation pack, the judgment unit 54 shown by
If the blood formulation ID included in the selected transfusion MAP does not identify with the blood formulation ID on the readout label of the formulation pack, the screen displays a message warning a false identification of formulation (S109).
On the other hand, if the blood formulation ID included in the selected transfusion MAP identifies with the blood formulation ID on the readout label of the formulation pack, the acquisition decision maker unit 58 shown by
Then, referring to the search result, the judgment unit 54 shown by
If the check has produced a result such as a cross-matching test result not inputted, no cross-match, et cetera, the screen displays a message prompting to carry out a cross-matching (S112).
On the other hand, if a cross-matching is already done, with the result having been inputted and a cross-match having been confirmed, then the screen displays, along with a transmission button to be pressed when a transfusion is started, a message prompting to start the transfusion (S113).
Incidentally, while the flow chart shown by
Such configuration enables a medical staff, et al, to comprehend the information about a medical practice prior to carrying out the medical practice such as transfusion, hence responsive to an order change relating to the medical practice as well.
Going back to
Note that the present embodiment is configured to manage a transfusion start and end for each pack of blood formulation in order to manage an operation process of transfusion more finely. This will require managing a transfusion start and end for each formulation pack in the case of one transfusion order consisting of transfusing two MAPs and one FFP in sequence for example.
In the sequence chart shown by
That is, identifier information of the blood formulation is read by way of the input unit at a transfusion end. The judgment unit 54 shown by
If it is not the one with which the transfusion started, the judgment unit 54 lets the screen of the mobile terminal display a message warning a false identification of formulation pack. Meanwhile, if it is the one with which the transfusion started, a transfusion end information & side effect report is transmitted, by way of the server apparatus of the hospital information system, to the server apparatus of the transfusion management system, and registered in the data base comprised thereby.
According to the present invention, a progress of medical practice is reflected to the data base as a result of the medical practice information management apparatus and medical practice operation assistance terminal exchanging “operation completed” information for example as described above, and in particular the reflection in the data base can be done in real time or semi-real time as a result of installing the medical practice operation assistance terminal close to a section where the items constituting the medical practice, or moving close thereto. Furthermore, information relating to the specified items constituting a medical practice can be acquired by way of the acquisition decision maker unit prior to carrying out the medical practice, hence enabling a response to a content change of the medical practice (i.e., order).
As shown by
Number | Date | Country | Kind |
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2004-220268 | Jul 2004 | JP | national |