1. Field of the Invention
The present invention relates to a system and a method for disclosing personal information such as medical record information.
2. Description of the Prior Art
Recently, an electronic medical record system has been proposed and commercialized gradually, in which medical records of patients are stored and managed as electronic data. Use of this system facilitates disclosure of medical records from one medical institution to another medical institution via a network. If medical records of patients can be shared among plural medical institutions, more effective and efficient medical service can be provided to patients.
However, if the conventional electronic medical record system is simply connected to a network for sharing medical records, there is possibility that unspecified number of people see the medical records. Therefore, there is a system proposed as disclosed in “EMI net, Medical information network in Matsudo city”, Katsuhiko Takabayashi, New Medical Care (Shin-iryou) September, 2002, ME Promotion Association.
The system described in the above mentioned document enables a plurality of medical institutions located in a predetermined area to share medical information of patients. In order to see the information, it is necessary to obtain a user authentication by using a fingerprint or an IC card. The user authentication by using a fingerprint or an IC card is known well as described in Japanese unexamined patent publication 2002-259562.
Generally, Before a medical record is disclosed to another doctor, a doctor who wrote the medical record usually consults with the patient about the medical record to be disclosed or not. In addition, a doctor does not always disclose a medical record written by himself or herself to any doctor who is qualified for medical practice, but in most cases, he or she discloses a medical record only to a reliable doctor.
Therefore, even if the system described in the first above-mentioned document is used, promotion of sharing medical records depends on a medical institution or a connection between doctors. Namely, unless a doctor has a positive thinking about disclosing medical records to other doctors, an installation of the system cannot produce an expected result.
On the other hand, patients have been increasing recently who want to know about validity of a diagnosis or a treatment plan made by a medical attendant or a family doctor. For this reason, such a patient may ask a doctor of a medical institution that has no relationship with the family doctor, i.e., a second doctor for an opinion (a second opinion). When the second doctor forms a second opinion, it is desirable for him or her to see a medical record written by the family doctor. As described above, however, the family doctor may not disclose the medical record to another doctor who does not have a connection with him or her in most cases.
According to the conventional method as described above, medical records are shared only between doctors who have a connection with each other. Therefore, when a patient asks for a second opinion, it is difficult for a second doctor to see a medical record written by a family doctor.
In addition, when setting for sharing information is performed in the method described in the first above-mentioned document, information of a patient is disclosed to every medical institution equally. Therefore, though an IC card or the like may be used for user authentication to maintain a predetermined level of security, it is inevitable that the information of the patient will be disclosed to a person who does not need the information. As a result, there is still a risk for a patient that his or her personal information might leak.
An object of the present invention is to provide a system for disclosing personal information such as a medical record more appropriately than the conventional system.
According to one aspect of the present invention, a system for disclosing personal information includes a storage portion for storing personal information of people who are provided with a service, a disclosure attribution setting portion for setting a disclosure attribution for each of the personal information, the disclosure attribution being an attribution of people who can see contents of the personal information, a provider attribution setting portion for setting a provider attribution for each of service providers, the provider attribution being an attribution about a service provider, a disclosure permissibility decision portion for deciding whether it is permissible or not to disclose the personal information to the provider by comparing the provider attribution of the provider with the disclosure attribution of the personal information, and an output portion for delivering the personal information to the provider when the disclosure permissibility decision portion decides it is permissible to disclose the personal information to the provider.
The system for disclosing personal information is used for disclosing a medical record, for example. The storage portion stores the personal information such as medical record information of patients who are provided with medical practice such as a medical examination. The provider attribution setting portion sets the provider attribution that is an attribution of a medical expert such as a doctor or a pharmacist. The attribution of a medical expert indicates what kind of qualification and what kind of specialty the medical expert has, for example.
The provider attribution setting portion can be plural. In this case, the disclosure permissibility decision portion decides whether it is permissible or not to disclose contents of the medical record information to the medical expert by comparing one or more of the medical expert attributions of the medical expert with the disclosure attribution of the medical record information.
According to the present invention, personal information such as a medical record can be disclosed more appropriately than the conventional system. In addition, an attribution of a medical expert such as a doctor can be set in more detail, so that a medical record can be disclosed more appropriately.
Hereinafter, the present invention will be explained more in detail with reference to embodiments and drawings.
The medical record information disclosure system 1 according to the present invention includes diagnostic type terminal devices 2 and 3, a medical record information server 4, an authority system 5 and a communication line 6 as shown in
The medical record information disclosure system 1 is used for disclosing information (i.e., a medical record) of a patient who was provided with a medical practice such as consulting, healing, an examination or a medication in a medical institution to another medical expert (e.g., a doctor, a dentist or a pharmacist) of another medical institution. Hereinafter, a case is exemplified where medical record information of a patient in a hospital A that includes a plurality of medical departments is disclosed to another medical expert in another medical institution.
The medical record information server 4 is installed in a data center for managing information about patients, doctors, dentists, pharmacists and staffs in the hospital A. The medical record information server 4 includes a medical record master 41, an item information database 42 and a policy master 43.
The medical record master 41 stores medical record information 71 of patients as shown in
Information about contents of the medical record is stored in fields “medical history”, “remark”, “X-ray”, “memo” and “prescription”. It is possible to store data of each of contents directly in these fields, but in this embodiment, URLs (Uniform Resource Locators) that indicate storage locations and names of the data are stored in these fields.
A term “policy” means a condition for disclosing the medical record information 71 to a medical expert in a medical institution except for the hospital A (hereinafter referred to as a “disclosure condition”). In this embodiment a plurality of patterns of data indicating the disclosure condition is prepared as being described later, and an ID of a pattern that is suitable for the disclosure condition (the policy ID shown in
The medical record information 71 also includes information about a creation date, a doctor who created it, a last update date and a last update doctor.
The item information database 42 includes five types of data as files as shown in
Namely, the fields from “medical history” to “prescription” of the medical record information 71 shown in
The policy master 43 stores a plurality of policy information 72 that indicates a disclosure condition as shown in
In addition, the medical record information server 4 includes a patient master storing information such as name, address, age and sex of each patient in connection with the patient ID, a doctor master for storing information such as name, department, address, age and sex of each doctor in the hospital A in connection with the doctor ID, a staff master storing information of other staff, and other databases.
With reference to
In this embodiment an example will be described in which the authority system 5 is installed in an academy of each department such as surgery or ophthalmology, in a medical association of each region and in each organization such as a medical corporation running one or more medical institutions as shown in
The diagnostic type terminal device 2 is installed at least one for each department in the hospital A. Programs and data are installed in the diagnostic type terminal device 2 so as to realize functions including a medical record process portion 21 and a policy information setting portion 22 as shown in
The diagnostic type terminal device 3 is installed in a medical institution except for the hospital A. Programs and data are installed in the diagnostic type terminal device 3 so as to realize functions including a disclosure permissibility decision portion 31, a medical record information obtaining portion 32 and a medical record information output portion 33 as shown in
Each of the medical experts in the hospital A is provided with a qualified person card CR in which an IC chip is embedded. In addition, medical experts of other hospitals are also provided with qualified person cards CR. The qualified person card CR stores information about attributions of the medical expert. The information is recorded in the qualified person card CR by the authority system 5. On this occasion, each organization examines identity of the medical expert such as a qualification the medical expert has, a predetermined training course the medical expert took or the membership of the organization the medical expert has. Namely, the information is for certifying that the attribution of the medical expert is authentic and that the medical expert is a doctor certified by the organization. Hereinafter, the information is referred to as “authority information 73”.
For example, the qualified person card CR of a doctor DR1 who is a surgeon in the hospital A stores authority information 73 including authority information 73a certified by Ministry of Health, Labor and Welfare, authority information 73b certified by the medical corporation X, authority information 73c certified by Association of surgeons and authority information 73d certified by the medical association in the region L as shown in
Patients in the hospital A are provided with patient cards KR. This patient card KR stores an ID for identifying the card, a name of the patient, policy information 72 that is a disclosure condition for the medical record information 71 of the patient and other information.
Hereinafter, contents of processes of each device of the medical record information disclosure system 1 will be described by dividing the processes into processes for registering the medical record information 71 and the policy information 72, and processes for viewing the medical record information 71.
(Processes for Registering the Medical Record Information 71 and the Policy Information 72)
In
Before starting the consulting, the doctor DR1 sets his or her qualified person card CR (see
Then, the medical record process portion 21 downloads the medical record information 71 (see
The doctor DR1 clicks an edit button BN12 in order to edit the medical record information 71. Then, the medical record edit screen HG2 as shown in
The doctor DR1 enters a result of consultation with the patient KN1 and others in text boxes TX21-TX25 (#104). However, a URL of an image file of an X-ray photograph (the X-ray file FL3) is entered in the text box TX25, or an image is pasted there. After the input process is finished and an OK button BN2 is clicked, the entered contents are displayed as a medical record screen HG1, so the doctor DR1 confirms there is no mistake and clicks the return button BN11.
Then, the medical record process portion 21 transmits the contents that were entered into the text boxes TX21-TX25 to the medical record information server 4. The medical record information server 4 performs a process for updating or registering the medical record information 71 and the medical history file FL1, . . . , the prescription file FL5 in accordance with the received contents (#105). In this way, registration or update of the medical record of the patient KN1 is completed.
The patient KN1 can have his or her medical record information 71 disclosed to a doctor or other medical expert of a medical institution except for the hospital A so as to take a healing or a second opinion also in the medical institution except for the hospital A. In this case (Yes in #106), the doctor DR1 performs a predetermined operation so that the disclosure condition set screen HG3 as shown in
Default data entered in these text boxes are the policy information 72 (see
The doctor DR1 consults with the patient KN1 to decide the disclosure condition of the medical record information 71. If the default policy information 72 of the doctor DR1 is acceptable (Yes in #108), the return button BN31 is clicked. Then, the policy information setting portion 22 transmits the policy ID read in the step #101 to the medical record information server 4 (#110) and writes the medical record ID of the medical record information 71 and the policy information 72 of the policy ID being connected to each other into the patient card KR of the patient KN1 (#111). The medical record information server 4 receives the policy ID and stores the same in “policy ID” of the medical record information 71.
If other policy information is desired than the default policy information 72 (the disclosure condition) (No in #108), the doctor DR1 changes contents in the text boxes TX31-TX35 (#109) and clicks the return button BN31. Then, the policy information setting portion 22 transmits the contents to the medical record information server 4 (#110) and writes the same being connected with the medical record ID of the medical record information 71 into the patient card KR of the patient KN1 (#111). The medical record information server 4 receives the contents as new policy information 72 and registers the same in the policy master 43. The medical record information server 4 also stores the policy ID of the new policy information 72 in “policy ID” of the medical record information 71 of the patient KN1.
(Process for Viewing the Medical Record Information 71)
The diagnostic type terminal device 3 obtains the medical record information 71 of the patient in the hospital A who visits for consulting in a procedure as shown in
The qualified person card CR of the doctor DR2 stores the authority information 73 as shown in
In
The disclosure permissibility decision portion 31 compares the read policy information 72 with the authority information 73 so as to decide whether it is permissible to disclose the medical record information 71 of the read medical record ID (#203). For example, the policy information 72 and the authority information 73 are expressed by binary numbers, and a logical product (AND) of them is operated. If the result is “1”, it can be decided that the disclosure is permissible.
As shown in “policy ID=P003” shown in
If it is decided there is no item that is permissible to be disclosed (No in #203), the process is finished.
If it is decided it is permissible to disclose all or a part of the items (Yes in #203), the doctor DR2 asks the patient KN1 for permission to view the medical record information 71. If the permission is obtained, it is entered in the diagnostic type terminal device 3 (Yes in #204). On this occasion, it is possible to ask the patient KN1 to enter a password that only the patient KN1 knows. In this case, the password is recorded in the patient card KR of the patient KN1 in advance, and matching between the entered password and the recorded password is performed. If the permission is not obtained (No in #204), the process is finished.
The medical record information obtaining portion 32 accesses the medical record information server 4 so as to obtain the medical record information 71 indicated by the medical record ID that is read out in the step #202 as well as the medical history file FL1, . . . , the prescription file FL5 from the URL indicated by the medical record information 71 (#205). However, it is allowed to obtain only the information of the item that is decided to be permissible to be disclosed in step #203.
The medical record information output portion 33 delivers the obtained medical record information 71 and contents of the file (#206). For example, the medical record reference screen HG4 as shown in
The card reader and writer 3RW records history information indicating that the doctor DR2 viewed the medical record information 71 during this consulting in the patient card KR of the patient KN1 (#207). Thus, the doctor in the hospital A can see who viewed the medical record information 71 when the patient KN1 visits the hospital A later.
According to this embodiment, medical record information is disclosed only to a person who satisfies a predetermined condition required by a patient and a doctor. In addition, satisfying the condition is certified by an authentication basis or a public authentication basis that is administrated by a government or an organization such as a medical association. Therefore, medical record information of a patient can be disclosed more appropriately than the conventional system, so that security can be improved.
In this embodiment, an example is described in which the medical record information 71 of the patient KN1 in the hospital A is disclosed to the doctor DR2 in another hospital B. In addition, it is possible to disclose the medical record information 71 in the hospital B to the doctor DR1 in the hospital A when the patient KN1 who took consulting in the hospital B takes consulting again in the hospital A. As a method for realizing this, there are following two methods considered, for example.
In one method, the policy information 72 is set also in the medical record information 71 that is managed in the hospital B similarly to the case of the hospital A. Namely, it is set in advance so that both of the hospitals A and B can view the medical record information 71 of each other.
In another method, at the timing when the doctor DR2 in the hospital B views the medical record information 71 of the patient KN1 in the hospital A, the policy information 72 is set so that the doctor DR1 in the hospital A can view the medical record information 71 of the patient KN1 made by the doctor DR2.
In this embodiment, the medical record information 71 is managed integrally by the medical record information server 4, and the diagnostic type terminal devices 2 and 3 obtain the medical record information 71 from the medical record information server 4 and deliver the same. However, it is possible to record the medical record information 71 in the patient card KR of each patient. In this case, the diagnostic type terminal devices 2 and 3 are structured so that the medical record information 71 can be obtained only if it is decided that the doctor who wants to view the medical record information 71 is qualified.
It is possible to decide whether it is permissible or not to disclose in accordance with the authority information 73 of the doctor DR1 not only in the case where a doctor in another hospital views the medical record information 71 stored in the medical record master 41 in the hospital A but also in the case where the doctor DR1 in the hospital A views the same (step #103 in
In this embodiment, the diagnostic type terminal device 2 that is used by the party whose medical record information 71 is viewed is distinguished from the diagnostic type terminal device 3 that is used by the party who views the information. However, it is possible that one terminal device has both functions of the diagnostic type terminal devices 2 and 3.
In order to improve reliability of the authority information 73, PKI (Public Key Infrastructure) may be adopted. In this case, the authority information 73 is encrypted by a secret key and is recorded on the qualified person card CR of a doctor. The public key certificate of the authority information 73 is also recorded on the qualified person card CR. The diagnostic type terminal device 3 requests the certificate authority to verify the public key certificate to be authentic and performs a process for disclosing the medical record information 71 in accordance with the authority information 73 if the result that the public key certificate is authentic. Note that the request for the verification to the certificate authority is not necessarily performed every time when viewing the medical record information 71, but it is sufficient to perform it at a predetermined interval (once a month for example).
Contents of the policy information 72 and the authority information 73 can be determined freely in accordance with an environment to which the medical record information disclosure system 1 is adopted. For example, it is possible to set the policy information 72 that indicates which authority system 5 issued the authority information 73 to be used for deciding permissibility of disclosure. Namely, the following contents may be set in the policy information 72. The contents is that in the case where “a surgeon in California” is to be permitted to view the information, being or not “a doctor in California” must be decided in accordance with the authority information 73 issued by the authority system 5 of “the medical association in California”, and being or not “a surgeon” must be decided in accordance with the authority information 73 issued by a “** academy”.
In addition, the policy information 72 is set in such way that it is permissible to disclose the medical record information 71 to “a doctor in California”, and the authority information 73 is set in such way that the doctor is “a doctor in Los Angeles”. In this case, their keywords do not match, so the diagnostic type terminal device 3 may decide it is not permissible to disclose the medical record information 71 even if the disclosure condition is satisfied substantially. In this case, it is possible to inquire the authority system 5 that issued the authority information 73 whether or not the doctor is “a doctor in California” for confirmation.
In this embodiment, a case is described above where the medical record information 71 of a patient is disclosed to a doctor in another medical institution. However, the present invention can be applied to other case where other personal information is disclosed. For example, it can be applied to a case where personal information of a citizen living in a region is disclosed to a staff of a local office in another region.
Furthermore, a structure of a whole or a part of the medical record information disclosure system 1, the diagnostic type terminal device 2, the diagnostic type terminal device 3, the medical record information server 4 or the authority system 5, contents of a process, an order of the process or others can be modified if necessary in accordance with the spirit of the present invention.
According to the present invention, personal information such as medical record information can be disclosed only to peoples who are considered to have necessity of the information. Therefore, the present invention can be used effectively in an industry that deals with this personal information.
While the presently preferred embodiments of the present invention have been shown and described, it will be understood that the present invention is not limited thereto, and that various changes and modifications may be made by those skilled in the art without departing from the scope of the invention as set forth in the appended claims.
Number | Date | Country | Kind |
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2004-107951 | Mar 2004 | JP | national |