JP2005267364A - Medical treatment supporting system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To realize a medical treatment supporting system capable of providing information on a treatment of other diseases to be considered in treating a disease concerned. <P>SOLUTION: In the medical treatment supporting system 1, an integration server 20 unitarily manages medical care information including an electronic chart on a plurality of diseases of a patient. When presenting treatment conditions related to one disease of the patient, it is possible to reflect an interrelation with the treatment conditions on other diseases of the patient. Thus, in the case that the patient suffers from more than one diseases, such as an original disease and complications, not the treatment conditions considering each of the diseases but treatment conditions which mutually consider a plurality of related diseases. That is, it becomes possible to provide information on other diseases to be considered in treating one disease. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a treatment support system, a treatment support device, a treatment support program, and a treatment support method that can provide information related to treatment.

Conventionally, so-called electronic medical records are being used to manage medical information in an integrated manner.
An electronic medical record is one in which a medical record for a doctor to record the treatment details of a patient is stored as electronic data on a server installed in a medical institution. Can be centrally managed with a database stored in the database.
In such a treatment support system using a conventional electronic medical record, treatment information related to each patient's disease is integrated and managed, but the history of each disease to be treated is managed out of the managed information. It was only presented. In other words, information on electronic medical records relating to other diseases has not been used in the treatment of certain diseases.

On the other hand, there are various types of treatments that should be performed in consideration of a plurality of diseases that a patient suffers from. In such a case, treatment of related diseases is performed at the time of treatment of the disease to be treated. And giving life guidance. For example, dialysis treatment is performed three times a week for patients who develop severe chronic nephritis as a complication of diabetes, and in some cases, diabetes is instructed once every few months. Has been done.
In such patients, a dialysis treatment specialist may also provide diabetes treatment on the occasion of dialysis treatment.
A technology relating to such a system for performing treatment support using an electronic medical record is disclosed on the Internet under the name of “Wakashio Medical Network” (see Non-Patent Document 1).

Japanese Patent Laid-Open No. 11-342198 discloses an artificial dialysis medical assistance system using a database. The system described in this publication is a system that manages data relating to personal information of dialysis patients, dialysis schedules, dialysis treatment conditions, and the like using a database (see Patent Document 1).
Japanese Patent Laid-Open No. 2003-198673 discloses a health / nutrition management service that manages health information analysis data related to meals and exercises using a database and notifies a disease with a high possibility of illness based on the health information analysis data. A providing method and its system are disclosed (see Patent Document 2).
Japanese Patent Laid-Open No. 11-342198 JP 2003-198673 A “Wakashio Medical Network”, [online], July 11, 2003, Chiba Prefectural Togane Hospital, [March 3, 2004 search], Internet <URL: http: //www.pref-hosp.togane. chiba.jp/J/wakasio/seikahappyou-03/seikahappyou.pdf ＞

However, all of the techniques described in Patent Documents 1 and 2 and Non-Patent Document 1 only provide support information for treatment of a specific disease, or only provide support information for specific treatment such as nutrition management. Thus, when a specific patient has multiple diseases, the system is not an advanced medical support system that can provide information relating to each disease. In other words, in the conventional technology, when a plurality of diseases that a patient suffers from are analyzed, various medical treatment information of the patient is comprehensively analyzed, and treatment information relating to one disease of the patient is provided. It is not possible to explicitly provide treatment conditions for other diseases, or use the opportunity to treat one disease to provide treatment or guidance for other diseases the patient suffers from It was. Therefore, in view of the increasing number of patients with multiple illnesses such as complications, information on the treatment of other diseases that should be considered in the treatment of one disease (for example, severe There is a need for a more advanced treatment support system that can provide information on diabetes treatment and guidance to be considered in dialysis treatment of patients with chronic nephritis.
An object of the present invention is to realize a treatment support system capable of providing information on treatment of another disease to be considered in treatment of one disease.

In order to solve the above problems, the present invention provides:
For patients with multiple diseases, medical information regarding the multiple diseases (for example, information as a patient's medical record (patient history, allergies, medication history, information on side effects, when diagnosis / treatment is performed on a patient) Information related to individual patient characteristics, such as dialysis treatment conditions including various test values (clinical test values) including biochemical test results or biometric information such as blood glucose measurement values) and insulin administration conditions Medical information management means (for example, the information management unit 22a in FIG. 3) that integrates and manages the patient's meal contents (ingested items, nutritional components, ingested calories, etc.) and information on exercise amount (lifestyle information), Based on the medical information managed by the medical information management means, treatment information corresponding to a predetermined disease of the patient (for example, “ A treatment support system including treatment information providing means (for example, the information management unit 22a and the calculation unit 22b in FIG. 3) that provides a "treatment condition" or "necessary precautions". With the provision of the treatment information relating to one disease of the patient (for example, severe chronic nephritis as a complication of diabetes), the treatment information relating to another disease (eg, diabetes) of the patient can be provided. It is characterized by being.

It should be noted that “providing treatment information related to other illnesses of a patient” referred to here is provided by reflecting the treatment information related to one illness in addition to explicitly providing treatment information related to other illnesses. It includes the case where it provides inherently.
In addition, the one disease is a complication caused by the other disease.
The other disease is diabetes, and the one disease is chronic nephritis as a complication of the diabetes.

Further, the other disease is diabetes, the one disease is chronic nephritis as a complication of the diabetes, and artificial dialysis is introduced for the chronic nephritis.
Also, medical information acquisition means (for example, the portable system 10 of FIG. 1, the main medical terminal) that acquires, as the medical information, at least one of the treatment conditions related to the treatment given to the patient or the biological information or lifestyle information of the patient 30, a medical terminal 40, a dialysis machine 50, a care service terminal 60, a food distribution server 70 or a professional terminal 80).

Further, the biological information of the patient is acquired when the self blood glucose measurement value (for example, the blood glucose level measured by the blood glucose level measurement unit 11 in FIG. 2) or the clinical test value (when the patient is diagnosed or treated). And / or various inspection values).
The treatment condition includes a dialysis treatment condition in artificial dialysis of the patient.

Moreover, the lifestyle habit information includes meal information related to meal contents (for example, ingested items, nutritional components, or ingested calories) taken by the patient.
In addition, the medical information further includes treatment execution means (for example, the portable system 10 or the dialysis apparatus 50 in FIG. 1) for performing a treatment related to a predetermined treatment based on the medical information provided by the treatment information providing means. Yes.

In addition, it further includes a distribution server (for example, the distribution server 70 of FIG. 1) for ordering a predetermined meal for a diner who provides meals to the patient, Based on the treatment information of the patient, an order for a predetermined meal (for example, a meal dedicated to a diabetic nephropathy patient) is made to the food distribution server.
In addition, meal information acquisition means (for example, a distribution server 70 in FIG. 1 or a portable terminal with a digital camera as a specific example of the portable system 10) that acquires information on the meal contents provided to the patient as the treatment information. Is further included.

  Further, a care service server (for example, the care service server 100 in FIG. 1) for requesting a predetermined care service to a care service person who provides care services (for example, foot care) to the patient is further provided. The treatment information providing means makes a request for a predetermined care service to the care service server based on the treatment information of the patient.

In addition, the information processing device further includes a care service information acquisition unit (for example, the care service terminal 60 or the portable system 10 in FIG. 1) that acquires, as the treatment information, information on the content of the care service provided to the patient. .
In addition, the treatment information providing means is capable of facilitating a diagnosis by a specialist of a disease that can develop in the patient based on the treatment information of the patient.
Here, as a method of promoting the examination by the specialist, it is possible to send a message such as an email for urging diagnosis to the terminal device installed under the specialist.

The present invention also provides:
For a patient having a plurality of diseases, medical information management means for integrating and managing medical information on the plurality of diseases, and corresponding to a predetermined disease of the patient based on the medical information managed by the medical information management means A treatment information providing means for providing treatment information, wherein the treatment information providing means provides the treatment information relating to one disease of the patient, and the treatment relating to the other disease of the patient. It is characterized by being able to provide information.

The present invention also provides:
For patients with multiple illnesses, respond to a specific illness of the patient based on the medical information management function that integrates and manages the medical information related to the multiple diseases and the medical information managed by the medical information management function A treatment support program for realizing a treatment information provision function for providing treatment information to a computer, wherein the treatment information provision function is associated with provision of the treatment information on one disease of a patient, It is characterized in that it can provide the treatment information related to other diseases.

The present invention also provides:
For a patient having multiple diseases, a medical information management process that integrates and manages medical information related to the multiple diseases, and the medical information that is managed by the medical information management process corresponds to a predetermined disease of the patient A treatment information providing step of providing treatment information to be performed, wherein, in the treatment information providing step, the treatment related to another disease of the patient accompanying the provision of the treatment information related to one disease of the patient It is characterized by being able to provide information.

According to the present invention, medical information relating to a plurality of diseases of a patient is integrated and managed. And when providing the treatment information regarding one disease of a patient, the correlation with the treatment information regarding the other disease of the patient can be reflected.
Therefore, when a patient suffers from multiple diseases such as primary diseases and complications, it provides treatment information that considers the treatment of multiple related diseases, rather than treatment information that considers each disease alone. be able to. That is, it is possible to realize a treatment support system that can provide information on treatment of other diseases to be considered in treatment of one disease.

In addition, when providing treatment information related to one disease of a patient, it is possible to explicitly provide treatment conditions related to another disease of the patient.
Therefore, it is possible to perform treatment or guidance regarding other diseases affected by the patient by using an opportunity to treat one disease, and it is possible to perform more appropriate treatment or guidance.
As described above, according to the present invention, it is possible to realize a treatment support system capable of providing information related to treatment of another disease to be considered in treatment of one disease.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
The treatment support system in the present embodiment integrates and manages electronic medical records of patients suffering from a plurality of diseases, and provides information related to the treatment and guidance of other diseases when treating one disease. Therefore, in the treatment of each of a plurality of diseases, it becomes possible to appropriately consider the effects of treatment of other diseases, etc., and the treatment and guidance of other diseases can be conducted using the treatment opportunity of one disease. Can be done.
Here, an example will be described in which the present invention is used when a patient has both diabetes and its complication of chronic nephritis.

First, the configuration will be described.
FIG. 1 is a diagram showing a system configuration of a treatment support system 1 according to the present embodiment. In FIG. 1, the treatment support system 1 includes a mobile system 10, an integrated server 20, an attending medical terminal 30, a comedy terminal 40, a dialysis device 50, a care service terminal 60, and a food distribution server 70. , An expert terminal 80 and a care service server 90, and the integrated server 20, the attending doctor's terminal 30, the dialysis device 50, the care service terminal 60, the food distribution server 70, the expert terminal 80 and the care The service server 90 is configured to be able to communicate via the network 100. Moreover, the portable system 10 and the integrated server 20 are configured to be able to communicate directly by short-range wireless communication and to be communicable via the network 100.

The portable system 10 is configured to be movable together with the body, for example, when the patient is attached to or carried by the patient. Then, the portable system 10 measures the blood glucose level of the patient or captures an image of the meal taken by the patient, and the measured blood glucose level or meal image via the network 100 including the mobile communication network. It can be transmitted to the integrated server 20, the food distribution server 70, and the like.
The portable system 10 is composed of a plurality of units, and each unit includes a predetermined functional unit described later. Each unit functions in cooperation by communicating by short-range wireless communication such as Bluetooth or infrared communication or wired communication.

Hereinafter, each functional unit of the mobile system 10 will be described.
FIG. 2 is a diagram illustrating a configuration of the mobile system 10. In FIG. 2, the portable system 10 includes a blood glucose level measurement unit 11, a control unit 12, an insulin pump 13, an exercise amount measurement unit 14, and a meal photographing unit 15.
The blood glucose level measurement unit 11 measures blood glucose level in an invasive manner (a method of obtaining blood by inserting a needle into a human body and measuring the blood glucose level) or non-invasively (percutaneously, directly or indirectly). System) sensor, and measures the blood glucose level (self blood glucose measurement value) of the patient. In addition, the blood glucose level measurement unit 11 measures the blood glucose level at preset time intervals and conditions, and transmits the blood glucose measurement value to the control unit 12 by short-range wireless communication. In response to this, the control unit 12 accumulates changes in blood glucose measurement values over time.

  Note that the blood glucose level measurement unit 11 is capable of intermittently measuring blood glucose levels at relatively short intervals (for example, several to 10 times a day), so that the sensor is always installed on the human body. It is the structure which can be made into the state. For example, it is possible to adopt a configuration such as a ring type or a band type that wraps around an arm, and an invasive or non-invasive sensor is provided on the side in contact with the human body.

  The control unit 12 is a unit that controls the entire mobile system 10 and is a small information processing apparatus including a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), and the like. The control unit 12 includes an interface for connecting a mobile phone or a card-type mobile communication unit for performing mobile communication, and functions as a mobile communication terminal by connecting these devices.

The control unit 12 then transmits the blood glucose level transmitted from the blood glucose level measurement unit 11, the insulin dose transmitted from the insulin pump 13, and the amount of exercise transmitted from the exercise amount measurement unit 14 by short-range wireless communication or wired communication. The meal image transmitted from the meal photographing unit 15 is stored in a storage device such as an IC chip or a hard disk device as patient medical information. This medical information is transmitted to the integrated server 20 by short-range wireless communication when the patient visits the dialysis clinic, or appropriately transmitted to the integrated server 20 via a cradle (connection terminal) connected to the network 100. .
The control unit 12 includes an instruction button for the patient to manually administer insulin, and the patient can administer a predetermined amount of insulin from the insulin pump 13 when the patient directly inputs an instruction.

  The insulin pump 13 is a device for automatically injecting insulin into the patient, and injects a predetermined amount of insulin into the patient based on the insulin dose instructed from the control unit 12. Further, the insulin pump 13 is in a state where the injection needle is always stabbed into the patient's blood vessel so that insulin can be injected at an arbitrary time when administration of insulin is required. The insulin dosage and administration time when the insulin pump 13 is instructed to administer insulin are stored by the control unit 12.

The momentum measuring unit 14 is a device that measures and digitizes the amount of exercise of the patient, such as a pedometer (registered trademark), and transmits the measured amount of exercise to the control unit 12 by short-range wireless communication or wired communication.
The meal photography part 15 is comprised by the apparatus provided with imaging functions, such as a digital camera or a portable terminal with a digital camera, for example. The meal photographing unit 15 has a sufficient number of pixels to discriminate meal contents from the photographed image. Furthermore, the meal imaging | photography part 15 transmits the image | photographed meal image to the control part 12 by near field communication or wired communication. In view of such an object, it is more preferable that the control unit 12 is a portable terminal with a digital camera and includes the meal photographing unit 15 as an integral unit.

Returning to FIG. 1, the integrated server 20 stores medical information related to a patient's disease in a database as an electronic medical record. Further, when treatment is performed on a patient, the integrated server 20 can present treatment conditions that comprehensively determine treatment for a plurality of diseases that the patient suffers based on stored medical treatment information.
Here, medical information includes information as a patient's medical record (patient medical history, allergy, medication history, information on side effects, and biochemical test results acquired when a patient is diagnosed / treated. Information related to individual patient characteristics such as various test values (clinical test values) or biological information such as blood glucose measurement values) and dialysis treatment conditions including insulin administration conditions, as well as patient meal content (ingestion items, nutrition) Information on ingredients (calorie intake, etc.) and exercise amount (lifestyle information).

  The medical information is input to the integrated server 20 by being input from the portable system 10 or when the treatment condition is fed back from the treatment device such as the dialysis device 50 when the patient is treated. Accumulate. In addition, care services such as foot care (treatment to prevent tissue necrosis due to circulatory insufficiency of peripheral blood vessels at the foot end due to obstructive arteriosclerosis, pain, etc.) are given to patients, and dietary guidance is provided. When a meal service is performed or treatment is performed by a specialist, the contents (care service contents, meal guidance and distribution contents, and treatment contents by a specialist) are sequentially fed back to the integrated server 20. Remembered. Furthermore, clinical test results (clinical test values) are stored in the integrated server 20 via the network 100 from a test center that has performed a blood test, a urine test, or the like of the patient.

The medical information is transmitted directly to the integrated server 20 via the network 100 or the like, or the data transmitted by a communication means such as a facsimile is copied by a medical person such as a nurse or a clinical laboratory technician. It may be stored in the integrated server 20 by manual input from the medical terminal 40.
In order to realize the above-described functions, the integrated server 20 is configured by an information processing apparatus such as a PC (Personal Computer) or a workstation.

FIG. 3 is a block diagram illustrating a functional configuration of the integrated server 20. In FIG. 3, the integrated server 20 includes an input unit 21, a management unit 22, and a communication unit 23.
The input unit 21 includes a keyboard and a pointing device such as a mouse having cursor keys and numeric input keys, and outputs a key pressing signal pressed on the keyboard and a mouse position signal to the management unit 22. With this input unit 21, it is possible to manually input a part of medical information into the integrated server 20.

The management unit 22 controls the entire integrated server 20 and has a function of reading out and executing programs related to various processes stored in a hard disk device (not shown) according to various instruction signals input from the input unit 21. .
The management unit 22 includes an information management unit 22a and a calculation unit 22b.
The information management unit 22a is transmitted from the mobile system 10, the attending medical terminal 30, the comedy terminal 40, the dialysis apparatus 50, the care service terminal 60, the food distribution server 70, the professional terminal 80, or the care service server 90. Store medical information.

  Further, the information management unit 22a executes a process of searching for a history similar to the current patient state from the stored medical information when the calculation condition is calculated in the calculation unit 22b, and calculates the search result. To the unit 22b. Specifically, the information management unit 22a determines the patient's state from the correlation between the patient's biological information (blood glucose measurement value, clinical test result, etc.) included in the medical information, the previous treatment condition, and the treatment result. Searching for a case close to, obtaining a new treatment condition and necessary precautions related to the disease while predicting the subsequent transition, and outputs it to the calculation unit 22b.

Here, the necessary precautions are related to the treatment of other diseases such as “This drug is contraindicated as a therapeutic drug for diabetes due to the risk of side effects of blood pressure reduction in dialysis” Information on factors affecting the treatment of disease.
The computing unit 22b acquires treatment conditions and necessary precautions from the information management unit 22a for each of a plurality of diseases that the patient suffers from. Then, the computing unit 22b calculates the final desired treatment condition for the patient while determining the influence of the treatment on the plurality of diseases based on the treatment conditions and necessary precautions regarding the plurality of diseases.

  Specifically, the computing unit 22b is configured to treat dialysis treatment conditions (blood flow rate, dialysate flow rate, dialyzer type, water removal amount, dialysis time, dialysate type treatment, etc. reflecting the treatment of diabetes or the contents of life guidance. Diabetes treatment conditions (diabetes treatment dosage type, dosage, administration date, administration time) reflecting the conditions of the device, type of chronic nephritis treatment drug, dosage, administration date, etc.), dialysis treatment or lifestyle guidance Etc.) or guidance content (meal guidance, exercise guidance, foot care content or diagnostic instructions for complications such as eye disease, neurosis, etc.).

Here, the dialysis treatment conditions include blood flow rate, dialysate flow rate, dialyzer type, water removal amount, dialysis time, dialysate type, chronic nephritis treatment type, dosage and administration date. Etc. are included. Diabetes treatment conditions include the type of medication, the dosage, the administration date, the administration time, etc. of the antidiabetic agent. In addition, the guidance content includes dietary guidance, exercise guidance, foot care content, diagnostic instructions for complications such as eye diseases and neurosis, and the like.
The dialysis treatment condition, the diabetes treatment condition, and the guidance content calculated by the calculation unit 22b in this way are transmitted to the attending medical terminal 30, the comedy terminal 40, or the professional terminal 80. The dialysis treatment conditions are transmitted to the dialysis machine 50, and a part of the instruction content is transmitted to the care service terminal 60 or the food distribution server 70, respectively.

The communication unit 23 performs data conversion processing and modulation processing into a predetermined format for various data instructed to be transmitted from the management unit 22, and outputs the data to a transmission destination device via the network 100. The communication unit 23 receives a signal transmitted from another device such as the portable system 10 via the network 100, performs a demodulation process to the original signal and a data conversion process to the original data format, and the management unit 22 for output.
Furthermore, the communication unit 23 has a short-range wireless communication function, and can receive biological information from the control unit 12 of the portable system 10 through short-range wireless communication.

Next, the doctor terminal 30 will be described.
The attending physician's terminal 30 is configured by an information processing device such as a PC, has a function as a client that can access the integrated server 20 via the network 100, and a dialysis clinic to which a doctor who performs dialysis treatment of a patient as the attending physician belongs Installed.
In addition, the dialysis treatment information and guidance information of a dialysis patient having diabetes are transmitted from the integrated server 20 to the attending medical terminal 30.
Therefore, when the patient visits dialysis treatment, the attending physician can perform dialysis treatment in consideration of the interrelationship with diabetes treatment based on the dialysis treatment information, and based on guidance information, It is possible to provide general lifestyle guidance. In addition, based on a diagnosis instruction included in the guidance information, it is possible to instruct a preventive diagnosis by a predetermined specialist (such as an ophthalmologist or a neurologist).

Next, the comedy terminal 40 will be described.
The comedy terminal 40 is configured by an information processing device such as a PC, and has a function as a client that can access the integrated server 20 via the network 100, and also belongs to a comedy that performs dialysis treatment and guidance for a patient. To be installed in a dialysis clinic.
In addition, the dialysis treatment information, diabetes treatment information, and guidance information of a dialysis patient suffering from diabetes are transmitted from the integrated server 20 to the comedy terminal 40.
Therefore, when a patient visits a dialysis clinic for dialysis treatment, comedy shares with the attending physician a dialysis treatment prescription that is based on dialysis treatment information and takes into account the interaction with diabetes treatment. It is possible to execute dialysis treatment after being converted, and to perform general treatment of diabetes including lifestyle habit guidance after sharing diabetes treatment information and guidance information.

Next, the dialysis apparatus 50 will be described.
The dialysis device 50 is a treatment device installed in a dialysis clinic, and is a device that performs artificial dialysis on a patient having severe chronic nephritis. The dialysis device 50 includes a dialysis console and a monitoring device, a dialyzer called a dialyzer, a blood circuit, a drug such as a dialysate and an anticoagulant used, a supply device thereof, and a program for controlling and managing them. Refers to the entire dialysis system. In this dialysis machine 50, operating conditions peculiar to each patient performing dialysis treatment are set, and medicines (dialysate etc.) and instruments (dialyzer etc.) used are also peculiar to each patient. Here, the dialysis treatment information is transmitted from the integrated server 20 via the network 100, and information regarding the treatment conditions actually performed is fed back to the integrated server 20. The dialysis treatment information transmitted from the integrated server 20 is set in the dialysis device 50 after being approved by the attending physician, and treatment is performed.

Next, the care service terminal 60 will be described.
The care service terminal 60 is configured by an information processing device such as a PC, and has a function as a client that can access the integrated server 20 and the care service server 90 via the network 100. It is installed under a registered dietitian who manages meals. When a care service request is made to the care service server 90, it can be confirmed from the care service terminal 60.

In addition, predetermined instruction information of a dialysis patient having diabetes is transmitted from the integrated server 20 to the care service terminal 60.
Therefore, the foot care service provider can grasp in advance when the patient needs treatment such as foot care, and can reliably perform treatment such as foot care at an appropriate time. In addition, since the dietitian can determine the meal content in consideration of a plurality of diseases that the patient has, the diet content can be made effective for each disease that the patient suffers from.

In addition, the treatment performed by the foot care service provider and the meal content determined by the registered dietitian are fed back from the care service terminal 60 to the integrated server 20 via the network 100 and added to the medical information.
Furthermore, it is also possible to order meal contents determined by a registered dietitian from the care service terminal 60 to the distribution server 70 via the integrated server 20 or directly.
In this way, the contents of meals determined by a registered dietitian are automatically ordered, compared to the case where a patient prepares meals (orders or self-catering) based on the guidance of a registered dietitian or doctor as in the past. , It will be possible to practice the content of guidance on meals more reliably.

Next, the distribution server 70 will be described.
The distribution server 70 is configured by an information processing apparatus such as a PC or a workstation, and can communicate with the integrated server 20 or the care service terminal 60 via the network 100. The distribution server 70 is installed under a nutrition management room of a dialysis clinic that distributes therapeutic food, a home delivery company that delivers health food, a nutritional guidance service provider, or the like.
And the meal distribution server 70 orders the meal of the dialysis patient who has diabetes from the integrated server 20 or the care service terminal 60. When the distributor is a home delivery company, the home delivery company can directly deliver the meal ordered to the server 70 for delivery to the patient's home.

Next, the expert terminal 80 will be described.
The expert terminal 80 is configured by an information processing apparatus such as a PC, has a function as a client that can access the integrated server 20 via the network 100, and is a specialist of a disease in which a patient can develop as a complication, such as an ophthalmologist. It is installed under a physician or neurologist.
In addition, dialysis treatment information and guidance information for dialysis patients with diabetes are transmitted from the integrated server 20 to the expert terminal 80.

Therefore, the specialist can instruct preventive diagnosis based on the diagnostic instruction included in the guidance information, and diagnoses the patient at an appropriate time based on his / her own judgment without depending on the guidance information. It becomes possible. In addition, since a specialist of a disease at risk of developing will check the electronic medical record as appropriate, it is possible to improve the patient's sense of security in the treatment or prevention of complications.
If it is determined on the integrated server 20 side that diagnosis by a specialist is necessary, the specialist may be diagnosed by transmitting a message prompting diagnosis to the expert terminal 80.

Next, the care service server 90 will be described.
The care service server 90 is configured by an information processing apparatus such as a PC or a workstation, and can communicate with the integrated server 20 or the care service terminal 60 via the network 100. Further, the care service server 90 accepts a request for a care service such as foot care or exercise instruction other than accepting an order for a meal to be handled by the distribution server 70, for example. It is installed under a care service provider that provides care services.
Then, when a request for care service for a dialysis patient having diabetes is made from the integrated server 20 to the care service server 90, the care service provider confirms the care service request from the care service terminal 60, Care services are performed on the patient.

Next, the flow of processing when treatment is performed using the treatment support system 1 will be described.
FIG. 4 is a flowchart showing the operation of the treatment support system 1.
The treatment support system 1 designates an electronic medical record in the integrated server 20 and starts processing in response to an instruction input of treatment support for a specific patient.
In FIG. 4, when an instruction to input treatment conditions for a predetermined patient is input to the integrated server 20 (step S <b> 1), the information management unit 22 a has a history similar to the patient state in the stored medical information. To obtain medical information and necessary notes as a search result (step S2).

  At this time, the state of the patient can be determined based on the electronic medical records that are sequentially updated, or can be manually input at the time of input of treatment support instructions. The parameters indicating the patient's condition include, for example, dialysis treatment conditions of the patient, used dialyzer, body weight, body fat percentage, blood sugar level, blood total protein, blood viscosity, hematocrit value, white blood cell count, platelet count Plasma potassium concentration, plasma phosphorus concentration, total cholesterol, blood fibrinogen concentration, blood LDL (low density lipoprotein) concentration, β-MG (myoglobin), and the like can be used.

Next, based on the search result of the information management unit 22a, the calculation unit 22b calculates the final treatment condition for the patient while determining the mutual effect of treatment of the plurality of diseases on which the patient suffers (step) S3).
At this time, an expert such as a doctor may appropriately change the treatment condition calculated by the calculation unit 22b and set the final treatment condition.
Then, the integrated server 20 transmits the treatment condition (dialysis treatment condition or instruction content) calculated by the calculation unit 22b to a predetermined device such as the primary medical terminal 30 (step S4). At this time, necessary treatment is performed on the patient by each subject (the attending physician, the care service provider, and the like) where the device that is the recipient of the treatment condition is installed.

Subsequently, the content of the treatment performed on the patient is fed back to the integrated server 20 and added to the medical information managed by the information management unit 22a (step S5).
At this time, when the device that has received the medical information directly feeds back the treatment contents to the integrated server 20, or the portable system 10 detects the treatment performed on the patient as biological information, the integrated server via the portable system 10 Any feedback to 20 is possible.
Then, the treatment support system 1 ends the process.

As described above, in the treatment support system 1 to which the present invention is applied, the integrated server 20 centrally manages medical information including electronic medical records related to a plurality of diseases of a patient. And when presenting the treatment condition regarding one disease of a patient, the correlation with the treatment condition regarding the other disease of the patient can be reflected.
Therefore, when a patient suffers from multiple diseases, such as the primary disease and complications, the treatment conditions that consider the treatment of multiple related diseases are presented instead of the treatment conditions that consider each disease alone. be able to. That is, it is possible to provide information related to the treatment of another disease to be considered in the treatment of one disease.

In addition, when presenting treatment conditions relating to one disease of a patient, it is possible to explicitly present treatment conditions relating to another disease of the patient.
Therefore, it is possible to perform treatment or guidance regarding other diseases affected by the patient by using an opportunity to treat one disease, and it is possible to perform more appropriate treatment or guidance. For example, a dialysis doctor who is not a diabetic specialist can perform certain treatment and guidance regarding diabetes.

As described above, in the treatment support system 1 according to the present invention, the insight possessed by the doctor is emphasized in the same manner as in the past, and further, the portion exceeding the insight of the doctor (non-specialty field, etc.) It is possible to provide information on instruction.
Further, in the treatment support system 1 to which the present invention is applied, treatments such as treatments and care services given to the patient are sequentially fed back to the electronic medical record.
Therefore, it is possible to always grasp the latest patient status for various treatments and care services performed on the patient, and to perform more appropriate treatment or guidance for the patient.

In the present embodiment, the information management unit 22a has been described as searching the history only for the medical information about the patient, but the search may be performed including the history of other patients.
In addition, the information management unit 22a has been described as searching for a history of medical information and acquiring new treatment conditions based on similar cases. However, the information management unit 22a is not limited to a predetermined medical-related organization (Ministry of Health, Labor and Welfare, Medical Association, or It is also possible to acquire new treatment conditions or the like reflecting guidelines issued by the subcommittee, etc.) or literature related to treatment.

Furthermore, in the present embodiment, the case where the plurality of diseases that the patient suffers from is diabetes and its complication of chronic nephritis has been described, but there is a certain difference in the frequency of instruction opportunities for the patient, and As long as any one disease is a chronic disease and it is necessary to go to a medical institution at a relatively short interval, the present invention can be applied even in the case of other diseases. For example, the present invention can be applied to a combination of rehabilitation, pacemaker management, and other diseases requiring treatment or guidance.
In the present embodiment, a terminal device that can communicate with the integrated server 20 is installed under the patient, and the patient can refer to his / her medical information managed in the integrated server 20 as necessary. Good. Or it is good also as notifying instruction information etc. to a patient using other communication means, such as a facsimile.

1 is a diagram showing a system configuration of a treatment support system 1. FIG. 1 is a diagram illustrating a configuration of a mobile system 10. 3 is a block diagram showing a functional configuration of an integrated server 20. FIG. 3 is a flowchart showing the operation of the treatment support system 1.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Treatment support system 10 Portable system 11 Blood glucose level measurement part 12 Control part 13 Insulin pump 14 Momentum measurement part 15 Meal imaging part 20 Integrated server 21 Input part 22 Management part 22a Information management part 22b Operation part 23 Communication part 30 Primary medical terminal 40 Comedical terminal 50 Dialysis machine 60 Care service terminal 70 Food distribution server 80 Professional terminal 90 Care service server 100 Network

Claims (18)

For a patient having a plurality of diseases, medical information management means for integrating and managing medical information on the plurality of diseases, and corresponding to a predetermined disease of the patient based on the medical information managed by the medical information management means A treatment support system including treatment information providing means for providing treatment information,
The treatment support system is characterized in that the treatment information providing means can provide the treatment information related to another disease of the patient with the provision of the treatment information related to one disease of the patient.   The treatment support system according to claim 1, wherein the one disease is a complication caused by the other disease.   3. The treatment support system according to claim 1, wherein the other disease is diabetes, and the one disease is chronic nephritis as a complication of the diabetes.   4. The disease according to claim 1, wherein the other disease is diabetes, the one disease is chronic nephritis as a complication of the diabetes, and artificial dialysis is introduced for the chronic nephritis. The treatment support system according to claim 1.   5. The medical information acquisition means according to claim 1, further comprising medical treatment information acquiring means for acquiring at least one of treatment conditions relating to the treatment given to the patient, biological information or lifestyle information of the patient as the medical information. The treatment support system according to claim 1.   6. The treatment support system according to claim 5, wherein the biological information of the patient includes at least one of a self blood glucose measurement value and a clinical test value.   The treatment support system according to claim 5, wherein the treatment condition includes a dialysis treatment condition in artificial dialysis of the patient.   The treatment support system according to claim 5, wherein the lifestyle habit information includes meal information relating to meal contents taken by the patient.   The treatment support according to any one of claims 1 to 8, further comprising a treatment execution unit that performs a treatment related to a predetermined treatment based on the medical information provided by the treatment information providing unit. system.   The treatment support system according to claim 9, wherein the treatment execution unit includes a dialysis apparatus that performs blood dialysis in artificial dialysis. A food distribution server for placing an order for a predetermined meal for a distributor who provides food to the patient;
The treatment support system according to any one of claims 1 to 10, wherein the treatment information providing unit orders a predetermined meal to the food distribution server based on the treatment information of the patient.   The treatment support system according to any one of claims 1 to 11, further comprising a meal information acquisition unit configured to acquire information regarding meal contents provided to the patient as the treatment information. A care service server for requesting a predetermined care service for a care service provider who provides care services to the patient;
The treatment support system according to any one of claims 1 to 12, wherein the treatment information providing means requests the care service server for a predetermined care service based on the treatment information of the patient. .   The treatment support system according to any one of claims 1 to 13, further comprising a care service information acquisition unit configured to acquire, as the treatment information, information related to a content of a care service provided to the patient.   The said treatment information provision means can accelerate | stimulate the examination by the specialist of the disease which can develop in the said patient based on the treatment information of the said patient, The any one of Claim 1 to 14 characterized by the above-mentioned. Treatment support system.   For a patient having a plurality of diseases, medical information management means for integrating and managing medical information on the plurality of diseases, and corresponding to a predetermined disease of the patient based on the medical information managed by the medical information management means A treatment information providing means for providing treatment information, wherein the treatment information providing means provides the treatment information relating to one disease of the patient, and the treatment relating to the other disease of the patient. A treatment support apparatus capable of providing information.   For patients with multiple illnesses, respond to a specific illness of the patient based on the medical information management function that integrates and manages the medical information related to the multiple diseases and the medical information managed by the medical information management function A treatment support program for realizing a treatment information provision function for providing treatment information to a computer, wherein the treatment information provision function is associated with provision of the treatment information on one disease of a patient, A treatment support program, characterized in that it can provide the treatment information related to other diseases.   For a patient having multiple diseases, a medical information management process that integrates and manages medical information related to the multiple diseases, and the medical information that is managed by the medical information management process corresponds to a predetermined disease of the patient A treatment information providing step of providing treatment information to be performed, wherein, in the treatment information providing step, the treatment related to another disease of the patient accompanying the provision of the treatment information related to one disease of the patient A treatment support method characterized by being capable of providing information.

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