JP5802615B2 - CLINICAL INFORMATION DISPLAY DEVICE, CLINICAL INFORMATION DISPLAY DEVICE OPERATION METHOD, AND CLINICAL INFORMATION DISPLAY PROGRAM - Google Patents

Description

  The present invention relates to a clinical information display device, an operation method of the clinical information display device, and a clinical information display program for displaying important clinical information necessary for diagnosis of each disease among clinical information included in an electronic medical record. .

  In recent years, in the medical field, diagnosis support using an electronic medical record has been performed for medical treatment of patients. Specifically, clinical information recorded in an electronic medical record is displayed when a medical examination is performed, and is used as reference information for diagnosing a disease name and determining a treatment policy.

  Patent Document 1 defines a normal value range in which no sign of any disease is recognized for each test item in a clinical test, and tests whether a normal value and an abnormal value are within the normal value range. A method has been proposed for classifying items, estimating suspected diseases based on abnormal values, obtaining the degree to which normal values negatively affect disease estimates, and correcting the degree of suspected diseases Yes.

  In Patent Literature 2, when new patient data is input, the similarity between each case data item and the new patient data item is obtained, and the disease name having the maximum similarity is used for the similarity calculation. A method has been proposed in which the value of an item in new patient data having the greatest influence is displayed together.

JP 10-11522 A JP 2004-288047 A

  There are various types of clinical information items, and the suspected disease is determined from the test values of these clinical information items. However, various combinations of clinical information items need to be considered. In actual medical practice, diagnosis is performed by inferring some candidate diseases from interviews and physical findings. However, the clinical information items that are considered important for each disease candidate are limited, and the doctor makes a diagnosis by paying attention to the test results of the important clinical information items to determine whether or not the disease is the disease. Is going. When the diagnosis is determined, the characteristics of the patient's disease state are grasped from the clinical information, and an appropriate treatment method is selected, and the progress during the treatment is grasped by the transition of the value of the clinical information to proceed with the treatment. In this case as well, important clinical information is limited, and treatment is proceeding with attention to important clinical information.

  In the methods of Cited Document 1 and Cited Document 2, the disease is estimated for all clinical information items, but the patient's condition is the living environment, past history, basic disease, progress status of current disease, and coping process. It is difficult to accurately estimate the disease at a practical level by showing various clinical information values due to various factors. Rather, it is practical support to extract only important information necessary for the judgment of the doctor from many clinical information items and present it in an easy-to-understand manner.

  In addition, when a specific disease is suspected, the doctor wants to check the test results of some clinical information items necessary for the diagnosis of the disease, and as in the cited reference 2, it may affect the determination of the disease. We do not want to confirm only the test result of the largest possible clinical information item.

  The present invention has been made in view of the above circumstances, and clinical information for automatically determining important clinical information items necessary for diagnosis and treatment of each disease from clinical information items of electronic medical records of past cases It is an object of the present invention to provide a display device, a clinical information display device operating method, and a clinical information display program.

  The clinical information display device according to the present invention includes an electronic medical chart acquisition means for acquiring a plurality of electronic medical records from an electronic medical record storage means for storing a large number of electronic medical records including disease information representing a disease and test values for a plurality of clinical information items, For each clinical information item of the acquired plurality of electronic medical records, when the disease information is a specific disease, a test value of the clinical information item indicating an outlier that is out of the normal value range at the start of treatment is Probability A that becomes a value within the normal value range or a value closer to the normal range than the outlier after a certain period of time, and out of the normal value range at the start of treatment when the disease information is not the specific disease Obtaining a probability that the test value of the clinical information item indicating an outlier is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and the probability A is Previous A decision means for deciding a clinical information item higher than a predetermined value from the probability B as an important clinical information item for the specific disease; a patient designation means for accepting designation input of a predetermined patient; and an electronic medical record of the predetermined patient Display means for displaying only test values corresponding to important clinical information items determined by the determination means corresponding to the disease information of the electronic medical record of the patient among the clinical information items of the display on the display device. It is what.

The operation method of the clinical information display device according to the present invention includes an electronic medical chart acquisition means for acquiring an electronic medical record, a determination means for determining an important clinical information item, a patient specification means for receiving a predetermined patient designation input, An operation method of a clinical information display device comprising display means for displaying only test values corresponding to the demand clinical information items of an electronic medical record on a display device,
An acquisition step of acquiring a plurality of electronic medical records from an electronic medical record storage unit that stores a plurality of electronic medical records including disease information representing a disease and test values for a plurality of clinical information items by the acquisition unit; and For each clinical information item of a plurality of acquired electronic medical records, when the disease information is a specific disease, the test value of the clinical information item indicating an outlier that is out of the normal value range at the start of treatment is constant. The probability A that the value is within the normal value range or the value closer to the normal range than the outlier after the elapse of the period of time, and when the disease information is not the specific disease, the normal value was out of the range at the start of treatment Obtaining a probability B that the test value of the clinical information item indicating an outlier is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and the probability A is A determination step of determining a clinical information item higher than a predetermined value from the writing probability B as an important clinical information item of the specific disease, and a patient specifying step of receiving a specified input of the predetermined patient by the patient specifying means; The display means displays only the test values corresponding to the important clinical information items determined by the determining means corresponding to the disease information of the electronic medical record of the patient among the clinical information items of the electronic medical record of the predetermined patient. And a display step for displaying above.

  The clinical information display program according to the present invention obtains an electronic medical record by acquiring a plurality of electronic medical records from an electronic medical record storage means for storing a large number of electronic medical records including disease information representing a disease and test values for a plurality of clinical information items. Means, and for each clinical information item of the acquired plurality of electronic medical records, when the disease information is a specific disease, the clinical information item indicating an outlier that is out of the normal value range at the start of treatment If the test value is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and if the disease information is not the specific disease, the normal value at the start of treatment A probability B that the test value of the clinical information item indicating an outlier outside the range becomes a value within the normal value range or a value closer to the normal range than the outlier after a certain period of time; And determining means for determining a clinical information item whose probability A is higher than a predetermined value from the probability B as an important clinical information item for the specific disease, and patient specifying means for receiving a predetermined patient specifying input, And displaying on the display device only the test values corresponding to the important clinical information items determined by the determining means corresponding to the disease information of the electronic medical record of the patient among the clinical information items of the electronic medical record of the predetermined patient It functions as a means.

  “Clinical information” refers to information about a patient acquired for diagnosis and treatment, and is information obtained from examinations performed on the patient, patient declarations, and the like. The “clinical information item” includes, for example, items corresponding to various examinations and items corresponding to various image findings and image characteristics. “Clinical information item test values” were obtained from tests performed, such as those representing test results obtained in various tests, and image findings and characteristics of images taken with various modalities. Value and recorded in the electronic medical record. A clinical information item for which no test value is recorded indicates that the test has not been performed.

  “Outlier” refers to a value that is out of the normal value range of the test value of the clinical information item, and indicates the possibility of a specific disease when the value exceeds the normal value range. And those indicating the possibility of a specific disease when the value is below the normal range. A clinical information item for diagnosing a specific disease when an “outlier” exceeding the normal value range is a clinical information item for diagnosing a specific disease, or an “outlier” that is below the normal value range is diagnosing a specific disease It depends on the disease.

  The “value closer to the normal range than the outlier” means a value at which clinical improvement is observed in the clinical information item test value, and the range of the value at which clinical improvement is recognized is determined by the clinical information item.

  Further, “after a certain period of time” may be when the treatment of the specific disease is completed or when the specific disease is a disease that takes a long time to treat.

  In the above invention, the determining means preferably determines a clinical information item whose ratio A / B between the probability A and the probability B exceeds a threshold as an important clinical information item of a specific disease.

  In the above invention, the determining means has a plurality of threshold values, and determines, for each of the plurality of threshold values, clinical information items that exceed the threshold values as the plurality of important clinical information items having different stages of the specific disease. In this way, there is further provided an instruction input receiving means for receiving an input for instructing the stage of the important clinical information item to be displayed on the display device, and the display means displays the test value of the important clinical information item at the stage according to the input. You may make it do.

  Further, in the above invention, the determination means includes the number of cases in which the test value of the clinical information item indicating the outlier at the start of treatment for each disease falls within a normal value after a certain period of time, and is more normal than the outlier A predetermined number of clinical information items may be determined as important clinical information items of the specific disease in order from clinical information items having a large number of cases with values close to the above range.

  In the above invention, the disease information includes disease name information, and the determination means includes a plurality of disease names classified into the same type of disease even when the disease information represents different disease names. As one disease, the acquired electronic medical records may be tabulated for each clinical information item.

  According to the present invention, there are a large number of clinical information items in the electronic medical record, but from the electronic medical records accumulated in the past, when a certain disease is present, the test value of the clinical information item showing an outlier before treatment is treated. It is considered that clinical information items whose probability of becoming a value within the range of normal values later or a value for which clinical improvement is recognized are higher than the probability of not having the disease are characteristic and important for this disease. Therefore, when displaying an electronic medical record by determining important clinical information items from clinical information items that have a somewhat higher probability of clinical improvement in cases of such diseases than in cases of no disease, Accordingly, it is possible to display only the test values of important clinical information items that are decisive for the diagnosis and treatment of the disease.

  Important clinical information items are determined according to multiple stages, and only the test values of a small number of important clinical information items are displayed in an easy-to-understand manner. If necessary, the test values of slightly less important clinical information items are also displayed. It is possible to create a state in which the operator's instructions can be received and displayed.

  Alternatively, by determining a predetermined number of clinical information items as important clinical information items in order from the clinical information items with the number of cases where clinical improvement is recognized in a certain disease, the disease can be examined in that disease. It is possible to display and confirm the test values of many tests that are likely to improve before being cured.

  Since there are many disease names, if important clinical information items are simply determined for each disease name, there is a high possibility that the important clinical information items determined for rare diseases will not be optimal because the number of cases is small. Therefore, even if the disease names are different, it is possible to deal with rare diseases by determining important clinical information items by using a plurality of disease names classified as the same type of disease as one disease.

The figure which shows schematic structure of the medical information system to which the clinical information display apparatus by embodiment of this invention is applied. Functional block diagram of clinical information display device Flow chart showing the flow of recording electronic medical records Flow chart showing the flow when generating a filter for display Flow chart showing the flow of display processing using a display filter

  An embodiment of a clinical information display device of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing a schematic configuration of a medical information system to which a clinical information display device according to an embodiment of the present invention is applied, and FIG. 2 is a functional block diagram of the clinical information display device in the present embodiment. As shown in FIG. 1, the medical information system 10 allows a medical information management server 3, an electronic medical record storage server 4, a medical department terminal 2, an examination room terminal 5, and an image diagnostic system 6 to communicate via a network 7. Connected and configured.

  The electronic medical record storage server 4 includes an electronic medical record database in which electronic medical records are stored, and is connected to the medical information management server 3, the medical department terminal 2, the examination room terminal 5, and the image diagnostic system 6 via the network 7. It becomes the composition.

  The clinical information display device 1 according to the present embodiment includes a medical information management server 3 and a medical department terminal 2 connected via a network 7. Each computer of the medical information management server 3 and the medical department terminal 2 is controlled by a program installed from a recording medium such as a CD-ROM and functions as the clinical information display device 1 of the present embodiment. The program may be installed after being downloaded from a storage device of a server connected via a network such as the Internet.

  The medical information management server 3 is a computer provided with a medical information database. In addition to the operating system and database management software, application software is installed in the medical information management server 3, and the medical information management server 3 acquires the electronic medical record from the electronic medical record storage server 4 as shown in FIG. Functioning as an electronic medical record acquisition means 31 and a determination means 32 for determining an important clinical information item of each disease from each clinical information item of the electronic medical record.

  The medical department terminal 2 is a computer used by medical doctors for browsing electronic medical records and inputting examination orders. In addition to standard software such as an operation system, application software for supporting the work of doctors, etc. As shown in FIG. 2, the clinical department terminal 2 includes a patient specifying means 21 for receiving a designation input of a patient to be examined, a display means 22 for displaying important clinical items of the patient's electronic medical record on a display device, It functions as instruction input receiving means 23 for receiving instructions of important clinical items to be displayed. Furthermore, the clinical department terminal 2 is also used to input information on the examination results performed in each clinical department, and the examination result information is input in association with the examination order and patient ID. The information on the input test result is also recorded as a test value in an electronic medical record having a matching patient ID and test order.

  The examination room terminal 5 is a computer that is used to input information on the results of examination performed in the examination room according to the examination order input from each examination department terminal 2 in an examination room that is separated from each department. Yes, in addition to standard software such as an operation system, software for viewing inspection orders and inputting inspection results is incorporated. Information on the results of examinations performed in each examination room is input from the examination room terminal 5 in association with the examination order and patient ID. Furthermore, the information on the input examination result is also recorded as an examination value in an electronic medical record having a matching patient ID and examination order.

  The image diagnostic system 6 is a known computer system, and includes, for example, an image management server 61 including an image diagnostic medical workstation and an image database in which image data obtained by imaging with a modality such as CT and MRI is stored. And an interpretation report server 62 having an interpretation report database in which an interpretation report including an interpretation result of an image obtained by photographing is stored is communicably connected via the network 7. The image diagnostic medical workstation is configured such that various image analysis processing software is installed, and various image analysis processing can be executed in accordance with the diagnosis purpose and target. Imaging is performed with various modalities according to the examination order issued from the medical department terminal 2, and information on the interpretation report and information on the image analysis result are input in association with the examination order and patient ID. Further, the captured image and information of the image analysis result are stored in the image management server 61, and the interpretation report is stored in the interpretation report server 62. Information on the analysis result and information on the interpretation report are also recorded as examination values in the electronic medical record having the same patient ID and examination order.

  The electronic medical record includes patient information such as a patient's name, date of birth, and sex, disease information such as a disease name, and a plurality of clinical information items and test value data for the clinical information items. In the disease information, a disease code corresponding to the disease name is recorded, and a plurality of disease codes are recorded when a plurality of diseases occur simultaneously. Further, when a plurality of disease codes are stored, they are recorded so that the main disease or the order of important diseases can be understood.

  The clinical information items are provided corresponding to the examination items of various examinations performed on the patient, and information on the examination values of the examination results conducted in each clinical department or examination room, information on the image diagnosis results, and the like are recorded. Specifically, height and weight, body temperature, cardiac function tests such as blood pressure, heart rate, and electrocardiogram, lung function tests such as respiratory rate and lung function, urine and stool tests, blood tests, various diagnostic imaging tests, vision tests, There is a hearing test. Blood tests include liver, gallbladder and spleen tests, kidney function tests, muscle-related enzyme tests, lipid metabolism tests, uric acid metabolism tests, electrolyte tests, blood cell count tests, inflammatory response tests, blood glucose tests, thyroid function tests, cancer tests Each item relating to (tumor marker) is provided, and a numerical value obtained by a blood test is recorded as a test value. The urine / stool test includes various items related to urine protein, urinary occult blood reaction, urine sugar, urine sediment, urine specific gravity, urine urobilinogen, fecal occult blood reaction, etc., and the values obtained from each test are recorded as test values. The Further, each item relating to various image diagnosis is provided, and the findings regarding the image diagnosis and the value of the feature value obtained by analyzing the image are recorded as the inspection value. For the findings regarding the image diagnosis, an index value or the like representing the malignancy of the shadow appearing in the image may be recorded as a test value.

  FIG. 3 is a flowchart showing a process for recording an electronic medical chart, and FIG. 4 is a flowchart showing a process for determining an important medical care information item and generating a display filter. In the present embodiment, description will be given below assuming that case information is recorded in the unit of one disease of one patient in the electronic medical record.

  At the first visit, patient information such as the patient's name, date of birth, and gender is registered in the electronic medical record (ST1), a patient ID is assigned, and an electronic medical record is created (ST2). The electronic medical record of the patient who has been accepted can be viewed and input at the clinical department terminal 2 of each corresponding clinical department (ST3). After completion of the examination, the electronic medical record for which input has been completed is transmitted to and stored in the electronic medical record storage server 4 (ST4). At the time of reexamination, the patient ID recorded on the patient's examination ticket or the like is read from the reexamination reception terminal or the like (ST9), and the patient ID is transmitted to the medical department terminal 2 where the patient receives an examination. Further, when a patient ID to be examined is designated from the patient designation means 21 of the medical department terminal 2 at the time of examination, an electronic medical record corresponding to the patient ID is retrieved from the electronic medical record storage server 4 and then transmitted to the clinical department terminal 2 (ST10 ) The electronic medical chart can be browsed and input again at the clinical department terminal 2 (ST3).

  At the time of outpatient visit or hospitalization, various examination orders are issued to the patient from the department terminal 2 of each department (ST5). In the inspection room, the inspection order is displayed on the inspection room terminal 5, and the inspection according to the inspection order is performed. Alternatively, the examination may be performed in each department. The test value obtained by the test is input from each laboratory terminal 5 in association with the test order and the patient ID (ST6). Furthermore, the input test value is recorded in the item corresponding to the performed test among the clinical information items of the electronic medical record corresponding to the patient ID (ST7). Alternatively, when an examination is performed in each department and an examination value is input from the department terminal 2 (ST6), the examination value is recorded in the electronic medical record (ST7).

  In addition, the name of the disease diagnosed at the first visit or the disease name determined from the test result is input from the clinical department terminal 2, and the disease code corresponding to the disease name is recorded in the disease information of the electronic medical record. The electronic medical record thus created is stored in the electronic medical record storage server 4 (ST8).

  Various clinical information items are recorded in the electronic medical record, but clinical information items whose test values are likely to deviate from the normal value range depending on the disease are almost determined. When diagnosing whether a patient has a certain disease, a doctor pays attention to an outlier in which a test value of a test result deviates from a normal value. In the actual examination, the doctor confirms the result of the test ordered from the clinical department terminal 2 on the display device of the clinical department terminal 2, and makes a diagnosis. In addition to tests, many tests are conducted, such as tests to confirm that there are no unexpected diseases, tests related to other complications, and tests that are not important but are performed as a set. Many clinical information items are generated. However, since clinical information items to be confirmed mainly by diseases are limited, it is not necessary to display the test values of all clinical information items in detail. Rather, it is preferable to display only important clinical information items that are considered important for diagnosis of each disease among clinical information items. For example, important clinical items can be confirmed as a time series graph including the progress. Is preferred. By creating a display filter 100 that pre-registers important clinical information items corresponding to the disease, it is possible to display only the test values of the important clinical information items necessary for diagnosis and treatment of each disease. . However, there are many diseases, and it is not realistic for a person to manually set important clinical information items in the display filter 100 for all diseases. Therefore, the electronic medical records stored in the electronic medical record storage server 4 are totaled, and important clinical information items important for diagnosis of each disease are automatically determined, and a display filter 100 is created for each disease.

  First, in the medical information management server 3, the electronic medical record acquisition means 31 acquires a large number of electronic medical records stored in the electronic medical record storage server 4 connected via the network 7 (ST11).

  Next, the determination means 32 is good enough to confirm the therapeutic effect after treatment for each disease code of the disease information in the electronic medical record, in which the test value of the clinical information item of the performed examination is an outlier at the start of treatment. The number of converted cases (that is, the number of electronic medical records) is counted, and important clinical information items are determined from the clinical information items.

  When suffering from a specific disease, a clinical information item indicating an outlier in which the test value of the clinical information item for a specific test is out of the normal value range is considered important for the disease. However, some of the clinical information items show outliers due to other factors that are not directly related to a specific disease, and those that were outliers after the treatment of the disease was within the normal range or normal The item that approaches the range is the item that has deteriorated peculiar to the disease, and is the clinical information item that is related to the disease. For example, since lung cancer often accompanies interstitial pneumonia, the test value of a tumor marker that worsens in lung cancer shows an outlier even in interstitial pneumonia. However, since the test value of the tumor marker does not change before and after the treatment of interstitial pneumonia, the tumor marker is not an important clinical information item for diagnosis and treatment for interstitial pneumonia. The clinical information item that becomes a test value improved so that the therapeutic effect can be confirmed after treatment is considered to be an important clinical information item. Therefore, changes in test values at the start and after treatment are collected from the patient's electronic medical record, and important clinical information items are selected from clinical information items whose treatment effects can be confirmed. Specifically, a test value near the time of admission and a test value at the time of discharge are compared, or for a disease that requires a long time for treatment, a test value is compared at the start of treatment and after a certain period of time has elapsed since the start of treatment.

An explanation will be given of the case where important clinical items are determined by taking a tabulation for each disease of “lung cancer”, “bacterial pneumonia” and “interstitial lung disease”. Table 1 below shows the number of cases of each disease and the number of cases of all diseases. The number of diseases is counted when the disease code of the disease information in the electronic medical record matches “lung cancer”, “bacterial pneumonia”, and “interstitial lung disease”.

  Table 2 below shows the number of diseases in which clinical information items have been examined, the number of cases in which the test values of clinical information items have improved in the case of each disease, the improvement rate, and the value of the improvement index. The test values of each clinical information item in the electronic medical record have a range of medical normal values. Therefore, the test values outside the normal range are regarded as outliers and become outliers at the start of treatment. If the clinical information item is after treatment (or after a certain period of time), the test value is within the normal value range, and the value is closer to the normal range than the outlier, and the value is clinically Tests that have improved values are considered good. Actually, whether or not the test value is a value that can be clinically improved is determined in advance by setting a value in a range where improvement is recognized even if it is outside the normal value range for each clinical information item. Judgment is made based on whether or not the inspection value is in the box.

  In addition, an inspection in which an inspection value indicating an outlier is a value further away from a value within the normal value range is deteriorated, and an inspection with a small change in the inspection value is not changed. In the disease unit, the improvement value is calculated by obtaining a cumulative value obtained by adding +1 for the improvement of the test value of each clinical information item, 0 for no change, and -1 for the deterioration (ST12). In addition, the frequency of beneficiation with respect to the number of cases tested is calculated as the rate of improvement (= frequency of improvement / number of diseases tested) (ST13). It can be recognized as important information to judge. However, for diseases that are originally difficult to treat, there are important tests even if the improvement rate is low. For example, a tumor marker for cancer is an important clinical information item for diagnosing whether cancer is improving even if the benign rate is low.

In order to extract such important clinical information items, the test value of the clinical information item that showed an outlier at the start of treatment within a certain disease is within the normal value range or the therapeutic effect can be confirmed And a probability B that has been improved to such an extent that the test value of the clinical information item indicating an outlier at the start of treatment is within the normal value range or the treatment effect can be confirmed if the disease is not the disease. Acquired (ST14), and selects the important clinical information item from those having the probability B higher than the probability A. However, if there is no significant difference between the probability A and the probability B, it cannot be said to be an important clinical information item. Therefore, a clinical information item in which the difference between the probability A and the probability B is equal to or greater than a predetermined value is set as an important clinical information item. Specifically, the ratio = probability A / probability B is obtained (ST15), and the item having a large ratio exceeding a predetermined threshold is determined as an important clinical information item (ST16). Since how important the difference between the probability A and the probability B varies depending on the clinical information item, it is preferable to set the threshold value for each clinical information item.

  Next, a case where the ratio for the clinical information item “NSE” in the case of lung cancer and interstitial pneumonia is calculated based on the results in Table 2 will be described.

Of lung cancer, the number of cases examined for the clinical information item “NSE” (tumor marker) is 2807, of which 295 cases have improved test values, and thus the probability A = 295/2807. The number of cases examined for “NSE” when not having lung cancer was (3558-2807), of which (321-295) were outliers, and therefore the probability B = ((321-295) / (3558-2807)). from now on,
Ratio of `` NSE '' in lung cancer = 295/2807 / ((321-295) / (3558-2807)) = 3.04
The ratio is 3.04, and it is considered that there is a large difference between cases with lung cancer and cases without lung cancer, and “NSE” is improved for peculiar lung cancer, so it can be said that it is important for lung cancer.

Similarly, the ratio of the clinical information item “NSE” is calculated for interstitial pneumonia.
Ratio of interstitial pneumonia “NSE” = 2/130 / ((321-5) / (3558-130)) = 0.42
The ratio is 0.42, and it is thought that there is a large difference between cases with interstitial pneumonia and cases without interstitial pneumonia, and it is not important for pneumonia because it does not worsen peculiar to interstitial pneumonia.

Among clinical information items in Table 2, an item having a benign rate of 50% or more or a ratio of 1.5 or more is determined as an important clinical information item.
From this, important clinical information items are
<Lung cancer>
CRP, CEA, NSE
<Bacterial pneumonia / interstitial pneumonia>
BT, CRP, WBC
Can be determined.

  As described above, the important clinical information items determined by the determining means 32 are registered in the clinical information item filter for each disease and stored in the storage device of the medical information management server 3 (ST17).

  Although disease codes corresponding to disease names are recorded in the disease information of the electronic medical record, if there are very few diseases, multiple disease names classified into the same type of disease, that is, multiple disease names The disease represented by the disease code is counted as one disease by the determining means 32. Thereby, it is possible to cope with rare diseases.

  In addition, when multiple illnesses occur at the same time, multiple disease codes are recorded in the disease information of the electronic medical record, but the electronic medical record indicates the main disease or the order of important diseases. Since the disease code is recorded, the major clinical information items are determined by counting the main diseases (the most important diseases). In addition to the main diseases, the diseases recorded in the electronic medical record include mild diseases, and many of the clinical information items have nothing to do with mild diseases. It is preferable to determine the important clinical information items by counting only the items. Conversely, it is possible to include only cases without complications, but there are many patients suffering from some minor disease, and the number of cases with a small number of cases is further limited. It may be difficult to determine important clinical information items as the number decreases. From this point of view, it is preferable to determine the important clinical information items by counting only the main diseases for the electronic medical records that have multiple diseases.

  In the determination means 32, it is desirable to provide not only one threshold value but also a plurality of threshold values when determining important clinical information items. The important clinical information item selected when the threshold is set to the highest level is considered to be a clinical information item that is particularly markedly improved in the case of a specific disease. However, if it is not possible to grasp the patient's condition by itself, there are cases where it is desired to make a diagnosis by increasing the number of clinical information items to be confirmed a little more. Therefore, two or more threshold values are provided to determine important clinical information items at a plurality of stages. A plurality of stages of important clinical information items are registered in the display filter 100 for each disease.

  When the patient is examined, the designation of the patient ID to be examined is received from the patient designation means 21 of each clinical department terminal 2, and the patient ID designated from each clinical department terminal 2 is sent to the medical information management server 3 together with the electronic medical record search request. Sent. The medical information management server 3 searches the electronic medical record storage server 4 for an electronic medical record having a matching patient ID (ST18), and transmits it to the medical department terminal 2 that has transmitted the patient ID. Further, the display filter 100 corresponding to the disease represented by the disease code in the disease information of the retrieved electronic medical record is transmitted from the medical information management server 3 to the medical department terminal 2 (ST19).

  In the clinical department terminal 2, first, only the test values of the important clinical information items selected when the threshold is the highest among the important clinical information items registered in the display filter 100 are displayed on the display unit 22. (ST20). The doctor makes a diagnosis with reference to the displayed test values. By displaying only the limited important clinical information items in this way, it is possible to immediately grasp necessary information.

  However, if the patient's condition cannot be grasped only by the important clinical information items displayed at the beginning, the doctor can obtain the important clinical information of the next stage of the display filter 100 from the instruction input receiving means 23 of the clinical department terminal 2. An instruction to select an item (that is, an important clinical information item selected when the threshold is set low) is input (ST21). The display means 22 displays the test values of the number of important clinical information items that are larger than the number of important clinical items initially displayed according to the instructed next display filter 100. By instructing which stage of important clinical information items are displayed in this way, it is possible to switch and display important clinical information items necessary for diagnosis.

  Further, when a plurality of disease codes of disease information are recorded in the electronic medical record of the patient to be examined, a plurality of display filters 100 corresponding to the diseases represented by each disease code are stored in the medical department terminal 2 from the medical information management server 3. The test values of important clinical items may be displayed for each disease while transmitting and switching the display filter 100.

  In the above description, the case where the important clinical information items of each disease are determined from the clinical information items whose ratio of improvement or probability exceeds the threshold value has been described. Among clinical information items whose probability A is larger than a predetermined value than the probability B that has improved to such an extent that the therapeutic effect can be confirmed when the disease is not the disease, a predetermined number of clinical items in order from the item with the largest number of cases improved An information item may be selected as an important clinical information item. In addition, when a predetermined number of clinical information items are selected as important clinical information items in order from items with a large number of cases that have improved, clinical information items can be set so that multiple stages of important clinical information items can be set. The number of items to be selected as important clinical information items may be determined in a plurality of stages.

  In this way, selecting important clinical information items in the order of items with a large number of improved clinical information items is highly likely to be tested in the disease and can confirm the treatment effect, which is useful for diagnosis. This is because it is considered important.

  As explained in detail above, simply the tests performed for each disease are not tests related to the disease, but tests related to other complications, or tests that are not important but are collectively tested. However, the present invention automatically determines important clinical information items necessary for diagnosis of each disease and displays only the important clinical information items suitable for the disease among the clinical information items of the electronic medical record. be able to.

  Note that the present invention is not limited to this embodiment, and some or all of the constituent elements of the clinical information display apparatus may be configured by one workstation, and one or more connected via a network It may be configured by a workstation, a server, and a storage device.

  Moreover, each embodiment mentioned above shows the one aspect | mode of this invention to the last, and a deformation | transformation and application are arbitrarily possible within the range which does not deviate from the meaning of this invention.

DESCRIPTION OF SYMBOLS 1 Clinical information display apparatus 2 Medical department terminal 3 Medical information management server 4 Electronic medical record storage server 5 Laboratory room terminal 6 Image diagnostic system 7 Network 10 Medical information system 21 Patient designation means 22 Display means 23 Instruction input reception means 31 Electronic medical record acquisition means 32 Determination means 61 Image management server 62 Interpretation report server
100 Filter for display

Claims (7)

Electronic medical record acquisition means for acquiring a plurality of electronic medical records from electronic medical record storage means for storing a large number of electronic medical records including disease information representing a disease and test values for a plurality of clinical information items;
For each clinical information item of the acquired plurality of electronic medical records, when the disease information is a specific disease, a test value of the clinical information item indicating an outlier that is out of the normal value range at the start of treatment is Probability A that becomes a value within the normal value range or a value closer to the normal range than the outlier after a certain period of time, and out of the normal value range at the start of treatment when the disease information is not the specific disease Obtaining a probability that the test value of the clinical information item indicating an outlier is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and the probability A is Determining means for determining a clinical information item higher than a predetermined value from the probability B as an important clinical information item of the specific disease;
A patient designation means for accepting a predetermined patient designation input;
Display means for displaying, on the display device, only test values corresponding to important clinical information items determined by the determining means corresponding to disease information of the electronic medical record of the patient among the clinical information items of the electronic medical record of the predetermined patient And a clinical information display device.   2. The clinical information display according to claim 1, wherein the determining means determines a clinical information item whose ratio A / B of the probability A and the probability B exceeds a threshold as an important clinical information item of the specific disease. apparatus. The determination means includes a plurality of the threshold values, and determines, as the plurality of important clinical information items having different stages of the specific disease, clinical information items that exceed the threshold for each of the plurality of threshold values.
An instruction input receiving means for receiving an input for instructing a stage of the important clinical information item to be displayed on the display device;
3. The clinical information display apparatus according to claim 2, wherein the display means displays a test value of an important clinical information item at a stage corresponding to the input.   The determination means includes the number of cases in which the test value of the clinical information item indicating the outlier at the start of treatment for each disease becomes a normal value range after a certain period of time, and a value closer to the normal range than the outlier The clinical information display device according to claim 1 or 2, wherein a predetermined number of clinical information items are determined as important clinical information items of the specific disease in order from clinical information items having a large number of cases. . The disease information includes disease name information,
Even when the disease information represents different disease names, the determination means counts the acquired electronic medical records for each clinical information item by using a plurality of disease names classified as the same type of disease as one disease. The clinical information display device according to claim 1, wherein the clinical information display device is a display device. An electronic medical record acquisition means for acquiring an electronic medical record;
A means of determining important clinical information items;
A patient designation means for accepting a predetermined patient designation input;
An operation method of a clinical information display device comprising display means for displaying only test values corresponding to the demand clinical information items of the patient's electronic medical record on a display device,
An acquisition step of acquiring a plurality of electronic medical records from electronic medical record storage means for storing a large number of electronic medical records including test values for disease information indicating a disease and a plurality of clinical information items by the acquisition means;
For each clinical information item of the plurality of electronic medical records acquired by the determination means, the clinical information indicating an outlier that is out of the normal value range at the start of treatment when the disease information is a specific disease. Normal value at the start of treatment when the test value of the item is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and when the disease information is not the specific disease Obtaining a probability B that the test value of the clinical information item indicating an outlier that is out of the range of values becomes a value within the normal value range or a value closer to the normal range than the outlier after a certain period of time Determining a clinical information item in which the probability A is higher than a predetermined value from the probability B as an important clinical information item of the specific disease;
A patient designation step for receiving designation input of the predetermined patient by the patient designation means;
Only the test values corresponding to the important clinical information items determined by the determining means corresponding to the disease information of the electronic medical record of the patient among the clinical information items of the electronic medical record of the patient are displayed on the display device by the display means. A method for operating a clinical information display device, comprising: a display step for displaying the clinical information. Computer
Electronic medical record acquisition means for acquiring a plurality of electronic medical records from electronic medical record storage means for storing a large number of electronic medical records including disease information representing a disease and test values for a plurality of clinical information items;
For each clinical information item of the acquired plurality of electronic medical records, when the disease information is a specific disease, a test value of the clinical information item indicating an outlier that is out of the normal value range at the start of treatment is Probability A that becomes a value within the normal value range or a value closer to the normal range than the outlier after a certain period of time, and out of the normal value range at the start of treatment when the disease information is not the specific disease Obtaining a probability that the test value of the clinical information item indicating an outlier is a value within a normal value range or a value closer to a normal range than the outlier after a certain period of time, and the probability A is Determining means for determining a clinical information item higher than a predetermined value from the probability B as an important clinical information item of the specific disease;
A patient designation means for accepting a predetermined patient designation input;
Display means for displaying, on the display device, only test values corresponding to important clinical information items determined by the determining means corresponding to disease information of the electronic medical record of the patient among the clinical information items of the electronic medical record of the predetermined patient Clinical information display program to function as