JP2010079712A - Radiation exposure dose management system in regional medical information cooperation center - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a radiation exposure dose management system in a regional medical information cooperation center having a function which draws up a cumulative radiation dose of the patient and a medical examination schedule by constructing a system for sharing a radiation exposure dose of a patient among regional medical institutions and managing the information of the system. <P>SOLUTION: In this regional medical information cooperation center 20 for managing the information in a regional medical network, an exposure managing part 21 calculates a cumulative exposure dose from the patient's past exposure history when the patient receives a medical examination in a medical institution 13<SB>1</SB>this time, and provides the information of the cumulative exposure dose to medical institutions 13<SB>2</SB>and 13<SB>3</SB>. Then, a schedule preparing part 28 prepares a five-year medical examination plan of the patient so as not to exceed a permissible exposure dose of the patient. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention belongs to the medical field, and relates to a regional medical network in which medical institutions are connected by a network and a regional medical information cooperation center that functions therein, and in particular, radiation exposure of patients in the medical institutions. The present invention relates to a radiation exposure management system in a regional medical information cooperation center used for managing or reducing the risk.

  In recent years, with the spread of diagnostic imaging apparatuses such as CT, the cancer discovery rate has increased. On the other hand, opportunities for radiation exposure by an image diagnostic apparatus and radiotherapy are increasing. Since the patient exposure history at each medical institution is not linked, there is a possibility that the patient may receive radiation exceeding the allowable amount when diagnosed or treated at a separate medical institution.

Attempts to share patient information in cooperation with each other are known in the art. For example, Non-Patent Documents 1 and 2 below are examples of regional medical cooperation as a conventional technique.
Ministry of Health, Labor and Welfare: Round-table conference between prefectures and countries for the creation of new medical plans (2nd) “Examples of medical collaborations nationwide” http://www.mhlw.go.jp/shingi/ 20005/10 / s1024-8c.html 2006 Healthcare Welfare Information System Industry Association Business Report Promotion of Standardization in Regional Medical Information Cooperation http://www.jahis.jp/activity/events/gyoumuhou/h18gyoumuhou/New_Folder/ Promotion of Standardization in Oshima Regional Medical Information Cooperation .pdf

  However, Non-Patent Documents 1 and 2 described above do not describe medical cooperation of radiation exposure by radiation therapy. And since the patient's exposure history in each medical institution is not coordinated, there is a possibility that when the patient is diagnosed or treated at a different medical institution, radiation exceeding the allowable amount may be received. This is because, as described above, there is an attempt to share patient information in cooperation with the region, but there is no mechanism for sharing the exposure dose and suppressing the patient exposure dose.

  In addition, there is no mechanism for creating a long-term medical treatment plan in consideration of the patient's exposure.

  Accordingly, the present invention has been made in view of the above circumstances, and its purpose is to construct a system for sharing the radiation exposure dose of patients at a local medical institution, to manage the information, and to calculate the cumulative exposure of patients. It is to provide a radiation exposure management system in a regional medical information cooperation center having a function of planning a dose and a medical treatment schedule.

  That is, the present invention is a center that manages information in a regional medical network, calculates an integrated exposure amount when a patient visits this time from a past exposure history of a patient, and corresponds to a plurality of medical institutions. Exposure management means for providing the information to a medical institution, and schedule creation means for creating a long-term medical care plan for the patient so that the patient does not exceed the allowable dose.

  The present invention also provides a radiation exposure management system comprising at least one medical institution and a regional medical information cooperation center that manages information in the at least one medical institution, the regional medical information cooperation center. And the at least one medical institution are connected to each other via a network, and the regional medical information cooperation center and each of the at least one medical institution each have a communication means, and transmit / receive exposure information to / from each other. And

  Furthermore, the present invention provides a regional medical information network that includes a plurality of medical institutions and a regional medical information cooperation center that manages information in the plurality of medical institutions. An exposure management means for calculating the cumulative exposure dose at this visit from the past exposure history and providing the information to the medical institution, and a fixed period of the patient so that the patient does not exceed the allowable exposure dose And a schedule creation means for creating a medical treatment plan.

  According to the present invention, a system for sharing a radiation exposure dose of a patient at a local medical institution is constructed, and the regional medical information having a function of managing the information and planning a patient's integrated exposure dose and a medical treatment schedule It is possible to provide a radiation exposure management system in the cooperation center.

  As a result, it is possible to share the exposure dose in cooperation with each other in the region, thereby suppressing the exposure dose of the patient, and to make a long-term medical treatment plan for the patient based on the information.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

(First embodiment)
FIG. 1 is a block diagram showing the configuration of a radiation exposure management system in the regional medical information cooperation center according to the first embodiment of the present invention.

  In FIG. 1, this radiation exposure management system 10 constructs a regional medical network 12 including a plurality of medical institutions 13 and a regional medical information cooperation center 20, and the patient exposure dose of each medical institution 13. For sharing and creating patient medical plans.

  The medical institution 13 is composed of, for example, a hospital, a clinic, an acute care hospital, a rehabilitation hospital, a medical treatment facility, etc. In this system, exposure information before an examination is acquired or an examination is performed. It is a part to update the medical record later.

  The regional medical network 12 is formed by connecting a regional medical information cooperation center 20 and a medical institution 13 belonging to a region through a network.

  The regional medical information cooperation center 20 is a part that manages information in the regional medical network 12.

  FIG. 2 is a block diagram showing a configuration in each element constituting the radiation exposure management system 10.

Each medical institution belonging to the medical institution regional medical network 12 includes the following elements. In other words, the medical institutions 13 ₁ , 13 ₂ , 13 ₃ , 13... Each include a communication unit 14 ₁ , 14 ₂ , 14 ₃ ,... And a medical record storage unit 15 ₁ , 15 ₂ , 15 ₃ ,. Is done.

The communication units 14 ₁ , 14 ₂ , 14 ₃ ,... Communicate with the regional medical information cooperation center 20 and other medical institutions via the regional medical network 12.

The medical record storage units 15 ₁ , 15 ₂ , 15 ₃ ,... Are used to store medical records of medical care performed at the medical institutions 13 ₁ , 13 ₂ , 13 ₃ ,. When a medical record is newly stored, a medical record registration unit (to be described later) in the regional medical information cooperation center 20 is updated (new medical record information is added).

  On the other hand, the regional medical information cooperation center 20 is configured as follows.

  That is, the regional medical information cooperation center 20 includes an exposure management unit 21, a communication unit 22, a medical treatment schedule storage unit 23, a patient exposure history storage unit 24, a regional patient ID management unit 26, and a medical record registration unit 27. And a schedule creation unit 28.

  The said exposure management part 21 is for hold | maintaining a patient's exposure log | history and a medical treatment schedule. When a patient visits a medical institution 13 and a diagnosis method is notified from the medical institution 13, the cumulative exposure amount at the time of this visit is calculated from the past exposure history of the patient, and information is sent to the medical institution 13. provide. The patient's medical plan is rescheduled so as not to exceed the exposure allowance. Further, when there is no information on the patient, the exposure management unit 21 has a function of searching the medical record of each medical institution 13, collecting information, and calculating the integrated exposure dose.

The communication unit 22 transmits and receives communications with the medical institutions 13 ₁ , 13 ₂ , 13 ₃ ,... Via the regional medical network 12.

  The medical care schedule storage unit 23 is a database that stores a medical care plan for each patient. The medical care plan describes a long-term medical care plan for a patient, and includes a medical record received in the past and a schedule of medical care to be received in the future. As will be described in detail later, when an unplanned medical treatment occurs, the patient's medical treatment plan is updated based on the exposure history. If there is no medical plan for the patient, the exposure management unit 21 collects information from the medical record storage of the medical institution, creates a new medical plan for the patient, and stores it in this database. If there is a medical plan, the content is updated when a patient newly receives medical care.

  The patient exposure history storage unit 24 includes a database that holds an exposure history for each patient. The exposure history includes the date and time the patient has been exposed in the past, the radiation dose, and its integrated value. If there is no patient exposure history, the exposure management unit 21 collects information from the medical record storage of the medical institution, creates a new patient exposure history, and stores it in this database. When there is an exposure history, the contents are updated when a patient newly receives medical care.

  The regional patient ID management unit 26 holds a unique patient ID in the regional medical network 12. The local patient ID management unit 26 notifies the patient ID in response to the inquiry.

  The medical record registration unit 27 is for holding information on a medical record storage location of a medical institution 13 belonging to the regional medical network 12. The medical record registration unit 27 notifies the storage location of the medical record in response to the inquiry.

  Furthermore, the schedule creation unit 28 is for creating a patient medical plan.

  Here, the scheduling created by the schedule creation unit 28 will be described with reference to FIG.

  For example, as shown in FIG. 3A, a five-year medical treatment schedule regarding the exposure of a patient is created so that the exposure dose does not exceed the allowable dose. As an example of such a medical treatment schedule, for example, a case where a patient is regularly examined as to whether or not cancer has metastasized can be considered.

In this case, it shall be exposed from the 1st year to the 3rd year by radiation therapy or the like. It is assumed that the exposure is also made in April of the fourth year, and thereafter, the exposure is scheduled for October and April of the fifth year. In FIGS. 3A to 3D, the hatched portion is the exposure dose to date.

  Here, as shown in FIG. 3 (b), it is assumed that an unscheduled medical treatment occurred between April and October of the fourth year and the patient was exposed (shown in black in the figure). ) Suppose that this patient received medical care in October as scheduled in the schedule. Then, as shown in FIG. 3C, the exposure dose exceeds the allowable dose at the time of medical treatment in October.

  Therefore, if medical treatment is performed according to the original schedule, the other medical institution is notified that the exposure dose of the patient exceeds the allowable dose. This is to prevent a patient from being exposed to an exposure exceeding an allowable amount when the patient is diagnosed or treated at a different medical institution as in the past.

  Then, as shown in FIG. 3D, the future schedule is corrected in view of the exposure dose generated by the unscheduled medical treatment described above. For example, in the example of FIG. 3D, the schedule is corrected so as to cancel the medical care in October of the fourth year. Then, similarly to the initial schedule shown in FIG. 3A, it is possible to perform medical treatment for five years without the exposure dose exceeding the allowable dose.

  However, when modifying the schedule, the patient may select which point of time in the initial schedule is to be stopped and what point of care is to be performed, or an operator such as a doctor may determine.

  In addition, although the exposure schedule is set as one set for five years here, the exposure dose is actually accumulated every year. Furthermore, the exposure schedule is not limited to five years, but may be any schedule created within a certain period.

  Next, the operation of the radiation exposure management system 10 in this embodiment will be described with reference to FIG.

  First, with reference to FIG. 4A, an example before an examination in a case where patient data already exists in the exposure management unit 21 in the regional medical information cooperation center 20 will be described.

For example, consultation of the patient is made to the medical institution 13 ₁ (a1). Then, through the communication unit 22 of the regional medical information sharing center 20 from the communication unit 14 ₁ of the medical institution 13 _1, the diagnostic method of the patient is notified to the exposure control unit 21 (a2). Next, an inquiry about the patient's ID is made to the regional patient ID management unit 26 (a3). In this case, when the ID of the patient is confirmed by the local patient ID management unit 26, the medical care schedule storage unit 23 is subsequently referred to and the schedule is updated for the schedule creation unit 28 (a4). .

Then, and the exposure history and schedule of the patient stored in the patient exposure history storage unit 24, is notified to the medical institution 13 ₁ through the communication unit 22 and the communication unit 14 ₁ (a5).

  Next, with reference to FIG. 4B, an example before examination when patient data does not exist in the exposure management unit 21 in the regional medical information cooperation center 20 will be described. That is, this is an example of creating a patient exposure history and schedule.

For example, when a patient is examined with respect to the medical institution 13 ₁ (b1), the communication management unit 14 ₁ of the medical institution 13 ₁ communicates with the exposure management unit 21 via the communication unit 22 of the regional medical information cooperation center 20. The patient diagnosis method is notified (b2). Next, an inquiry about the patient's ID is made to the regional patient ID management unit 26 (b3).

In this case, since the local patient ID management unit 26 does not confirm the ID of the patient, the medical record registration unit 27 is subsequently inquired about the medical record storage location (b4). Thereafter, the medical record is inquired from the exposure management unit 21 to the medical institutions 13 ₂ and 13 ₃ other than the medical institution 13 ₁ via the communication unit 22 and the communication units 14 ₂ and 14 ₃ (b5). . As a result, a medical record is acquired from one of the medical institutions 13 ₂ and 13 ₃ where the medical record of the patient is stored.

Then, the medical schedule storage unit 23 is referred to, and the schedule is updated for the schedule creation unit 28 (b6). Then, and the exposure history and schedule of the patient stored in the patient exposure history storage unit 24, via the communication unit 22 and the communication unit 14 ₁ is notified to the medical institution 13 ₁ (b7).

In this example, since the patient ID is not confirmed by the regional patient ID management unit 26, the medical institution 13 ₁ does not have information on the patient being examined, but the other medical institutions 13 ₂ and 13 ₃ perform radiation therapy. It is thought that there was a possibility of having received. That is, originally _at other medical institutions 13 _2, 13 _3, assuming that have visited the radiation therapy based on medical schedule as shown in FIG. 3 (a), visits the medical institution 13 _1, Figure 3 It may be unscheduled as shown in (b). Then, when receiving radiation therapy in the medical institution 13 _1, as shown in FIG. 3 (c), for exposure at unscheduled initial clinical schedule is exposure amount at the next clinic allowance Will be exceeded.

Therefore, in order to prevent exposure exceeding this allowable amount, in regional medical information sharing center 20, with respect to the medical institution 13 medical institution 13 ₂ other than _1, 13 _3, query medical records of the patient is carried out . As a result, the medical record is notified to the regional medical information cooperation center 20 from the corresponding medical institution (for example, the medical institution 13 ₂ or 13 ₃ ) where the patient is consulted. Then, in response to the notified medical record, the regional medical information cooperation center 20 notifies the medical institution 13 ₁ of the history of exposure and schedule of the patient.

  Next, the operation of the system after inspection with respect to the operation of the system before inspection described above will be described with reference to FIG.

When a patient is examined at the medical institution 13 ₁ described above, the medical record is updated at the medical institution 13 ₁ (c1). Then, the completion of diagnosis is notified from the medical institution 13 ₁ to the exposure management unit 21 of the regional medical information cooperation center 20 via the communication unit 14 ₁ and the communication unit 22 (c2). Next, an inquiry about the patient ID is made to the local patient ID management unit 26 (c3), and further an inquiry about the medical record storage location is made to the medical record registration unit 27 (c4).

Next, a medical record inquiry is made from the exposure management unit 21 to the medical institution 13 ₁ via the communication unit 22 and the communication unit 14 ₁ (c5). If the medical record is acquired by this inquiry, the medical schedule storage unit 23 is referred to, and the schedule is updated for the schedule creation unit 28 (c6). In this case, the medical record of the patient after the inspection is stored in the medical record storage unit 15 ₁ shown in FIG.

  In this way, the regional medical institution 13 cooperates with the regional medical network 13 to notify and share the exposure dose. Therefore, the patient exposure dose can be suppressed, and the patient can be controlled based on the information. The long-term medical schedule can be corrected.

(Second Embodiment)
Next, a second embodiment of the present invention will be described.

  In the second embodiment, the configuration and operation of the radiation exposure management system are the same as the configuration and operation of the radiation exposure management system of the first embodiment shown in FIGS. Therefore, the same reference numerals are assigned to the same parts, illustration and description thereof are omitted, and only different parts will be described.

  FIG. 5 is a block diagram showing a configuration in each element constituting a radiation exposure dose management system according to the second embodiment of the present invention.

  In the first embodiment described above, the database that holds the exposure history for each patient is provided on the medical institution side, but the present invention is not limited to this.

For example, as shown in FIG. 5, a medical record storage unit 25 may be provided in the regional medical information cooperation center 20 and used as a database. In this case, the medical record storage units 15 ₁ , 15 ₂ , 15 ₃ ,... On the medical institutions 13 ₁ , 13 ₂ , 13 ₃ ,.

  Even if comprised in this way, since the local medical institution 13 and the regional medical information cooperation center 20 cooperate and share an exposure dose via the regional medical network 12, the exposure dose of the patient can be suppressed. In addition, the patient's long-term medical treatment schedule can be corrected based on the information.

  In the first and second embodiments described above, only three medical institutions including the communication unit and the medical record storage unit are illustrated. However, the present invention is not limited to this, and there is at least one medical institution. It ’s good.

  As for the regional medical information cooperation center, one of the existing medical institutions may be constructed as a regional medical information cooperation center having each element as shown in FIG. A new regional medical information cooperation center may be provided.

  Although the embodiment of the present invention has been described above, the present invention can be variously modified without departing from the gist of the present invention other than the above-described embodiment.

  Further, the above-described embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements. For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, the problem described in the column of the problem to be solved by the invention can be solved, and the effect described in the column of the effect of the invention Can be obtained as an invention.

It is the block diagram which showed the structure of the radiation exposure management system in the regional medical information cooperation center which concerns on the 1st Embodiment of this invention. It is the block diagram which showed the structure in each element which comprises the radiation exposure management system 10 of FIG. It is a figure explaining the scheduling produced by the schedule production part 28 of the regional medical information cooperation center 20. FIG. It is a figure for demonstrating operation | movement of the radiation exposure dose management system 10 in 1st Embodiment. It is the block diagram which showed the structure in each element which comprises the radiation exposure dose management system which concerns on the 2nd Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 ... Radiation exposure management system, 12 ... Regional medical network, 13, 13 ₁ , 13 ₂ , 13 ₃ , ... Medical institution, 14 ₁ , 14 ₂ , 14 ₃ , ..., 22 ... Communication part, 15 ₁ , 15 ₂ , 15 ₃ ,..., 25 ... medical record storage unit, 20 ... regional medical information cooperation center, 21 ... exposure management unit, 23 ... medical schedule storage unit, 24 ... patient exposure history storage unit, 26 ... regional patient ID management , 27 ... medical record registration unit, 28 ... schedule creation unit.

Claims (11)

A center that manages information in a regional medical network,
From the past exposure history of the patient, an exposure management means for calculating an integrated exposure amount when this visit is made and providing the information to the corresponding medical institution among a plurality of medical institutions,
A schedule creation means for creating a long-term medical plan for the patient so that the patient does not exceed an exposure allowance;
Radiation exposure management system in the regional medical information cooperation center characterized by having.   2. The regional medical information cooperation center according to claim 1, wherein the exposure management unit searches medical records of the plurality of medical institutions, collects information, and calculates an integrated dose of the patient. Radiation exposure management system.   The exposure management means searches for medical records of medical institutions other than the medical institution and collects information when the medical institution where the patient consulted is different from the medical institution where the patient consulted in the past. The integrated radiation exposure management system according to claim 2, wherein the integrated exposure dose is calculated.   4. The regional medical information cooperation center according to claim 2, wherein the schedule creation unit corrects a long-term treatment plan of the patient based on the integrated exposure amount calculated by the exposure management unit. Radiation exposure management system. A radiation exposure management system comprising at least one medical institution and a regional medical information cooperation center for managing information in the at least one medical institution,
The regional medical information cooperation center and each of the at least one medical institution are connected by a network,
Each of the regional medical information cooperation center and the at least one medical institution has a communication unit, and transmits and receives exposure information to each other.   The regional medical information cooperation center includes an exposure management unit that searches medical records of the at least one medical institution, collects information, and calculates an integrated dose of the patient. 5. Radiation exposure management system in the regional medical information cooperation center described in 5.   The exposure management means searches for medical records of medical institutions other than the medical institution and collects information when the medical institution where the patient consulted is different from the medical institution where the patient consulted in the past. The integrated radiation exposure management system in the regional medical information cooperation center according to claim 6, wherein the integrated exposure dose is calculated. In a regional medical network including a plurality of medical institutions and a regional medical information cooperation center that manages information in the plurality of medical institutions,
The regional medical information cooperation center
From the past exposure history of the patient, an exposure management means for calculating the cumulative exposure amount at this time and providing the information to the medical institution,
A schedule creation means for creating a medical treatment plan for a certain period of the patient so that the patient does not exceed the allowable exposure;
Radiation exposure management system in the regional medical information cooperation center characterized by having.   The region according to claim 8, wherein the exposure management means searches medical records of the plurality of medical institutions, collects information on the corresponding patient, and calculates an integrated dose of the patient. Radiation exposure management system at medical information collaboration center.   The regional medical information cooperation center according to claim 9, wherein the regional medical information cooperation center and the plurality of medical institutions each have communication means for transmitting and receiving the information, and transmit and receive exposure information to each other. Radiation exposure management system at the center.   When the medical institution that the patient has visited is different from the medical institution that the patient has received in the past, the exposure management means makes an inquiry about the past exposure history of the patient to a medical institution other than the medical institution. The radiation exposure management system in the regional medical information cooperation center according to claim 9, wherein information related to a history is obtained and an integrated exposure dose of the patient is calculated.

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