JP2006185396A - Diagnostic treatment support system with biological rhythm taken into consideration - Google Patents

Diagnostic treatment support system with biological rhythm taken into consideration Download PDF

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JP2006185396A
JP2006185396A JP2004381342A JP2004381342A JP2006185396A JP 2006185396 A JP2006185396 A JP 2006185396A JP 2004381342 A JP2004381342 A JP 2004381342A JP 2004381342 A JP2004381342 A JP 2004381342A JP 2006185396 A JP2006185396 A JP 2006185396A
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diagnosis
biological rhythm
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Tei Nomoto
禎 野本
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Higashi Nihon Medicom Co Ltd
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Abstract

<P>PROBLEM TO BE SOLVED: To not only present diagnosis, manipulation and prescription on the basis of general medical information and to but also instruct appropriate diagnosis, medical treatment and medicine prescription, etc., by taking personal information of a patient, biological rhythm or the like into consideration. <P>SOLUTION: This diagnostic treatment support system comprises a data server 1 having a database stored with general individual medical information of the patient, general medical information, and biological rhythm information in which general biological rhythm and individual biological rhythm of the patient corresponding to each disease condition are recorded, and terminals 2 and 3 which include a medical management program and medicine management program, externally connect to the data server 1 to be able to input and retrieve the various pieces of information and have a processing means for determining precise diagnosis, manipulation and medicine prescription on the basis of the information. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

本発明は、医師が患者の症状や検査結果を基に判断した病名や治療・処方の的確性を示唆することや薬剤師が処方された薬剤に基づいて患者の症状や病名を確認することができる診断治療支援システムに関するものであり、特に、生体リズムを加味したことを特徴とする。   The present invention suggests the name of a disease determined by a doctor based on the patient's symptoms and test results, the accuracy of treatment / prescription, and the pharmacist can confirm the patient's symptoms and disease name based on the prescribed drug. The present invention relates to a diagnostic treatment support system, and is particularly characterized in that biological rhythm is added.

従来、医師は、患者の症状などの診察結果や検査結果を基にして病名を特定し、治療や薬剤の処方を行うが、患者を診断するには、過去の経験や書物などを基に診断や治療、処方を行うこともある。   Traditionally, doctors identify the disease name based on the examination results and test results of the patient's symptoms, etc., and prescribe treatment and drugs, but in order to diagnose the patient, diagnose based on past experience and books etc. Or treatment or prescription.

そのため、診断の結果が医師の経験や知識によって異なる場合も考えられ、殊に、経験が浅い医師や異なる専門分野において診察する場合には的確な診断や治療を迅速にすることが困難である。   For this reason, the diagnosis results may differ depending on the experience and knowledge of the doctor, and it is difficult to speed up the accurate diagnosis and treatment, especially when the doctor is inexperienced or in a different specialized field.

そこで、例えば特開平６−８３８８０号公報、特開２００３−１０８６６５号公報、特開２００４−２４０７３４号公報などに病名ごとの症状や検査結果をデータ化しておき、これらと患者の病状や電子カルテ情報とを比較・対照して病状を検索することにより、迅速で的確な診断を行うための支援システムが提示されており、経験の少ない医師や専門でない医師にとっても適正な診断が可能となっている。   Therefore, for example, in JP-A-6-83880, JP-A-2003-108665, JP-A-2004-240734, etc., symptoms and test results for each disease name are converted into data, and the patient's medical condition and electronic medical record information. By comparing and contrasting with search for medical conditions, a support system for quick and accurate diagnosis is presented, and appropriate diagnosis is possible even for doctors with little experience or non-specialists .

ところが、前記従来の医療支援システムは、症状や検査結果を予めデータベースに記憶させてある一般的な医療情報と比較・照合して診断結果を検索するものであり、また、薬剤の処方は病状に合った薬剤をデータにより選択し、その際に、例えば体重や服用している他の薬剤との副作用や相互作用をチェックする程度であり、患者個人に合わせた処方は医師の判断に任されており、治療や薬剤の処方についてまで患者個人に合わせた適切な指示をするものはない。   However, the conventional medical support system searches the diagnosis result by comparing and collating the symptom and the test result with the general medical information stored in the database in advance, and the prescription of the drug is a medical condition. The right drug is selected based on the data, and at that time, for example, the side effects and interactions with other drugs taken are checked, and the prescription tailored to the individual patient is left to the judgment of the doctor. However, there is nothing that gives appropriate instructions tailored to the individual patient, including treatment and drug prescription.

特に、従来の薬剤の処方については、通常の生活習慣や、薬剤の吸収や消化などに都合のよいように定められている朝・昼・夕、或いは食前・食後のような服用時期が指定されている。   In particular, for conventional drug prescriptions, normal lifestyle habits, morning / noon / evening, or pre-meal / post-meal periods specified for convenience in absorption and digestion of drugs are specified. ing.

しかしながら、人間は１日に１回転自転をする昼夜の変化をする地球に永年にわたって進化してきたものであり、１日を基準とした生体リズム（概日リズム、日周リズム）があり、例えば体温、血圧、各種ホルモンの分泌、自律神経などは１日の周期で繰り返される特有の時間帯によって変化し、これらの生体リズムが病状についても重要で例えば１日の内で時間によって発症率や病状に変化があり（図６参照）、また、服用についても服用した薬剤が有効に作用する時間帯や却って副作用だけが作用する時間帯などが生じる場合もある。更に、近頃は生活習慣も一律でなく深夜営業や夜更かし、朝の欠食などきわめて多様化しており、生体リズムにも個人差があり、一律ではない。   However, humans have evolved over the years to a day-and-night change that rotates once a day, and there are biological rhythms (circadian rhythms, circadian rhythms) based on one day. , Blood pressure, secretion of various hormones, autonomic nerves, etc. vary depending on the specific time period that is repeated in a daily cycle, and these biological rhythms are also important for disease states. There is also a change (see FIG. 6), and there are cases where a time zone in which the medicine taken effectively acts or a time zone in which only a side effect acts is taken. Furthermore, recently, lifestyles are not uniform, but they are extremely diversified, such as late-night business, staying up late, and missing meals in the morning.

即ち、従来の医療支援システムは一般的な医療情報に基づいて診断、処置、処方を提示するものであり、患者個人の情報や、病態毎の特徴、生体リズムなどを考慮せずになされるものであり、充分な的確性を有していない場合が多い、というものである。
開昭６０−１３４８１７号公報 実開昭６２−１２５７０８号公報 特開平４−３１２２２号公報 That is, the conventional medical support system presents diagnosis, treatment, and prescription based on general medical information, and is made without taking into consideration individual patient information, characteristics for each disease state, biological rhythm, etc. In many cases, it does not have sufficient accuracy.
Japanese Utility Model Publication No. 60-134817 Japanese Utility Model Publication No. 62-125708 JP-A-4-31222

本発明が解決しようとする課題は、従来の医療支援システムのように一般的な医療情報に基づいて診断、処置、処方を提示するだけでなく、患者個人の情報や、生体リズム等を考慮して適切な診断並びに治療、薬剤の処方等を指示することができる診断治療支援システムを提供するものである。   The problem to be solved by the present invention is not only presenting diagnosis, treatment, and prescription based on general medical information as in the conventional medical support system, but also taking into account individual patient information, biological rhythm, etc. The present invention provides a diagnosis and treatment support system capable of instructing appropriate diagnosis and treatment, prescription of drugs, and the like.

前記課題を解決するためになされた本発明は、患者の身体的な特徴、病歴、薬歴、検査データなどの個人医療情報と、各種の身体的な症状や検査結果を基にした病名の診断、その処置、薬剤の処方を記録した一般的医療情報と、各病態に応じた一般的生体リズムおよび患者個人の個別的生体リズムを記録した生体リズム情報とを記憶させたデータベースを有するデータサーバと、医療管理プログラム及び薬剤管理プログラムが組み込まれて外部から接続した端末機を介して前記医療情報、薬剤情報、個人の電子カルテ、電子薬歴、検査データ、生体リズム情報などのデータを入力且つ検索可能であり、且つ前記端末機からの前記情報によって的確な診断および処置並びに薬剤の処方を決定するための処理手段を有することを特徴とする。   The present invention has been made to solve the above-mentioned problems. The present invention provides a diagnosis of a disease name based on personal medical information such as a patient's physical characteristics, medical history, drug history, test data, and various physical symptoms and test results. A data server having a database storing general medical information recording the treatment, prescription of the medicine, and general biorhythm according to each pathology and biorhythm information recording individual biorhythm of the individual patient; Enter and search data such as medical information, drug information, personal electronic medical record, electronic drug history, examination data, biological rhythm information, etc. through a terminal connected from the outside with a medical management program and a drug management program installed It is possible and has a processing means for determining an accurate diagnosis and treatment and prescription of a medicine based on the information from the terminal.

本発明によれば、従来の一般的な医療情報だけでなく、患者個人に関する情報、更には、生体リズム情報を含めて診断、治療並びに薬剤の処方を行うことが可能であり、その結果、的確な診断、早期の回復、不要な副作用などの発生の阻止を図る治療を施すことができる。   According to the present invention, it is possible to perform not only conventional general medical information but also information related to individual patients, and further, including biological rhythm information, diagnosis, treatment, and drug prescription. Treatment to prevent the occurrence of serious diagnoses, early recovery, and unwanted side effects.

次に、本発明を実施するための最良の形態について説明する。   Next, the best mode for carrying out the present invention will be described.

図１は本発明の好ましい実施の形態の概略を示すもので、本発明である生体リズムを加味した診断治療支援システムは、主として、例えば管理センターなどのような箇所に配置された各種の医療に関する情報を記憶させたデータベースを有するデータサーバ１と、医療機関に設置されて前記データサーバ１に例えばインターネットなどの各種の伝達手段を通じて接続される医療機関用端末機２並びに調剤薬局に設置されて前記データサーバ１に例えばインターネットのような各種の伝達手段を通じて接続される調剤薬局用端末機３とを有している。これらの医療機関用端末機２および調剤薬局用端末機３には従来の診断支援システムと同様に、前記データサーバ１に入力された病状や検査情報、個人情報の内容に応じてデータサーバ１に記録されている情報の検索・選択をしたり、医療機関用端末機２および調剤薬局用端末機３に表示させたりする処理機能を有している。   FIG. 1 shows an outline of a preferred embodiment of the present invention. A diagnosis and treatment support system taking into account a biological rhythm according to the present invention mainly relates to various medical treatments arranged at a place such as a management center. A data server 1 having a database storing information; a medical institution terminal 2 installed in a medical institution and connected to the data server 1 through various transmission means such as the Internet; and a dispensing pharmacy. A dispensing pharmacy terminal 3 is connected to the data server 1 through various transmission means such as the Internet. The medical institution terminal 2 and the dispensing pharmacy terminal 3 are connected to the data server 1 in accordance with the medical condition, examination information, and personal information input to the data server 1, as in the conventional diagnosis support system. It has a processing function of searching and selecting recorded information and displaying it on the medical institution terminal 2 and the dispensing pharmacy terminal 3.

そして、前記データサーバ１に配置されるデータベースには、図２，３及び４に示すように、例えば、診断データベース用データ、患者データベース用データ、処方データベース用データ等の各データ（情報）が記憶されている。   In the database arranged in the data server 1, as shown in FIGS. 2, 3 and 4, each data (information) such as diagnostic database data, patient database data, prescription database data, etc. is stored. Has been.

特に、前記各データは、診療科マスタ、症状大分類マスタ、症状小分類マスタ、身体的所見マスタ、検査マスタ、診断名マスタ、身体的所見マスタ、処方マスタ、診断名マスタ、概日情報マスタ等、更に各マスタ毎に区分けして記録されている。   In particular, each of the data includes a medical department master, a symptom major classification master, a symptom minor classification master, a physical finding master, an examination master, a diagnostic name master, a physical finding master, a prescription master, a diagnostic name master, a circadian information master, etc. In addition, it is recorded separately for each master.

尚、本発明で特に重要とされる生体リズムについての情報は生体マスタ、生体個人マスタ等に区分けされて各コード毎に記録される。   It should be noted that information on the biological rhythm that is particularly important in the present invention is classified into a biological master, a biological individual master, and the like and recorded for each code.

そして、診察時に医師は医療機関用端末機２をデータサーバ１に接続して、患者の個人情報をデータサーバ１の患者データの患者マスタ、個人情報マスタ、個人生体マスタなどに入力する。   At the time of the examination, the doctor connects the medical institution terminal 2 to the data server 1 and inputs the patient's personal information to the patient master, personal information master, personal biometric master, etc. of the patient data of the data server 1.

この個人情報には、氏名、住所性別、身長、体重、既往症、現在または過去に服用している薬剤、アレルギーなどの体質だけでなく、個人の生体リズムなどの情報も含まれ、生体リズムの項目としては、例えば１日の食事や睡眠の時間、仕事の内容や時間、場所など生活リズムや生活環境等の個人情報を含むものである。   This personal information includes not only the name, address gender, height, weight, pre-existing disease, current or past medications, allergies, etc., but also personal biorhythms, etc. For example, it includes personal information such as daily rhythms and living environments such as daily meals and sleeping hours, work contents and times, and places.

尚、前記個人情報は診察の際に前記医療機関用端末機２を用いて入力してもよいが、既に電子カルテや電子薬歴が形成されている場合にはそれらの情報を利用してもよく、また、既にデータサーバ１に記録されている場合には必要な情報を追加或いは変更するだけでよい。   The personal information may be input using the medical institution terminal 2 at the time of medical examination. However, if an electronic medical record or an electronic medicine history is already formed, the information may be used. In addition, if it is already recorded in the data server 1, it is only necessary to add or change necessary information.

そして、次に、前記医療機関用端末機２を用いて患者の症状情報、検査情報などのデータをデータサーバ１に送って前記症状大分類マスタ、症状小分類マスタ、身体的所見マスタ、検査マスタ、診断名マスタ、身体的所見マスタ、処方マスタ、診断名マスタ、概日情報マスタ等の情報毎に照合・選択をして、可能性のある診断名を有効性の確率とともに医療機関用端末機２の表示部２１に表示する。その表示例を図５に示す。   Then, using the medical institution terminal 2, data such as patient symptom information and examination information are sent to the data server 1, and the large symptom classification master, small symptom classification master, physical observation master, and examination master , Diagnosis name master, physical findings master, prescription master, diagnosis name master, circadian information master, etc. 2 on the display unit 21. An example of the display is shown in FIG.

尚、本実施の形態では、必ずしも一つの診察名を定めて表示するのではなく、各種の情報から考えられる診察名を、その有効性の割合とともに全て表示し、これらの内で最も可能性の高いものを医師が選択して診断結果とするものであり、医師の診断並びに治療を支援するシステムとしての機能を有するものである。   In the present embodiment, it is not always necessary to define and display one diagnosis name, but display all the diagnosis names that can be considered from various types of information together with their effectiveness ratios. A doctor selects a higher one and obtains a diagnosis result, and has a function as a system that supports the diagnosis and treatment of the doctor.

また、本実施の形態では、特に、従来の医療支援システムのように一般的な医療情報を基にして患者の病態や検査結果を入力して診断するだけでなく、患者の
個人的情報、更には、病態についても生体マスタにおいて一般的な生体リズム情報と個別的な生体リズム情報とを勘案して診断結果を選択することから、きわめて精度の高い診断を下すことが可能である。 Further, in the present embodiment, in addition to the diagnosis of the patient's pathology and test results based on general medical information, as in the conventional medical support system, the patient's personal information, Since the diagnosis result is selected in consideration of general biological rhythm information and individual biological rhythm information in the biological master, the diagnosis can be made with extremely high accuracy.

更に、本実施の形態では処方マスタにおいて従来の医療支援システムのように処方する薬剤（医薬品）の選択もすることができるが、この際、従来の医療支援システムと同様に他に服用している或いは処方する複数の薬剤との相互作用や個人的な情報を含めて副作用などについて指示することが可能であるばかりでなく、得意な個人情報や生体リズム情報を用いることにより、従来の、朝、昼。夕とか食前食後などの服用時期だけでなく、例えば、胃潰瘍であれば就寝中に薬効が生じるような就寝前に服用を指示するとか、１日の内で朝と夕とで服用量を変化させる等きめ細かい診断された病名に対する薬剤これらの服用方法などを適切に指示することができる。   Furthermore, in this embodiment, the prescription master can select a medicine (medicine) to be prescribed as in the conventional medical support system, but at this time, it is taken in the same manner as in the conventional medical support system. Alternatively, it is possible not only to instruct about side effects including interaction with multiple prescription drugs and personal information, but also by using good personal information and biological rhythm information, Noon. Not only when it is taken in the evening or after a meal before meals, but for example, if it is a gastric ulcer, the dose should be changed between morning and evening within the day, such as instructing to take it before going to bed so that it will be effective during bedtime. It is possible to appropriately instruct the medicines for the diagnosed disease names and the like.

また、本実施の形態により、処理された診断及び処方データはデータサーバ１に保存されて次回の検診に備えることになり、更に、電子カルテや電子薬歴に転送してそれらのデータの更新をすることができる。このように、検診毎のデータを蓄積して医師がこれらの情報を用いて診断することにより医師の知識レベルの向上が図れるとともに誤診などのミスを防ぐことができる。   Further, according to the present embodiment, the processed diagnosis and prescription data are stored in the data server 1 to prepare for the next examination, and further, the data is updated to the electronic medical record or the electronic drug history. can do. As described above, by accumulating data for each examination and making a diagnosis using the information by the doctor, the knowledge level of the doctor can be improved and mistakes such as misdiagnosis can be prevented.

更に、本実施の形態では、調剤薬局では調剤薬局用端末機３において、医療機関用端末機２やデータサーバ１から送られる処方情報について、その処方過程を分析して患者にとって正しい処方であるか否かを確認することが可能である。   Furthermore, in this embodiment, in the dispensing pharmacy, whether the prescription information sent from the medical institution terminal 2 or the data server 1 in the dispensing pharmacy terminal 3 is the correct prescription for the patient by analyzing the prescription process. It is possible to confirm whether or not.

患者の所見及び検査値を入力することにより、他の医師が所見及び検査値等から診断した結果を参照しつつ診断をすることができるので、医師の診断の妥当性を確認しつつより正確な診断をすることができ、医療ミスを極力防止することができる。   By entering the patient's findings and test values, it is possible to make a diagnosis while referring to the results diagnosed by other doctors based on the findings and test values. Diagnosis can be made and medical errors can be prevented as much as possible.

本発明の好ましい実施の形態におけるシステムの概略図。1 is a schematic diagram of a system in a preferred embodiment of the present invention. 図１に示した実施の形態におけるデータサーバの診断データベースのデータ関連図。FIG. 3 is a data relation diagram of a diagnostic database of the data server in the embodiment shown in FIG. 1. 図１に示した実施の形態におけるデータサーバの患者データベースのデータ関連図。The data related figure of the patient database of the data server in embodiment shown in FIG. 図１に示した実施の形態におけるデータサーバの処方データベースのデータ関連図。The data related figure of the prescription database of the data server in embodiment shown in FIG. 図１に示した実施の形態における医療機関用端末機の表示態様の一例を示す概略図。Schematic which shows an example of the display mode of the terminal for medical institutions in embodiment shown in FIG. 生体リズムと病気の発生との関係図。Diagram of the relationship between biological rhythm and disease occurrence.

符号の説明Explanation of symbols

１ データサーバ、 ２ 医療機関用端末機、 ３ 調剤薬局用端末機、 ２１ 表示部
1 data server, 2 medical institution terminal, 3 dispensing pharmacy terminal, 21 display

Claims (1)

患者の身体的な特徴、病歴、薬歴、検査データなどの個人医療情報と、各種の身体的な症状や検査結果を基にした病名の診断、その処置、薬剤の処方を記録した一般的医療情報と、各病態に応じた一般的生体リズムおよび患者個人の個別的生体リズムを記録した生体リズム情報とを記憶させたデータベースを有するデータサーバと、医療管理プログラム及び薬剤管理プログラムが組み込まれて前記データサーバに接続可能で前記医療情報、薬剤情報、個人の電子カルテ、電子薬歴、検査データ、生体リズム情報などのデータを入力且つ検索可能であり、且つ前記情報によって的確な診断および処置並びに薬剤の処方を決定するための処理手段を有する端末機とを有することを特徴とする生体リズムを加味した診断治療支援システム。
General medical care that records personal medical information such as the patient's physical characteristics, medical history, medical history, laboratory data, diagnosis of the disease name based on various physical symptoms and test results, treatment, and prescription of the drug A data server having a database storing information and biological rhythm information in which general biological rhythms corresponding to each disease state and individual biological rhythms of individual patients are stored, and a medical management program and a drug management program incorporated therein Connectable to a data server and capable of inputting and searching for data such as medical information, drug information, personal electronic medical record, electronic drug history, examination data, biological rhythm information, and accurate diagnosis and treatment and drug based on the information And a terminal having processing means for determining the prescription of the diagnosis and treatment support system in consideration of biological rhythm.
JP2004381342A 2004-12-28 2004-12-28 Diagnostic treatment support system with biological rhythm taken into consideration Pending JP2006185396A (en)

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JP2014160517A (en) * 2007-10-12 2014-09-04 Patientslikeme Inc Personal management and monitoring of disease condition
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