JP2004280455A - Medical information system - Google Patents

Abstract

An object of the present invention is to record almost all information related to medical procedures such as surgery and treatment over time. In addition, the information can be displayed and presented in chronological order. In addition, the recorded information can be easily analyzed based on the time information.
The information processing apparatus includes a sensor for detecting information related to an operation, a server for connecting information detected by the sensor to time information and storing the information. Further, a display device 13 for displaying information stored by the server 12 in chronological order is provided. Further, the server 12 has a function of analyzing stored information based on time information.
[Selection diagram] Fig. 1

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention can store and store information on treatments performed in medical operations such as surgery and events occurring therein in a time-series manner, whereby the information can be post-analyzed and verified in medical operations. In addition, the present invention relates to a medical information system that can be effectively used for optimizing a procedure of a medical practice.
[0002]
[Prior art]
Generally, at a medical site, when a medical operation such as an operation is performed, details of the operation are recorded as a document by a doctor or the like who is involved in the operation, and are attached to a medical chart and stored. This record is often accompanied by a chart or a photograph showing data output from various devices during the operation.
[0003]
For this reason, after performing such a medical practice, when trying to verify or reproduce the procedure and contents of the practice, the focus is on browsing the record. However, in this record, various kinds of data are often described irrespective of the order of time, and not all information is recorded. In many cases, information related to medical practice is not centralized and is stored individually in each department.
[0004]
For example, even if the operation is considered to be relatively simple, in addition to monitor information for observing the patient's body condition such as electrocardiogram, respiration, blood pressure, anesthesia monitor (anesthesia amount, input rate), electric scalpel ( Information on medical work to be performed on patients, such as voltage and time, is involved. In addition, information on various medical actions, such as the use of instruments and medication, is often complicatedly involved as medical actions performed by the surgeon.
[0005]
For this reason, even a physician who is familiar with medical care must take a considerable amount of time to collect and analyze information in order to thoroughly check and verify the entire medical practice after the fact. The labor and time were enormous. In addition, even if it is intended to collect all information, there is often information that is not recorded, such as the behavior of staff other than the main surgeon and changes in the operating room environment.
[0006]
Therefore, it is very difficult even for specialists such as doctors to confirm and verify the entire medical practice after the fact. In other words, considering medical procedures such as surgery performed once, and trying to construct a more optimal procedure, not all the information to be at hand is at hand, and enormous effort is required for such optimization. there were. In fact, the fact is that ordinary people who are not accustomed to medical treatment can hardly read medical treatment accurately from an operation record book or the like after the fact.
[0007]
Therefore, in order to confirm and verify medical actions such as surgery and treatment objectively without leaking, in addition to the above-mentioned surgery record, we record conversations exchanged at the site of medical actions and state of such sites It is also conceivable to shoot the video with a television camera and use those conversations and videos together.
[0008]
[Problems to be solved by the invention]
However, even if voices and images are used together as described above, the amount of work to connect the medical chart and those voices and images on the time axis becomes enormous because they are separately recorded and photographed, and are extremely large. It will take time and effort. This is a problem that occurs because all medical actions performed by the operator or medical staff on the patient during the operation are recorded, and the relations are not connected by the concept of time.
[0009]
Therefore, an object of the present invention is to record almost all information related to medical actions such as surgery and treatment performed on a patient at the above-mentioned medical site as it is over time. .
[0010]
It is another object of the present invention to allow information to be displayed and presented in chronological order in addition to the above-described information recording along the passage of time.
[0011]
Still another object of the present invention is to enable the recorded information to be easily analyzed based on the time information, in addition to the information recording and the time-series information display along the time lapse described above.
[0012]
[Means for Solving the Problems]
In order to achieve the above object, a medical information system according to the present invention includes a detecting means for detecting information related to a medical practice, and an information storing means for storing information detected by the detecting means in connection with time information. It is characterized by having. This makes it possible to record almost all information related to a medical operation such as an operation or treatment performed on a patient at a medical site as it is over time.
[0013]
At this time, preferably, a display unit for displaying information stored by the information storage unit in a time-series manner is further provided. Therefore, the information can be displayed and presented in chronological order during the medical practice, and the work required for the medical practice can be facilitated and streamlined.
[0014]
In a preferred embodiment, the information storage device further includes an analysis unit that analyzes information stored by the information storage unit based on the time information. As a result, the recorded information can be easily analyzed based on the time information, so that the labor and time required for research and standardization of the work procedure of the medical practice can be greatly reduced as compared with the conventional method.
[0015]
Further, as another example, the detection means may include information indicating an operation status of a medical device related to the medical practice, medication information, patient biological information, vital information of an operator, image information reflecting a medical site, image information at a medical site. It is a means for detecting at least one type of information belonging to at least one category among sound information, information on a person entering and leaving a medical site, patient recognition information, and medical site environmental information.
[0016]
In addition, the medical practice is an operation to be performed on a patient, the detection means is information representing the operating status of a medical device in the operating room, biological information of the patient, vital information of the surgeon, a video image showing the operating room, It may include audio in the operating room, information on people entering and leaving the operating room, and patient recognition information.
[0017]
Further, for example, the medical practice is an operation performed on a patient, and the time information is clock information or electronic clock information of the medical information system.
[0018]
Further, for example, the information storage unit is a unit that stores information related to the medical practice and the time information by storing them in one recording medium. The use of one recording medium simplifies the handling.
[0019]
More preferably, the information storage means includes means for automatically or semi-automatically marking a cue on the information detected by the detection means, and the display means reads out the information based on the cue. Means. The means for marking the cue is, for example, vital information of an operator detected by the detection means, voice recognition information of a voice exchanged at a medical site, image recognition information of an image reflecting a medical site, and an operator's Means for marking the cue according to at least one of the acceleration information of the body movement.
[0020]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings.
[0021]
FIG. 1 shows an outline of the configuration of the medical information system according to the present embodiment. This medical information system relates to almost all important events that occur during surgery as one of the medical procedures (such as surgical operations of medical staff and accompanying medical procedures, patient conditions, operating room conditions, and operating environment, etc.). This is a system that records, displays and archives information of events in chronological order in the order of occurrence, and can be used for subsequent analysis and the like. The medical practice is not necessarily limited to surgery, but is to be interpreted in a broad sense including diagnosis, medication, treatment, rehabilitation, and the like.
[0022]
As shown schematically in FIG. 1, the medical information system includes a group 11 of various sensors (measuring devices, monitors, and the like) for detecting information related to surgery, and a detection signal of the group 11 of the various sensors. And an information collection / recording server 12 that performs processing such as recording (storage), display, and analysis of the time series of the input information, and a display device 13.
[0023]
Among them, the sensors 11 can be classified into a plurality of categories according to an installation target and an installation location. These categories include (1) a plurality of sensors 21a to 21n (n means an arbitrary number) installed at one or more types of medical devices or their peripherals to check the operation status of the medical devices, ( 2) a plurality of cameras 22a to 22n for photographing a plurality of locations such as an operating room and a surgical site; (3) a plurality of sensors 23a to 23n for detecting vitals of surgical staff such as doctors; A plurality of microphones 24a to 24n for detecting voice (including the sound of an object); (5) one or a plurality of sensors 25 (or 25a to 25n) for grasping the entry and exit of staff to and from the operating room; A plurality of sensors 26a to 26n for detecting biological information of a patient and (7) one or a plurality of sensors 27 (or 27a to 27n) for obtaining identification information of a patient are included.
[0024]
Specific examples of these sensors are listed by category, with some applications of the sensor signals.
[0025]
(1) The first category is a group of sensors for checking the operation status of the medical device, and detects a signal indicating the operation status to check whether the medical device is operating normally. Consists of sensors. Hereinafter, specific examples of the sensor will be described.
[0026]
・ Drip drip monitor sensor: The drip dripping state is measured by wetness, pressure, flow meter, dripping, etc. Further, such a dripping state may be measured based on how the weight of the drip bag is reduced.
Bed angle sensor: A goniometer or pressure gauge is used to measure the angle of the patient bed.
-Suction machine sensor: The suction state of the suction machine is detected such as the sound, pressure and flow rate of the suction machine.
-Electric scalpel sensor: The driving state of the electric scalpel is estimated from the current and voltage consumed by the electric scalpel.
・ Bed warmer temperature sensor: Measured with a thermometer.
-Sensor of anesthesia system: The concentration and amount of anesthesia gas are detected.
Navigator sensor: Measured by the output of an X-ray CT scanner.
Earth current sensor: The earth current in the operating room is measured to monitor the current flowing into the room.
A sensor for confirming the power supply of the medical device: The light amount of the pilot lamp is measured by an optical sensor, thereby confirming whether the power supply is normally turned on. The light on the monitor screen may be measured by an optical sensor, or the current of a power cable may be measured.
・ Medical device dial and switch setting confirmation sensor: This includes sticking an angle monitor on the dial, taking a picture with a camera (coloring the dial), attaching a contact switch externally, sticking a magnet, measuring with a light sensor, etc. Can be adopted as appropriate.
[0027]
(2) Examples of the plurality of cameras in the second category include the following.
[0028]
-Instrument table camera: Installed near the instrument table on which instruments such as scalpels are placed, and photograph the instruments taken out of the instrument table.
・ Wide-angle camera: Multiple cameras are installed to show the entire field of view in the operating room.
-Surgical field camera: One or more cameras are installed to show the patient's surgical site and its surroundings (attached to a microscope). The operation field camera includes an endoscope image.
Anesthesiologist camera: This camera is used to take images of emergency medicine shelves (preferably, only when there is movement), and to take pictures of a monitor seen by an anesthesiologist. A camera may be attached to the penlight used by the anesthesiologist.
-Shadowless camera: Automatically select and display two or more channels that are reliably captured (do not switch suddenly). The criteria for the selection and non-selection of the camera involved in this automatic selection are the brightness of the image, the abnormal focal length when using an autofocus camera, the color of the hat worn by medical staff, the measurement of distance sensors such as markers and ultrasonic waves. As a result, whether or not halation has occurred, there is a color code shown in an image when a color code for identification is attached to a doctor's hat, and the like.
・ Head-mounted camera: Attached to doctor's protective glasses and orthopedic protective clothing.
[0029]
(3) The following sensors are classified into a third category for detecting a doctor's vitals. This sensor is installed to monitor the doctor's stress. Preferably, vitals are simultaneously detected from a plurality of medical personnel such as doctors, technicians, and nurses, and a queue is marked on a data sequence using detection signals from one or more specific medical personnel. Is performed by the server 12. This queuing process is performed in consideration of the fact that the pattern of the detection signal differs for each individual. A specific example of the sensor is as follows.
[0030]
・ A sensor that detects heart rate, adrenaline (stress hormone) in saliva, brain waves, body temperature, blood pressure, etc. ◎
A sensor for detecting blinking of the eyes: It is measured in such a manner that the position of the eyelash is detected by an optical sensor, the state of reflection of an eyeball is detected, an electromyograph is used, and an operator is looked up at a camera.
-Acceleration sensor: An acceleration sensor is attached to the doctor's arm. This acceleration sensor is also used as an inclinometer. For example, sensor wiring is applied to the surgical gown.
・ Sensor for detecting perspiration: Perspiration is measured by attaching electrodes to socks.
-Pressure, humidity, etc. sensors: Respiratory sensors are built into masks such as doctors.
[0031]
(4) The sensors belonging to the fourth category are as follows.
[0032]
Microphones are installed at necessary multiple locations. At this time, it is desirable to notify the medical staff in advance that the voice is being recorded and have the utterance as much as possible. It is desirable to mark cues based on volume or power. This is because, when an event that becomes a key point occurs during an operation, the volume of the medical staff usually changes. It is also desirable to identify the speaker by analyzing the voice detection signal of the voiceprint, and when the identified speaker is a predetermined medical staff (for example, the attending physician), a cue is marked on the utterance. can do. Further, it is possible to analyze the stress applied to the medical staff from the voice detection signal. The speech data recognized as speech may be converted into text data and recorded. Note that a microphone array may be used for speaker display.
[0033]
(5) The following sensors can be used to detect a person entering or exiting the operating room according to the fifth category.
[0034]
A sensor for monitoring the opening / closing of an operating room door: a door opening / closing switch, a camera, and the like can be used.
-ID card reader: Recognition information at the time of reading an ID card can be used.
[0035]
(6) Representative examples of the sensor for detecting the biological information of the patient according to the sixth category include the following.
[0036]
-Sensor of anesthesia monitor: Heart rate, oxygen partial pressure, body temperature, etc. are monitored.
BIS monitor: A BIS value (Bispectral Index), which is the depth of anesthesia during anesthetic administration, is detected.
Cranial nerve monitor: EEG is detected.
[0037]
(7) The seventh category is a sensor for detecting identification information of a patient, and the sensors include the following.
[0038]
-Fingerprint recognition sensor: Identifies the patient by fingerprint.
Recognition sensor by eye iris: Identifies patients based on eye iris.
・ Electronic medical record system: Confirms the identity in cooperation with the electronic medical record system.
-Wristband: The identity of the patient is confirmed by the identification information of the wristband attached to the patient list in advance.
[0039]
The concept of installing these various sensors (monitors) 21 to 27 is shown in FIGS. These various sensors 21 to 27 may be installed externally to existing medical equipment (see FIGS. 3A to 3D). In FIG. 3, reference numerals 10a, 10b, and 10c denote medical devices to be detected. Each of the sensors 21 to 27 is connected to a wireless LAN antenna AN. Further, the sensors 21 to 27 may be incorporated in the device at the time of manufacture in advance. The signals detected by the sensors 21 (to 27) are sent to the information collection / recording server 12 via the antenna AN by wireless LAN. Among them, some monitors and sensors are connected to the information collection / recording server 12 via a wireless LAN via a dedicated computer (PC) that performs processing such as format conversion and A / D conversion.
[0040]
As described above, the information collection / recording server 12 receives a signal (monitor signal) transmitted from the sensors (monitors) 21 to 27 via the wireless LAN, and outputs a time based on the same clock (time information) to the signal. The data is stamped and recorded on a recording medium such as an HDD, CD, or DVD. FIG. 2 shows a more specific functional configuration diagram of the server 12.
[0041]
Therefore, the information collection / recording server 12 starts data collection and recording in response to lighting of the light in the operating room, as schematically shown in FIG. 4 (steps S1, S2). Then, the detection data from all the sensors (monitors) 22 to 27 are collectively collected at a certain timing and collectively recorded on the recording medium (steps S3 and S4).
[0042]
At the time of this recording, the information collection / recording server 12 determines whether a predetermined condition is satisfied with respect to a predetermined detection signal among detection (measurement) signals of one or more sensors (monitors) in each category. Judge. When a predetermined condition is satisfied, a cue is marked on the signal at that time. For this reason, as shown in FIG. 5, as time elapses, signals are detected and recorded by category and further by sensor (monitor). Marked. This cue is represented as a key point in FIG. This key point is therefore used for cueing during data reproduction.
[0043]
FIG. 6 shows specific recorded contents at each time together with key points when a certain operation is taken as an example.
[0044]
In parallel with the collection and recording, the information collection / recording server 12 displays the data of a predetermined item, representative data, data that has changed in time series, or all data on the display device 13 in time series. They are displayed collectively (step S5). FIG. 7 conceptually shows a screen layout of the display device 13 for this display. In the case of the batch display image according to this example, the entire image of the operating room, the operation field image, the instrument table image, the time-series data 1, 2, the numerical data 1, 2, 3, and the switching button are displayed. By operating the switching button, another image can be displayed.
[0045]
The collective collection, collective recording, and display are repeatedly performed at a constant frame rate until the lights in the operating room are turned off (steps S6 and S7).
[0046]
As described above, the recording is started when the light of the operating room is turned on, and the detection (measurement) information from various sensors (monitors) is collectively collected and recorded in the information collection / recording server 12 in a time series. Displayed with This process is continued until the operating room light is turned off.
[0047]
Further, the information collection / recording server 12 is capable of executing the processing shown in FIG. 8 on the data collected and recorded in this way, concerning various kinds of operations. That is, based on a command from the operation terminal of the server 12, it is determined whether or not to analyze the data. When such analysis is performed, the desired analysis item and key point information are input to the input signal from the operation terminal. (Steps S21 to S23). Next, a data sequence searched for based on desired key point information is read from the recorded data, and a desired analysis process is executed (steps S24 and S25). This analysis result is displayed on the display device 13 (step S26).
[0048]
As described above, according to the medical information system according to the present embodiment, almost all information relating to the operation can be faithfully and objectively recorded as it is over time. For this reason, when it is necessary to verify a medical practice later in a trial of a medical accident or the like, it is considered that it effectively functions as objective information.
[0049]
In addition, almost all information related to the operation can be displayed and presented in chronological order during the operation. Thereby, the surgeon and medical staff collect the patient's biological information, the behavior information of the surgeon and the like, the intraoperative image and the operation information of various medical devices in a time-series manner during the operation, and extract and view necessary information. be able to. This is advantageous in terms of shortening the operation time.
[0050]
Further, in addition to the above-described information recording along time passage and time-series information display, the recorded information can be easily analyzed based on the time information. For this reason, doctors and the like can analyze the progress of the operation in detail after the operation and obtain knowledge that contributes to improvement of the surgical method and instruments. That is, since information on the operations arranged in a time series can be obtained easily and with less labor, it is an extremely effective tool for establishing an optimal procedure for a target operation. The procedure optimized in this way can also be read out and displayed intraoperatively, thereby exhibiting a powerful navigator function for the operator.
[0051]
Note that the clock (clock signal) used as a reference when the information collection / recording server 12 performs the time stamp processing on the data is not necessarily limited to the configuration using the internal clock of the server itself, and is input from the outside. Electronic clock information. Further, the internal clock may be periodically corrected using such external clock information.
[0052]
Further, when the information collection / recording server 12 causes the display device 13 to display the time-series information, various types of information can be displayed. For example, in addition to the fixed information, information showing a large change with time can be preferentially displayed, or the display items can be changed according to the progress of the operation and the operation contents at that time.
[0053]
Further, regarding the marking of the queue when the data from the sensors (monitors) 21 to 27 are stored in the information collection / recording server 12 in a time series, an automatic marking method based on the software processing of the server 12 is not necessarily required. It is not limited to. For example, a medical staff or the like may manually operate a console or a sensor of the server 12 to transmit a signal for cue marking to the server 12 when a unique event occurs in a medical practice. good. In this case, the server 12 may use the signal of the manual operation to perform signal processing so as to mark the input data at that time with a queue. As a result, key points that the medical staff wants to verify later can be stored flexibly.
[0054]
In addition, the present invention can be appropriately modified and executed without departing from the gist of the claims.
[0055]
【The invention's effect】
As described above, according to the medical information system according to the present invention, almost all information related to medical actions such as surgery and treatment performed on a patient at a medical site can be recorded as it is over time. In addition, the information can be displayed and presented in chronological order. Further, the recorded information can be easily analyzed based on the time information. Therefore, it is easy to determine the fact of the medical practice after the operation. In addition, the time and labor required for analyzing and standardizing the work procedure of medical practice can be greatly reduced.
[Brief description of the drawings]
FIG. 1 is a schematic block diagram of a medical information system according to an embodiment of the present invention.
FIG. 2 is a functional block diagram showing a more detailed example of the medical information system shown in FIG. 1;
FIG. 3 is a diagram illustrating a state in which a sensor is externally attached to a medical device.
FIG. 4 is a schematic flowchart illustrating data collection and recording processing executed by a server.
FIG. 5 is a view for explaining time-series data collected and recorded (stored) by a server together with key points.
FIG. 6 is a time-series list of information on surgery detected (measured) through a sensor (monitor) when a certain surgery is taken as an example.
FIG. 7 is a schematic diagram showing an example of a display screen during surgery.
FIG. 8 is a flowchart illustrating an outline of an analysis based on time information of information related to post-operative surgery.
[Explanation of symbols]
11 Sensor (Monitor) Group 12 Information Collection / Recording Server 13 Display Devices 21 to 27 Sensor (Monitor)

Claims (9)

A medical information system comprising: detecting means for detecting information relating to medical practice; and information storage means for storing information detected by the detecting means in connection with time information. The medical information system according to claim 1,
A medical information system comprising a display unit for displaying information stored by the information storage unit in a time-series manner. In the medical information system according to claim 1 or 2,
A medical information system comprising: an analysis unit that analyzes information stored by the information storage unit based on the time information. In the medical information system according to any one of claims 1 to 3,
The detection means, information indicating the operation status of the medical device related to the medical practice, medication information, patient biological information, vital information of the operator, image information reflecting the medical site, sound information at the medical site, to the medical site A medical information system characterized in that it is means for detecting at least one type of information belonging to at least one category among human entry / exit information, patient recognition information, and environmental information on medical sites. The medical information system according to claim 1,
The medical procedure is an operation performed on a patient,
The detection means, information representing the operating status of the medical equipment in the operating room, patient biological information, vital information of the surgeon, video images reflecting the operating room, audio in the operating room, information on the person entering and exiting the operating room, And a medical information system including recognition information of a patient. The medical information system according to claim 1,
The medical information system is characterized in that the medical action is an operation performed on a patient, and the time information is clock information or electronic clock information of the medical information system. The medical information system according to claim 1,
The medical information system according to claim 1, wherein the information storage unit is a unit that stores information related to the medical practice and the time information by storing them in one recording medium. The medical information system according to claim 2,
The information storage means includes means for automatically or semi-automatically marking a cue to the information detected by the detection means,
The medical information system according to claim 1, wherein the display unit includes a unit that reads the information based on the queue. The medical information system according to claim 8,
The means for marking the cue includes vital information of an operator detected by the detecting means, voice recognition information of a voice exchanged at a medical site, image recognition information of an image reflecting a medical site, and physical information of the operator's body. A medical information system, which is means for marking the cue according to at least one piece of motion acceleration information.

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