Method for assisting medical worker in interpreting gene information, information management system, and integrated data management device
阅读说明:本技术 辅助医务工作者解释基因信息的方法、信息管理系统、综合数据管理装置 (Method for assisting medical worker in interpreting gene information, information management system, and integrated data management device ) 是由 高畑隆之 胁元立 松尾裕作 于 2020-03-06 设计创作,主要内容包括:本发明涉及辅助医务工作者解释基因信息的方法、信息管理系统、综合数据管理装置。辅助由多位医务工作者对基因信息进行解释的专家会议。一种综合数据管理装置(A),其为辅助由多位医务工作者对基因信息进行解释的专家会议的综合数据管理装置(A),具备控制部(10)及存储部(30),控制部(10)接受患者的基因信息的检查委托,从存储部提取与所接受的检查委托建立关联而记录的、关于针对检查委托的检查进展的检查进展信息及关于解释在针对检查委托的检查中得到的基因信息的专家会议的日程的日程信息,发送用于使所提取的检查进展信息及日程信息显示在多位医务工作者的终端装置(B13)的信息。(The present invention relates to a method for assisting medical workers in interpreting genetic information, an information management system, and an integrated data management device. An expert conference to assist in the interpretation of genetic information by a plurality of medical workers. An integrated data management device (A) for assisting an expert conference in which genetic information is interpreted by a plurality of medical workers, the integrated data management device (A) comprising a control unit (10) and a storage unit (30), wherein the control unit (10) receives an examination request for the genetic information of a patient, extracts, from the storage unit, examination progress information on the progress of the examination with respect to the examination request and schedule information on the schedule of the expert conference in which the genetic information obtained in the examination with respect to the examination request is interpreted, which are recorded in association with the received examination request, and transmits information for displaying the extracted examination progress information and schedule information on terminal devices (B13) of the plurality of medical workers.)
1. A method for assisting an expert conference for gene information interpretation by a plurality of medical workers, comprising the steps of:
a step of receiving a request for examination of genetic information of a patient; and the combination of (a) and (b),
extracting examination progress information on the progress of an examination with respect to the examination request and schedule information on a schedule of an expert meeting explaining genetic information obtained in the examination with respect to the examination request, which are recorded in association with the accepted examination request; and the combination of (a) and (b),
and displaying the extracted examination progress information and the schedule information on terminal devices of the plurality of medical workers.
2. The method according to claim 1, wherein in the step of displaying the examination progress information and the schedule information on the terminal devices of the plurality of medical workers, an examination progress screen showing both the examination progress information and the schedule information is displayed.
3. The method according to claim 1, further comprising the steps of: receiving information on a preparation status of a subject to be examined for genetic information of the patient,
the examination progress information contains information on a preparation status of the subject.
4. The method according to claim 1, further comprising the steps of: receiving information on the delivery status of a subject to be subjected to genetic information examination of the patient,
the examination progress information includes information on a transport condition of the subject.
5. The method according to claim 1, further comprising the steps of: receiving information on whether genetic information of the patient is completed or not,
the examination progress information includes information on whether the genetic information examination of the patient is completed.
6. The method according to claim 1, further comprising the steps of: receiving information on a registration status of patient information of the patient,
the examination progress information includes information of registration status of the patient information.
7. The method according to claim 6, further comprising the steps of:
a step of detecting that the patient information is registered; and the combination of (a) and (b),
and notifying the detected patient information to the terminal devices of the plurality of medical workers.
8. The method according to claim 1, further comprising the steps of: receiving information of the schedule setting status of the specialist conference,
the schedule information includes information on a setting status of the schedule.
9. The method according to claim 1, further comprising the steps of: accepting information for prompting at least 1 of schedule setting, alteration, and cancellation of the specialist conference,
the schedule information includes information for prompting at least 1 of schedule setting, change, and cancellation of the specialist conference.
10. The method according to claim 1, further comprising the steps of: accepting information on a scheduled completion day of examination for the examination order,
the examination progress information contains information about a predetermined completion day of the examination.
11. The method according to claim 5, further comprising the steps of:
displaying a registration screen for registering an examination result of an examination request corresponding to interaction of the displayed examination progress information, wherein
Accepting information as to whether or not the genetic information examination on the patient is completed includes registering the examination result by dragging and dropping a file of the examination result to a displayed registration screen.
12. An information management system for assisting an expert conference in which a plurality of medical workers interpret gene information, comprising: a terminal device having a display unit, and an integrated data management device having a control unit and a storage unit,
the control unit of the integrated data management apparatus,
receiving an examination request for gene information of a patient, extracting examination progress information on the progress of an examination with respect to the examination request and schedule information on a schedule of an expert meeting explaining the gene information obtained in the examination with respect to the examination request, which are recorded in association with the received examination request, from the storage unit, and displaying the extracted examination progress information and the schedule information on the display unit of the terminal device.
13. The information management system according to claim 12, wherein the control unit of the integrated data management apparatus displays an examination progress screen showing the examination progress information and the schedule information at the same time on the display unit of the terminal apparatus.
14. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
receiving information on the preparation status of a subject to be examined for genetic information of the patient,
the examination progress information including information on the preparation status of the subject is displayed on the display unit of the terminal device.
15. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
receiving information on the delivery status of a subject to be subjected to genetic information examination of the patient,
the examination progress information including information on the transport condition of the subject is displayed on the display unit of the terminal device.
16. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
receiving information on whether genetic information of the patient is completed or not,
displaying the examination progress information including information on whether or not the genetic information examination on the patient is completed on the display section of the terminal device.
17. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
receiving information on a registration status of patient information of the patient,
the examination progress information including information on the registration status of the patient information is displayed on the display unit of the terminal device.
18. The information management system according to claim 17, wherein the control section of the integrated data management apparatus,
detecting that the patient information has been registered,
notifying the terminal device of the detected patient information.
19. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
receiving information of the schedule setting status of the specialist conference,
and displaying the schedule information including the information of the setting status of the schedule on the display part of the terminal device.
20. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
accepting information for prompting at least 1 of schedule setting, alteration, and cancellation of the specialist conference,
and displaying the schedule information including information for prompting at least 1 of schedule setting, change, and cancellation of the expert conference on the display unit of the terminal device.
21. The information management system according to claim 12, wherein the control section of the integrated data management apparatus,
accepting information on a scheduled completion day of examination for the examination order,
displaying the examination progress information including information on the scheduled completion day of the examination on the display section of the terminal device.
22. An integrated data management device for assisting an expert conference in which a plurality of medical workers interpret gene information, comprising a control unit and a storage unit,
as for the control section, it is preferable that,
receiving an examination request for gene information of a patient, extracting, from the storage unit, examination progress information on the progress of an examination with respect to the examination request and schedule information on a schedule of an expert meeting explaining the gene information obtained in the examination with respect to the examination request, which are recorded in association with the received examination request, and transmitting the extracted examination progress information and the schedule information to be displayed on terminal devices of the plurality of medical staff.
Technical Field
The present invention relates to a method for assisting medical staff in interpreting gene information.
Background
In recent years, genetic tests for detecting mutations in specific genes have been carried out in order to confirm the presence or absence of inherited diseases, the efficacy of drugs, and the like. In particular, cancer genomics, which is a test of genome sets capable of collectively investigating mutations of a plurality of genes by a next-generation sequencer or the like for each patient and which establishes a treatment course suitable for each patient based on the results, is being studied for cancer treatment.
Here, the electronic medical record, the pathological image, and the various examination results of the genomic examination of the patient, which are referred to when the treatment policy suitable for each patient is prepared, are managed by different systems in the medical facility. Patent document 1 discloses an information platform that summarizes examination results such as electronic medical records, pathological images, and genomic suite examinations dispersed in a certain medical facility, and assists in the formulation of a treatment guideline for a patient.
Disclosure of Invention
Problems to be solved by the invention
When a treatment course of each patient is prepared based on the results of the genome examination, it is important to conduct a conference of experts of a group of experts capable of medical interpretation, and prepare a treatment course most suitable for the patient by a plurality of experts. This expert conference is also referred to as a "panel of experts". When the expert conference is carried out, a plurality of experts such as attending physicians, pathologists, bioinformatics experts, genetics consultants, molecular genetics researchers, clinical inspectors of inspection facilities, and the like participate. In the specialist conference, clinical information from medical facilities such as electronic medical records and pathological images of each patient, information from examination facilities such as examination results of a genome test, genetic backgrounds of patients, latest academic findings, and the like are comprehensively discussed, and a treatment guideline of each patient is prepared. In some cases, in addition to a plurality of experts belonging to any one of a medical facility and an examination facility, an expert not belonging to a specific facility participates in an expert conference.
In order to carry out the specialist conference, it is necessary to provide information required for making a treatment guideline to each specialist belonging to different facilities and adjust a schedule of the specialist conference so that each specialist can attend, etc. The number of calls for a predictive expert conference will increase greatly with the spread of genomic medicine in the future. It is expected that adjusting the schedule of an expert meeting between experts participating in the expert meeting or providing information referenced in the expert meeting accurately and suitably to each expert will require a great deal of effort.
An aspect of the present invention is directed to assist an expert conference in which experts belonging to different facilities participate.
Means for solving the problems
In order to solve the above problem, one embodiment of the present invention is a method for assisting an expert conference for gene information interpretation by a plurality of medical staff, including the steps of: a step of receiving a request for examination of genetic information of a patient (S13 in FIG. 5); extracting examination progress information on the progress of the examination with respect to the examination request and schedule information on a schedule of an expert meeting explaining genetic information obtained in the examination with respect to the examination request, which are recorded in association with the accepted examination request (S507 and S508); and a step (S509) of displaying the extracted examination progress information and schedule information on a terminal device of the medical staff.
Referring to fig. 2, another embodiment of the present invention is an information management system (100) for assisting an expert conference for gene information interpretation by a plurality of medical workers, comprising: the control unit (10 in fig. 3) of the integrated data management device (a) receives a request for examination of gene information of a patient, extracts examination progress information on the progress of the examination with respect to the request for examination and schedule information on the schedule of an expert meeting explaining the gene information obtained in the examination with respect to the request for examination, which is recorded in association with the received request for examination, and displays the extracted examination progress information and schedule information on the display unit of the terminal device (B13).
Further, referring to fig. 3, another embodiment of the present invention is an integrated data management device (a) for assisting an expert conference in which a plurality of medical workers interpret gene information, the integrated data management device including a control unit (10) and a storage unit (30), wherein the control unit (10) receives an examination request for gene information of a patient, extracts examination progress information on the progress of an examination with respect to the examination request and schedule information on a schedule of the expert conference in which the gene information obtained in the examination with respect to the examination request is interpreted, which are recorded in association with the received examination request, and transmits information for displaying the extracted examination progress information and schedule information on a terminal device (B13 in fig. 2) of the medical workers.
Effects of the invention
According to the present invention, an expert conference in which experts belonging to different facilities participate can be assisted.
Drawings
FIG. 1 is a diagram showing an example of a flow of genetic screening and therapy.
Fig. 2 is a diagram showing an example of the configuration of the information management system.
Fig. 3 is a block diagram showing a configuration example of the integrated data management apparatus.
Fig. 4 is a diagram showing an example of a flow of genetic testing to which an information management system according to an embodiment of the present invention is applied.
Fig. 5 is a flowchart showing an example of the process of the inspection request accepting step.
Fig. 6 is a diagram showing an example of the authentication table.
Fig. 7 is a diagram showing an example of a GUI displayed on the terminal device for inputting the examination request information.
Fig. 8 is a diagram showing an example of a facility table.
FIG. 9 is a diagram showing an example of a genome set table.
Fig. 10 is a diagram showing an example of a user registration form.
Fig. 11 is a diagram showing an example of the inspection facility table.
Fig. 12 is a diagram showing an example of the processing flow of the bonding step.
Fig. 13 is a diagram showing an example of a GUI provided with a field for inputting a disease name and a disease ID of a patient.
Fig. 14 is a diagram showing an example of the master table.
Fig. 15 is a diagram showing a configuration example of a case where there is an administrator having the management authority of the integrated data management apparatus a.
Fig. 16 is a flowchart showing an outline of a process in which the control unit associates a patient with an expert participating in an expert conference.
Fig. 17 is a diagram showing an example of the group table.
Fig. 18 is a diagram showing an example of a schedule table.
Fig. 19 is a diagram showing an example of the integrated ID table.
Fig. 20 is a diagram showing another example of the integrated ID table.
Fig. 21 is a diagram showing an example of a patient information table.
Fig. 22 is a diagram showing an example of a disease table.
Fig. 23 is a diagram showing an example of a pathological image table.
Fig. 24 is a diagram showing an example of the inspection result table.
Fig. 25 is a diagram showing an example of the comment information table.
Fig. 26 is a diagram showing an example of a responsibility table.
Fig. 27 is a diagram showing an example of the access authority management table.
Fig. 28 is a diagram showing an example of a screen display displayed when logging in from a terminal device of the transportation affairs department to the data integration server.
Fig. 29 is a diagram showing an example of a GUI displayed on the terminal device for accepting an input of a reservation for an expert conference.
Fig. 30 is a diagram showing an example of a GUI displayed on the terminal device for accepting an input of a reservation for an expert conference.
Fig. 31 is a diagram showing an example of a processing flow for transmitting a notification of the scheduled holding of the specialist conference to each medical worker address.
Fig. 32 is a diagram showing an example of a processing flow performed by the control unit of the integrated data management device for transmitting information on the schedule of the specialist conference to the terminal devices of the respective medical workers.
Fig. 33 is an example of a GUI in which information on an examination request list and an expert meeting schedule are included in a terminal device used by a medical worker.
Fig. 34 is a diagram showing an example of a process flow for displaying information on an examination request list and a schedule of an expert conference associated with a patient in charge of medical staff on a terminal device.
Fig. 35 is a diagram showing an example of a processing flow performed by the control unit of the integrated data management apparatus for displaying information relating to the progress of the examination and information relating to the schedule of the specialist conference on the terminal device of the medical staff.
Fig. 36 is a diagram showing an example of a GUI displayed on a terminal device for accepting input of given information of experts attending an expert conference.
Fig. 37 is a diagram showing an example of a GUI displayed on the terminal device for receiving a schedule setting of an expert conference.
Fig. 38 is a diagram showing an example of a GUI in which a schedule for holding an expert conference and information related to each expert conference are included in the terminal device of the medical staff.
Fig. 39 is a diagram showing an example of a GUI in which a conference holding schedule of an expert and information related to each expert conference are included in a terminal device of a medical worker.
Fig. 40 is a diagram showing an example of a GUI in which information related to each expert conference is included in the terminal device of the medical staff.
Fig. 41 is a diagram showing an example of a processing flow for causing the terminal device to display an expert conference holding schedule related to a patient in charge of medical workers and information related to each expert conference.
Fig. 42 is a diagram showing an example of a processing flow performed by the control unit of the integrated data management apparatus for causing the terminal device of the medical staff to display an expert conference holding schedule related to a patient in charge of the medical staff and information related to each expert conference.
Fig. 43 is a diagram showing an example of a process flow for displaying information related to a patient in charge of medical staff.
Fig. 44 is a diagram showing an example of a processing flow performed by the control unit of the integrated data management apparatus for causing the terminal device of the medical staff to display clinical information and examination results of the patient.
Fig. 45 is a diagram showing an example of a screen displayed on the terminal device by the control unit in response to the received information acquisition request.
Fig. 46 is a diagram showing an example of a method in which the control unit associates each piece of data input as the examination request information with data in the integrated database.
Fig. 47 is a flowchart illustrating an example of processing in which the control unit associates information on a mutation detected by the examination and information on a therapeutic drug with an examination result.
Fig. 48 is a diagram showing an example of a mutation table.
Fig. 49 is a diagram showing an example of a therapeutic drug table.
Fig. 50 is a flowchart illustrating an example of processing in which the control unit associates the input comment information with the examination result.
Fig. 51 is a diagram showing an example of a display screen of the mutation database search entry.
Fig. 52 is a diagram showing an example of screen display used for searching for related information.
Fig. 53 is a diagram showing a configuration example of a medical facility provided with an information management device.
Fig. 54 is a diagram showing another example of the configuration of the information management system.
Detailed Description
An embodiment of the present invention will be described in detail below.
(Gene examination)
First, the genetic screening will be described with reference to FIG. 1. FIG. 1 is a diagram showing an example of a flow of genetic screening and therapy. Here, a description will be given of a flow when performing a genome kit test as an example of a genetic test. The genome test is a test that can collectively examine a plurality of genetic variations in each patient using a next-generation sequencer or the like.
< Process I: patient description (before examination request) >
The process I comprises the following steps: in the medical facility B1, a doctor H1a who is a medical staff in charge explains the advantages, cautions, and the like of the genomic suite examination to the patient P1. If the patient P1 agrees to perform the genome suite examination, the process proceeds to step II.
< Process II: preparation of subject
The step II is a step of: in the medical facility B1, a pathologist H1B as a medical staff prepares a subject to be subjected to a genome suite examination. The specimen is a lesion tissue specimen from which a gene to be examined for a genome test can be extracted, and for example, Formalin-Fixed Paraffin-Embedded FFPE (Formalin-Fixed Paraffin-Embedded) is applied to a lesion tissue of patient P1. If the pathologist H1b prepares a lesion tissue specimen for pathological diagnosis before the step II, the lesion tissue specimen may be used for the genome suite examination.
In the medical facility B1, a blood sample may be collected from the patient P1 as a sample for extracting a wild-type gene that is a comparative target when detecting a gene variation in a lesion tissue. In this case, a plurality of samples such as FFPE samples and blood samples are subjected to a single genomic examination.
The lesion tissue specimen and blood specimen of patient P1 are transported from the medical facility to the test facility C1 where the genome suite test is performed. The FFPE specimen and the blood specimen of the patient P1 may be transported by a transportation worker who is engaged in transportation, or may be directly transported by the inspection facility C1 that receives a request for the genome kit inspection.
< Process III: carrying out sequence determination
The step III is as follows: in the facility C1 that receives the lesion tissue specimen and the blood specimen of the patient P1, a clinical laboratory technician H3 as a medical staff performs a pretreatment for extracting genes from the lesion tissue specimen and the blood specimen, and reads the nucleotide sequence of the extracted genes with the next-generation sequencer C13.
< Process IV: production of inspection result report
The step IV is as follows: in the inspection facility C1, the clinical laboratory staff H3 analyzed the nucleotide sequence read by the next-generation sequencer C13, identified the presence or absence of a mutation in the nucleotide sequence, the position of the mutation, the type of the mutation, and the like, and created an inspection result report.
The examination result report contains information on the genome kit used in the examination, information on the examination result, and information on the quality evaluation index for evaluating the quality of the examination. The information on the result of the examination includes, for example, the presence or absence of a mutation in the nucleotide sequence, the position of the mutation, and the type of the mutation. In addition, the examination result report may include drug information, academic paper information, and the like associated with the mutation detected by the genome kit examination.
Herein, "variant" includes: substitution, deletion or insertion of a nucleotide of a gene; fusion of genes; or copy number polymorphism. "substitution" means: a phenomenon in which at least 1 base in a gene sequence is changed to a different base. "substitution" includes point mutations and single nucleotide polymorphisms. "Deletion" and "Insertion" are also referred to as "InDel (Insertion and/or Deletion)". InDel is the phenomenon of at least 1 base insertion and/or deletion in a gene sequence. "fusion of genes" means: a phenomenon in which a sequence on the 5 '-side of a certain gene binds to a sequence on the 3' -end side of another gene due to chromosomal translocation or the like. "copy number polymorphism" refers to: the copy number on the genome in each cell varies among individuals. Specifically, VNTR (Variablenucleotide of Tandem Repeat, Repeat polymorphism), STRP (Short Tandem Repeat polymorphism), gene amplification, and the like can be given as examples.
"information on the quality evaluation index" is an index for evaluating whether or not the genomic suite test is appropriately performed, and examples thereof include: the ratio of the nucleotide sequence to be read to all nucleotide sequences contained in the gene to be analyzed, the Depth of reading (Depth of coverage) of the nucleotide sequence to be read, whether or not a mutation of a standard gene contained in the quality control sample is detected, and the like. Here, the quality control samples are: gene samples containing known variations that should be read in sequence determination using next generation sequencer C13.
< step V: holding expert conference >
The step V is as follows: a plurality of medical staff members who are a group of experts who perform medical interpretation of the examination results of the genome panel examination participate in the medical facilities B1, B2, examination facilities C1, C2, external facilities D1 and D2, and the like to conduct an expert conference. In the expert conference, a plurality of medical workers conduct a multi-step discussion with reference to an examination result report of the genome panel examination, clinical information of the patient P1, genetic background of the patient P1, latest academic insights, and the like, and establish a treatment course with a validity period for each patient. The "clinical information" of the patient P1 referred to in the specialist conference includes, for example, an electronic medical record created in the medical facility B1 in which the patient P1 visits and a pathological image captured by the pathologist H1B.
Here, "medical workers" who attend the specialist conference may list, for example: (1) a physician H1a in charge, a pathologist H1B, a specialist for cancer drug therapy of patient P1 who is affiliated with medical facility B1; (2) a clinical laboratory staff member H3 who is affiliated with the laboratory facility C1; (3) bioinformatics experts, genetics counselors, molecular genetics researchers, and specialist doctors for genetic medicine who belong to outside facilities D1 and D2 such as research institutions and universities. That is, an expert meeting may be attended by a plurality of medical workers affiliated with different facilities and organizations. The expert conference may be a conference in which medical workers are held at a medical facility B1, or may be in the form of a video conference in which some or all of the medical workers participate via a communication network.
< Process VI: patient description (after expert conference) >
The step VI is as follows: in medical facility B1, the responsible physician H1a explains to patient P1 the treatment guideline for patient P1 formulated through the discussion of the specialist conference. If the patient P1 agrees, the process proceeds to step VII.
< Process VII: treatment
The step VII is as follows: in the medical facility B1, the treatment of the patient P1 was performed based on the treatment guidelines established through the discussion of the specialist conference. When a treatment requiring a very specialized knowledge or experience is performed, the treatment may be performed not at the medical facility B1 where the patient P1 is treated but in combination with another medical facility B2 having a system capable of smoothly performing the treatment.
In the step V, in order to hold an expert conference, it is necessary to collect various information to be referred to by a plurality of medical workers without omission and provide the information to each medical worker in advance. However, clinical information such as electronic medical records and pathological images of the patient P1 is managed in the medical facility B1, and the examination results of the genome suite examination are managed in the examination facility C1. Therefore, as preparation for holding an expert conference, an operation requiring a large amount of work, such as calling information to be referred to by the expert conference from a plurality of facilities and providing the information to each medical worker, is indispensable.
In the present invention, the examination result of patient P1, which is requested for the genomic examination, is associated with clinical information on patient P1, and the associated examination result and clinical information are provided to medical staff. This can assist in preparation for an expert conference.
< construction of information management System 100 >
First, the configuration of the information management system 100 according to an embodiment of the present invention will be described with reference to fig. 2. Fig. 2 is a diagram showing an example of the configuration of the information management system 100.
The information management system 100 includes an integrated data management apparatus a and at least 1 terminal apparatus B13, B23, C14, C24, D11, D21, and E12 installed in various facilities. The integrated data management apparatus a is communicably connected to the terminal apparatuses B13, B23, C14, C24, D11, D21, and E12 via the
The information management system 100 may include at least 1 of the integrated data management apparatus a and the plurality of terminal apparatuses B13, B23, C14, C24, D11, D21, and E12, and other apparatuses provided in the medical facilities B1, B2, the inspection facilities C1, C2, the external facilities D1, D2, and the transportation affairs department E1 are not necessarily configured. The details of the medical facilities B1 and B2, the inspection facilities C1 and C2, the external facilities D1 and D2, and other devices installed in the transportation affairs department E1 will be described later.
[ Integrated data management apparatus A ]
The integrated data management apparatus a is a computer functioning as a server. The integrated data management apparatus a is communicably connected to various devices such as medical facilities B1, B2, examination facilities C1, C2, external facilities D1, D2, and terminal devices installed in the transportation affairs department E1, and a mutation information management apparatus F11, a medicine information management apparatus F21, and an academic paper information management apparatus F31 via a
Fig. 3 is a block diagram showing a configuration example of the integrated data management apparatus a. The integrated data management device a includes a
The functions performed by the integrated data management apparatus a are realized as follows: the
The integrated database 302 stores various tables and data to be used when the
[ medical facilities B1, B2]
Returning to fig. 2, medical facilities B1 and B2 are medical institutions such as hospitals to which medical workers such as doctor H1a in charge of patient P1 belong.
Medical facilities B1, B2 may include core node hospitals with advanced functions leading to cancer genome medicine. In addition, the medical facilities B1, B2 may include joint node hospitals, which are medical institutions having a regime in which cancer treatment and the like can be smoothly performed in conjunction with core node hospitals. In the case of conducting a genomics suite examination on patient P1 at the joint node hospital, interpretation of the examination results and formulation of treatment guidelines for patient P1 at the joint node hospital can be conducted in an expert conference hosted by the core node hospital.
It should be noted that the doctor H1a in charge and the pathologist H1B belonging to the medical facilities B1 and B2 may become medical workers who attend the specialist conference.
The medical facilities B1 and B2 are provided with electronic medical record management apparatuses B11 and B21, pathology image management apparatuses B12 and B22, and terminal apparatuses B13 and B23. In addition, lan (local Area network) is provided in the medical facilities B1 and B2. Hereinafter, the LAN in the medical facility is referred to as "LAN in medical facility". The LAN in the medical facility is communicably connected to the
The electronic medical record management apparatuses B11 and B21 are computers that function as servers for managing electronic medical record information of patients at the medical facility B1. In addition, the pathological image management apparatuses B12, B22 are computers that function as servers for managing pathological images taken in the medical facility B1.
The terminal devices B13 and B23 are computer terminals used by medical staff members affiliated with medical facilities B1 and B2. The terminal devices B13 and B23 are, for example, personal computers, tablet terminals, smartphones, and the like. The terminal devices B13 and B23 include a communication unit for communicating with other devices, an input unit such as a keyboard and a microphone, a display unit such as a monitor, and an output unit such as a speaker.
[ inspection facilities C1, C2]
The inspection facilities C1 and C2 are inspection entrusted facilities to which medical staff such as a clinical inspector H3 who performs a genome suite inspection based on an inspection request from the medical facilities B1 and B2 and creates an inspection result report.
When the medical facilities B1, B2 have a laboratory in which the genome panel inspection can be performed, the genome panel inspection can be performed in the medical facilities B1, B2. In this case, the medical facilities B1 and B2 also function as the examination facilities C1 and C2.
It should be noted that the clinical examiner H3 who is affiliated with the examination facilities C1 and C2 may become a medical worker who attends an expert conference.
The inspection facilities C1 and C2 are provided with inspection information management devices C11 and C21, next-generation sequencers C13 and C23, and terminal devices C14 and C24. In addition, LANs are provided in the inspection facilities C1 and C2. Hereinafter, the LAN in the inspection facility will be referred to as "in-inspection-facility LAN". The in-facility LAN is communicably connected to the
The inspection information management devices C11 and C21 are computers that function as servers for managing inspection information.
The next-generation sequencers C13 and C23 are various devices used for the examination performed by the examination facility C1, and are, for example, next-generation sequencers capable of simultaneously and concurrently measuring the nucleotide sequences of the cleaved DNA fragments.
The terminal devices C14 and C24 are computer terminals used by medical workers who are affiliated with the inspection facilities C1 and C2. The terminal devices C14 and C24 are, for example, personal computers, tablet terminals, smartphones, and the like. The terminal devices C14 and C24 include, for example, a communication unit for communicating with other devices, an input unit such as a keyboard and a microphone, a display unit such as a monitor, and an output unit such as a speaker.
[ outside facilities D1, D2]
The outside facilities D1 and D2 are offices and institutes to which experts and the like belong, other than the medical facilities B1 and B2 and the inspection facilities C1 and C2. Examples of the medical staff belonging to the outside facilities D1 and D2 include bioinformatics experts, genetics counselors, and molecular genetics researchers.
Bioinformatics experts, genetics consultants, and molecular genetics researchers belonging to the outside facilities D1 and D2 may become medical workers who attend the expert conference.
The outside facilities D1 and D2 are provided with terminal devices D11 and D21. In addition, LANs are provided in the outside facilities D1 and D2. Hereinafter, the LAN in the outside plant will be referred to as "LAN in outside plant". The in-outside-facility LAN is communicably connected to the
The terminal devices D11 and D21 are computer terminals used by medical staff members affiliated with the outside facilities D1 and D2. The terminal devices D11 and D21 are, for example, personal computers, tablet terminals, smartphones, and the like. The terminal devices D11 and D21 include a communication unit with other devices, an input unit such as a keyboard and a microphone, a display unit such as a monitor, and an output unit such as a speaker.
[ transportation affairs department E1]
The transportation business department E1 is a business department of a transportation worker who transports a subject from medical facilities B1 and B2, which are inspection consignors of a genome team inspection, to inspection facilities C1 and C2, which are inspection consignments.
When the inspection facilities C1 and C2 have the function of transporting the subject, the transport staff belonging to the inspection facilities C1 and C2 may receive the subject from the medical facilities B1 and B2 and transport the subject to the inspection facilities C1 and C2. In this case, the inspection facilities C1 and C2 also have the function of the transportation affairs department E1.
It should be noted that, in general, the transportation staff at the department of transportation affairs is not a medical worker and does not participate in an expert meeting.
The transportation business entity E1 is provided with a transmission/reception management device E11 and a terminal device E12. In addition, a LAN is provided in the transportation business unit E1. Hereinafter, the LAN in the transportation affairs part will be referred to as "LAN in the transportation affairs part". The intra-transit-transaction LAN is communicably connected to the
The transmission/reception management device E11 is a computer that functions as a server for managing transmission/reception of subjects.
The terminal device E12 is a computer terminal used by a carrier who belongs to the transportation affairs department E1. The terminal E12 is communicably connected to the integrated data management apparatus a and the like via the
[ external information management device ]
The information management system 100 is communicably connected to an external information management apparatus via the
The mutation information management device F11, the medicine information management device F21, and the academic paper information management device F31 are computers functioning as servers. The information managed by the mutation information management apparatus F11, the drug information management apparatus F21, and the academic paper information management apparatus F31 is used as comment information to be given to a mutation identified by a genome suite examination performed by the examination facilities C1 and C2.
Examples of the information managed by the mutation information management apparatus F11 include the COSMIC database (web page www.sanger.ac.uk/genetics/CGP/COSMIC /), the ClinVar database (web page www.ncbi.nlm.nih.gov/ClinVar /), and dbSNP (web page www.ncbi.nlm.nih.gov/SNP /).
The information managed by the mutation information management device F11 may be a database containing mutation frequency information for each human species or each animal species. Examples of databases having such information include HapMapgenome Browser #28, Human Genetic Variation Browser (Web pages www.genome.med.kyoto-u.ac. jp/SnpDB/index. html), and 1000Genomes (Web page www.1000genomes.org /)). For example, variation frequency information of japanese can be obtained from these databases. The mutation information is not limited to information on genetic variation, and may include information on polymorphism and methylation.
The information managed by the drug information management device F21 may include, for example, information on the composition, structural formula, use case, side effect, and the like of each approved drug, information on the experience of treatment with an unapproved drug, and the like.
The information managed by the academic paper information management apparatus F31 may include, for example, information on bibliographic matters and text data of academic papers related to diseases, mutation, and therapeutic drugs, which are posted to scientific journals and the like.
[ safety measures ]
It is desirable to use vpn (virtual Private network) for communication between the integrated data management apparatus a and various apparatuses of the medical facilities B1, B2. Similarly, it is desirable to communicate between the integrated data management apparatus a and various apparatuses at the inspection facilities C1 and C2 using VPN. By using the VPN, it is possible to protect clinical information of the patient P1 at the medical facilities B1 and B2 and examination results of the genome panel examination of the patient P1 at the examination facilities C1 and C2 from threats such as theft or tampering by a third party.
The integrated data management apparatus a is loaded with various apis (application program interface). The integrated data management apparatus a provides clinical information of the patient P1 and examination results of the genome team examination, etc. discussed in the specialist conference to the terminal apparatuses B13, B23, C14, C24, D11, and D21 installed in various facilities using the API.
It is desirable that the integrated data management apparatus a use, as a security measure, encrypted communication such as ssl (secure Socket layer) for communication with the terminal apparatuses B13, B23, C14, C24, D11, and D21 installed in various facilities. Thus, clinical information of the patient P1 and examination results of the genome suite examination discussed in the specialist conference can be safely provided to medical staff.
(Gene examination procedure Using information management System 100)
Next, the flow of genetic testing using the information management system 100 will be described with reference to fig. 4. Fig. 4 is a diagram showing an example of a flow of genetic testing using the information management system 100. Fig. 4 shows a flow of gene testing corresponding to steps I to IV shown in fig. 1. Hereinafter, a case where the medical facility B1 requests the test facility C1 to perform a genome test will be described as an example.
< Process Ia >
The step Ia is as follows: the integrated data management apparatus a receives a request for a genomic suite examination from the terminal apparatus B13 used by the responsible physician H1 a.
The processing in the inspection request accepting step in step Ia will be described with reference to fig. 5. Fig. 5 is a flowchart showing an example of the process of the inspection request accepting step.
In step Ia, the responsible physician H1a first starts a program for logging in to the information management system 100 using the terminal device B13 used by the physician in the medical facility B1 and inputs login information.
The integrated data management apparatus a receives the login information including the login password and the like from the terminal B13 (step S11), and authenticates the login from the terminal B13 used by the responsible physician H1a by referring to the authentication table 38 stored in the integrated database 302 of the integrated data management apparatus a (step S12).
Fig. 6 is a diagram showing an example of the authentication table 38. The authentication table 38 is stored in the integrated database 302. As shown in fig. 6, the authentication table 38 stores a set of a login password for authentication set for each user and a user ID of each user.
When the integrated data management apparatus a performs login authentication, the
[ GUI130 for inputting examination request information ]
The GUI130 displayed on the display unit of the terminal device B13, which has been authenticated by the integrated data management device a, for allowing the responsible physician H1a to input examination request information will be described. Fig. 7 is a diagram showing an example of the GUI130 displayed on the display unit of the terminal B13 for inputting the examination request information.
The GUI130 includes: an area R1 that accepts input of information of the medical facility B1 as a consignor facility from which the examination is requested, an area R2 that accepts input of examination request information, and a request button R3 that accepts an instruction to transmit the examination request information from the terminal device B13 to the integrated data management device a.
The region R1 is provided with columns for accepting input of, for example, "facility name", "facility ID", "address", and "contact address" as information of the medical facility B1.
Here, the "facility name" is the name of the medical facility B1 that is the consignor of the examination. The "facility ID" is identification information assigned to each medical facility B1. The integrated data management apparatus a can refer to the medical facility table 21 shown in fig. 8 stored in the integrated database 302 and automatically display the facility ID corresponding to the input facility name in the facility ID column.
Fig. 8 is a diagram showing an example of the medical facility table 21 stored in the integrated database 302. The medical facility table 21 records a plurality of facility IDs in association with facility names corresponding to the facility IDs.
The
Or may be constituted as follows: the
Returning to fig. 7, the "address" of the region R1 inputted with the information inputted to the acceptance requester's facility is the address of the medical facility B1 as the facility of the examination requester. The "contact address" is a telephone number, an electronic mail address, and the like of the medical facility B1 as the facility of the examination requester.
The region R2 is provided with a field for receiving input of examination request information such as "examination type", "doctor in charge of the patient", "user ID of the doctor in charge", "patient ID", "agreement of the patient", "patient name", "sex of the patient", "date of birth of the patient", "examination facility", "examination request date", "facility for interpreting examination results", and "ID of the facility for interpreting examination results".
Here, the "test type" is information on the type of the requested genomic library test. The type of the genomic library test may be, for example, the name of the test, or the name of the genomic library used in the requested genomic library test.
The
Fig. 9 is a diagram showing an example of the genome set table 22 stored in the integrated database 302. The genome set table 22 records the genome set IDs in association with the genome set names corresponding to the respective IDs. The
Returning to fig. 7, the "responsible physician of the patient" input into the region R2 that accepts input of the examination order information is the name of the responsible physician H1a of the patient P1.
In addition, the "user ID of the responsible physician" is identification information of the responsible physician H1a of the patient P1. The user ID is medical worker identification information for identifying a medical worker. The
Fig. 10 is a diagram showing an example of the user registration table 23 stored in the integrated database 302. The user registration form 23 records the user ID, the name of the medical worker, the contact address of the medical worker, and the professional field of the medical worker in association with each other. Here, the specialized fields of medical workers include, for example, the types of cancers that medical workers have specialized in "lung cancer" and "colorectal cancer".
The
Or may be constituted as follows: the
Returning to fig. 7, the "patient ID" input to the region R2 in which the examination request information is input is identification information given to the patient P1. The patient ID may be a patient ID given to each patient P1 by the medical facility B1 of the examination requester. Alternatively, before the examination request information is input, the patient ID generated by the
The "patient name" entered into region R2 is the name of patient P1. "sex of patient" is the sex of patient P1. The "year, month and day of birth of the patient" is the year, month and day of birth of the patient P1. Here, an input field of "patient's age" may be displayed on the GUI130, and the age of the patient P1 may be input.
The "examination request date" input to the region R2 is the date when the examination request was transmitted from the terminal device B13 provided in the medical facility B1 to the integrated data management apparatus a. For example, the following configuration is possible: when the display unit of the terminal B13 displays the GUI130 for inputting the examination request information, the date of the current day is automatically input as the examination request date.
The "inspection facility" input to the region R2 is the name of the inspection facility C1 that performs the genome panel inspection. Instead of the name, an inspection facility ID corresponding to the inspection facility C1 may also be input.
The
Fig. 11 is a diagram showing an example of the inspection facility table 24 stored in the integrated database 302. The inspection facility table 24 records inspection facility IDs in association with inspection facility names corresponding to the respective inspection facility IDs.
Returning to fig. 7, "facility for interpreting examination results" input to the region R2 that accepts input of examination request information is the name of a facility that holds an expert conference for interpreting examination results of a genome suite examination. The expert conference may be performed by the medical facility B1 itself, which is the consignor of the examination, or may be applied to participate in an expert conference held in another medical facility B2.
The "ID of the facility interpreting the inspection result" input to the region R2 accepting input of the inspection request information is identification information corresponding to the name of the inspection facility interpreting the inspection result. The
When the facility ID corresponding to the facility name input as the facility for interpreting the examination result does not exist, the facility ID generated by the
Further, the following constitution is possible: the
[ variation of GUI for inputting examination request information ]
Fig. 13 is a diagram showing an example of the GUI130a provided with fields R22 and R23 for inputting the disease name and disease ID of the patient P1. Therefore, instead of the GUI130 for inputting examination request information shown in fig. 7, a field R22 for inputting the disease name of patient P1 and a field R23 for inputting the disease ID may be provided in the region R2, and the GUI130a for inputting the disease name and the disease ID of patient P1 to the responsible physician H1a may be displayed on the display unit of the terminal device B13 provided in the medical facility B1.
< Process Ib >
Referring back to fig. 4, the step Ib is the following step: the integrated data management apparatus a issues a notification of "acceptance of examination request" to the terminal apparatus B13 installed in the medical facility B1.
In step Ib, the
< Process Ic >
The step Ic is a step of: the integrated data management apparatus a issues a notification of "acceptance of inspection request" to the inspection information management apparatus C11 of the inspection facility C1.
In the step Ic, the
< Process Id >
The step Id is a step of: the integrated data management apparatus a transmits a sample transport request to the transmission/reception management apparatus E11 of the transportation transaction unit E1.
In the step Id, the
< Process Ie >
The step Ie is as follows: the integrated data management apparatus a receives clinical information of the patient P1 corresponding to the examination request from the terminal apparatus B13 provided in the medical facility B1.
In the step Id, the responsible physician H1a reads out the clinical information of the patient from the electronic medical record management apparatus B11 using the terminal apparatus B13, and transmits the clinical information together with the patient Id, the examination request Id, and the like to the integrated data management apparatus a.
The following configuration is also possible: instead of transmitting the clinical information of the patient P1 by the responsible physician H1a, the
< Process IIa >
The step IIa is a step of: in the medical facility B1, the terminal device B13 used by the responsible physician H1a issues an instruction "preparation of the blood specimen of the patient P1" to another terminal device B13 used by a nurse or the like in the blood collection room in the medical facility B1. The instruction transmitted from the terminal B13 used by the responsible physician H1a includes the patient ID and the examination request ID.
When the preparation of the blood sample in this step is completed, a nurse or the like in the blood collection room transmits information such as the date and time when the blood collection was completed from the terminal device B13 in the blood collection room to the electronic medical record management device B11, and updates the electronic medical record of the patient P1.
< Process IIb >
The step IIb is as follows: in the medical facility B1, an instruction "preparation of a lesion tissue subject of the patient P1" is issued from the terminal device B13 used by the doctor H1a to the other terminal device B13 in the pathological section in the medical facility B1. The instruction transmitted from the terminal B13 used by the responsible physician H1a includes the patient ID and the examination request ID.
When the preparation of the lesion tissue specimen in this step is completed, the pathologist H1B transmits information such as the date and time when the preparation of the lesion tissue specimen is completed from the terminal device B13 of the pathology department to the electronic medical record management device B11, and updates the electronic medical record of the patient P1.
< Process IIc >
The step IIc is as follows: the integrated data management device a receives a notification indicating that "preparation of blood sample and preparation of lesion tissue sample" are completed, together with the patient ID, the examination request ID, and the like.
In step IIc, the
The following configuration is possible: the integrated data management apparatus a periodically monitors the electronic medical record management apparatus B11, and detects update of the preparation status information of the blood sample and the lesion tissue sample with respect to the electronic medical record management apparatus B11 of the patient P1. Further, the following configuration is also possible: when the preparation of the subject is not completed, a notification of information indicating the preparation status of the subject is transmitted to the integrated data management apparatus a. For example, when the preparation of the subject has not been completed, the terminal device B13 or the electronic medical record management device B11 used by the nurse in the blood collection room and the pathologist H1B in the pathology department transmits the information "subject is being prepared" to the integrated data management device a.
< Process IId >
The step IId is as follows: the integrated data management apparatus a receives a pathology image and the like of the patient P1 together with the patient ID, the examination request ID, and the like from the terminal apparatus B13 used by the pathologist H1B.
In this step, the
The pathologist H1b may transmit information such as a pathological image of the patient P1 to the integrated data management apparatus a. In this case, the pathologist H1B reads out a pathological image of the patient P1 from the pathological image management apparatus B12 via the in-medical-facility LAN using the terminal apparatus B13 used by the pathologist H1B, and transmits the pathological image, etc., together with the patient ID and the examination request ID, to the integrated data management apparatus a.
< Process IIe >
The step IIe is as follows: the integrated data management device a requests the transport staff of the transport transaction unit E1 to transport the lesion tissue specimen and the blood specimen. The integrated data management apparatus a notifies the transmission/reception management apparatus E11 of the transportation affair unit E1 that the preparation of the blood specimen and the lesion tissue specimen in the medical facility B1 is completed and that the preparation can be transmitted from the medical facility B1 to the test facility C1, together with the patient ID, the test request ID, and the like.
< Processes IIf and IIg >
The steps IIf and IIg are as follows: the blood specimen and the lesion tissue specimen are transferred from the blood collection room and the pathology department of the medical facility B1 to the transportation staff of the transportation affairs department E1.
The subject container and its package for storing the blood subject and the lesion tissue subject are provided with RFID tags storing information indicating the medical facility B1 to which the subject is handed, information indicating the inspection facility C1 which is the destination of the subject, the patient ID of the patient P1 who collected the subject, the inspection request ID for performing the genome suite inspection, and the like. Alternatively, instead of the RFID, a seal printed with a barcode for reading information indicating the medical facility B1, information indicating the examination facility C1, the patient ID, the examination request ID, and the like may be attached.
< Process IIh >
In step IIh, the terminal device E21 of the carrier of the transportation transaction part E1 reads information indicating the medical facility B1, information indicating the examination facility C1, the patient ID, the examination request ID, and the like from the RFID tag or the barcode wrapped around the blood specimen and the lesion tissue specimen received from the medical facility B1. Then, the terminal device E12 of the transportation transaction part E1 compares the read information with the information notified in advance in the process Id.
The carrier of the transportation transaction unit E1 receives, for example, from the medical facility B1, the blood sample and the lesion tissue sample whose information stored in the RFID tag matches the information notified in the process Id. Then, the transportation engineer inputs "completion of reception" to the terminal E12 of the transportation engineer, and the terminal E12 of the transportation affairs department E1 transmits "notification of completion of reception" to the transmission/reception management device E11.
< Process IIi >
The step Iii is a step of: the integrated data management apparatus a receives, from the transmission/reception management apparatus E11, a notification indicating that "the transportation transaction unit E1 has completed the reception of the subject and started the transportation to the test facility C1" together with the patient ID, the test request ID, and the like.
< Process IIj >
The step IIj is a step of: the transportation personnel of the transportation business department E1 transports the subject received from the medical facility B1 to the examination facility C1.
The inspection facility C1, which has received the subject from the carrier, confirms that the information stored in the RFID tag of the blood subject and the lesion tissue subject matches the information notified in step III. After confirming that the correct subject has been received, the terminal device E12 of the transport person in the transport affairs department E1 sends a notification to the transmission/reception management device E11 that the transport of the subject has been completed.
< Process IIk >
The step IIk is as follows: the integrated data management apparatus a receives a notification indicating that "the transport of the subject has been completed" together with the patient ID, the examination request ID, and the like from the transmission/reception management apparatus E11.
The
< step IIIa >)
The step III is as follows: at the test facility C1, a genome test is performed using a blood sample and a lesion tissue sample.
Genomic suite examination includes, for example: comprises a pretreatment step of extracting DNA from a subject, a sequence measurement step of reading a base sequence with a next-generation sequencer, and an extraction step of a mutation in a lesion tissue. In addition, the examination information management device C11 of the examination facility C1 may give comments to the extracted mutation based on the information acquired by the mutation information management device F11, the medicine information management device F21, and the academic paper information management device F31. Thus, the test result of the requested genome test is obtained.
In the step IIIa, the examination information management apparatus C11 of the examination facility C1 can notify the integrated data management apparatus a of examination progress information indicating "which step the genome suite examination has been completed to", together with the patient ID, the examination request ID, and the like as appropriate.
< Process IVa >
The step Iva is a step of: the integrated data management apparatus a receives the examination result performed at the examination facility C1 together with the patient ID, the examination request ID, and the like from the examination information management apparatus C11 of the examination facility C1.
The clinical laboratory technician H3 may transmit the examination result to the integrated data management apparatus a. In this case, the clinical laboratory technician H3 reads the examination result from the examination information management apparatus C11 via the intra-examination-facility LAN by using the terminal apparatus C14 of the examination facility C1 used by the technician H via the examination facility, and transmits the examination result together with the patient ID and the examination request ID to the integrated data management apparatus a.
The test results of the genomic suite test can be summarized into a test result report containing related information such as mutation information, drug information, academic paper information and the like.
< Process Va >
Step Va is as follows: the integrated data management apparatus a associates the examination request information acquired in step Ia, the clinical information of the patient P1 acquired in step Ie and step IId, and the examination result acquired in step IVa, and records the information in the master table 25 of the integrated data management apparatus a.
Hereinafter, a process flow in the integration step of integrating the data acquired in the steps Ia, Ie, IId, and Va will be described with reference to fig. 12. Fig. 12 is a diagram showing an example of a processing flow of the integrated process performed by the
In the above-described step Ia, the integrated data management apparatus a receives the examination request information from the terminal apparatus B13 of the medical facility B1 (step S13, see fig. 5). Next, in the above-described step Ie, the clinical information of the patient P1 associated with the examination request is received from the terminal device B13 of the medical facility B1 (step S21). In the above-described step IId, the inspection result for the inspection request is received from the terminal C14 of the inspection facility C1 (step S22).
Then, the
In the present embodiment, an example is shown in which the
[ Main Table 25]
Fig. 14 is a diagram showing an example of the master table 25 stored in the integrated database 302. As shown in fig. 14, the main table 25 records "patient ID", "subject ID", "examination request ID", "genome ID", "patient name", "sex of patient", "date of birth of patient", "agreement of patient", "examination request date", "user ID of medical worker", "name of medical worker", "group ID", "progress information of examination", "clinical information", "examination result", "facility for holding an expert meeting", and "date and time of holding an expert meeting".
The "patient ID", "patient name", "patient sex", "date of birth of the patient", "patient's consent", "examination order date", "user ID of medical worker", "name of medical worker", and "facility where expert conference is held" are information input by the responsible physician H1a using the GUI130 shown in fig. 7. The "name of the medical staff" is a name entered in the column of "doctor in charge of patient" in the region R2 of the
The information about "patient consent" of the region R2 of the GUI130 includes, but is not limited to, consent for the examination, providing anonymous examination results to third party institutions, and combinations of these. The information on "patient consent" of the region R2 of the GUI130 may be displayed by selecting with a pull-down menu or radio buttons, or by selecting an arbitrary combination from a list.
In the main table 25, the selected content in "patient's consent" of the region R2 of the GUI130 is recorded as the information on "patient's consent". In addition, in the main table 25, a link to the scan data of the consent form of the patient may be recorded as the information on "consent of the patient".
The "inspection request ID" is identification information that the
The "subject ID" is subject identification information given to each subject prepared in the medical facility B1. In step IIc of fig. 4, the
"genome set ID" is identification information given to each of the genome sets used in the genome set examination. The
The "group ID" is group identification information given to each group consisting of medical workers who attend an expert conference. First, the
The "inspection progress information" is information on the progress status of the inspection, which the
The "inspection progress information" may include information on the preparation status of the subject to be inspected, the transport status of the subject, the completion status of each process of the inspection, and the like. As the "examination progress information", the "subject preparation in progress", "subject transport in progress", "preprocessing step: unfinished "," pretreatment step: complete "," sequencing procedure: incomplete "," sequencing procedure: completion of "mutation analysis process: incomplete "," mutation analysis process: complete ", etc. "subject preparation" indicates that: the stage in which the medical staff has completed the examination request but the acquisition of the subject has not yet been completed, "subject being transported" indicates: a stage in which the transportation affair department E1 has received the subject from the medical facility B1 but the transport to the examination facility C1 has not been completed. "pretreatment process: incomplete "means: when the transport transaction unit E1 has already sent the subject to the inspection facility C1 but the pretreatment process of the subject has not yet been completed, "pretreatment process: complete "," sequencing procedure: incomplete "," sequencing procedure: completion of "mutation analysis process: incomplete "and" mutation analysis procedure: completion "means respectively: before and after the pretreatment step, the sequencing step and the mutation analysis step of the inspection at the inspection facility C1.
The "clinical information" may include, for example, information included in an electronic medical record of a patient, a pathological image of a pathological part, and the like. When the
The "inspection result" is the inspection result of the genome kit inspection received by the
The "inspection result" may be transmitted from the inspection facility C1 together with the "inspection request ID" and received by the
The inspection facility C1 may record information on the "remaining amount of subject" in the main table 25 in association with one or both of the "inspection request ID" and the "subject ID". In addition, the inspection facility C1 may record information on "the location where the subject remains" in the main table 25 in association with one or both of the "inspection request ID" and the "subject ID". Here, an example in which the examination facility C1 is associated with "the remaining amount of the subject" and "the location where the subject remains" is illustrated, but the present invention is not limited to this, and the doctor H1a in charge of the medical facility B1 that receives the return of the remaining subject may record the information in the main table 25.
The "holding date and time of the specialist conference" is, for example, information on a scheduled holding date of a newly registered specialist conference, a schedule of the specialist conference already held. For example, when a terminal device used by a medical professional who has authority to determine a scheduled date of an expert conference inputs registration, change, deletion, and the like of the scheduled date of the conference, the
The scheduled date and time of the expert conference may be determined and registered by adjusting a schedule among medical workers constituting the group, or an arbitrary scheduled date and time of the expert conference may be registered by a medical worker having authority to set the expert conference.
In addition, information on a holding requirement indicating whether or not medical workers required for holding of the specialist conference have confirmed participation may be recorded in the main table 25. For example, the specialist conference requires (1) a doctor in charge including 1 or more subject patients to be studied, (2) a plurality of pathologists, (3) a specialist including a plurality of cancer pharmacotherapy, (4) a bioinformatics specialist including 1 or more, (5) a genetic counselor including 1 or more, (6) a molecular genetics researcher including 1 or more, and (7) a specialist including 1 or more genetic medicine.
In this case, the integrated database of the integrated data management apparatus a may associate and record the above-described requirements (1) to (7) in the specialist conference schedule 27 shown in fig. 18. That is, regarding the schedule of each expert meeting, the following information may be recorded: (1) minimum number of participants in the responsible physician (responsibility ID: R01): 1, the same as below, (2) pathologist (responsibility ID: R02): 2. (3) specialist for cancer drug therapy (responsibility ID: R03): 2. (4) bioinformatics expert (responsibility ID: R04): 1. (5) genetics consultant (responsibility ID: R05): 1. (6) molecular genetics researcher (responsibility ID: R06): 1. (7) specialist in genetic medicine (responsibility ID: R07): 1. these numerical values are examples, and are not limited to these.
When receiving approval of schedule adjustment for a predetermined specialist conference from a medical worker, the
That is, for example, when the medical staff who has approved the schedule adjustment has a responsibility ID of R05, that is, a genetic counselor, 1 is subtracted from 1, which is a numerical value recorded in (5) a genetic counselor (responsibility ID: R05) recorded in the expert meeting calendar 27, and 0 is set. Thereby confirming that sufficient genetic counselors are present in the schedule of the expert meeting. The
The
The master table 25 can be managed, for example, as follows: the update can be manually performed by the administrator H8 to which the management authority of the integrated data management apparatus a is given. Fig. 15 is a diagram showing a configuration example of a case where there is an administrator H8 having the management authority of the integrated data management apparatus a. The administrator H8 can create the master table 25 using the integrated data management apparatus a based on the notified patient ID, patient name, sex, date of birth of the patient, and the like before the
[ Association of patients with groups participating in an expert conference ]
The
First, the
Fig. 17 is a diagram showing an example of the group table 26. As shown in fig. 17, the group table 26 records groups of group IDs, facility IDs, and a plurality of user IDs.
Here, the process in which the
When there are a plurality of group IDs corresponding to the determined facility IDs, the
[ expert meeting Schedule 27]
Fig. 18 is a diagram showing an example of the specialist conference schedule 27. As shown in fig. 18, the group ID, facility ID, scheduled holding time of the specialist conference, and the number of permitted patients are recorded in the specialist conference schedule 27. The allowed patient number refers to an upper limit of the established number of patients for which the treatment method may be discussed in an expert meeting. The number of allowed patients may be set according to the length of time the specialist is in a meeting. For example, in the specialist conference schedule 27 shown in fig. 18, when the specialist conference is predetermined to be 4 hours (for example, "1: 00pm to 5: 00 pm"), the number of permitted patients is set to "4", and when the specialist conference is predetermined to be 3 hours (for example, "3: 00pm to 6: 00 pm"), the number is set to "3".
The process of the
[ Integrated ID ]
The
For example, the
The composite ID may be associated with a patient ID and an examination delegate ID. In this case, the
Alternatively, the comprehensive ID may be associated with the patient ID, facility ID, and examination order ID. In this case, the
(management of various data stored in the integrated database 302)
The
The data ID is an ID assigned to each data. On the other hand, the data type ID is an ID given for distinguishing the data type. The data type ID includes, for example, the following data type IDs.
"PA": the
"IM": the
"TEST": the
"ANN": the
Note that the data seed ID may be given so as to more finely distinguish a plurality of data included in the data seed. For example, the
< patient information Table 31 >
Fig. 21 is a diagram showing an example of the patient information table 31, and the patient information table 31 includes the patient information received from the terminal B13 by the
The
For example, the
< pathological image Table 33 >
Fig. 23 is a diagram showing an example of the pathology image table 33, and the pathology image table 33 includes the pathology images received by the
< Table of examination results 34 >
Fig. 24 is a diagram showing an example of the inspection result table 34, and the inspection result table 34 includes the inspection results received by the
As shown in fig. 24, the examination result table 34 includes links to reports, mutation information, therapeutic agent information, disease IDs, subject quality information, and DNA amount information.
The links to the reports refer to: link information to document data of an examination result report created by a clinical examiner H3 or the like at the examination facility C1.
The variant information is: information about the variation detected by genomic suite examination. For example, the data "EGFR T790M" in the inspection result table 34 shown in fig. 24 represents: in the amino acid sequence of EGFR, amino acid residue 790, which is threonine in the wild type, is mutated to methionine. On the other hand, the data "BRAF V600E" indicates that: in the amino acid sequence of the BRAF protein, the 600 th amino acid residue which is valine in a wild type is changed into glutamic acid.
The therapeutic information is: information on therapeutic agents corresponding to the variation detected by the genome panel examination. For example, the data of "EGFR T790M" in the examination result table 34 shown in fig. 24 indicates "drug a", and the data of "BRAFV 600E" indicates "drug B".
The genome set ID is identification information indicating the type of the genome set used for the genome set examination. The
The disease ID is identification information corresponding to the disease name of each patient. For example, the data of "LUNG" shown in fig. 24 indicates that the disease of the patient is LUNG cancer, and the data of "CORON" indicates that the disease of the patient is large intestine (colon) cancer (see fig. 22).
The subject quality information refers to information on the quality of the subject of the patient sent from the medical facility B1 to the examination facility C1. The object quality information may be, for example, "good", or "ok". Here, "good" and "good" indicate a state in which a sufficient amount of DNA can be extracted from a diseased tissue of a patient in a pretreatment process of a genomic suite examination, and "may" indicate a state in which the genomic suite examination can be performed without problems although it is confirmed that DNA decomposition is proceeding. In the case where most of the DNA is decomposed or the state where a sufficient amount of DNA for conducting the genomic library test cannot be extracted is obtained, the state information of the specimen such as "not available" can be assigned.
The amount of DNA is: information on the amount of DNA extracted from a diseased tissue of a patient in a pretreatment process of a genome kit examination. The amount of DNA may be, for example, the weight (ng) of DNA extracted per 1mg of pathological tissue.
< Note information Table 35 >
Fig. 25 is a diagram showing an example of the comment information table 35, and the comment information table 35 includes comment information acquired by the
< responsibility form 36 >
When a medical staff belonging to the medical facilities B1, B2, the examination facilities C1, C2, and the external facilities D1, D2 applies for the use of the information management system 100, the
Fig. 26 is a diagram showing an example of the responsibility table 36. As shown in fig. 26, the role table 36 stores the correspondence between role IDs and role names corresponding to the role IDs. The
< Access Right management Table 37 >
For example, the
Fig. 27 is a diagram showing an example of the access authority management table 37. As shown in fig. 27, the access authority management table 37 stores a correspondence relationship between the job ID and the data type ID of data to which access is permitted for a person corresponding to each job ID. The
[ Access restrictions of workers at the transportation affairs department E ]
In the step IIe of fig. 4, the
For example, when a worker logs in the integrated data management apparatus a, the terminal apparatus E12 displays a screen display 140 shown in fig. 28. Fig. 28 is a diagram showing an example of a screen display displayed on the terminal device E12 of the transportation affairs department. For example, the terminal E12 displays the list of examination requests accepted by the integrated data management apparatus a. The staff can confirm the date on which the comprehensive data management apparatus a received the screen inspection request, the inspection request ID, the preparation status of the subject, the inspection requester (for example, the medical facility name), and the inspection facility (for example, the inspection facility name) in which the inspection is performed.
The following configuration is possible: the preparation status of the subject can be updated from the terminal device E12 by receiving an operation (for example, a click operation) of selecting information displayed in the "preparation status of the subject" displayed on the screen display 140. For example, a practitioner may input information such as "during the conveyance of the subject" and "completion of the conveyance of the subject" by using the terminal device E12. In this case, the candidate list of "preparation conditions of the subject" that can be input from the terminal device E12 may be displayed in a pull-down manner at the position of the selected "preparation conditions of the subject".
(Schedule management of expert meetings)
Appointment of expert meeting
In the information management system 100, when a medical staff requests an examination performed at the examination facility C1, an expert conference for making a treatment method for a patient based on the result of the examination can be reserved.
For example, the
The GUI150 includes: an area R1 for accepting input of information of the consignor facility for requesting the examination, an area R2 for accepting input of examination request information, an area R4 for accepting input of a reservation for an expert conference, and a request button R3 for accepting an instruction to transmit examination request information from the terminal device B13 to the
The region R4 may have: a list of scheduled holding days and time periods for holding an expert conference among facilities (and facility IDs) input into the region R2 as "facilities for interpreting the inspection results", and a confirmation dialog for selecting each scheduled holding day and time period. For example, the
For example, it is desirable to reserve 10: 00-12: 00 the medical staff of the expert meeting can click on the corresponding confirmation dialog box as illustrated. The regions R1 to R3 are the same as the GUI130 shown in fig. 7.
The
The
Then, the
Handling of sending notification of held expert meeting to address of each medical worker
Next, an example of a process flow for transmitting information on a schedule of an expert meeting reserved by medical workers and an examination result associated with the schedule to each of the medical workers constituting the group will be described with reference to fig. 31. Fig. 31 is a diagram showing an example of a processing flow for transmitting a notification of the scheduled holding of the specialist conference to each medical worker address.
First, the terminal device B13 receives an instruction to display an examination request acceptance screen from a medical staff member, and transmits a display instruction to the integrated data management device a (step S1201). The inspection request acceptance screen may be, for example, a GUI150 shown in fig. 29.
The integrated data management apparatus a receives a display instruction from the terminal apparatus B13 (step S1202), acquires information on the kind of genetic examination, information on the examination facility, and information on the facility that interprets the examination result from the integrated database 302, and transmits them to the terminal apparatus B13 (step S1203).
The terminal device B13 displays the check request acceptance screen based on the information received from the integrated data management device a (step S1204).
Then, the terminal device B13 receives the information on the facility explaining the examination result for the examination request selected by the medical staff on the examination request acceptance screen, and transmits the information to the integrated data management apparatus a (step S1205). The selection of the information on the facility for interpreting the inspection result of the inspection request may be selected from the displayed list or the pull-down menu based on the information acquired by the
The integrated data management apparatus a receives information on a facility that explains the result of the examination for the examination request (step S1206), acquires schedule information of a plurality of expert conferences held in the facility from the expert conference schedule 27, and transmits the schedule information to the terminal apparatus B13 (step S1207).
The terminal apparatus B13 receives the schedule information of the plurality of specialist conferences from the integrated data management apparatus a and displays it in the region R4 of the GUI150 (step S1208).
Terminal B13 then accepts the healthcare worker's selection of 1 expert meeting. The terminal B13 receives an instruction to notify the medical workers who are to participate in the selected expert conference that the expert conference is "held", and transmits the instruction to the integrated data management apparatus a (step S1209).
The integrated data management apparatus a receives the schedule information of the selected 1 specialist conference. The integrated data management apparatus a determines whether or not the application can be accepted for the selected specialist conference schedule. That is, the integrated data management apparatus a acquires the number of patients permitted in the selected specialist conference schedule from the specialist conference schedule table 27, and determines whether or not the number is 1 or more. When the number of permitted patients is 1 or more, the application of the selected expert meeting schedule is received, and 1 is subtracted from the number of permitted patients at that time. (step S1210)
The integrated data management apparatus a acquires the contact information of the plurality of medical workers associated with the selected expert conference from the team table 26 (step S1211), and transmits a summons notification containing information on the schedule of the selected expert conference to the acquired contact used by the plurality of medical workers (step S1212).
Then, the terminal devices B13, B23, C14, C24, D11, and D21 used by the respective medical workers receive a notification of the holding of the specialist conference (step S1213).
Then, the medical staff registers the examination result of the examination request for the genetic information of the patient in the requested specialist conference on the screen exemplified by the GUI160 shown in fig. 33. That is, the medical staff checks the status of the requested examination in the "status of preparation and examination of the subject" column by himself/herself with reference to the GUI160 displayed on the terminal device B13. When the examination is completed, a hyperlink given to a character string of "unregistered" displayed in the registration status of the examination result is clicked, and a registration screen of the examination result is displayed. The medical staff registers the examination result by dragging and dropping a file of the examination result report into the displayed registration screen of the examination result. The terminal device B13 receives the registration request of the examination result from the medical staff, and transmits it to the integrated data management device a (step S1214). The inspection result registration request may be received from the inspection information management device C11 of the inspection facility C1, but the present invention is not limited thereto. Upon receiving a request for registration of examination results from the examination information management apparatus C11 at the examination facility C1, the
The integrated data management apparatus a records the inspection result received from the terminal apparatus B13 in the corresponding record of the main table 25. Thereby, the schedule of the expert meeting is recorded in association with the examination result. (step S1215)
Then, when each medical worker clicks the "related information display" in the "related information" column of the GUI210 shown in fig. 38 displayed in the terminal devices B13, B23, C14, C24, D11, and D21 used, the GUI240 shown in fig. 45 including the examination result recorded in association with the schedule of the specialist conference in step S1215 is displayed (step S1216).
Next, an example of a process flow performed by the
The
Next, the
After the login is authenticated, the
Then, the
That is, the
Then, the
After determining whether or not the selected expert conference can accept the application (step S411), the
Then, the
Then, the
Further, the
In the selected specialist conference, when each medical professional attending the specialist conference causes each terminal device B13, B23, C14, C24, D11, and D21 to display the GUI210 shown in fig. 38 and clicks the "related information display" in the "related information" column, the
The
Accordingly, the integrated data management apparatus a can receive not only the input of the examination request information from the responsible physician H1a but also the input of the reservation of the specialist conference for interpreting the examination result of the examination performed at the examination facility C1. Further, the integrated data management apparatus a may transmit a notification indicating "reservation for an expert conference" to the terminal apparatuses B13, B23, C14, C24, D11, and D21 of the medical staff attending the expert conference to which the reservation is made.
Display of holding schedule of expert conference
The
The GUI160 includes a region R5 displaying an examination delegation list and a region R6 displaying a schedule of an expert meeting.
For example, "request date", "patient ID", "status of preparation and examination of subject", "registration status of patient information", and "registration status of examination result" are displayed in the region R5. Note that "examination request ID" may be displayed in the region R5. The patient information and the examination result information are information for a plurality of medical workers to refer to in an expert conference.
Examples of the "state of preparation and examination of a subject" include "during preparation of a subject", "completion of preparation of a subject", "during transfer of a subject", "completion of transfer of a subject", "re-acquisition of a subject", "termination of examination", "completion of DNA extraction", "completion of pretreatment", "completion of sequence measurement", "completion of sequence analysis", and "completion of examination". The time of day at which the examination is expected to be completed may also be displayed.
Examples of the display of "registration status of patient information" include "unregistered", "partial registration", and "registration completed". The "partial registration" is, for example, a situation in which the electronic medical record of the patient is registered but no pathological image or the like is registered.
Examples of "registration status of inspection result" include "unregistered" and "registration completed".
In accordance with the case where the medical facility B1 and the examination facility C1 register the patient information, examination results, and the like referred to by a plurality of medical workers in the expert conference in the integrated data management apparatus a, the terminal apparatuses B13, B23, C14, C24, D11, D21, and the like corresponding to the plurality of medical workers can be notified of the registration status.
On the other hand, in the region R6, for example, "facility at which an expert conference is held", "status", and "holding date and time" are displayed.
The "status" displays information indicating the setting status of the expert conference. For example, in the case where the schedule of holding an expert conference has been determined, and medical workers who attend the expert conference have been notified of the schedule, "set" is displayed in the "status". In addition, if the schedule of the expert conference is not determined or medical staff participating in the expert conference is not notified, the "unset" is displayed.
Regarding the "held date and time", the expert conference "held in the state" set "is displayed, or the held schedule is displayed in the form of date and time, and the expert conference" not set "is displayed. Whether the "status" is "set" or "unset", new setting of the expert conference and update of the holding status of the expert conference can be performed by clicking the display.
The
The
The
The icon 170 is not limited to "! ". Instead of displaying the icon 170, the display of the conference specialist and the date and time of holding may be performed in a font, a color, or the like different from the surrounding.
More specifically, the
The
< Process flow for displaying GUI160 >
Here, a process flow of displaying a GUI160 including information on an examination request list and a schedule of an expert meeting on a terminal device B13 used by a medical staff at a medical facility B1 will be described with reference to fig. 34. Fig. 34 is a diagram showing an example of a processing flow for causing the terminal device B13 to display an examination request list related to a patient in charge of medical staff and information on a schedule of an expert meeting.
First, the terminal device B13 receives an instruction to display a schedule of an expert meeting from a medical worker belonging to the medical facility B1 (step S1301). Then, the terminal device B13 transmits a request for information such as the patient ID of the patient in charge of the medical staff, the examination date of the examination request for the patient, the subject preparation and examination information, the facility in which the specialist conference is held, and the date and time of holding the specialist conference, together with the user ID of the medical staff, to the integrated data management device a (step S1302).
Then, the control unit of the integrated data management apparatus a acquires the requested information by referring to the main table 25 stored in the storage unit 30 with the received user ID as a key (step S1303). The integrated data management apparatus a transmits the acquired information to the terminal apparatus B13 (step S1304).
Then, the terminal B13 displays the information received from the integrated data management apparatus a on the display unit of the terminal B13 in the form of the GUI160 (step S1305).
Details of processing performed by the integrated data management apparatus a for causing the terminal apparatus B13 used by the medical staff to display the GUI160 will be described with reference to fig. 35. Fig. 35 is a diagram showing an example of a processing flow performed by the
The
Then, the
Then, the
Then, the
< registration of schedule of expert conference >
When accepting the input of the appointment of the specialist conference via the GUI150 displayed on the terminal device B13 of the medical facility B1 for accepting the input of the appointment of the specialist conference as shown in fig. 29, the
The
The
When the
The extraction conditions include, for example, the following conditions (1) to (5).
(1) When the "condition of subject preparation and examination" is "examination completed", a schedule of, for example, two weeks is displayed for a list of scheduled holding days and time periods on which an expert conference is held after the next day of the date indicated by the current date and time.
(2) When the "state of subject preparation and examination" is "subject reacquisition", a schedule of, for example, two weeks is displayed for a list of scheduled holding days and time periods on which an expert conference is held after a predetermined number of days (for example, 40 days) from the current date and time.
(3) When the "condition of subject preparation and examination" is any one of "subject preparation completed", "subject conveyance in progress", and "subject conveyance completed", a schedule of, for example, two weeks is displayed for a list of scheduled holding days and time periods for which an expert conference is held after a predetermined number of days (for example, 30 days) from the current date and time.
(4) When the "condition of subject preparation and examination" is either "DNA extraction completion" or "preprocessing completion", a schedule of, for example, two weeks is displayed for a list of scheduled holding days and time periods on which an expert conference is held after a predetermined number of days (for example, 15 days) from the current date and time.
(5) When the "condition of subject preparation and examination" is either one of "completion of sequence reading" and "completion of analysis", a schedule of, for example, two weeks is displayed for a list of scheduled holding days and time periods on which an expert conference is held after a prescribed number of days (for example, 10 days) from the current date and time.
The conditions for extracting the schedule candidates for the specialist conference are not limited to these conditions, and may be appropriately changed depending on the use of the medical facilities B1 and B2.
Notification of schedule of expert meeting to medical worker
The
For example, the
For example, when the condition for displaying the icon 170 is satisfied, the
[ GUI180 for accepting input of selected information of experts participating in an expert conference ]
The
Fig. 36 is a diagram of an example of GUI180 displayed on terminal devices B13, B23, C14, C24, D11, and D21 for receiving a predetermined instruction from an expert participating in an expert conference. The GUI180 includes: an area R7 that accepts selection of a predetermined day and period of time for holding the expert conference; and a region R8 that accepts a selected instruction of an expert participating in the expert conference.
A list (schedule candidates) of appointments for an expert conference scheduled to be held in the facility selected in the region R4 of the GUI150 shown in fig. 29 is displayed in the region R7, and a selection bar for selecting each expert conference is provided.
In addition, the region R8 is provided with a selection field for selecting a name, a role, a professional field, and each of medical workers as candidates for an expert, which is a medical worker capable of participating in the expert meeting selected in the region R7. For example, the candidates of experts who can participate in the selected expert meeting may be medical workers who do not participate in other expert meetings at the date and time of the selected expert meeting, that is, medical workers who have a free schedule at the date and time.
In the example shown in fig. 36, 10 predetermined to "1, 7 and 2019" is selected in the region R7: 00-12: 00 "held expert meeting, a candidate list of medical workers attending the selected expert meeting is displayed in region R8. Further, the genetic counselor "XXXX" and the medical worker "ZZZZZZZZ" who specializes in lung cancer were selected as participants in the expert conference.
The
The
As shown in fig. 18, the "number of permitted patients" is set to the date and time of each conference call of the specialist conference calendar 27 stored in the comprehensive database 302 of the comprehensive data management apparatus a.
For example, when the
When the number of permitted patients who have received the selected expert conference is "0", the
[ combination with known applications ]
The
In this case, the
The
[ setting of day of holding of an expert conference based on the date and time when the examination is expected to be completed ]
The
For example, the holding date and time closest to the date and time at which the examination is expected to be completed received from the examination information management apparatus C11 may be referred from the specialist conference schedule 27, and the holding date and time of the specialist conference may be set.
The
The
For example, the
That is, when the inspection process is delayed from the scheduled time, the
When the
When the examination completion estimated day is updated, the
< GUI190 for accepting setting of expert conference >
The
The GUI150a is provided with a "conference setting" button R23. The terminal B13 can be caused to display a GUI190 (fig. 37) for setting an expert meeting in accordance with the point at which the medical worker clicks the "meeting setting" button R23.
Fig. 37 is a diagram showing an example of GUI190 displayed on terminal devices B13 and B23, terminal devices C14 and C24, terminal devices D11 and D21, and the like, for accepting a schedule setting of an expert conference.
The GUI190 includes: a region R9 for accepting input of patient information, a region R10 for displaying a list of medical workers who participate in an expert meeting, a region R11 for accepting schedule setting of an expert meeting, and a "meeting notification" button.
The region R9 is provided with a field for receiving input of patient information such as the name of the patient, the sex of the patient, and the date and year of birth of the patient. The name and the like of the medical worker who participated in the specialist conference selected in the region R11 are displayed in the region R10. A "meeting notification" button that accepts an operation for notifying the medical staff displayed in the region R10 of the date and time of the selected expert meeting is displayed in the region R12.
The
The
The notification is sent, for example, in an email. Alternatively, information on the date and time of the holding of the specialist conference may be transmitted to a predetermined table of accounts managed by Microsoft Outlook (registered trademark) installed in the terminal devices B13, B23, C14, C24, D11, D21, etc. of the medical workers and registered in the predetermined table.
< GUI210 for retrieving information associated with an expert conference >
The
Fig. 38 is a diagram showing an example of the GUI210 including the patient ID, the examination ID, the schedule of the specialist conference, and the information related to each specialist conference among the terminal devices B13, B23, C14, C24, D11, and D21 of the medical staff.
The GUI210 displays columns of "patient ID", "inspection patient ID", "patient name", "sex", "name of facility in which expert conference is held", "date and time of holding of expert conference", and "related information" of the patient in charge of the medical staff registered in the integrated data management apparatus a.
For example, the medical staff can confirm the patient ID, the examination order ID, and the date and time of the holding of the specialist conference, which are associated with themselves, using the
The display of "associated information display" of the column of "associated information" is link information that points to information about the patient for which the medical worker is responsible. For example, the
The GUI210 displays not only identification information about a patient such as a patient ID but also the date and time when an expert conference was held and the name of a facility in which the expert conference was held. Therefore, the medical staff logged in to the integrated data management apparatus a can easily confirm information such as "when and where an expert meeting about a patient for which himself is responsible" using the terminal apparatus B13, for example.
[ variation of GUI for accepting selection of expert meeting ]
Instead of the GUI210 shown in fig. 38, the
The GUI220 displays information about the team holding the specialist conference and the holding date and time of the specialist conference in the terminal devices B13, B23, C14, C24, D11, and D21 of the medical workers.
The column of the "team" of the GUI220 displays summary information for a team of medical workers. Here, the summary information of the group may be information on a medical facility to which at least 1 medical worker constituting the group belongs, or information on a facility in which an expert conference is held.
Alternatively, the summary information of the group may be information such as a facility ID associated with the "group ID" in the group table 26. For example, when the display of the "group information" field is clicked, the
The GUI220 first enables the medical worker to select information about the desired team. Next, the
A list of patient IDs for the selected panel in GUI220 is displayed in GUI 230. For example, when "XX hospital a group" is selected in the GUI220 shown in fig. 39, the
The group (and the group ID) displayed on the GUI220 by the
< Process flow for displaying GUI210 >
Here, a process flow of causing the terminal device B13 used by the medical staff to display the GUI210 (see fig. 38) containing the patient information on the patient P1 and the meeting information on the specialist conference will be described with reference to fig. 41. Fig. 41 is a diagram showing an example of a processing flow for displaying, on the terminal device B13 of the medical worker, an expert conference schedule related to the patient P1 in charge of the medical worker and information related to each expert conference.
First, the terminal B13 transmits a request for displaying a login screen to the integrated data management apparatus a (step S1001). The integrated data management apparatus a receives a request for displaying a login screen from the terminal B13 (step S1002), and transmits login screen information to the terminal B13 (step S1003). The terminal device B13 receives the login screen information from the integrated data management device and displays the login screen (step S1004).
Then, the terminal device B13 transmits the login information received from the medical staff to the integrated data management device a (step S1005). The login information includes, for example, a user ID of the medical worker.
Next, the integrated data management apparatus a receives the registration information from the terminal B13 (step S1006), and authenticates the registration of the medical staff by referring to the authentication table 38 stored in the integrated database 302 of the integrated data management apparatus a (step S1007). Here, the authentication table 38 manages user IDs of users permitted to log in to the integrated data management apparatus a.
The integrated data management apparatus a refers to the master table 25 using the user ID included in the login information as a key, acquires information on the patient associated with the user ID, and transmits the information to the terminal apparatus B13 (step S1008).
Then, the terminal device B13 displays the information on the patient associated with the user ID received from the integrated data management device a as the GUI210 (step S1009).
Details of processing by the integrated data management apparatus a for causing the terminal apparatus B13 used by medical workers to display the GUI210 containing the patient information on the patient P1 and the meeting information on the specialist conference will be described using fig. 42. Fig. 42 is a diagram showing an example of a processing flow performed by the
The
Then, the
Then, the
Then, the
When receiving the patient information and the selection information of the expert conference from the terminal device B13 in which the authenticated medical staff is registered (YES in step S209), the
< Process flow for displaying GUI240 >
Here, a process flow of displaying the GUI240 (see fig. 45) displayed as a screen including examination result information and clinical information related to the patient P1 on the terminal devices B13, B23, C14, C24, D11, D21, etc. of the medical staff participating in the specialist conference will be described with reference to fig. 43. Fig. 43 is a diagram showing an example of a process flow for displaying information related to a patient in charge of medical staff.
First, the terminal device B13 installed in the medical facility B1 receives an information acquisition request from a medical practitioner via the GUI210 shown in fig. 38. The terminal device B13 transmits the request for acquiring related information and the patient ID and the examination request ID corresponding to the "related information display" that has been clicked by the medical staff in the related information column of the GUI210 to the integrated data management device a (step S1101).
Referring to fig. 43, the integrated data management apparatus a receives an information acquisition request of the related information together with the patient ID and the examination request ID (step S1102). Then, the master table 25 stored in the integrated database of the integrated data management apparatus a is referred to using the received patient ID and examination request ID as keys (step S1103). The integrated data management apparatus a acquires the examination result and the patient clinical information corresponding to the patient ID and the examination request ID from the master table 25, and transmits them to the terminal apparatus B13 (step S1104).
Then, the terminal B13 of the medical facility B1 displays the clinical information of the patient, the examination result, and the like received from the integrated data management apparatus a as the GUI240 (step S1105).
Details of processing performed by the integrated data management apparatus a for causing the terminal apparatus B13 used by the medical staff to display the GUI240 containing the examination result information of the patient P1 and the clinical information of the patient P1 will be described with reference to fig. 44. Fig. 44 is a diagram showing an example of a processing flow performed by the
The
Then, the
Then, the
Then, the
Then, the
Then, the
Here, the integrated database 302 associates the clinical information of the patient P1 with the examination request ID and records it in the master table 25 of the integrated database 302 (step S21 of fig. 12). By thus associating the examination request ID with the examination result and storing it in the integrated database 302, the clinical information of the patient P1 is associated with the examination result of the patient P1 via the examination request ID and recorded in the master table 25 of the integrated database 302 (step S23 of fig. 12).
Referring to fig. 44, the
Then, the
< display of screen based on information acquisition request >
Next, screen displays displayed on the terminal devices B13, B23, C14, C24, D11, D21, and the like used by the participants of the expert conference in response to the reception of the information acquisition request will be described with reference to fig. 45. Fig. 45 is a diagram showing an example of the GUI240 displayed by the
The GUI240 displays "patient ID", "patient history", "examination result", "pathology image", and "what the pathologist sees". The patient's medical history includes information about patient P1 such as the present condition, family history, past history, treatment history of patient P1.
The "test result" shown in the region R13 includes, for example, the presence or absence of a mutation in the nucleotide sequence, the position of the mutation, and the type of the mutation, which are information on the test result, such as "EGFR T790M". The region R13 includes, for example, "drug a" or the like as drug information relating to a mutation detected by a genome test, and information on a therapeutic drug associated with each detected mutation.
The region R14 displays a pathological image that the integrated data management apparatus a has received from the medical facility B1 associated with the patient as clinical information of the patient P1. In addition, the region R15 displays a "pathologist seen" button for inputting an instruction to enter a screen seen by the pathologist H1b who makes a pathological diagnosis of the patient. By clicking the "pathologist seeing" button, the seeing of the pathologist H1b based on the pathological image or the like input by the pathologist H1b as the clinical information of the patient P1 can be further confirmed.
By providing the multiple experts participating in the expert conference with the GUI240 containing the examination result and clinical information of patient P1 before and during the expert conference, information necessary for establishing the optimal treatment policy for patient P1 can be collectively presented. This makes it possible to facilitate the operation of the expert conference and to assist the discussion of the treatment policy for the patient.
< Association of examination result with information relating to therapeutic drug >
Fig. 47 is a flowchart illustrating an example of a process in which the
The
If the detected variation does not exist (NO in step S132), the
The
(introduction of comment information)
Referring to fig. 2, the integrated data management apparatus a assists in acquiring external information as comment information to be referred to by the specialist conference. For example, the integrated data management apparatus a provides links to information retrieval websites managed by the mutation information management apparatus F11, the medicine information management apparatus F21, and the academic paper information management apparatus F31.
Fig. 50 is a flowchart illustrating an example of a process in which the
The
If the detected mutation does not exist (NO in step S142), the
The
As described above, the related information can be searched not only from the screen display, but also from the search key such as "gene information" inputted in the region R17, "drug information" inputted in the region R18, "disease information" inputted in the region R19, and "package information" inputted in the region R20, as shown in fig. 52.
The related information is not limited to the mutation information and the drug information managed by the mutation information management device F11 and the drug information management device F21, and may be, for example, the paper information and the treatment experience information of the academic paper information management device F31. The
[ modification 1]
In the data integration processing of the integrated data management apparatus a, the
Specifically, first, the
For example, as shown in fig. 46, when the input data includes key items of "name", "sex", and "year, month, day of birth", an edit distance (Levenshtein distance) function is used as an example of the evaluation function fa () of "name". Then, in the comparison of the key item ("name") values of the integration base and the integration target, the evaluation value is calculated from the lowest number of edits made when the character string of the integration target is deformed into the character string of the integration base. For example, the evaluation function fa () returns an evaluation value of "1" when editing is not required, returns an evaluation value of "0" when all characters need to be edited, and returns an evaluation value between 0 and 1 depending on the number of times of editing when a part of characters need to be deformed.
In addition, as an example of the evaluation function fb () of "sex" and the evaluation function fc () of "year, month, and day of birth", a "perfect match" function is used. The perfect agreement function calculates an evaluation value indicating whether or not the key item values of the integration base and the integration target are completely in agreement. For example, the perfect agreement function returns "1" when 2 values agree perfectly, and returns an evaluation value of "0".
Then, the
Then, the
The
[ modification 2]
Referring to fig. 53, an information management apparatus B14 may be further connected to the intra-medical-facility LAN in the medical facility B1, and the information management apparatus B14 may manage various information and data communications of the electronic medical record management apparatus B11, the pathologic image management apparatus B12, and the terminal apparatus B13. In this case, the integrated data management apparatus a communicates with the electronic medical record management apparatus B11, the pathology image management apparatus B12, and the terminal apparatus B13 provided in the medical facility B1 via the information management apparatus B14. Fig. 53 is a diagram showing a configuration example of a medical facility B1 provided with an information management device B14. The information management apparatus B14 is a computer that performs reception processing of various information sent from an external apparatus to the medical facility B1 and transmission processing of various information sent from the medical facility B1 to an external apparatus. Examples of the reception process include file decompression, classification of received data, receipt of a reception notification, and the like. The transmission processing includes, for example, acquisition, compression, and format conversion of transmitted data.
[ modification 3 ]
Referring to fig. 54, the integrated data management apparatus a is not necessarily a cloud server, and may be, for example, a server provided in the medical facility B1. Fig. 54 is a diagram showing a configuration example of an information management system 100a according to an embodiment of the present invention. In this case, the terminal devices of the other medical facilities B2, the terminal devices C14 and C24 of the inspection facilities C1 and C2, and the terminal devices D11 and D21 of the external facilities D1 and D2 communicate with the integrated data management apparatus installed in the medical facility B1 via the
Fig. 54 shows an example in which the integrated data management apparatus a is connected to the intra-medical-facility LAN of the medical facility B1, but may be directly connected to the
[ modification 4 ]
The integrated data management apparatus a may have a configuration having both the functions of the inspection information management apparatuses C11 and C21.
[ constitution of
The
In the latter case, the integrated data management apparatus a includes a computer that executes a program command, the program being software that realizes each function. The computer includes, for example, 1 or more processors, and a computer-readable recording medium storing the program.
The object of the present invention is achieved by reading the program from the recording medium and executing the program in the computer. As the processor, for example, a cpu (central Processing unit) can be used. As the recording medium, a non-transitory tangible medium, such as a rom (read Only memory), a tape, a disk, a card, a semiconductor memory, a programmable logic circuit, or the like can be used. The program may further include a ram (random access memory) or the like for expanding the program.
In addition, the program may be supplied to the computer via any transmission medium (communication network, radio wave, etc.) that can transmit the program. An embodiment of the present invention can be implemented in the form of a data signal embedded in a carrier wave for electronically transmitting the program.
The present invention is not limited to the above embodiments, and various modifications can be made within the scope shown in the claims, and embodiments obtained by appropriately combining technical features disclosed in different embodiments are also included in the technical scope of the present invention.
[ notation ] to show
A integrated data management device
B1 and B2 medical facilities
B11, B21 electronic medical record management device
B12 and B22 pathological image management device
B13 and B23 terminal devices
C1, C2 inspection facility
C11, C21 inspection information management device
C14, C24 terminal device
D1, D2 external facilities
D11 and D21 terminal devices
E1 transportation affairs department
E11 transmitting-receiving management device
E12 terminal device
F11 mutation information management device
F21 medicine information management device
F31 academic paper information management device
10 control part
30 storage part
301 procedure
302 integrated database
100. 100a information management system
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