Patient support system, method, and program

Abstract

To provide a patient support system capable of providing appropriate support to patients during outpatient treatment or home-based care, a method, and a program.SOLUTION: The patient support system includes a medical history server 20 and the PHR server 30. The system acquires patient information, including responses to questions about symptoms, medication use and the like, from a user terminal 10, acquires results of laboratory tests, details of treatment regimen / prescription, and information on supportive therapies / guidelines from a medical facility system 40 as patient treatment information, compares patient information with patient treatment information, determines whether appropriate treatment has been provided for the symptoms entered in the patient information based on the patient treatment information, and displays the same as support information on the user terminal 10.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a system, method, and program for providing support to patients, particularly cancer patients, who require ongoing support. [Background technology]

[0002] Advances in medical care have led to the widespread provision of long-term, continuous treatment and follow-up care after acute treatment. This has led to an increase in outpatient and home care (hereafter referred to as home care, etc.). For example, in cancer treatment, chemotherapy and radiation therapy are increasingly performed while patients are visiting the hospital. Home care, etc., offers the benefit of reducing anxiety and stress by allowing patients to receive treatment while living their daily lives at home. However, several problems have been identified. For example, patients and their families may become anxious because they are unable to determine whether the changes in their physical condition they are experiencing are within the expected range of side effects of drug therapy. Furthermore, when symptoms arise, they are unable to immediately inquire with medical professionals about symptom relief. Furthermore, medical professionals are unable to monitor medication status and daily life in real time, making it difficult to understand the effectiveness and side effects of treatment. Furthermore, home care, etc., lacks accurate information on daily life, such as diet and activity, making it difficult to accumulate data for drug development and selecting optimal supportive care.

[0003] In cancer chemotherapy, detailed medical interviews have traditionally been conducted at hospital visits. For example, questions such as whether patients are able to carry out their daily activities without any problems, whether there have been any changes in the amount of food they eat, and possible side effects of drug therapy such as nausea and diarrhea have been written on a medical questionnaire, which medical staff then record in an electronic medical record system, or patients have been asked to enter their answers to similar questions into a tablet or other device and record them.

[0004] Problems with filling out paper questionnaires include the time it takes to transfer data to the electronic medical record system and the difficulty of utilizing the data. Furthermore, even if free-form writing sections are provided, the limited space on the paper means that it is insufficient to record individual sensations such as discomfort or numbness, making it impossible to fully understand the patient's condition. Entering data into a tablet eliminates the problems of entering data into the electronic medical record system and utilizing the data, but because the interview is conducted at the time of the patient's visit, it is not possible to record details such as whether the patient experienced similar symptoms throughout the entire period, such as several weeks of home care.

[0005] Systems for medical professionals to manage treatments with side effects, such as cancer chemotherapy, have already been disclosed. Patent Document 1 discloses a system for medical professionals to plan effective and safe medication schedules. The system includes a risk management unit that calculates the probability of future adverse reactions over time for each level of adverse reaction based on treatment information that chronologically stores the severity history of adverse reactions to drug treatment, and an input / output processing unit that displays the calculated probabilities over time. This system allows medical professionals to grasp the risk of adverse events. Patent Document 2 discloses a system that, when a user's medication may cause multiple symptoms, determines a symptom score to be presented to the user indicating the priority of each symptom. The system displays information on the user's device showing symptoms in descending order of symptom score, prompting the user to select a symptom. The server determines remedial action information indicating remedial actions to alleviate the selected symptom based on the user's selection and user history information, and presents the remedial action information to the user's device. This system allows medical professionals to alleviate treatment-related symptoms, such as drug side effects. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Japanese Patent Application Publication No. 2023-143452 [Patent Document 2] International Publication No. 2020 / 148822 Summary of the Invention [Problem to be solved by the invention]

[0007] The invention described in Patent Document 1 enables medical professionals to safely plan treatment plans, but does not provide a system that can respond to side effects or address patient concerns. The invention described in Patent Document 2 allows patients to select their symptoms from a list of symptoms displayed on a user terminal, and then implements appropriate measures to alleviate the symptoms. However, medical professionals cannot grasp patients' symptoms in real time, nor can they obtain information on their daily living status, making it difficult to accurately incorporate information about the patient's symptoms into treatment. In other words, these inventions merely present existing medical information to patients and do not provide support tailored to each patient's individual condition. Furthermore, they are unable to collect patient symptoms, preventing the use of data to develop better supportive care.

[0008] The present invention aims to provide a system that compares symptoms and medication status entered by patients or caregivers, as well as daily life information, with a personal health record (PHR) during home care, etc., and presents support appropriate to the patient's symptoms. Another objective of the present invention is to provide a system that integrates the symptoms and medication status recorded by patients into a medical institution's database and utilizes them in drug development and the selection of optimal supportive care. [Means for solving the problem]

[0009] The present invention relates to the following patient support system, patient support method, and program. (1) A patient support system comprising a medical interview server and a PHR server, wherein patient treatment information synchronized from a medical facility system to the PHR server can be obtained from the medical interview server using patient identification link information that is sent to the PHR server and linked and authenticated; the medical interview server compares the medical interview answers entered from a user terminal with the patient treatment information, determines the support information required for the patient, and sends the support information to the user terminal for display. By making it possible for the medical interview server to refer to patient treatment information stored on the PHR server, it becomes possible to obtain information related to the patient's treatment. As a result, it becomes possible to provide patients with appropriate support information that cannot be obtained with conventional medical interview systems.

[0010] (2) A method for supporting patients undergoing outpatient treatment and / or home care, comprising the steps of: acquiring patient information as a medical interview response from a user terminal in a medical interview server; acquiring patient treatment information synchronized from a medical facility system from a PHR server; comparing the patient information with the patient treatment information; determining from the patient treatment information whether appropriate treatment is being given for the symptoms entered as the patient information, and generating the support information; transmitting the support information to the user terminal; and displaying the transmitted support information on the user terminal. Even during periods of home care, by using the patient support system, patient information entered through interviews can be compared with patient treatment information obtained from medical institutions, and appropriate support information can be obtained. [Brief explanation of the drawings]

[0011] [Figure 1] FIG. 1 is a diagram schematically illustrating an example of the configuration of a patient support system according to an embodiment. [Figure 2] FIG. 2 is a functional block diagram of a user terminal, an interview server, a PHR server, and a medical facility system of the patient system according to the embodiment. [Figure 3] FIG. 2 is a diagram showing an example of an operation flow of the patient support system according to the embodiment. [Figure 4] FIG. 10 is a diagram showing an example of a screen for inputting regimen registration information on a user terminal. [Figure 5] A diagram showing expected side effects for each regimen. [Figure 6] FIG. 2 is a diagram schematically showing a symptom input screen of the patient support system according to the embodiment. [Figure 7] FIG. 1 is a diagram illustrating an example of the configuration of a system that accumulates patient information from multiple facilities. DETAILED DESCRIPTION OF THE INVENTION

[0012] This embodiment illustrates a system that compares information entered by a patient suffering from cancer with patient information recorded at a medical institution and provides support appropriate for the patient. However, it goes without saying that the system can also be applied to the treatment of diseases other than cancer. For example, the system can be applied to chronic diseases such as diabetes, chronic kidney disease, and chronic obstructive pulmonary disease, which require long-term outpatient treatment and / or home care.

[0013] In the following description, "healthcare professionals" refers to professionals involved in patient care who have direct contact with patients, specifically doctors, nurses, pharmacists, etc. "Users" refers to patients or caregivers providing care at home. "Symptoms" refer to the condition or signs of disease observed in patients, including subjective symptoms and objective symptoms recognized by caregivers. No distinction is made between those caused by the disease and adverse reactions caused by medication or other treatments. "Adverse reactions" refer to symptoms experienced by patients who have undergone interventional medical procedures, such as drug therapy, radiation therapy, surgical treatments such as surgery, or combinations thereof, as well as any undesirable or unintended signs or symptoms temporally related to the interventional medical procedure. In the case of cancer drug therapy, adverse reactions may occur as symptoms such as peripheral neuropathy, tremors in the hands and feet, constipation, diarrhea, and loss of appetite. "Patient information" refers to daily life information such as the patient's symptoms, medication status, diet, and activity.

[0014] Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings. FIG. 1 schematically illustrates an example of a patient support system according to this embodiment. The patient support system comprises a medical interview server 20 and a PHR server 30. A user (patient or caregiver) can connect to the medical interview server 20 via a user terminal 10, such as a smartphone or PC, used for inputting information, and a network such as the Internet. The medical interview server 20 can be connected via a network such as the Internet to a PHR server 30, which stores information related to an individual's health, medical care, and nursing care. The PHR server 30 can also be connected via a network to a medical facility system 40, including an electronic medical record system within a medical facility. As will be described later, patient information entered and stored by a user during outpatient treatment and / or home care is read when the patient visits a medical facility and automatically transcribed into the patient's medical record.

[0015] FIG. 2 shows an example of a functional block diagram of the user terminal 10, medical interview server 20, PHR server 30, and medical facility system 40 according to this embodiment. Each of the user terminal 10, medical interview server 20, PHR server 30, and medical facility system 40 is realized by a configuration including a computer. The user terminal 10 includes an input unit 110, a display unit 120, a communication unit 130, a control unit 140, and a storage unit 150. The user terminal 10 may be an information terminal such as a smartphone, a personal computer, a tablet computer, or a touchpad. The elements constituting each function may be incorporated into the same device, or may be connected via an interface.

[0016] The medical interview server 20 includes an input unit 210, a display unit 210, a communication unit 230, a control unit 240, a comparison unit 250, a support information determination unit 260, and a storage unit 270. Although a cloud server is illustrated as an example of the medical interview server 20 in Fig. 1, any server may be used. The communication unit 230 of the medical interview server 20 exchanges information with the communication unit 130 of the user terminal 10 and the communication unit 330 of the PHR server 30 via wired communication or a network.

[0017] The PHR server 30 and the medical facility system 40 each include input units 310, 410, display units 320, 420, communication units 330, 430, control units 340, 440, and memory units 350, 450. The communication unit 330 of the PHR server 30 exchanges information with the communication unit 230 of the medical interview server 20 and the communication unit 430 of the medical system 40 via wired communication or a network. Although a cloud server is shown as an example of the PHR server 30 in Figure 1, any server may be used.

[0018] Each functional block may be configured with a single device or multiple devices. The medical interview server 20 and the PHR server 30 may be operated by the same organization or different organizations. As will be described later, the medical facility system 40 includes an electronic medical record system within the medical facility and a structured medical data integrated management database that structures and manages medical data in an integrated manner, and each component is connected via an interface.

[0019] The input unit 110 of the user terminal has the function of accepting input from the user, the input unit 210 of the medical interview server 20 and the input unit 310 of the PHR server 30 from each organization, and the input unit 410 of the medical facility system 40 from medical professionals. The display units 120, 220, 320, and 420 have the function of displaying information on each terminal so that it can be visually confirmed by the user, the person in charge of each organization, or the medical professional. The communication units 130, 230, 330, and 430 have the function of sending and receiving information to and from other devices. The control units 140, 240, 340, and 440 have the function of executing control of information processing, etc. The memory units 150, 270, 350, and 450 have the function of storing data, programs for data processing, etc. The comparison unit 250 of the medical interview server 20 has a function of comparing patient information such as symptoms, medication status, and daily living status transmitted by the user with patient treatment information transmitted from the medical facility system 40, specifically, drug therapy regimens / prescriptions and prescriptions / instructions for supportive care, and specimen test results, and analyzing whether the symptoms reported by the patient, changes in daily living status, etc. are due to medication or are within the expected range of adverse reactions. In addition, the support information determination unit of the medical interview server 20 has a function of determining what kind of support the patient needs based on the analysis results of the comparison unit 250. The support required for the patient is transmitted to the user terminal 10 via the communication units 230 and 130 and displayed on the user terminal 120.

[0020] Next, an example of the operation of the patient support system will be described (Fig. 3). The user inputs patient information from a user terminal 10 at home, such as a smartphone or PC. The user starts a program, inputs patient identification link information into the input unit 110, and transmits it to the medical interview server 20 via the communication units 130 and 230 (step S101). The patient identification link information transmitted to the medical interview server is transferred from the medical interview server to the PHR server 30 via the communication units 230 and 330 (step S201). The transferred patient identification link information is linked and authenticated in the PHR server 30 (step S301). This allows the medical interview server to access the patient treatment information transmitted to the PHR server 30 by the medical system 40 (step S401). The patient treatment information is updated by periodically synchronizing the PHR server 30 and the data server of the medical facility system 40.

[0021] For example, if a smartphone is used for input, the patient identification link information can be a phone number, which can be entered into the user terminal, and the user's identity can be confirmed via SMS authentication before input can begin. Alternatively, a medical record number or a separate ID can be set to identify the patient.

[0022] When the patient identification link information is received and authenticated by the communication unit 230 of the PHR server 30 via the communication unit 130 and the medical interview server, a medical interview template selection screen is displayed on the display unit 120 of the user terminal 10 to start the medical interview. For example, if drug therapy is being used in cancer treatment, regimen information is displayed on the user terminal (FIG. 4). The user selects the regimen they are receiving from the regimen information. Alternatively, when starting home therapy, it is possible to receive a QR code (registered trademark) or the like converted into regimen information from a medical institution in advance, have it scanned, and obtain a medical interview template. A medical interview template is selected by specifying the regimen (step S102).

[0023] The expected side effects differ depending on each regimen (Figure 5). The storage unit 270 of the medical interview server 20 stores questions about adverse events set for each regimen, as well as input forms for inputting symptoms unrelated to treatment, diet, activity status, medication status, etc. These are transmitted to the user terminal via the communication unit 230 (step S202), and an input screen (medical interview) for inputting patient information is displayed on the display unit 120 of the user terminal 10. Alternatively, questions about side effects that may occur depending on the regimen selected by the user are extracted and displayed as an input screen for inputting patient information together with questions about medication status, diet, etc. Patient information refers to the patient's condition, including symptoms, medication status, diet, activity, etc. The user inputs answers according to the presented medical interview (step S103).

[0024] By answering the questionnaire, patients can record their daily condition, such as medication status, diet, and activity, as well as their symptoms. In addition to symptoms resulting from the disease, symptoms in the questionnaire include adverse events that may be caused by drug treatments administered at home or surgery or radiation therapy administered at a medical facility.

[0025] For the medical interview, multiple input forms are prepared as templates in the memory unit 270 of the medical interview server 20 depending on the treatment (regimen) the patient is receiving, or are set to be an appropriate input form depending on the regimen, and the input form appropriate for the patient is sent to the user terminal.

[0026] For example, if the patient has nausea, they are asked to select specific indicators, just like when they were admitted to the hospital, such as "none," "nauseous, but able to eat," "eating less due to nausea," or "unable to eat or drink," to obtain accurate data without any fluctuations. Also, if the patient has developed skin symptoms, such as hand-foot syndrome, they are shown photos of the specific symptoms and asked to select an option, allowing the patient to accurately select their condition (Figure 6).

[0027] By entering medication status into the app once a day, missed doses can be confirmed, allowing medical professionals to accurately grasp the timing and frequency of missed doses when patients visit the hospital. Furthermore, by allowing patients to check and recognize missed doses themselves, it also helps prevent forgetting to take medication. If patients are prescribed emergency medication, allowing them to record how many tablets they have taken will also enable medical professionals to record and manage the date, time, and amount of emergency medication taken.

[0028] Figure 6 shows a schematic diagram of the selection screen for the symptom entry form. The entry form sequentially presents adverse events that may occur due to drug treatment. The user responds by selecting the symptom that applies to them or by indicating that there are no symptoms. For example, if a regimen is expected to cause skin symptoms, a selection screen with a photo is displayed. The patient selects and enters the symptom that best describes their own condition. For example, if a patient selects that their hand has "redness and dry skin, but no pain," the next screen prompts them to respond to the presence or absence of symptoms depending on the situation. Specifically, questions are displayed asking about the presence or absence of hand pain in daily life, such as whether hot water stings when bathing or whether their hands hurt when opening a book (Figure 6). Because these questions address the presence or absence of pain in specific situations, the options are easy for patients to answer. The grade of hand-foot syndrome, a side effect of the drug, is determined and recorded based on the answers to each question. For symptoms that cannot be entered via the selection screen, a space is provided for entry.

[0029] The input patient information is sent to the medical interview server 20 via the communication unit 130 (step S104). The medical interview responses received by the medical interview server are transferred to the PHR server 30 (step S204) and are used to determine patient support information. Since the medical interview server 20 and the PHR server 30 are linked and authenticated at the start of the medical interview, it is possible to obtain treatment information necessary for patient support from the PHR server 30. Therefore, information necessary for patient support from the patient treatment information synchronized from the medical facility system 40 is obtained by the medical interview server 20 (step S205). It is important that the data shared between the medical interview server and the PHR server conforms to standards such as HL7 FHIR.

[0030] The medical interview server 20 compares and collates the drug therapy regimen / prescription, prescription / instruction for supportive care, and specimen test results with the patient information entered by the patient (step S206). Specifically, the comparison unit 250 compares and examines whether the symptoms, etc., reported by the patient are within the range predicted from drug treatment and the course of treatment so far, whether symptoms expected from the results of the previous blood test are present, and whether supportive care prescriptions have been made to address these symptoms. The support information determination unit 260 determines support information for the patient to continue appropriate treatment (step S207), transmits the support information to the user terminal (step S208), and displays it on the display unit of the user terminal (step S105).

[0031] As an example of support information, if a patient enters constipation as a symptom in the symptom section of the patient information, the medical facility will check the patient treatment information to see if a laxative has been prescribed and send support information to confirm that the laxative is being taken appropriately. Alternatively, if the patient information entered by the user is compared with the specimen test results and previous patient information and it is determined that an emergency examination or treatment at a medical facility is required, support information urging the patient to call the medical facility immediately will be sent. Support information appropriate for the patient's symptoms and treatment is determined and sent to the patient terminal 10. Since specific support information is displayed on the display unit 120 of the user terminal, the user can receive appropriate and prompt support even when receiving treatment at home, etc.

[0032] Furthermore, when the user sends the medical interview response, the medical interview response is transferred from the medical interview server 20 to the PHR server 30 (step S204), and the transferred medical interview response can be transferred from the PHR server to the medical facility system 40 (step S302). The transferred medical interview response is recorded in the electronic medical record system within the medical system (step S402). Furthermore, support information can also be transferred from the PHR server to the medical facility system (step S303). The transferred support information is recorded in the electronic medical record system within the medical system (step S403). If the medical interview response and support information are transferred, there is no need to input patient information at home from the user terminal when visiting the hospital, as will be described later.

[0033] Patient information such as the patient's symptoms, medication status, and daily life information entered by the user during home care or other such occasions is stored on the medical interview server. The stored patient information is linked to a two-dimensional barcode such as a QR code on the user's terminal, and when presented at a medical institution, it is downloaded from the medical interview server 20 and recorded in the structured medical data integrated management database 60 of the medical system 40, and then recorded in the electronic medical record system (Figure 7). As a result, medical facilities can continuously record the patient's condition during periods such as home care, which not only helps with patient treatment but also shortens the time medical professionals spend on medical interviews.

[0034] The medical data recorded as structured data in the structured medical data integrated management database 60 is transmitted to the multi-facility server 70, where it can be stored and used. Since the structured medical data excludes information that could identify the patient, such as the patient's name, and contains information on the disease, symptoms, treatment, etc., it can be analyzed quickly and with high accuracy. For example, it can be used for pharmaceutical companies' drug development and post-marketing surveillance, as well as for investigating unknown side effects. Furthermore, with diseases such as cancer, in addition to the symptoms associated with the cancer, side effects, complications, and aftereffects caused by treatment are problematic, and it is difficult to compare and evaluate supportive therapies to prevent and treat these. By accumulating information from multiple facilities, it can also be used to develop optimal supportive therapies.

[0035] Patient support systems not only provide appropriate support for the treatment of patients receiving home care, but also offer significant benefits to medical professionals, as they allow for accurate understanding of patients' conditions during periods of home care. Furthermore, by using patient information synchronized with PHRs, it is possible to provide patients with high-quality support information not available through conventional medical interview services. Furthermore, understanding patient data during periods of home care and obtaining high-quality medical data can be used to develop new treatment methods, such as pharmaceuticals and supportive care. [Explanation of symbols]

[0036] 10...user terminal, 20...medical interview server, 30...PHR server, 40...medical facility system, 50...electronic medical record system, 60...structured medical data integrated management database, 70...multi-facility use server

Claims

1. The system includes a medical interview server and a PHR server, Patient treatment information synchronized from the medical facility system to the PHR server includes: The patient identification link information transmitted to the PHR server and authenticated can be obtained from the medical interview server. The medical interview server compares the medical interview answers input from the user terminal with patient treatment information; Determine the support information needed by the patient; A patient support system characterized in that support information is transmitted to the user terminal and displayed thereon.

2. In the inquiry server, There are multiple templates available for entering patient information, including symptoms, medication status, and daily life information. The template is selected according to a patient treatment method; 2. The patient support system according to claim 1, wherein the symptom is input by selecting from a list of symptoms that are presumed depending on the patient's disease and treatment method.

3. Patient information entered by the user during outpatient treatment and / or home care: The information is sent from the interview server to the medical facility system via the PHR server and recorded in the electronic medical record system, or 3. The patient support system according to claim 1, wherein the patient's information is recorded in an electronic medical record system of the medical facility system from a user terminal when the patient visits the hospital.

4. Patient information recorded in the electronic medical record system is 4. The patient support system according to claim 3, wherein the structured medical data is transmitted to a structured medical data integrated management database and stored in a usable manner in a multi-facility server.

5. 1. A method for assisting a patient undergoing outpatient and / or home care, comprising: a step of acquiring patient information as a medical interview response from a user terminal in the medical interview server; retrieving synchronized patient care information from a PHR server from a medical facility system; comparing said patient information with said patient treatment information; a step of determining whether appropriate treatment is being given to the symptoms input as the patient information from the patient treatment information and generating the result as support information; transmitting the assistance information to a user terminal; A patient support method including a step of displaying the transmitted support information on a user terminal.

6. Patient information entered by the user into the user terminal during outpatient treatment and / or home care is The information is sent from the interview server to the medical facility system via the PHR server and recorded in the electronic medical record system, or 6. The patient support method according to claim 5, wherein the patient's information is transmitted to a medical facility system at the time of the patient's visit and recorded in an electronic medical record system at the medical facility.

7. Patient information recorded in the electronic medical record system is The data is converted into structured data and stored in a structured medical data integrated management database.

7. The patient support method according to claim 6, wherein the patient support information is transmitted to a multi-facility server for use.

8. A program for causing one or more computers to execute the method according to any one of claims 5 to 7.

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