Program, medical information processing device, medical information processing system, and medical information processing method

Abstract

To reduce the burden on healthcare workers who review clinical findings.SOLUTION: A control unit of an image management server (medical information processing device) acquires finding information for a medical image (step S1), and acquires input person information related to the input person who entered the finding information (step S2). The control unit also acquires pre-set determination conditions from a storage unit (step S3). The control unit (determination means) determines the priority of the finding information on the basis of the determination conditions (step S4). For example, the control unit determines the priority of the finding information on the basis of the input person information and the finding information, etc.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to a program, a medical information processing device, a medical information processing system, and a medical information processing method. [Background technology]

[0002] In recent years, there has been a demand for doctors to shift their tasks to other medical professionals (Medical Affairs Bureau Notification 0930 No. 16). For example, if an abnormal finding of high urgency is found in the images from an examination performed by a diagnostic radiologist, the diagnostic radiologist can report objective information to the doctor. However, it is the doctor who must make a judgment on the patient's condition based on the findings. With this task shift, technologists may report information on their findings from the images to the doctor. However, currently, the technologist's information on findings is only communicated to the doctor by phone, etc., and is sometimes not recorded.

[0003] Furthermore, with the advancement of AI (Artificial Intelligence) in medical image analysis and diagnosis, the sources of image findings are diversifying, including radiologists, AI, and technicians. Therefore, the secondary radiologist (approving physician) or clinician who makes the final decision on medical images must determine the validity of the diagnostic results based on the findings and the priority of image review based on the source and reliability of the findings. As such, simply introducing task shifting may not reduce the burden on doctors themselves.

[0004] Patent Document 1 discloses a technology in which, when multiple doctors enter multiple findings into an interpretation report, each piece of finding information is stored in association with the person who wrote it, and the finding information is displayed so that the person who wrote it can be identified. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2009-60945 Summary of the Invention [Problem to be solved by the invention]

[0006] However, in the above-described conventional technology, although the person who entered the finding information is displayed in an identifiable manner, the person who references the finding information (such as a radiologist) must determine whether or not to prioritize checking the finding information. For example, the person who references the finding information may be an inexperienced radiologist or a clinician who has recently been transferred to a facility. It is difficult for such a person to determine whether or not to prioritize checking the information when they do not know the person who entered the finding information.

[0007] If the referee tries to avoid this decision, they will have to check all the findings with equal priority, which makes work inefficient. Also, there is a risk that the urgency of the information will not be properly conveyed, such as by putting off findings that should be checked first.

[0008] With the promotion of task shifting, there are an increasing number of cases where technologists report to doctors the need to order new tests when they find abnormal findings. In such cases, patients often have to wait for additional tests (imaging), and the imaging is required early. Therefore, there is often no time to go through the usual steps of primary and secondary interpretation. Therefore, the findings entered by the technologist may be information that should be checked with priority.

[0009] The present invention has been made in consideration of the above-mentioned problems in the conventional technology, and an object of the present invention is to reduce the burden on medical professionals who check finding information. [Means for solving the problem]

[0010] In order to solve the above problem, the invention described in claim 1 is a program for causing a medical information processing device to execute a judgment step of judging the priority of the patient's finding information based on at least inputter information about the inputter who input the patient's finding information.

[0011] According to a second aspect of the present invention, in the program according to the first aspect, the determining step determines the priority of the finding information based on a combination of the inputter information and the finding information.

[0012] The invention described in claim 3 is the program described in claim 1, wherein the inputter information includes at least one of information indicating the type of inputter, personal identification information that identifies the individual inputter, and information regarding the means by which the observation information was input.

[0013] The invention described in claim 4 is the program described in claim 1, wherein in the determination step, the priority of the finding information is determined based on a combination including, in addition to the inputter information and the finding information, at least one of referrer information indicating a referrer who refers to the finding information and additional test candidates.

[0014] The invention described in claim 5 is the program described in claim 1, further causing the medical information processing device to execute a display control step of displaying the finding information on a display unit based on the priority of the finding information, wherein the display control step causes the medical information processing device to display the finding information based on the priority of the finding information using a method including at least one of changing a reference destination of the finding information, changing a degree of emphasis of the finding information, and changing a display order of the finding information.

[0015] The invention described in claim 6 is the program described in claim 1, wherein the finding information is a finding obtained from one or more of a medical image, an electrocardiogram, and a biopsy.

[0016] The invention of claim 7 is a medical information processing apparatus including a determining means for determining the priority of the patient's finding information based on at least inputter information relating to the inputter who inputted the patient's finding information.

[0017] The invention of claim 8 is a medical information processing system including a determining means for determining the priority of the patient's finding information based on at least inputter information relating to the inputter who inputted the patient's finding information.

[0018] The invention of claim 9 is a medical information processing method including a determining step of determining the priority of the patient's finding information based on at least inputter information relating to the inputter who inputted the patient's finding information. [Effects of the Invention]

[0019] According to the present invention, the burden on medical professionals who check finding information can be reduced. [Brief explanation of the drawings]

[0020] [Figure 1] 1 is a diagram illustrating an example of the system configuration of a medical image system according to an embodiment of the present invention. [Figure 2] FIG. 2 is a block diagram showing the functional configuration of an image management server. [Figure 3] FIG. 2 is a block diagram showing a functional configuration of a display terminal. [Figure 4] 10 is a flowchart showing a priority determination process executed in the image management server. [Figure 5] 10 is a flowchart showing a medical information presentation process executed in the image management server. [Figure 6] 10 is an example of an examination list screen displayed on a display unit of a display terminal. [Figure 7] 10 is an example of an image interpretation screen displayed on a display unit of a display terminal. [Figure 8] FIG. 10 is a diagram illustrating an example of an interpretation workflow. DETAILED DESCRIPTION OF THE INVENTION

[0021] Hereinafter, embodiments of the present invention will be described with reference to the drawings. Advantages and features provided by the embodiments will be understood from the following detailed description and drawings. However, the scope of the present invention is not limited to the embodiments disclosed below or the examples shown in the drawings.

[0022] [Configuration of medical imaging system] FIG. 1 shows an example of the system configuration of a medical image system 100 as a medical information processing system in this embodiment. As shown in FIG. 1, the medical imaging system 100 includes a modality 10, a console 20, a RIS (Radiology Information System) 30, an electronic medical record server 40, an image management server 50 (medical information processing device), a display terminal 60, etc. The devices constituting the medical imaging system 100 are connected via a communication network N such as a LAN (Local Area Network) or a WAN (Wide Area Network). The devices constituting the medical imaging system 100 comply with the HL7 (Health Level Seven) and DICOM (Digital Image and Communications in Medicine) standards. Communication between these devices is performed in accordance with HL7 and DICOM. The number of modalities 10, consoles 20, display terminals 60, etc. is not particularly limited.

[0023] The modality 10 is an imaging device such as an X-ray device (DR, CR), an ultrasound diagnostic device (US), a CT, an MRI, etc. The modality 10 takes images of the patient's examination target area based on the examination order sent from the RIS 30 and generates a medical image.

[0024] The console 20 is an imaging control device that controls imaging in the modality 10. The console 20 includes a control unit, an operation unit, a display unit, a communication unit, a memory unit, etc., which are not shown. The console 20 outputs imaging conditions and image reading conditions to the modality 10 based on the examination order sent from the RIS 30. The console 20 acquires medical images captured in the modality 10. The console 20 attaches additional information to the medical images by writing the additional information in the header of the image file of the medical image in accordance with the DICOM standard. The console 20 transmits the medical images with the attached additional information to the image management server 50. A technician can input information on the medical images or findings for the patient from the operation unit of the console 20.

[0025] The supplementary information of a medical image includes patient information, examination information, series information, image information, and the like. Patient information is information about a patient, including a patient ID, patient name, date of birth, age, sex, height, weight, etc. The examination information is information about the examination, including the examination ID, examination instance UID, examination date and time, type of modality (DR, CR, US, CT, MRI, etc.), examination area (chest, abdomen, etc.), requesting department, requesting physician (clinician), technician (photographer), radiologist (primary radiologist, secondary radiologist), examination description, examination comments, and examination purpose. Series information is information about a series, including a series instance UID, a series description, and a series comment. Image information is information related to medical images, including SOP instance UIDs, image comments, etc.

[0026] The RIS 30 manages information within the radiology department, including appointments for examinations and treatments using radiation equipment, examination results, etc. The RIS 30 manages examination orders issued by the electronic medical record server 40 and sends the examination orders to the modality 10 (console 20) to be examined.

[0027] The electronic medical record server 40 manages electronic medical record information, test orders, etc. The electronic medical record information includes information such as medical treatments for patients and diagnosis results. Test orders are information for requesting tests for patients. Test orders include the requesting physician (clinician), radiology interpreter, patient information, test information, etc. The electronic medical record server 40 generates electronic medical record information, test orders, etc. in response to operations from the display terminal 60 by doctors such as clinicians.

[0028] The image management server 50 is, for example, a server (medical image management device) that constitutes a PACS (Picture Archiving and Communication System). The image management server 50 saves and manages image data of medical images, finding information, and the like.

[0029] The display terminal 60 is a terminal device used by a user (medical professional). For example, the display terminal 60 is used as a client (PACS viewer) of the image management server 50. The display terminal 60 reads medical images or finding information from the image management server 50 in response to user operations, and displays the read medical images or finding information. The user interprets the medical images on the display terminal 60 and creates report information (including finding information) for the medical images. The display terminal 60 is also used as a client (electronic medical record terminal) of the electronic medical record server 40.

[0030] [Image management server configuration] FIG. 2 is a block diagram showing the functional configuration of the image management server 50. As shown in FIG. 2, the image management server 50 includes a control unit 51, an operation unit 52, a display unit 53, a communication unit 54, and a storage unit 55. The units constituting the image management server 50 are connected via a bus.

[0031] The control unit 51 includes a CPU (Central Processing Unit), RAM (Random Access Memory), etc. The control unit 51 comprehensively controls the operations of each unit of the image management server 50. Specifically, the CPU reads out various processing programs stored in the storage unit 55 and loads the read programs into the RAM. The CPU performs various processes in cooperation with the programs.

[0032] The operation unit 52 includes a keyboard, a mouse, etc. The operation unit 52 outputs an operation signal to the control unit 51 based on an operation by the user. The display unit 53 is configured by an LCD (Liquid Crystal Display) etc. The display unit 53 displays various screens according to instructions of a display signal input from the control unit 51. The communication unit 54 is configured by a network interface, etc. The communication unit 54 transmits and receives data to and from an external device connected via the communication network N.

[0033] The storage unit 55 is configured with an HDD (Hard Disk Drive), an SSD (Solid State Drive), a non-volatile semiconductor memory, etc. The storage unit 55 stores programs for executing various processes, parameters required for executing the programs, files, etc. The storage unit 55 also stores medical images and finding information. The storage unit 55 stores a user information table 551, an image management table 552, and a finding information management table 553.

[0034] The user information table 551 is a table for managing user information of users (medical professionals) who can access the medical image system 100. The user information table 551 stores, for each user, a user ID, password, user name, department, occupation, email address, etc., in association with each other. The user ID is the user's identification information. The password is a password that the user uses when using the medical image system 100 . The user name is the name of the user. The department is the medical department to which the user belongs. The occupation is the occupation of the user. Examples of occupations include doctor, nurse, technician, etc. Furthermore, doctors may be further classified into occupations such as clinicians and radiologists. The email address is the email address of the user.

[0035] The image management table 552 is a table for managing medical images. The image management table 552 stores patient information, examination information, series information, image information, interpretation status, etc. in association with each medical image. The patient information, examination information, series information, and image information are information acquired from the supplementary information of the medical image. The interpretation status is information indicating the progress of an interpretation workflow (procedures for interpreting medical images). The interpretation status can take values ​​such as uninterpreted, currently being interpreted, and interpreted (primary interpretation completed, secondary interpretation completed).

[0036] The finding information management table 553 is a table for managing finding information. The finding information management table 553 stores, for each piece of finding information, patient information, examination information, finding information, inputter information, priority, reference destination change information, etc., in association with each other. In the finding information management table 553, the finding information is managed in association with the examination information. The patient information and examination information are the patient information and examination information related to the medical image that is the subject of the finding information. The finding information is information about a medical image (medical image identified by examination information) obtained by photographing a patient. The finding information may also include a comprehensive assessment of the patient's condition at the time of the examination. The finding information may be obtained from the supplementary information (header) of the medical image, or may be generated as report information separately from the medical image. The inputter information is information about the inputter who inputs the finding information. The priority is the priority of the finding information. The reference destination change information is information (such as a user ID) indicating the next user who should refer to the finding information when the image interpretation workflow is changed based on the priority of the finding information.

[0037] The control unit 51 acquires medical images transmitted from the console 20 via the communication unit 54 and stores the acquired medical images in the storage unit 55. The control unit 51 also stores the patient information, examination information, series information, and image information, which are incidental information of the acquired medical images, in the image management table 552. Here, the control unit 51 sets the interpretation status of the newly added record in the image management table 552 to "uninterpreted." Thereafter, while the medical image is being interpreted, the control unit 51 changes the interpretation status of the target record in the image management table 552 to "interpretation in progress." When the primary interpretation of the medical image is completed, the control unit 51 changes the interpretation status of the target record in the image management table 552 to "primary interpretation completed." When the secondary interpretation of the medical image is completed, the control unit 51 changes the interpretation status of the target record in the image management table 552 to "secondary interpretation completed."

[0038] The control unit 51 (determination means) determines the priority of the finding information based on at least inputter information related to the inputter who input the patient's finding information. Based on the inputter information of the finding information, the control unit 51 determines whether the finding information should be output with priority. The control unit 51 may acquire the finding information in a form attached to the medical image. For example, the finding information is attached to the medical image as a header of a DICOM image file. The control unit 51 may acquire the finding information as a file separate from the medical image via the communication unit 54. For example, the control unit 51 acquires the finding information manually input in an electronic medical record terminal or a PACS viewer separately from the medical image. Specifically, the control unit 51 acquires the finding information in the format of a structured report such as an SR (Structured Report), a CSV file, or the like.

[0039] The inputter information includes at least one of information indicating the type of inputter, personal identification information that identifies the inputter, and information regarding the means by which the observation information was input. The type of inputter is a type that indicates the affiliation, position, or role of the inputter. Different types of medical professionals (e.g., radiologists, technicians, nurses, clinicians, etc.) are classified as different types. Furthermore, medical professionals and AI (Artificial Intelligence) are classified as different types. For example, image analysis using AI may be performed on medical images within the image management server 50 or an external device, and findings information may be automatically generated. Image analysis includes image diagnosis such as lesion detection using CAD (Computer Aided Diagnosis). In this case, the inputter of findings information is classified as "AI." Furthermore, primary radiologists and secondary radiologists are classified as different types. Furthermore, the type of inputter may be classified according to the department to which the inputter belongs, such as radiology, cardiology, orthopedics, etc. The personal identification information is, for example, the user ID of the person who inputs the information, etc. The control unit 51 may refer to the user information table 551 to acquire various information corresponding to the personal identification information, and use the acquired information as the information of the person who inputs the information.

[0040] "Information about the input means" refers to information about the route by which the finding information was input. Hereinafter, "information about the input means" will be referred to as "input means information." Examples of input means information include attachment to medical images, proxy input based on contact via telephone or fax, input by the user on the input screen of the PACS viewer, and the device from which the finding information was input. The device from which the finding information was input is the modality 10, the console 20, an electronic medical record terminal, etc.

[0041] Priority refers to the degree to which finding information is output with priority. From the perspective of a user referencing the finding information, priority refers to the degree to which finding information should be prioritized for review. High-priority finding information is required to be reviewed earlier than low-priority finding information. Priority may also be referred to as urgency (urgency). For example, the priority of finding information may be classified into two levels: emergency and normal. When the priority is classified into two levels, it may be managed using an emergency ON / OFF flag. The priority of finding information may be classified into three levels: high, medium, and low, or may be classified into more levels. Priority may also be calculated as a continuous number. The degree of detail in the priority classification can be arbitrarily set for each medical facility or system. Note that "high priority" may mean a priority higher than a predetermined standard. Also, "high priority" may mean a relatively high priority compared to finding information with a lower priority. Similarly, "low priority" may mean a priority lower than a predetermined standard, or a relatively low priority compared to finding information with a higher priority.

[0042] The control unit 51 determines the priority of the finding information based on a combination of the inputter information and the finding information. For example, the control unit 51 determines the priority of the finding information based on a combination of the inputter information and the description of the finding information.

[0043] The control unit 51 recognizes the finding information as characters (text) and extracts specific keywords to determine the content of the finding information. Examples of specific keywords include "retake," "type of modality," "portion of imaging," "imaging direction," and "emergency." Keywords extracted from the finding information can be arbitrarily set for each medical facility. Furthermore, if the finding information has flags or items indicating the document type, purpose, or other information type (memo / notification / confirmation, etc.), the control unit 51 acquires information according to the flags or items and determines the content of the finding information.

[0044] The control unit 51 determines the priority of the finding information based on a combination including at least one of referrer information indicating a referrer who refers to the finding information and additional examination candidates in addition to the inputter information and the finding information. The referrer includes, for example, a clinician. The clinician is not limited to a clinician in charge of the patient for whom the finding information pertains or a clinician who has requested the test order for the test for which the finding information pertains. The clinician also includes a clinician other than a clinician in charge of the patient for whom the finding information pertains or a clinician who has not requested the test order for the test for which the finding information pertains. The additional examination candidates are candidates for examinations (imaging) to be performed additionally.

[0045] For example, when referrer information or additional examination candidates are specified in the finding information, the control unit 51 extracts the referrer information or additional examination candidates from the description of the finding information. When the referrer information or the additional examination candidate is included in the supplementary information of the medical image, the control unit 51 acquires the referrer information or the additional examination candidate from the supplementary information of the medical image.

[0046] The control unit 51 determines the priority of the finding information based on a determination condition that is set in advance. The determination condition is stored in the storage unit 55. The determination condition is set, for example, according to the operation of each medical facility.

[0047] The control unit 51 displays the finding information on the display unit 63 (see FIG. 3) of the display terminal 60 based on the priority of the finding information. The control unit 51 displays the finding information based on the priority of the finding information using a method including at least one of changing the reference destination of the finding information, changing the emphasis degree of the finding information, and changing the display order of the finding information. The reference destination of the finding information is the next user who will refer to the finding information.

[0048] The control unit 51 preferentially outputs finding information with a high priority. For example, the control unit 51 displays the finding information in an emphasized manner so that the finding information with a high priority stands out. Furthermore, the control unit 51 orders the finding information in the list in descending order of priority, and displays the finding information with a high priority at the top of the list. Furthermore, the control unit 51 may use the priority of the finding information in the notification itself that notifies the user of the existence of finding information that should be prioritized.

[0049] Here, the sources from which various types of information are obtained will be described. For example, a case will be described in which a technician performs operations related to imaging on the console 20 and inputs the finding information, resulting in the finding information being attached to the medical image. The control unit 51 of the image management server 50 acquires various pieces of information from the attached information in the header of the medical image. The control unit 51 can acquire the "technician" who captured the medical image as the "inputter information" from the name of the performing doctor (0008,1050), the name of the operator (0008,1070), and the like. The control unit 51 can acquire "finding information" from the examination description (0008,1030), series description (0008,103E), image comment (0020,4000), and the like. The control unit 51 obtains the "referring physician information" of the finding information from the name of the referring physician (0008,0090). The name of the referring physician is the name of the attending physician (clinician) who requested the examination. If the name of the referring physician is not in the header of the image file, the control unit 51 inquires of the RIS 30 via the communication unit 54 about the "requesting physician" who requested the corresponding examination, and obtains the "requesting physician" from the RIS 30.

[0050] When the image management server 50 acquires the finding information entered on an electronic medical record terminal or the like, the control unit 51 manages the finding information by linking it to the examination information using information such as the examination instance UID (0020,000D) and examination ID (0020,0010) of the finding information.

[0051] [Display terminal configuration] FIG. 3 is a block diagram showing the functional configuration of the display terminal 60. As shown in FIG. 3, the display terminal 60 includes a control unit 61, an operation unit 62, a display unit 63, a communication unit 64, a storage unit 65, etc. The units constituting the display terminal 60 are connected by a bus.

[0052] The control unit 61 includes a CPU, RAM, etc. The control unit 61 comprehensively controls the operation of each unit of the display terminal 60. Specifically, the CPU reads out various processing programs stored in the storage unit 65 and loads the read programs into the RAM. The CPU performs various processes in cooperation with the programs.

[0053] The operation unit 62 includes a keyboard, a mouse, etc. The operation unit 62 outputs an operation signal based on a user's operation to the control unit 61. The operation unit 62 may have a touch screen that is configured integrally with the display screen of the display unit 63. The display unit 63 is configured by an LCD etc. The display unit 63 displays various screens according to instructions of a display signal input from the control unit 61. The communication unit 64 is configured by a network interface, etc. The communication unit 64 transmits and receives data to and from an external device connected via the communication network N.

[0054] The storage unit 65 is configured by an HDD, an SSD, a semiconductor memory, etc. The storage unit 65 stores programs for executing various processes, parameters required for executing the programs, files, etc.

[0055] [Operation of medical imaging system] Next, the operation of the medical image system 100 of this embodiment will be described. 4 is a flowchart showing the priority determination process executed in the image management server 50. The priority determination process is realized by software processing in cooperation between the CPU of the control unit 51 and a program stored in the storage unit 55.

[0056] First, the control unit 51 acquires finding information for a medical image via the communication unit 54 (step S1). The control unit 51 stores the acquired finding information in the storage unit 55. For example, the control unit 51 acquires the finding information from supplementary information of the medical image. Alternatively, the control unit 51 acquires the finding information separately from the medical image.

[0057] Next, the control unit 51 acquires information about the person who inputs the finding information (step S2). For example, when the finding information is attached to the medical image as additional information, the control unit 51 may acquire information about the person who input the finding information from the additional information of the medical image. When the finding information is acquired separately from the medical image, the control unit 51 acquires the creator of the finding information as the inputter information of the finding information. When the finding information is generated separately from the medical image, the user who input the finding information is recorded in the file of the finding information as the creator (inputter).

[0058] When the finding information is attached to the medical image as incidental information, the control unit 51 associates the finding information acquired from the incidental information of the medical image with the patient information, examination information, and inputter information, and stores the information in the finding information management table 553. The control unit 51 can also acquire the patient information and examination information from the incidental information of the medical image. When the finding information is acquired separately from the medical image, the control unit 51 associates the identification information of the finding information (such as the file name of the report information) with the patient information, examination information, and inputter information, and stores the associated information in the finding information management table 553. Here, for the patient information and examination information, the control unit 51 can acquire information associated with the examination instance UID, examination ID, etc. of the finding information from the image management table 552.

[0059] Next, the control unit 51 acquires preset judgment conditions from the storage unit 55 (step S3). The judgment conditions are set to determine the priority of the finding information based on a combination of items of information from among inputter information, finding information, referrer information, and additional test candidates, etc. The combination of judgment conditions includes at least inputter information.

[0060] Next, the control unit 51 determines the priority of the finding information based on the determination conditions (step S4). The control unit 51 stores the priority in the finding information management table 553 in association with the finding information that is the determination target. For example, the control unit 51 determines the priority of the finding information based only on the inputter information. Alternatively, the control unit 51 determines the priority of the finding information based on a combination of the inputter information and the finding information. Alternatively, the control unit 51 determines the priority of the finding information based on a combination of the inputter information, the finding information, and the referrer information. Alternatively, the control unit 51 determines the priority of the finding information based on a combination of the inputter information, the finding information, and the additional examination candidate. Alternatively, the control unit 51 determines the priority of the finding information based on a combination of inputter information, finding information, referrer information, and additional examination candidates.

[0061] Next, the control unit 51 determines whether to change the reference destination of the finding information based on the priority of the finding information (step S5). For example, when it is necessary to have a clinician urgently check the finding information input by the technician, the control unit 51 determines to change the reference destination of the finding information. When changing the reference destination of the finding information (step S5; YES), the control unit 51 changes the reference destination of the finding information and stores the information of the changed reference destination (changed reference destination information) in the finding information management table 553 in association with the finding information that is the determination target (step S6). After step S6, or in step S5, if the reference destination of the finding information is not changed (step S5; NO), the priority determination process ends.

[0062] 5 is a flowchart showing the medical information presentation process executed in the image management server 50. The medical information presentation process is realized by software processing in cooperation between the CPU of the control unit 51 and a program stored in the storage unit 55.

[0063] First, the control unit 51 receives a request to acquire an examination list from the display terminal 60 via the communication unit 54 (step S11). The request to acquire an examination list includes search conditions input from the operation unit 62 on the display terminal 60.

[0064] Next, the control unit 51 extracts examinations that match the search conditions from the image management table 552 (step S12). The control unit 51 causes the display unit 63 of the display terminal 60 to display a list of the extracted examinations via the communication unit 54 (step S13). Here, the control unit 51 displays the examination list in accordance with the priority of the finding information corresponding to each examination.

[0065] 6 shows an example of an examination list screen 631 displayed on the display unit 63 of the display terminal 60. The examination list screen 631 includes a search condition selection area 71, a search button 72, a clear button 73, and an examination list area 74. The search condition selection area 71 is an area for selecting search conditions. The user selects search conditions in the search condition selection area 71 by operating the operation unit 62 of the display terminal 60. For example, by narrowing down the search condition selection area 71 to the reference user corresponding to the user using the display terminal 60, it is possible to display only a list of tests for which the user himself is the reference user. The search button 72 is a button for issuing an instruction to search for an examination according to the search conditions selected in the search condition selection area 71 . The clear button 73 is a button for issuing an instruction to cancel the search conditions selected in the search condition selection area 71 .

[0066] The examination list area 74 displays a list of examinations (medical images) that match the search criteria. The examination list includes columns such as patient ID, patient name, date of birth, age, gender, examination date, image interpretation status, modality, reference, and priority. One line in the examination list corresponds to one examination. The patient ID column, patient name column, date of birth column, age column, and gender column display the patient's patient ID, name, date of birth, age, and gender, respectively. The examination date column displays the date on which the examination (photography) was performed. The interpretation status column displays the interpretation status of the target examination. The modality column displays the type of modality used in the examination. The reference column displays the user name of the next reference in the interpretation workflow (the destination where the findings will be deployed). Basically, the control unit 51 determines the reference based on the "interpretation status" of the record of the target examination in the image management table 552. Specifically, if the "interpretation status" of the record of the target examination is "uninterpreted," the control unit 51 displays the "user name of the primary interpreter" in the reference column. If the "interpretation status" of the record of the target examination is "primary interpreted," the control unit 51 displays the "user name of the secondary interpreter" in the reference column. If the "interpretation status" of the record of the target examination is "secondary interpreted," the control unit 51 displays the "user name of the clinician" in the reference column. However, the reference is changed according to the priority of the finding information. If there is a changed reference in the "reference change information" of the record of the target examination in the finding information management table 553, the control unit 51 displays the "user name of the changed reference" in the reference column. In the priority column, if there is any finding information for the corresponding examination (image), a colored mark corresponding to the priority (high / medium / low, etc.) of the finding information is displayed. In the examination list, each examination is sorted according to the priority of the finding information. Specifically, each examination is displayed in descending order of priority.

[0067] The control unit 51 may also be able to sort or narrow down the list displayed in the examination list area 74 according to priority. The control unit 51 may not only display the priority in the priority column, but also display the entire row of the list in a color according to the priority. The control unit 51 may also notify the user that there is a "high" priority case by displaying a dialog box or the like only when there is a "high" priority case.

[0068] Next, the control unit 51 determines whether any test has been selected from the test list on the display terminal 60 (step S14). For example, the user selects an test by operating the operation unit 62 on the display terminal 60 to double-click any test on the test list displayed on the display terminal 60. If no test has been selected from the test list (step S14; NO), the process returns to step S14.

[0069] In step S14, when an examination is selected from the examination list (step S14; YES), the control unit 51 causes the display unit 63 of the display terminal 60 to display an interpretation screen of the medical image related to the selected examination (step S15). Here, the control unit 51 changes the degree of emphasis based on the priority of the finding information of the selected examination.

[0070] 7 shows an example of an interpretation screen 632 displayed on the display unit 63 of the display terminal 60. The interpretation screen 632 includes an image area 81, a patient examination information area 82, a findings information area 83, a comment area 84, and the like. The image area 81 displays the medical image corresponding to the selected examination. The patient exam information area 82 displays patient information and exam information corresponding to the selected exam. The finding information area 83 displays the finding information corresponding to the selected examination (medical image). For findings with high priority, the control unit 51 highlights keywords that are the basis for determining the high priority in red, bold, or the like in the finding information area 83. In the finding information area 83, the words "CT imaging permitted" are highlighted. Comments area 84 displays comments corresponding to the selected exam.

[0071] Furthermore, when finding information is linked to the selected examination, the control unit 51 displays a mark 85 indicating the presence of finding information on the image interpretation screen 632. The control unit 51 changes the color of the mark 85 depending on the priority (high / medium / low, etc.) of the finding information.

[0072] After step S15, the control unit 51 determines whether an instruction to end the interpretation has been issued on the display terminal 60 (step S16). For example, the user issues an instruction to end the interpretation by operating the operation unit 62 on the display terminal 60 to press an end button displayed on the display terminal 60. If an instruction to end the interpretation has not been issued (step S16; NO), the process returns to step S14. In step S16, if an instruction to end the interpretation is given (step S16; YES), the medical information presentation process ends.

[0073] [Examples of priority determination] Next, a specific example of determining the priority of the finding information will be described. An example of an interpretation workflow is shown in Figure 8. Medical images taken by a technician at a modality 10 are sent to an image management server 50. In the typical route A, medical images are interpreted by a primary radiologist, then by a secondary radiologist, and then a final diagnosis is made by a clinician. In Route B, medical images are interpreted by a secondary radiologist without going through primary interpretation, and then a final diagnosis is made by a clinician. In Route C, medical images are directly interpreted and diagnosed by a clinician without going through primary and secondary interpretation.

[0074] The image interpretation workflow shown in Figure 8 is just an example, and there may be a single image interpretation physician or multiple clinicians. The image interpretation workflow can be modified as appropriate for each medical facility, each clinical department, and each examination.

[0075] The control unit 51 of the image management server 50 determines whether the interpretation workflow shown in Figure 8 should branch into route A (priority: low), route B (priority: medium), or route C (priority: high) based on the inputter information of the findings information, etc. For example, if the medical image received by the image management server 50 does not have any attached finding information, the control unit 51 selects route A as usual. If there is no finding information, there is also no information about the person who input the finding information. In this case, the control unit 51 requests the primary radiology doctor to interpret the medical image received by the image management server 50.

[0076] When the technician inputs the finding information from the operation unit of the console 20, the finding information is sent from the console 20 to the image management server 50 in a state where it is attached to the medical image. Even if the medical image is accompanied by finding information from a technician, if the content of the finding information is supplementary information to the medical image, such as the shooting conditions, the control unit 51 determines the priority of the finding information to be "low" and selects route A.

[0077] When a medical image is accompanied by finding information from a technician and the content of the finding information is caution information, the control unit 51 determines that the priority of the finding information is "medium" and selects Route B. Caution information is information that describes what the technician wants the viewer to pay attention to, but is not urgent enough to require direct confirmation from a clinician.

[0078] When a technician finds an abnormality in a medical image and proposes re-imaging or additional imaging under different conditions, the technician inputs finding information regarding the re-imaging or additional imaging into the console 20. When the control unit 51 detects permission confirmation for additional examination (re-imaging, additional imaging) from the finding information input by the technician, it determines the priority of the finding information to be "high (urgent)" and selects route C.

[0079] Furthermore, when a referrer is designated for the finding information, the control unit 51 determines that the later the designated destination is in the image interpretation workflow, the higher the priority is. For example, when a technician determines the urgency of a medical image from the medical image, the technician designates an experienced radiologist or clinician, such as a secondary radiologist, as the referee in the findings information. When a technician requests confirmation of a candidate for an additional test, the technician specifies the requesting physician (clinician) who ordered the original test as the referrer in the findings information. Furthermore, if the finding information includes a candidate for an additional examination that uses a different modality 10 (imaging device), the technician may designate an administrator who can determine the availability information of the modality 10 to be used for the additional examination as the viewer in the finding information.

[0080] Next, an example in which the person who inputs the finding information is other than a technician will be described. The finding information entered by the "nurse" is likely to have been entered by a proxy. Therefore, the control unit 51 of the image management server 50 determines the priority of the finding information based on the description of the finding information and the input means information. The finding information input by the nurse on the input screen of the PACS viewer may be notification information received by telephone or fax (information with high immediacy). When the input means information is "input on the input screen of the PACS viewer," the control unit 51 determines the priority (urgency) of the finding information to be "high." Note that the control unit 51 also determines the priority of the finding information to be "high" when the input means information itself includes "via telephone or fax." The finding information entered by the nurse into the electronic medical record terminal is presumed to have been entered by the nurse on behalf of the technician at the time of imaging. When the input means information is "input into the electronic medical record terminal," the control unit 51 analyzes the contents of the finding information and determines the priority of the finding information depending on whether it is simply an annotation, an additional test, etc.

[0081] When a "nurse" inputs the findings information of a technician, the input may be given a lower priority than findings information entered by a "technologist" because the technician has not entered it. On the other hand, if the technician is simply busy and the nurse inputs the findings information from an electronic medical record terminal, etc., this may not affect the priority.

[0082] The priority of the finding information input by the "primary radiologist" depends on the content of the finding information. If the finding information includes a request for re-imaging, such as when an image was not captured correctly, the control unit 51 determines the priority of the finding information to be "high" and changes the reference destination of the finding information to the "clinician." Consider the following scenario: A mammography examination is performed on a patient suspected of having breast cancer at a medical facility, and medical images are obtained. A primary radiologist interprets the medical images displayed on the display unit 63 (PACS viewer) of the display terminal 60. As a result, a disease is detected in the medical images, and the primary radiologist determines that an additional MRI scan is necessary. The primary radiologist inputs findings for the additional MRI scan using the operation unit 62 of the display terminal 60. In this case, the control unit 51 of the image management server 50 determines the priority of the findings based on a combination of the inputter information (primary radiologist) and the findings. Following a conventional radiology workflow, if a secondary radiologist were to check the interpretation results, it would take time. Therefore, the control unit 51 changes the reference destination for this examination to "clinician" so that the additional examination can be directly recommended to a clinician without being sent for secondary interpretation.

[0083] The finding information input by "AI" is treated the same as the finding information input by a normal radiology doctor. The control unit 51 determines that the finding information input by "AI" is not urgent and determines the priority of the finding information to be "low."

[0084] There are cases where AI automatically generates finding information for medical images captured by the modality 10 before the image is interpreted by a radiologist. The technician's judgment is made closer to the patient (at an earlier stage) than the image analysis by AI. Therefore, it can be thought of as having a higher priority for finding information input by a "technologist" than for finding information input by an "AI." For example, the control unit 51 may select Route A when no finding information is attached to the medical image, select Route B when the finding information is input by an "AI," and select Route C when the finding information is input by a "technologist" (see FIG. 8).

[0085] An example of finding information where the inputter is a "clinician" will be described. For example, suppose that a valid case is found in the content that the clinician is considering presenting at an academic conference. The clinician inputs a specific keyword into the finding information of the test report information. The control unit 51 determines the priority of the finding information based on a combination of the inputter information (clinician) and the finding information. The control unit 51 extracts a specific keyword from the finding information input by the clinician and determines the priority of the finding information to be "high." As a result, the control unit 51 adds a new step to the examination workflow, which is usually completed by the clinician, to inquire with the head of the radiology department, etc., whether it is okay to use this examination for the academic conference presentation. This allows the clinician to shorten the time it takes to subsequently confirm permission for the patient to use the case.

[0086] [Display after additional testing] The control unit 51 of the image management server 50 displays different items and whether or not to display the finding information that is the target of priority output when outputting the finding information preferentially (during emergency notification) and during normal image interpretation.

[0087] For example, when the technician who performed the first examination (imaging) submits finding information for confirmation of an additional examination, the control unit 51 first requests confirmation of the finding information from a clinician as a top priority along route C (see FIG. 8). As a result of the clinician agreeing to the implementation of the additional examination, a second examination (additional imaging) is added and the imaging is performed. Thereafter, the image interpretation workflow for the first and second examinations follows the normal route A (see FIG. 8). At this point, the addition of the examination has been completed, and therefore, the technician's finding information (proposal for additional examinations) is unnecessary during normal image interpretation. Therefore, the control unit 51 hides the technician's finding information in route A. Note that the technician's finding information cannot be used as an image interpretation finding, and a doctor's (image interpretation physician, clinician, etc.) judgment is required.

[0088] The control unit 51 uses inputter information associated with the finding information when displaying the finding information on the display unit 63 of the display terminal 60. When the clinician checks the finding information, the control unit 51 also displays the finding information whose inputter information is "technologist" on the display unit 63 of the display terminal 60. In the case of an emergency notification, the clinician receives the finding information from the technician, so the technician's finding information is displayed on the image interpretation screen. Note that the control unit 51 may display the finding information whose inputter information is "technologist" on the display unit 63 of the display terminal 60 only when the finding information for the first examination is output preferentially. When the radiologist interprets the first and second examinations, the control unit 51 does not display the finding information for which the inputter information is "technologist" on the display unit 63 of the display terminal 60. During normal interpretation by the radiologist, the technologist's finding information is not displayed on the interpretation screen. Note that the control unit 51 may display the technologist's finding information solely as reference information, but in that case, measures are required to prevent the radiologist from being influenced by the technologist's finding information.

[0089] As described above, according to this embodiment, the control unit 51 of the image management server 50 determines the priority of the finding information based on at least the inputter information about the inputter who input the patient's finding information. Therefore, medical professionals using the medical image system 100 do not have to determine the priority of the finding information themselves. Therefore, the control unit 51 can reduce the burden on medical professionals who check the finding information.

[0090] For example, the control unit 51 can determine the priority of the finding information based on information indicating the type of person entering the information, personal identification information that identifies the person entering the information, information on the input means of the finding information, and the like.

[0091] Furthermore, the control unit 51 can determine the priority of the finding information based on the content of the finding information in addition to the inputter information. For example, if the finding information includes content that requires an urgent decision, the control unit 51 determines that the finding information has a high priority.

[0092] Furthermore, the control unit 51 can determine the priority of the finding information based on the inputter information and the finding information, as well as the referrer information of the finding information or additional examination candidates. For example, the control unit 51 determines that the later the referrer indicated by the referrer information is in the image interpretation workflow, the higher the priority. Furthermore, the control unit 51 determines that the priority is high when the finding information includes a description of an additional examination candidate.

[0093] Furthermore, the control unit 51 displays the finding information on the display terminal 60 based on the priority of the finding information. For example, by changing the reference destination of the finding information, the control unit 51 can shorten the time it takes for a person to whom an emergency notification is to be made to check the finding information, thereby efficiently progressing the process of referring to the finding information. By changing the emphasis level of the finding information, the control unit 51 can highlight finding information with a high priority and prevent the user (healthcare worker) from overlooking it. By changing the display order of the finding information, the control unit 51 can highlight finding information with a high priority and prevent the user from overlooking it.

[0094] The above-described embodiments are merely examples of the program, medical information processing device, medical information processing system, and medical information processing method according to the present invention, and are not intended to limit the scope of the present invention. The detailed configurations and operations of the devices constituting the system may also be modified as appropriate without departing from the spirit of the present invention.

[0095] In the above embodiment, the image management server 50 (medical image management device) has been described as an example of the medical information processing device according to the present invention, but the medical information processing device according to the present invention may also be an electronic medical record device.

[0096] In the above embodiment, the processing executed by the image management server 50 may be executed by another device within the medical image system 100. Also, in the above embodiment, the processing executed by the image management server 50 may be performed by multiple devices within the medical image system 100 in cooperation with each other.

[0097] In the above embodiment, the display terminal 60 serves as both a PACS viewer and an electronic medical record terminal. Alternatively, the display terminal 60 may be a display terminal dedicated to finding information.

[0098] Furthermore, when a technician is the person who inputs the finding information, information about the person who inputted the information (photographer) may be assigned to tags such as examination description, examination comment, series comment, and image comment in the header of the DICOM image file. Furthermore, the control unit 51 of the image management server 50 may uniformly determine that the priority of all the finding information input by the technician is "high."

[0099] In the above embodiment, the control unit 51 of the image management server 50 determines the priority of the finding information, but it may also determine the priority of report information that includes multiple pieces of finding information. For example, when the report information includes "Finding 1" and "Finding 2," if either one of the findings has a "high" priority, the control unit 51 determines the priority of the report information to be "high." The control unit 51 then changes the display order of the examinations on the examination list screen or adds a mark according to the priority so that the examinations of the report information determined to have a "high" priority are output preferentially.

[0100] Furthermore, the priority of the finding information according to the occupation of the person entering the information may differ depending on the medical facility or the operation of the facility, and therefore the criteria for determining the priority can be set arbitrarily for each medical facility.

[0101] Additionally, medical facilities may have a rule in place that requires users to log in with an emergency user ID when entering information about findings that they wish to communicate directly to a clinician. In this case, each user will switch to the emergency user ID and enter the information about findings when they determine that the situation is urgent.

[0102] Furthermore, since inexperienced radiologists may be influenced by automated findings generated by AI, it may be possible to allow inexperienced radiologists to refer to automated findings generated by AI only after they have input their own findings.

[0103] In the above embodiment, the priority determination has been described mainly with respect to the finding information of medical images. However, instead of or in addition to this, the medical information processing device according to the present invention may also determine the priority and / or urgency of the finding information of a patient's electrocardiogram (notification from an electrocardiographer) or the finding information of a patient's biopsy (notification from a clinical laboratory technician).

[0104] The computer-readable medium for storing the program for executing each process is not limited to the above examples. A carrier wave may also be used as a medium for providing program data via a communication line.

[0105] Although the embodiments of the present invention have been described and illustrated in detail above, the disclosed embodiments are for purposes of illustration and example only, and not for purposes of limitation. The scope of the present invention should be interpreted by the terms of the appended claims. [Explanation of symbols]

[0106] 10 Modalities 20 Console 30 RIS 40 Electronic Medical Record Server 50 Image Management Server 51 Control section 54 Communications Department 55 Storage section 60 Display Terminals 61 Control Unit 62 Operation section 63 Display section 64 Communications Department 65 Storage section 100 Medical Imaging Systems 551 User Information Table 552 Image Management Table 553 Findings Information Management Table 631 Examination list screen 632 Reading screen N Communication Network

Claims

1. For medical information processing equipment, A program for executing a determination step of determining the priority of the patient's finding information based on at least inputter information relating to the inputter who inputted the patient's finding information.

2. 2. The program according to claim 1, wherein the determining step determines the priority of the finding information based on a combination of the inputter information and the finding information.

3. 2. The program according to claim 1, wherein the inputter information includes at least one of information indicating the type of the inputter, personal identification information identifying the inputter, and information regarding the means by which the observation information was input.

4. 2. The program according to claim 1, wherein the determining step determines the priority of the finding information based on a combination including, in addition to the inputter information and the finding information, at least one of referrer information indicating a referrer who refers to the finding information and an additional test candidate.

5. The medical information processing device includes: further executing a display control step of displaying the finding information on a display unit based on the priority of the finding information; 2. The program according to claim 1, wherein the display control step displays the finding information based on the priority of the finding information using a method including at least one of changing a reference destination of the finding information, changing a degree of emphasis of the finding information, and changing a display order of the finding information.

6. The program according to claim 1 , wherein the finding information is a finding obtained from one or more of a medical image, an electrocardiogram, and a biopsy.

7. A medical information processing apparatus comprising: a determining means for determining the priority of patient finding information based on at least inputter information relating to an inputter who inputs the patient finding information.

8. A medical information processing system comprising a determining means for determining the priority of patient finding information based on at least inputter information relating to an inputter who inputs the patient finding information.

9. A medical information processing method comprising a determining step of determining the priority of patient finding information based on at least inputter information relating to a person who inputs the patient finding information.

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