Ordering cooperation system, ordering system, and ordering program

Abstract

To provide an ordering cooperation system, an ordering system and an ordering program for further improving safety in an MRI examination.SOLUTION: An order reception unit configured to receive an MRI examination order for a patient from a doctor terminal, a detection request unit configured to request a medical device detection server to detect a medical device implanted in a body of the patient, and an order transmission unit configured to transmit the MRI examination order to a laboratory technician terminal in a case where a result of the detection indicates that the medical device is not detected, the medical device detection server includes a detection request reception unit that receives a detection request from the ordering system, an image acquisition unit that acquires X-ray image data of a patient, a detection unit that detects a medical device implanted in a body of the patient from the X-ray image data of the patient, and a detection result transmission unit that transmits a result of the detection to the ordering system.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] The present invention relates to an ordering collaboration system, an ordering system, and an ordering program. [Background technology]

[0002] In recent years, in-hospital ordering systems for transmitting doctor's instructions to each department have become widespread. When a doctor inputs a test order (instructions) on a PC, the order information is electronically sent to the relevant department, which then receives it on its PC and carries out the test based on the doctor's order information.

[0003] From a safety perspective, it is important to check for the presence of implanted cardiac devices such as pacemakers when conducting MRI (Magnetic Resonance Imaging) examinations. Because MRI is a medical device that utilizes magnetic principles, there is a risk of pacemakers malfunctioning, and patients with implanted pacemakers cannot undergo MRI examinations.

[0004] For this reason, before ordering an MRI scan, doctors will, for example, interview the patient, check their medical history from the electronic medical record, and even use chest X-ray images to evaluate whether a pacemaker or other device is visible. Doctors should thoroughly confirm that the patient does not have a pacemaker or other device implanted, and only after ensuring the safety of the MRI scan can they order the MRI scan.

[0005] For example, Patent Document 1 describes a foreign body detection support device that more effectively prevents foreign bodies from being left inside a patient's body. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Patent Publication No. 2021-186252 Summary of the Invention [Problem to be solved by the invention]

[0007] However, due to the increasing miniaturization of pacemakers and other devices, it is difficult to completely eliminate the risk of missing a patient's implanted pacemaker or other device through checks by human doctors alone, and ensuring safety in MRI examinations is a challenge.

[0008] In recent years, MRI-compatible pacemakers have appeared. These pacemakers have been improved with the use of materials that are less susceptible to magnetic fields, making it possible for patients with these types of pacemakers to undergo MRI scans. However, there are some conditions and precautions to take when undergoing the scan. Therefore, if a patient has this type of pacemaker implanted, doctors must thoroughly check these conditions and precautions and ensure the safety of MRI imaging before ordering an MRI scan.

[0009] The present invention has been proposed in view of the above points, and one object of the present invention is to further improve safety in MRI examinations. [Means for solving the problem]

[0010] In order to solve the above problems, the ordering collaboration system of the present disclosure is an ordering collaboration system in which an ordering system, a medical device detection server, a doctor's terminal, and a technician's terminal are connected via a network, and the ordering system has an order receiving means for receiving an MRI examination order for a patient from the doctor's terminal, a detection request means for requesting the medical device detection server to detect a medical device implanted in the patient's body, and an order sending means for sending the MRI examination order to the technician's terminal if the detection result indicates that the medical device cannot be detected, and the medical device detection server has a detection request receiving means for receiving the detection request from the ordering system, an image acquisition means for acquiring X-ray image data of the patient, a detection means for detecting a medical device implanted in the patient's body from the X-ray image data of the patient, and a detection result sending means for sending the detection results to the ordering system. [Effects of the Invention]

[0011] According to the embodiments of the present disclosure, it is possible to further improve safety in MRI examinations. [Brief explanation of the drawings]

[0012] [Figure 1] 1 is a diagram illustrating an example of the configuration of an ordering collaboration system according to an embodiment of the present invention. [Figure 2] FIG. 2 is a diagram illustrating an example of the hardware configuration of a medical device detection server according to the present embodiment. [Figure 3] FIG. 2 is a diagram illustrating an example of the software configuration of a medical device detection server according to the present embodiment. [Figure 4] FIG. 2 is a sequence diagram of the ordering collaboration system according to the present embodiment. [Figure 5] FIG. 10 is a diagram showing an example 1 of an MRI examination order screen according to the present embodiment. [Figure 6] FIG. 10 is a diagram showing an example 2 of an MRI examination order screen according to the present embodiment. [Figure 7]FIG. 10 is a diagram showing an example 3 of an MRI examination order screen according to the present embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0013] Hereinafter, this embodiment will be described with reference to the drawings. <System configuration> Fig. 1 is a diagram showing an example of the configuration of an ordering collaboration system according to this embodiment. The hospital ordering collaboration system 100 shown in Fig. 1 includes an image management system 10, an ordering system 20, a medical device detection server 30, a doctor terminal 40, a technician terminal 50, and an MRI apparatus 60, and is connected via a network 70.

[0014] The image management system 10 is a system for storing, viewing, and managing patient image data (DICOM image data) taken by imaging devices such as general radiography, CT, MRI, ultrasound, and endoscopy. It is also called a PACS (Picture Archiving and Communication System).

[0015] The ordering system 20 is a hospital information system (HIS) that electronically transmits test instructions, prescription instructions, etc. from doctors who examine patients, etc. After the ordering system is installed, an electronic medical record system that manages patient information in a centralized manner is often introduced, but the ordering system itself may also be installed as part of the electronic medical record system's functions.

[0016] The medical device detection server 30 is a server apparatus that detects medical devices (particularly implantable cardiac devices such as pacemakers) implanted in the patient's body by performing image analysis processing on the patient's X-ray image data (particularly chest X-ray image data). The patient's chest X-ray image data is captured in advance by a chest X-ray imaging device (not shown) and stored in the image management system 10.

[0017] The doctor terminal 40 mainly includes, for example, a PC, a smartphone, or a tablet terminal, and is a client terminal of a doctor who uses the image management system 10 and the ordering system 20. A doctor uses the doctor terminal 40 to access and log in to the image management system 10 or the ordering system 20, view (interpret) patient image data on a high-definition monitor, and issue orders for examinations, prescriptions, etc. to each department.

[0018] The technician terminal 50 is a client terminal for technicians who perform various examinations, including MRI examinations, and mainly includes, for example, a PC, a smartphone, or a tablet terminal. The technician receives examination instructions from a doctor using the technician terminal 50 and performs the examination based on the order information from the doctor. In particular, in this embodiment, when a technician in the radiology department receives an MRI examination instruction from a doctor using the technician terminal 50, the technician performs the MRI examination using the MRI device 60 in accordance with the MRI examination order information from the doctor.

[0019] (Hardware configuration) 2 is a diagram showing an example of the hardware configuration of a medical device detection server according to this embodiment. As shown in FIG. 2, the medical device detection server 30 includes a central processing unit (CPU) 31, a read-only memory (ROM) 32, a random access memory (RAM) 33, a hard disk drive (HDD) 34, a communication device 35, and a display device 36.

[0020] The CPU 31 executes various programs and performs arithmetic processing. The ROM 32 stores programs required at startup, etc. The RAM 33 is a work area for temporarily storing processing by the CPU 31 and storing data. The HDD 34 stores various data and programs. The communication device 35 communicates with other devices including the ordering system 20. The display device 36 is a display.

[0021] (Software configuration) FIG. 3 is a diagram showing an example of the software configuration of the ordering system 20 and the medical device detection server 30 according to this embodiment.

[0022] The ordering system 20 has an order receiving unit 201, a detection request unit 202, a detection result receiving unit 203, a detection result transmitting unit 204, a notification receiving unit 205, and an order transmitting unit 206 as main functional units.

[0023] The order receiving unit 201 has a function to receive an MRI examination order for a patient from the doctor terminal 40. The detection requesting unit 202 has a function to request the medical device detection server 30 to detect a medical device implanted in the patient's body. The detection result receiving unit 203 has a function to receive the detection result from the medical device detection server 30. The detection result sending unit 204 has a function to send the detection result to the doctor terminal 40. The notification receiving unit 205 has a function to receive a doctor's confirmation notification of the detection result from the doctor terminal 40. The order sending unit 206 has a function to send an MRI examination order to the technician terminal when the detection result indicates that no medical device is detected.

[0024] The medical device detection server 30 has a detection request receiving unit 301, an image acquiring unit 302, a detecting unit 303, and a detection result transmitting unit 304 as main functional units.

[0025] The detection request receiving unit 301 has a function of receiving a request for detecting a medical device from the ordering system 20. The image acquiring unit 302 has a function of acquiring X-ray image data of a patient. The detecting unit 303 has a function of detecting a medical device implanted in the patient's body from the X-ray image data of the patient. The detection result transmitting unit 304 has a function of transmitting the detection result to the ordering system 20.

[0026] Each functional unit is realized by a program executed on hardware resources such as a CPU, ROM, and RAM of the computer that constitutes the ordering system 20 and the medical device detection server 30. These functional units may be referred to as "means," "module," "unit," or "circuit." The storage unit may also be located in an external storage device on the network 70. The computer program and application program may be stored in a computer-readable storage medium.

[0027] <System flow> 4 is a sequence diagram of the ordering collaboration system according to this embodiment. Each step (hereinafter referred to as "S") can be realized by having the CPU of each device load and execute a program that can realize this sequence. The following shows the system flow when a doctor orders an MRI examination for a patient from a technician via the ordering system 20.

[0028] S1: The doctor terminal 40 accesses and logs into the ordering system 20 and requests an order creation screen for creating an order for an MRI examination.

[0029] S2: When the ordering system 20 receives an order creation screen request for an MRI examination from the doctor terminal 40, it sends the order creation screen to the doctor terminal 40 and displays it on the screen. The doctor inputs and selects examination information such as the patient ID, patient name, and examination name on the order creation screen.

[0030] S3: When the ordering system 20 receives an order for an MRI examination via the order creation screen of the doctor terminal 40 (when an order for an MRI examination is generated), it sends a medical device detection request (a request to determine the presence or absence of a medical device) to the medical device detection server 30. The medical device detection request includes a patient identifier (e.g., patient ID, etc.) of the patient who will be the subject of the MRI examination. Note that the medical device implanted in the body particularly refers to an implantable cardiac device such as a pacemaker.

[0031] S4: When the medical device detection server 30 receives a medical device detection request from the ordering system 20, it transmits a request to acquire chest X-ray image data of the patient (patient ID) to the image management system 10. The acquisition request also includes a capture date and time condition (e.g., within the past week) for the chest X-ray image data to be acquired.

[0032] S5: If the patient's chest X-ray image data has been captured (imaged) in advance by a chest X-ray imaging device and stored in the image management system 10, the image management system 10 searches for it and responds / transmits the chest X-ray image data of the patient (patient ID) in response to an acquisition request from the medical device detection server 30. Note that if the patient's chest X-ray image data does not exist or if the chest X-ray image data is old and no chest X-ray image data captured within the most recent imaging date and time (for example, within the last week) exists, the image management system 10 responds to that effect (no image data) to the medical device detection server 30.

[0033] S6: The medical device detection server 30 receives the chest X-ray image data of the patient from the image management system 10 and performs image analysis processing to detect (determine the presence or absence of) a medical device inside the patient's body. The detection result (determination result) is "present" if a medical device is detected in the chest X-ray image of the patient, "absent" if no medical device is detected, and "not possible" if chest X-ray image data of the patient does not exist and a medical device cannot be detected.

[0034] Here, the medical device detection server 30 has a model that has been trained in advance on a large number of sets of chest X-ray image data of patients who have implanted medical devices in their bodies and their correct answers (present), and sets of chest X-ray image data of patients who do not have implanted medical devices in their bodies and their correct answers (absent), and can detect (determine) medical devices inside the patient's body depending on, for example, the degree of pattern matching between the input chest X-ray image data of the patient and the model image.

[0035] S7: The medical device detection server 30 responds to and transmits the detection result of S6 to the ordering system 20 in response to the detection request for the medical device in S3.

[0036] S8: The ordering system 20 transmits the detection result to the doctor terminal 40 and displays it on the MRI examination order creation screen.

[0037] S9: The doctor terminal 40 transmits an MRI examination order (MRI examination instruction) to the ordering system 20. As will be described later, on the MRI examination order creation screen, the detection result indicating the presence or absence of a medical device in the patient's body is displayed. The doctor terminal 40 can transmit an MRI examination order to the ordering system 20 on the condition that the doctor has confirmed the detection result as a principle.

[0038] S10: When the ordering system 20 receives an MRI examination order from the doctor terminal 40, it determines whether the MRI examination order includes a confirmation notice (confirmed flag) from the doctor for the detection result displayed on the MRI examination order creation screen.

[0039] S11: When the ordering system 20 determines that it includes a confirmation notice (confirmed flag) from the doctor, it transmits the MRI examination order to the technician terminal 50.

[0040] S12: When the technician terminal 50 receives an MRI examination order (MRI examination instruction), it displays the MRI examination order information from the doctor on the screen. The technician checks the confirmation notice from the doctor and further accesses the image management system 10 to check the chest X-ray image of the patient (patient ID) to fully confirm that no medical device is implanted in the patient's body, and then performs an MRI examination using the MRI device 60 according to the MRI examination order information from the doctor.

[0041] <Example of MRI examination order screen> Fig. 5 is a diagram showing an example 1 of an MRI examination order screen according to this embodiment. When a doctor accesses and logs in to the ordering system 20 and places an order for an MRI examination, he or she selects "radiography" in the examination selection on screen (a) shown in Fig. 5, "MRI" in the image diagnostic device selection on screen (b), and any part in the imaging part selection on screen (c).

[0042] As described above, when an order for an MRI examination is placed, the ordering system 20 transmits a medical device detection request to the medical device detection server 30 (S3).

[0043] 6 is a diagram showing an example 2 of an MRI examination order screen according to this embodiment. The ordering system 20 displays, for example, screens (d), (e), and (f) shown in FIG. 6 on the order creation screen for the MRI examination on the doctor terminal 40 according to the detection results (S8).

[0044] Screen (d) shows the detection result as "Yes." In this case, because a medical device was detected in the chest X-ray image of the patient, a detection result display (alert display) 601 is displayed, stating, for example, "A cardiac implant device has been detected. Please have the doctor check." Furthermore, when "Details" 602 is selected, a chest X-ray image 605 of the patient is displayed so that it can be viewed, with a guide display of, for example, an area 606 containing the medical device in the chest X-ray image. If a medical device is detected in the patient, the doctor can make an appropriate decision and take appropriate action, such as canceling the order for the MRI examination. Furthermore, if the detection result is "Yes," "Next" 604 is disabled, and the doctor cannot proceed to submit the MRI examination order.

[0045] Screen (e) shows the detection result "Not possible." If there are no chest X-ray images of the patient, a detection result display (alert display) 601 is displayed, stating, for example, "There are no chest X-ray images (not taken). Please take a chest X-ray image." In this case, the doctor operates "Back" 605 to return to Figure 5(b) and order a chest X-ray image taken using a chest X-ray imaging device (general imaging). Furthermore, if the detection result is "Not possible," the operation of "Next" 604 is invalid, and the doctor cannot proceed to submit an MRI examination order.

[0046] Screen (f) shows the detection result as "none." In this case, because no medical device was detected in the chest X-ray image of the patient, a detection result display 601 is displayed, for example, stating "No cardiac implant device was detected." Furthermore, when "Details" 602 is selected, a chest X-ray image 605 of the patient in which no medical device was detected is displayed for viewing. When the doctor checks the doctor confirmation field 603, for example, "Yes, the doctor has confirmed," the operation of "Next" 604 becomes valid. If no medical device was detected in the patient, the doctor can proceed to order an MRI examination under the doctor confirmation conditions.

[0047] As described above, in the ordering system 20 according to this embodiment, if a chest X-ray image indicates that the patient has an implantable cardiac device or that no chest X-ray image has been taken, the doctor cannot proceed with ordering an MRI examination and takes appropriate action, such as canceling the MRI examination order. On the other hand, if it is determined that the patient does not have an implantable cardiac device, the doctor can proceed with ordering the MRI examination, provided that the doctor confirms that the patient does not have an implantable cardiac device. When a radiology technician receives an order for an MRI examination, the radiology technician performs the MRI examination after confirming with the doctor that the patient does not have an implantable cardiac device.

[0048] Due to the miniaturization of pacemakers and other devices in recent years, it is difficult to completely eliminate the risk of missing the implantation of a pacemaker or other device in a patient through checks by human doctors alone. However, according to this embodiment, the ordering system 20 is configured so that an order for an MRI examination can be sent only after confirming that there are no cardiac implanted devices in the chest X-ray image, thereby reducing the risk of missing an implantable medical device during an MRI examination.

[0049] (Variation) In the above-mentioned S6, the medical device detection server 30 can also detect (determine) the presence or absence of an "MRI compatible" medical device in the patient's body by receiving chest X-ray image data of the patient and performing image analysis processing.

[0050] The medical device detection server 30 has a model that has been trained in advance with a large number of sets of chest X-ray image data of patients who have MRI-compatible medical devices implanted in their bodies and their correct answers (MRI-compatible / present), and sets of chest X-ray image data of patients who have MRI-non-compatible medical devices implanted in their bodies and their correct answers (MRI-non-compatible / present), and can detect the presence or absence of MRI-compatible / MRI-non-compatible medical devices in the patient's body depending on, for example, the degree of pattern matching between the input chest X-ray image data of the patient and the model image.

[0051] Alternatively, a medical device may be provided with a predetermined mark that appears on a predetermined X-ray image as a standard for indicating that it is an MRI-compatible medical device. The medical device detection server 30 can receive chest X-ray image data of a patient and perform image analysis processing to detect the mark captured in the chest X-ray image and detect the presence or absence of an MRI-compatible medical device inside the patient's body.

[0052] In any case, if an MRI-compatible medical device and an MRI-non-compatible medical device show differences (characteristics) that allow the two medical devices to be detected from a chest X-ray image, the medical device detection server 30 can detect the presence or absence of an MRI-compatible medical device inside the patient's body.

[0053] FIG. 7 shows an example 3 of an MRI examination order screen according to this embodiment. Screen (g) shows the detection result "MRI-compatible medical device / present." When an MRI-compatible medical device is detected in a patient's chest X-ray image, a detection result display (alert display) 601 may be displayed, e.g., "An MRI-compatible cardiac implant device has been detected. Physician, please confirm the conditions and precautions for MRI imaging." Furthermore, when "Details" 602 is selected, a chest X-ray image of the patient is displayed, for example, with a guided display of the area containing the MRI-compatible medical device. After thoroughly checking the conditions and precautions for MRI imaging, the physician can check, for example, "Yes, the physician has confirmed" in the physician confirmation field 603, which activates "Next" 604. Therefore, if the detection result is "MRI-compatible medical device / present," the physician can proceed to order the MRI examination under the conditions confirmed by the physician.

[0054] <Summary> Due to the miniaturization of pacemakers and other devices in recent years, it is difficult to completely eliminate the risk of missing the implantation of a pacemaker or other device in a patient through checks by human doctors alone. However, the ordering linkage system 100 of this embodiment is configured so that an order for an MRI examination can finally be sent on the condition that no cardiac implanted devices are detected in chest X-ray images on the ordering system 20 and that the doctor has confirmed this, thereby making it possible to further improve the safety of MRI examinations.

[0055] While the present invention has been described above by showing particular examples according to preferred embodiments of the present invention, it will be apparent that various modifications and changes can be made to these examples without departing from the broader spirit and scope of the present invention as defined in the appended claims. In other words, the details of the examples and the accompanying drawings should not be construed as limiting the present invention.

[0056] In addition, the present invention can also be realized by supplying a program that realizes one or more functions of the above-mentioned embodiments to a system or device via a network or recording medium, and having one or more processors in the computer of that system or device read and run the program.

[0057] It also mentions the following: The medical device detection server 30 according to this embodiment or its functions (particularly S6 in FIG. 4) may be implemented, for example, as part of the image management system 10, the ordering system 20, or the electronic medical record system.

[0058] The medical device implanted (implanted) in the body is, for example, an implantable cardiac device, but is not limited to cardiac devices detected by the present invention. In other words, it includes medical devices implanted (implanted) in areas other than the heart. Therefore, the X-ray image data is not limited to X-ray image data of the chest, but may be X-ray images of other areas that show medical devices implanted in areas other than the heart.

[0059] Implantable cardiac devices include pacemakers, leadless pacemakers, biventricular pacemakers, implantable cardioverter defibrillators, and implantable cardioverter defibrillators with biventricular pacing function. [Explanation of symbols]

[0060] 10 Image Management System 20 Ordering System 30 Medical Device Discovery Server 40 Doctor's terminal 50 Technician terminal 60 MRI machine 70 Network 100 Ordering Collaboration System 201 Order Receiving Department 202 Detection request part 203 Detection result receiving unit 204 Detection result transmission unit 205 Notification Receiving Unit 206 Order Transmission Department 301 Detection request receiver 302 Detection request receiver 303 Detection unit 304 Detection result transmission unit

Claims

1. An ordering collaboration system in which an ordering system, a medical device detection server, a doctor terminal, and a medical technician terminal are connected via a network, The ordering system is an order receiving means for receiving an MRI examination order for a patient from a doctor's terminal; a detection request means for requesting a medical device detection server to detect a medical device implanted in the patient's body; an order sending means for sending the MRI examination order to a medical technician terminal when the detection result indicates that the medical device is not detected; and The medical device discovery server: a detection request receiving means for receiving a detection request from an ordering system; image acquisition means for acquiring X-ray image data of the patient; a detection means for detecting a medical device implanted in the patient's body from the X-ray image data of the patient; a detection result transmitting means for transmitting the detection result to an ordering system; An ordering collaboration system comprising:

2. the order sending means does not send the MRI examination order to the technician terminal when the detection result indicates that the medical device has been detected; The ordering linkage system according to claim 1 ,

3. The ordering system is a detection result transmitting means for transmitting the detection result to a doctor terminal; a notification receiving means for receiving, from the doctor's terminal, a notification that the doctor has confirmed the detection result when the detection result indicates that the medical device is not detected; and the order sending means sends the MRI examination order to a medical technician terminal when receiving the confirmation notification; 2. The ordering collaboration system according to claim 1,

4. The ordering system is a detection result transmitting means for transmitting the detection result to a doctor terminal; a notification receiving means for receiving, from the doctor's terminal, a notification that the doctor has confirmed the detection result when the detection result indicates that the MRI-compatible medical device has been detected; and the order sending means sends the MRI examination order to a medical technician terminal when receiving the confirmation notification; 2. The ordering collaboration system according to claim 1,

5. An ordering system connected to a doctor terminal and a technician terminal via a network, an order receiving means for receiving an MRI examination order for a patient from a doctor's terminal; image acquisition means for acquiring X-ray image data of the patient; a detection means for detecting a medical device implanted in the patient's body from the X-ray image data of the patient; an order sending means for sending the MRI examination order to a medical technician terminal when the detection result indicates that the medical device is not detected; An ordering system comprising:

6. the order sending means does not send the MRI examination order to the technician terminal when the detection result indicates that the medical device has been detected; 6. The ordering system according to claim 5,

7. a detection result transmitting means for transmitting the detection result to a doctor terminal; a notification receiving means for receiving, from the doctor's terminal, a notification that the doctor has confirmed the detection result when the detection result indicates that the medical device is not detected; and the order sending means sends the MRI examination order to a medical technician terminal when receiving the confirmation notification; 6. The ordering system according to claim 5,

8. a detection result transmitting means for transmitting the detection result to a doctor terminal; a notification receiving means for receiving, from the doctor's terminal, a notification that the doctor has confirmed the detection result when the detection result indicates that the MRI-compatible medical device has been detected; and the order sending means sends the MRI examination order to a medical technician terminal when receiving the confirmation notification; 6. The ordering system according to claim 5,

9. An ordering program for causing a computer to function as the ordering system according to any one of claims 5 to 8.

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