PICS information sharing system

Abstract

To provide an information sharing system capable of tracking PICS information over a long period.SOLUTION: A PICS information sharing system according to the present invention includes a management server that manages PICS information, an ICU terminal, a general ward terminal, and an outpatient terminal, wherein the ICU terminal, the general ward terminal, and the outpatient terminal are connected to the management server via a network and view and update PICS information of a patient, the ICU terminal inputs function evaluation information when the patient leaves the ICU, and the management server registers the input function evaluation information as PICS information. A general ward terminal inputs function evaluation information when a patient leaves a general ward, a management server registers the input function evaluation information as PICS information, an outpatient terminal inputs function evaluation information when the patient receives medical care at an outpatient, and the management server registers the input function evaluation information as PICS information.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a PICS information sharing system that shares information related to post intensive care syndrome (PICS) in patients who have received intensive care in an intensive care unit (ICU). [Background technology]

[0002] In recent years, in the field of critical care medicine, the specific long-term functional impairments in physical, cognitive, and mental functions that occur in patients who have received intensive care in the ICU, from their stay in the ICU until after discharge and even after discharge from the general ward, have come to be known as PICS (Post Intensive Care Syndrome). Awareness-raising activities are being conducted regarding care for PICS. Summary of the Invention [Problem to be solved by the invention]

[0003] However, medical care for PICS faces many challenges. Data from epidemiological studies on PICS has not been accumulated. Furthermore, information on diagnoses and care related to PICS is scattered throughout medical records. Furthermore, methods for assessing the function of patients with PICS impairments (e.g., scales for assessing physical, cognitive, and mental function) are not standardized and are cumbersome. Furthermore, awareness of PICS is low among medical staff working outside the ICU and the general public. As a result of these challenges, medical care for PICS has been inadequate, and patients have not been able to fully detect and evaluate PICS or restore function. These challenges are likely due to the fact that management of patients' PICS-related information is discontinued after they leave the ICU, and medical staff are unable to track and share PICS information focused on patients' PICS-related information over the long period from intensive care to discharge.

[0004] The present invention has been made in consideration of the above points, and its purpose is to provide a PICS information sharing system that allows medical staff to track and share PICS information, which focuses on information related to a patient's PICS, over a long period of time, from during intensive care to after discharge from the hospital. [Means for solving the problem]

[0005] The inventors conducted intensive research to solve the above problems, and proposed a continuous multidisciplinary follow-up model aimed at restoring patients' functions after they were discharged from intensive care. They then constructed an electronic information sharing system that serves as the basis for this model, leading to the present invention.

[0006] That is, the PICS information sharing system of the present invention comprises a management server that manages PICS information including risk factor information on PICS onset and functional evaluation information related to PICS for patients who have received intensive care in an ICU, an ICU terminal managed in the ICU, a general ward terminal managed in a general ward to which the patient moves after being discharged from the ICU, and an outpatient terminal managed in an outpatient facility to which the patient receives outpatient treatment after being discharged from the general ward, and the ICU terminal, the general ward terminal and the outpatient terminal are connected to the management server via a network, and The PICS information is viewed and updated, the ICU terminal inputs the functional evaluation information when the patient is discharged from the ICU, and the management server registers the input functional evaluation information as the PICS information, the general ward terminal inputs the functional evaluation information when the patient is discharged from the general ward, and the management server registers the input functional evaluation information as the PICS information, and the outpatient terminal inputs the functional evaluation information when the patient receives medical treatment in the outpatient clinic, and the management server registers the input functional evaluation information as the PICS information. [Effects of the Invention]

[0007] According to the present invention, medical staff can track and share PICS information, focusing on information related to a patient's PICS, over a long period of time, from intensive care to after discharge, thereby enabling the detection and evaluation of a patient's PICS and the recovery of function. [Brief explanation of the drawings]

[0008] [Figure 1] 1 is a schematic configuration diagram of a PICS information sharing system according to an embodiment. [Figure 2A] FIG. 2 is a schematic configuration diagram of a management server of the PICS information sharing system according to the embodiment. [Figure 2B] 10 is an explanatory diagram showing the relationship between records in a user information table, an access authority table, and a patient information table. FIG. [Figure 3] 10 is a diagram illustrating an outline of an operational flow when a PICS information sharing system according to an embodiment is used to share PICS information of a patient between an ICU and a general ward in a hospital with an ICU, and between affiliated clinics. [Figure 4] 1 is a schematic diagram of a "login" screen of the PICS information sharing system according to an embodiment. [Figure 5] 10 is a schematic diagram of an "ICU patient management" screen of the PICS information sharing system according to the embodiment. [Figure 6] 10 is a schematic diagram of a "view and update patient information" screen of the PICS information sharing system according to the embodiment. [Figure 7] 10 is a schematic diagram of a "View / Update Intensive Care Information" screen of the PICS information sharing system according to the embodiment. [Figure 8] 10 is a schematic diagram of a "View / update functional evaluation information when leaving the room" screen of the PICS information sharing system according to the embodiment. [Figure 9] 10 is a schematic diagram of a "View / update nursing care plan when leaving the room" screen of the PICS information sharing system according to the embodiment. [Figure 10] 10 is a schematic diagram of a "Register summary when leaving the room" screen of the PICS information sharing system according to the embodiment. [Figure 11]10 is a schematic diagram of a "general ward patient management" screen of the PICS information sharing system according to the embodiment. [Figure 12] 10 is a schematic diagram of a "View and update admission and discharge information at the time of discharge" screen of the PICS information sharing system according to the embodiment. [Figure 13] 10 is a schematic diagram of a "View / update functional assessment information at the time of discharge" screen of the PICS information sharing system according to the embodiment. [Figure 14] 10 is a schematic diagram of a "View / update nursing care plan at time of discharge" screen of the PICS information sharing system according to the embodiment. [Figure 15] 10 is a schematic diagram of a "discharge summary registration" screen of the PICS information sharing system according to the embodiment. [Figure 16] 10 is a schematic diagram of a "Patient Management of Affiliated Clinics" screen of the PICS information sharing system according to the embodiment. [Figure 17] 10 is a schematic diagram of a "View and update functional evaluation information 6 months after leaving the room" screen of the PICS information sharing system according to the embodiment. [Figure 18] 10 is a schematic diagram of a "View and update nursing care plan 6 months after discharge" screen of the PICS information sharing system according to the embodiment. [Figure 19] 10 is a schematic diagram of a "Display of functional progress six months after leaving the room" screen of the PICS information sharing system according to the embodiment. [Figure 20] 10 is an outline of "registration of summary six months after leaving the room" in the PICS information sharing system according to the embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0009] Hereinafter, an embodiment of the PICS information sharing system of the present invention will be described. Fig. 1 is a schematic diagram of the configuration of a PICS information sharing system according to an embodiment, Fig. 2A is a schematic diagram of the configuration of a management server of the PICS information sharing system according to an embodiment.

[0010] As shown in FIG. 1 , a PICS information sharing system 1 according to an embodiment is a system used to share PICS information related to a patient's PICS (Post Intensive Care Medicine Syndrome) among medical staff at an ICU (Intensive Care Unit) 20 and a general ward 30 of a hospital 10 with an ICU, an outpatient facility 50 of the hospital 10 with an ICU, an affiliated clinic 52 (outpatient facility), and a hospital 54 (outpatient facility) to which the patient is transferred. The general ward 30 is a ward to which the patient is transferred after being discharged from the ICU 20. The affiliated clinic 52 is a regional medical institution affiliated with the hospital 10 with an ICU, and is a facility where the patient receives outpatient care after being discharged from the hospital 10 with an ICU (general ward 30). The hospital 54 to which the patient is transferred from the hospital 10 with an ICU is equipped, and is equipped with a general ward where the transferred patient is admitted for follow-up observation and a facility where the transferred patient receives outpatient care after being discharged from the general ward. In this specification, "medical staff" refers to people involved in medical care, and is not particularly limited, and includes, for example, nurses, doctors, etc.

[0011] The PICS information sharing system 1 manages PICS information focused on information related to a patient's PICS, including risk factor information for PICS development in patients receiving intensive care in an ICU, functional assessment information related to the patient's PICS, and nursing care plans for the patient's PICS. The risk factor information includes patient information evaluating the patient's characteristics, intensive care information evaluating the content and environment of the patient's intensive care, and severity assessment information evaluating the severity of the patient's illness. The functional assessment information is information evaluating multiple major functional categories, including physical function category, nutrition category, cognitive function category, mental function category, family category, stress category, and QOL category, as well as evaluation indicators belonging to other functional categories. The nursing care plan is information including the necessity and specific care for care items belonging to multiple care types, including physical care, nutritional care, cognitive care, mental care, and family care.

[0012] The PICS information sharing system 1 includes a management server 5 that manages PICS information, an ICU terminal 20a managed by an ICU 20, a general ward terminal 30a managed by a general ward 30, and outpatient terminals 50a, 52a, and 54a managed by an outpatient facility 50, an affiliated clinic 52 (outpatient facility), and a transfer hospital 54 (outpatient facility), respectively. The ICU terminal 20a, the general ward terminal 30a, and the outpatient terminals 50a, 52a, and 54a are connected to the management server 5 via a network N so as to be able to communicate with each other. Furthermore, the management server 5 is connected to an electronic medical record management server 105 of an electronic medical record sharing system 100 that manages electronic medical record information of patients so as to be able to communicate with each other. Note that the terminal managed by the ICU is not identified by the terminal device, but refers to a terminal used by ICU medical staff (user attribute: "ICU") to log in to and use the system 1. A terminal managed in a general ward means a terminal that is not identified by terminal equipment and is used by medical staff in a general ward (user attribute: "general ward") to log in to and use system 1. A terminal managed in an outpatient facility means a terminal that is not identified by terminal equipment and is used by medical staff in an outpatient facility (user attribute: "outpatient facility") to log in to and use system 1.

[0013] The management server 5, ICU terminal 20a, general ward terminal 30a, outpatient terminals 50a, 52a, and 54a, and electronic medical record management server 105 are information processing devices such as desktop computers or notebook computers, and are composed of a computer main body, an output device such as a monitor, and input devices such as a keyboard and a mouse. The computer main body is equipped with a ROM, RAM, CPU, HDD, SDD, communication IF, etc., and executes predetermined processing according to an installed program (for example, a web browser, etc.).

[0014] 2A, the management server 5 has an application server (sometimes abbreviated as "AP server" in this specification) 6 and a PICS database (sometimes abbreviated as "PICSDB" in this specification) 7. When the ICU terminal 20a, general ward terminal 30a, and outpatient terminals 50a, 52a, and 54a connect to the AP server 6, it provides a Web application (sometimes abbreviated as "WebAP" in this specification) 9 to these terminals.

[0015] The WebAP 9 has, as functional units that function by executing a program, a login information input unit, a patient management information output unit, a patient information input / output unit, a calculation processing unit, an intensive care information input / output unit, a severity assessment information input / output unit, a functional assessment information input / output unit, a care type output unit, a nursing care plan input / output unit, a summary input / output unit, an admission / discharge information input / output unit, a functional progress information output unit, and a reference evaluation index output unit. The AP server 6 has, as functional units that function by executing a program, a login processing unit, a patient information acquisition unit, a patient information registration unit, an electronic medical record information acquisition unit, an intensive care information registration unit, a severity assessment information registration unit, a functional assessment information registration unit, a care type recommendation determination unit, a nursing care plan registration unit, a summary registration unit, an admission / discharge information registration unit, a functional progress information acquisition unit, and a reference evaluation index acquisition unit.

[0016] PICSDB7 stores the following tables for managing data used in system 1: a user information table, an access permission table, a patient information table, an intensive care information table, a severity assessment information table, a functional assessment information table, a nursing plan table, a progress summary table, and an admission / discharge information table.

[0017] The user information table has columns for user ID, organization ID, name, password, and user attribute ("ICU," "general ward," or "outpatient facility") for each user information record. The organization ID is an ID assigned to the organization to which the user to which the user ID belongs. The access permission table has columns for patient ID and organization ID for each access permission information record, and the organization ID is linked to the patient ID of a patient who can be accessed by a user belonging to the organization to which the organization ID is assigned. The patient information table has columns for patient ID, organization ID, name, age, sex, height before the patient's hospitalization (sometimes abbreviated as "pre-hospitalization" in this specification), weight before hospitalization, BMI before hospitalization, whether or not the patient had a history of dementia before hospitalization, whether or not the patient had a history of delirium before hospitalization, whether or not the patient had a history of psychiatric illness before hospitalization, and whether or not the patient has undergone surgical treatment for the current illness, for each patient information record. In this specification, "before the patient is admitted" ("pre-admission") refers to the time before the patient enters the ICU and before the patient is admitted to a facility, including the ICU and general wards of a hospital, and more specifically, refers to the time before the patient requires medical treatment through hospitalization for the current illness that requires intensive care. The relationship between the records of the user information table, access permission table, and patient information table is shown in Figure 2B.

[0018] The intensive care information table has columns for each record of intensive care information: patient ID, ICU admission date, ICU discharge date, ICU admission duration, ventilator attachment date and time, ventilator weaning date and time, ventilator attachment duration, ICU admission type, type of assisted circulation, whether blood purification therapy was used, type of analgesic, whether benzodiazepines were used, number of days of deep sedation, whether muscle relaxants were used, and whether sepsis occurred during admission.The severity assessment information table has columns for each record of severity assessment information: patient ID, APACHE II score, and SOFA score at the time the patient was admitted to the ICU (sometimes abbreviated as "at admission" in this specification), SOFA score on day 3, and SOFA score on day 7.

[0019] The functional assessment information table has columns for each functional assessment information record: patient ID, time attribute ("before hospitalization," "at admission," "at discharge," "at discharge," "6 months after discharge," "12 months after discharge," or "at a time after 12 months after discharge as needed (e.g., 18 months after discharge)"), evaluation indicators belonging to the physical function category, nutrition category, cognitive function category, mental function category, family category, stress category, and QOL category (multiple major function categories), evaluation indicators belonging to other function categories, and PICS judgment. The nursing care plan table has columns for each nursing plan record: patient ID, time attribute, and nursing care plans for physical care, nutritional care, cognitive care, mental care, and family care (multiple types of care). The progress summary table has columns for each record: patient ID, time attribute, and progress summary. The admission and discharge information table has columns for each admission and discharge record: patient ID, admission date, discharge date, length of hospital stay, outcome, discharge destination, number of days with positive delirium, period on ventilator, and whether or not there was a post-discharge visit.

[0020] The electronic medical record management server 105 has an electronic medical record database (sometimes abbreviated as "electronic medical record DB" in this specification) 107. The electronic medical record DB 107 stores a medical record patient information table, a medical record intensive care information table, and a medical record severity assessment information table as tables for managing electronic medical record information used in the electronic medical record sharing system 100. The medical record patient information table, medical record intensive care information table, and medical record severity assessment information table each have the same columns as the patient information table, intensive care information table, and severity assessment information table of PICSDB7.

[0021] The ICU terminal 20a, general ward terminal 30a, and outpatient terminals 50a, 52a, and 54a view and update the PICS information managed by the management server 5. The ICU terminal 20a inputs functional evaluation information when a patient leaves the ICU via a functional evaluation information input / output unit, and the AP server 6 (management server 5) registers the input functional evaluation information as PICS information in the functional evaluation information table via a functional evaluation information registration unit. The general ward terminal 30a inputs functional evaluation information when a patient is discharged from a general ward via a functional evaluation information input / output unit, and the AP server 6 registers the input functional evaluation information as PICS information in the functional evaluation information table via a functional evaluation information registration unit. The outpatient terminals 50a, 52a, and 54a input functional evaluation information when a patient receives outpatient treatment via a functional evaluation information input / output unit, and the AP server 6 registers the input functional evaluation information as PICS information in the functional evaluation information table via a functional evaluation information registration unit. The ICU terminal 20a inputs patient information about the patient through a patient information input / output unit, and the AP server 6 registers the input patient information as PICS information in the patient information table through a patient information registration unit. The ICU terminal 20a inputs intensive care information about the patient through an intensive care information input / output unit, and the AP server 6 registers the input intensive care information as PICS information in the intensive care information table through an intensive care information registration unit. The ICU terminal 20a inputs severity assessment information about the patient through a severity assessment information input / output unit, and the AP server 6 registers the input severity assessment information as PICS information in the severity assessment information table through a severity assessment information registration unit. The ICU terminal 20a inputs a nursing care plan for the patient at the time of ICU discharge through a nursing care plan input / output unit, and the AP server 6 registers the input nursing care plan as PICS information in the nursing care plan table through a nursing care plan registration unit. The general ward terminal 30a inputs a nursing care plan for the patient when he or she is discharged from the general ward through the nursing care plan input / output unit, and the AP server 6 registers the input nursing care plan in the nursing care plan table as PICS information through the nursing care plan registration unit. The outpatient terminals 50a, 52a, and 54a input a nursing care plan for the patient when he or she receives outpatient treatment through the nursing care plan input / output unit, and the AP server 6 registers the input nursing care plan in the nursing care plan table as PICS information through the nursing care plan registration unit.According to the above-described embodiment, medical staff can track and share PICS information focused on information related to a patient's PICS over a long period of time, from intensive care to after discharge, thereby enabling the detection and evaluation of a patient's PICS and the recovery of function, etc.

[0022] In response to a request from any of the ICU terminal 20a, general ward terminal 30a, and outpatient terminals 50a, 52a, and 54a, the AP server 6 uses the care type recommendation determination unit to determine whether a specific type of care should be recommended for the patient based on the functional evaluation information input from the terminal, and causes the care type output unit to output the determination result to the terminal. This supports the formulation of nursing care plans and makes it easier to formulate nursing care plans that are in line with the patient's condition.

[0023] In response to a request from any of the terminals, the AP server 6 causes the functional progress information acquisition unit to acquire functional assessment information for multiple periods from before the patient's admission to the time of the request from the functional assessment information table, and the functional progress information output unit to output functional progress information based on the patient's functional assessment information for multiple periods to the terminal. This allows medical staff and patients at each medical facility to check the progress of the patient's function over time. In addition, in response to a request from any of the terminals, the AP server 6 causes the reference evaluation index acquisition unit to acquire the patient's patient information, intensive care information, and severity assessment information from the patient information table, intensive care information table, and severity assessment information table, and the reference evaluation index output unit to output a reference evaluation index based on the patient's patient information, intensive care information, and severity assessment information to the terminal. This allows medical staff and patients at each medical facility to check the patient's reference evaluation index.

[0024] The ICU terminal 20a inputs the patient's PICS progress summary up to the time the patient is discharged from the ICU via the summary input / output unit, and the AP server 6 registers the input progress summary in the progress summary table as PICS information via the summary registration unit. The general ward terminal 30a inputs the patient's PICS progress summary up to the time the patient is discharged from the general ward via the summary input / output unit, and the AP server 6 registers the input progress summary in the progress summary table as PICS information via the summary registration unit. The outpatient terminals 50a, 52a, and 54a input the patient's PICS progress summary from the time the patient is discharged from the hospital to the time the patient receives outpatient treatment via the summary input / output unit, and the AP server 6 registers the input progress summary in the progress summary table as PICS information via the summary registration unit. This allows medical staff and patients at each medical facility to check the patient's progress summary.

[0025] In response to a request from any of the terminals of the ICU-equipped hospital 10 (e.g., the ICU terminal 20a, general ward terminal 30a, and outpatient terminal 50a), the terminal of the affiliated clinic 52 (e.g., the outpatient terminal 52a), and the terminal of the transfer destination hospital 54 (e.g., the outpatient terminal 54a), the AP server 6 uses the patient information acquisition unit to acquire an organization ID linked to the user ID of the medical staff member using the terminal from the user information table, acquires one or more patient IDs linked to the organization ID from the access permission table, acquires only the patient information records linked to the one or more patient IDs from the patient information table, and causes the patient management information output unit to output only the patient information records to the terminal. In this case, the medical staff member can only access information about patients in their own organization, thereby protecting the patient's personal information.

[0026] <Operation flow> Next, as an example of the operational flow of the PICS information sharing system 1 according to the embodiment, the operational flow will be described below in the case where a patient (sometimes abbreviated as "target patient" in this specification) for whom PICS information is to be shared is admitted to the ICU 20 of the hospital 10 equipped with an ICU to receive intensive care, moves to the general ward 30 after being discharged from the ICU 20, and after being discharged from the general ward 30, visits the affiliated clinic 52 to which the referral letter written by the doctor in the general ward 30 refers the patient. In this case, the PICS information sharing system 1 is used to share the patient's PICS information among the medical staff of the ICU 20, the medical staff of the general ward 30, and the medical staff of the affiliated clinic 52 in the hospital 10 equipped with an ICU.

[0027] Separately from this operational flow, the ICU medical staff prepares the target patient's medical record information, including the target patient's medical record patient information, medical record intensive care information, and medical record severity assessment information, by interviewing the target patient and their relatives and referring to records, and then uses the electronic medical record sharing system 100 to register the target patient's medical record information as electronic medical record information in the electronic medical record DB 107. Specifically, before registering the patient information (S2), the target patient's medical record patient information (patient ID, name, age, sex, height before hospitalization, weight before hospitalization, BMI before hospitalization, whether or not there is a history of dementia before hospitalization, whether or not there is a history of delirium before hospitalization, whether or not there is a history of psychiatric illness before hospitalization, whether or not there has been surgical treatment for the current illness) is prepared and registered as a record in the medical record patient information table. Before registering intensive care information (S7), the target patient's medical record intensive care information (patient ID, ICU admission date, ICU discharge date, duration of ICU admission, date and time of mechanical ventilation, date and time of mechanical ventilation weaning, duration of mechanical ventilation, type of ICU admission, type of auxiliary circulation, whether or not blood purification therapy was used, type of analgesic, whether or not benzodiazepines were used, number of days of deep sedation, whether or not muscle relaxants were used, and whether or not sepsis was present during admission) is prepared and registered as a record in the medical record intensive care information table.Before registering severity assessment information (S8), the target patient's medical record severity assessment information (patient ID, APACHE II score, and SOFA score at admission, SOFA score on day 3, and SOFA score on day 7) is prepared and registered as a record in the medical record severity assessment information table.

[0028] [Patient admission and registration of patient information and pre-hospital functional assessment information (S1-S3)] In this operation flow, first, as shown in Fig. 3, a target patient enters the ICU 20 (S1). At that time, an ICU medical staff member (user ID: "sx0001") who is in charge of using the system 1 on the ICU terminal 20a uses the system 1 to register patient information (S2).

[0029] In the patient information registration (S2), first, the ICU medical staff connects to the AP server 6 from the ICU terminal 20a using a web browser and displays the "Login" screen of the WebAP 9 shown in FIG. 4 on the output device of the ICU terminal 20a. Then, on the screen, the medical staff enters the user ID and password previously assigned to the ICU medical staff into the text boxes, respectively, and presses the "Login" button. The login information input unit then inputs the user ID and password, and based on the determination of the login processing unit, the medical staff logs into the system 1. The patient management information output unit then displays the "ICU Patient Management" screen shown in FIG. 5. In response to a request from the login information input unit, the patient information acquisition unit acquires the organization ID ("toho") associated with the user ID ("sx0001") from the user information table, acquires one or more patient IDs associated with the organization ID from the access permission table, and acquires only the patient information records associated with the one or more patient IDs from the patient information table. Then, the patient management information output unit displays a list of records of the patient information in the "Patient List" field on the screen. At this time, a link is set to the patient ID of each patient information.

[0030] Next, in the "Patient Registration" field on the "ICU Patient Management" screen (FIG. 5), the patient ID ("pxYYYY") from the target patient's medical record information is entered into the text box, and the "Register Patient" button is pressed. As shown in FIG. 2B, the patient information registration unit registers new patient information (sometimes abbreviated as "target patient information" in this specification) including the target patient's patient ID as a record in the patient information table, and also registers new access permission information including the target patient's patient ID ("pxYYYY") and the organization ID ("toho") linked to the user ID ("sx0001") in the user information table as a record in the access permission table. Once the target patient information and access permission information have been registered, the patient information acquisition unit again acquires the organization ID ("toho") linked to the user ID from the user information table, acquires one or more patient IDs linked to the organization ID from the access permission table, and acquires only the patient information records linked to the one or more patient IDs, including the target patient information record, from the patient information table. Then, the patient management information output unit displays a list of records of the patient information in the "Patient List" field on the screen (Figure 5). At this time, new records of the target patient information are displayed, and a link is set to the patient ID of each patient information.

[0031] Next, click on the link for the patient ID ("pxYYYY") of the target patient information. This causes the electronic medical record information acquisition unit to acquire the record of the medical record patient information linked to that patient ID from the medical record patient information table (patient ID, name, age, sex, height before hospitalization, weight before hospitalization, BMI before hospitalization, whether or not there is a history of dementia before hospitalization, whether or not there is a history of delirium before hospitalization, whether or not there is a history of psychiatric illness before hospitalization, and whether or not there has been surgical treatment for the current illness), and the patient information input / output unit displays the "View / Update Patient Information" screen for the target patient information shown in Figure 6. At this time, the patient ID is displayed in the upper right corner of the "Patient Information" column on that screen. In the "Basic Information" section of the "Patient Information" column, the name and age of the patient in the medical record are entered into the name and age text boxes, the gender of the patient in the medical record is selected using the gender pull-down options ("Male" and "Female"), the height and weight of the patient in the medical record before admission are entered into the height and weight text boxes, and the BMI before admission is automatically calculated from the height and weight by the calculation processor and entered into the BMI text box. In the "Medical History" section of the "Patient Information" column, the pull-down options ("Yes" and "No") for whether or not the patient has a history of dementia, delirium, or psychiatric illness select whether or not the patient in the medical record had a history of dementia, delirium, or psychiatric illness before admission. In the "Other" section of the "Patient Information" column, the pull-down options ("Yes" and "No") for whether or not the patient had surgical treatment for the current illness before admission select whether or not the patient in the medical record had surgical treatment for the current illness before admission.

[0032] Next, after confirming the input and selection details in the "Patient Information" field, the user corrects the input and selection details as necessary and presses the "Save" button. The patient information input / output unit then inputs the patient information that is the input and selection details, and the patient information registration unit updates the record of the target patient information in the patient information table using the patient information. In this patient information registration (S2), the patient's medical record patient information can be imported from the electronic medical record DB 107 of the electronic medical record sharing system 100 and reused as the patient's patient information, eliminating the need for input and allowing the patient's patient information to be shared with the electronic medical record sharing system 100.

[0033] Next, as shown in Figure 3, the ICU medical staff will conduct a retrospective investigation to obtain the functional assessment information of the target patient before admission, and will register (S3) the pre-admission functional assessment information using System 1. The pre-admission functional assessment information of the target patient will serve as a baseline of the target patient's function before medical intervention becomes necessary.

[0034] In the retrospective investigation, functional assessment information of the target patient before admission is investigated and obtained by interviewing the target patient and their relatives and by referring to records, etc. At this time, just as in the functional assessment at discharge (S9) described below, the values ​​of the evaluation indexes for the target patient's Barthel Index, which belongs to the physical function category, BMI and SGA, which belong to the nutritional category, SMQ, which belongs to the cognitive function category, and health VAS, which belongs to the family category, are investigated and obtained, and just as in the functional assessment at discharge (S23) described below, the values ​​of the evaluation indexes for the level of recovery, which belong to the target patient's other functional categories, are investigated and obtained, and functional assessment information before admission consisting of the values ​​of these evaluation indexes is obtained.

[0035] In registering pre-admission functional assessment information (S3), the "Viewing / updating pre-admission functional assessment information" screen (FIG. 6) is displayed by the functional assessment information input / output unit by clicking the "Pre-admission" tab under "Time" in the "Menu" column of the "Viewing / updating patient information" screen. Next, in the "Functional Assessment" section of the "Menu" column of the screen, similar to the "Registering functional assessment information at discharge" (S10) described below, one or more tabs for evaluation indices belonging to the physical function category, nutrition category, cognitive function category, and family category are clicked to display the "Viewing / updating pre-admission functional assessment information" screen (not shown) corresponding to the evaluation indices in each tab. Then, in the "Functional Assessment Information" column of the screen, similar to the "Registering functional assessment information at discharge" (S10) described below, the user inputs or selects the value of the evaluation indices and presses the "Save" button. This registers the value of the evaluation indices together with the patient ID and time attribute ("Pre-admission") as a record in the functional assessment information table, or updates the record with the value of the evaluation indices. Next, as in the case of registering functional assessment information at the time of discharge (S24) described below, by clicking the "Return" tab for the "Other" functional category, the "View / Update Functional Assessment Information Pre-Admission (Return of Other Category)" screen (not shown) is displayed. Then, as in the case of registering functional assessment information at the time of discharge (S24) described below, by inputting or selecting the value of the evaluation index for the other functional category in the "Functional Assessment Information" field on that screen and pressing the "Save" button, the record in the functional assessment information table is updated with the value of the evaluation index for the other functional category.

[0036] In this way, pre-hospitalization functional assessment information consisting of the evaluation index values ​​for the target patient's physical function category, nutritional category, cognitive function category, family category, and other functional categories is registered as a record in the functional assessment information table together with the patient ID and time attribute ("pre-hospitalization").

[0037] [Functional assessment upon entry and registration of functional assessment information (S4 and S5)] Next, as shown in Figure 3, when the target patient enters the ICU 20 (sometimes abbreviated as "at the time of admission" in this specification), the medical staff of the ICU conducts a functional assessment of the target patient at the time of admission (S4) to the extent possible depending on the situation, to obtain functional assessment information at the time of admission, and then registers the functional assessment information at the time of admission using the system 1 (S5).

[0038] In the functional assessment at admission (S4), similar to the functional assessment at discharge (S9) described below, the evaluation of the evaluation indexes belonging to the physical function category, nutrition category, and family category of the subject patient is carried out.

[0039] In registering functional assessment information at admission (S5), first, as in the case of registering patient information (S2), the ICU medical staff logs in to system 1 and displays the "View / Update Patient Information" screen (Fig. 6) for the target patient's information. Then, by clicking the "Admission" tab under "Time" in the "Menu" column of the screen, the functional assessment information input / output unit displays the "View / Update Functional Assessment Information at Admission" screen (not shown). Next, in the "Functional Assessment" section of the "Menu" column of the screen, by clicking one or more tabs for evaluation indices belonging to the physical function category, nutrition category, and family category, the respective "View / Update Functional Assessment Information at Admission" screens (not shown) corresponding to the evaluation indices in each tab are displayed, as in the case of registering functional assessment information at discharge (S10), which will be described later. Then, in the "Functional Evaluation Information" field on the screen, similar to the registration of functional evaluation information at the time of leaving the room (S10) described below, by entering or selecting the value of the evaluation index and pressing the "Save" button, the value of the evaluation index will be registered as a record in the functional evaluation information table together with the patient ID and time attribute ("time of entry"), or the record will be updated with the value of the evaluation index.

[0040] In this way, functional evaluation information at the time of admission, consisting of the evaluation index values ​​for the physical function category, nutrition category, and family category of the target patient, is registered as a record in the functional evaluation information table together with the patient ID and time attribute ("time of admission").

[0041] [Registration of intensive care and intensive care information and severity assessment information (S6~S8)] Next, as shown in Figure 3, intensive care (S6) is performed by medical staff of the ICU for the target patient. Thereafter, when the target patient leaves the ICU 20 (sometimes abbreviated as "when leaving" in this specification), the medical staff of the ICU uses the system 1 to register intensive care information (S7) and severity assessment information (S8).

[0042] In the intensive care information registration (S7) step, similar to the patient information registration (S2), the ICU medical staff first logs in to System 1, displays the "View / Update Patient Information" screen (Figure 6) for the target patient's information, and clicks the "Discharge" tab under "Time" in the "Menu" column on the screen. This causes the electronic medical record information acquisition unit to retrieve records of the intensive care information linked to the patient ID from the intensive care information table (patient ID, ICU admission date, ICU discharge date, ICU admission duration, ventilator attachment date and time, ventilator weaning date and time, ventilator attachment duration, ICU admission type, type of assisted circulation, use of blood purification therapy, type of analgesic, use of benzodiazepines, number of days of deep sedation, use of muscle relaxants, and presence or absence of sepsis during admission). The intensive care information input / output unit then displays the "View / Update Intensive Care Information" screen shown in Figure 7. The patient ID is displayed in the upper right corner of the "Intensive Care Information" column on the screen. In the "Intensive Care Information" column, the ICU admission and discharge dates (year / month / day format) and ICU stay duration (days) text boxes are populated with the ICU admission and discharge dates and duration of the intensive care record information. The intensive care ventilator onset and weaning dates (year / month / day / minute format) and ventilator onset duration (hours) text boxes are populated with the ventilator onset and weaning dates and duration of the ventilator onset. The ICU admission mode for the intensive care record information is selected by selecting "Yes" or "No" from the pull-down menu for whether the patient was admitted to the ICU unscheduled (ICU admission mode). The type of circulatory support used in the patient's intensive care is selected by checking the checkbox options ("VV ECMO," "VA ECMO," "IABP," and "Other") for the type of circulatory support used. In addition, whether or not blood purification therapy was used in intensive care (whether or not hemodialysis was performed) can be selected from the pull-down options ("Yes" and "No") to select whether or not blood purification therapy was used in the intensive care information of the relevant medical record.In addition, the checkbox options for the type of analgesic used in intensive care ("dexmedetomidine," "propofol," "midazolam," and "other") check and select the type of analgesic in the relevant intensive care medical record information. In addition, the pull-down options for whether benzodiazepines were used in intensive care ("yes" and "no") select whether benzodiazepines were used in the relevant intensive care medical record information. In addition, the number of days of deep sedation in intensive care in the text box is entered into the relevant intensive care medical record information. In addition, the pull-down options for whether muscle relaxants were used in intensive care ("yes" and "no") select whether muscle relaxants were used in the relevant intensive care medical record information. In addition, the pull-down options for whether sepsis was present during admission (from admission to discharge) ("yes" and "no") select whether sepsis was present during admission in the relevant intensive care medical record information.

[0043] Next, after confirming the input and selection details in the "Intensive Care Information" field, the user modifies the input and selection details as necessary and presses the "Save" button. The intensive care information input / output unit then inputs the intensive care information, which is the input and selection details, and the intensive care information registration unit registers the intensive care information together with the patient ID as a record in the intensive care information table. In this intensive care information registration (S7), the patient's medical record intensive care information can be imported from the electronic medical record DB 107 of the electronic medical record sharing system 100 and reused as the patient's intensive care information, eliminating the need for input and enabling the patient's intensive care information to be shared with the electronic medical record sharing system 100.

[0044] Next, to register severity assessment information (S8), click the "APACHE II" tab and the "Admission," "Day 3," and "Day 7" tabs in the "SOFA" category under "Severity Assessment" in the "Menu" column of the "View / Update Intensive Care Information" screen (Figure 7). This causes the electronic medical record information acquisition unit to retrieve records of medical record severity assessment information linked to the patient ID (patient ID, APACHE II score, and SOFA score at admission, SOFA score on Day 3, and SOFA score on Day 7) from the medical record severity assessment information table, and the severity assessment information input / output unit to display the "View / Update Severity Assessment Information" screen (not shown) corresponding to the items on those tabs. At this time, the patient ID is displayed in the upper right corner of the "Severity Assessment Information" column on those screens. In the "Severity Assessment Information" column on these screens, the APACHE II score, SOFA score at admission, SOFA score on day 3, and SOFA score on day 7 text boxes are filled in with the APACHE II score, SOFA score at admission, SOFA score on day 3, and SOFA score on day 7 from the severity assessment information in the medical record, respectively.

[0045] Next, the user checks the input contents in the "Severity Assessment Information" field on each screen, corrects the input contents as necessary, and presses the "Save" button. The severity assessment information input / output unit then inputs the severity assessment information, which is the input contents, and the severity assessment information registration unit registers the severity assessment information together with the patient ID as a record in the severity assessment information table. In this registration of severity assessment information (S8), the patient's medical record severity assessment information can be imported from the electronic medical record DB 107 of the electronic medical record sharing system 100 and reused as the patient's severity assessment information, thereby eliminating the need for input and enabling the patient's severity assessment information to be shared with the electronic medical record sharing system 100.

[0046] [Functional assessment upon leaving the room and registration of functional assessment information (S9 and S10)] Next, as shown in Figure 3, at the time of discharge, the ICU medical staff conducts a functional assessment of the target patient at the time of discharge (S9) to obtain functional assessment information at the time of discharge, and then registers the functional assessment information at the time of discharge using system 1 (S10).

[0047] In the functional assessment at discharge (S9), the evaluation of the evaluation indexes belonging to each of the multiple major functional categories of the target patient, which are the physical function category, nutritional category, cognitive function category, mental function category, family category, stress category, and QOL category, is carried out. This acquires functional assessment information at discharge consisting of the values ​​of the evaluation indexes belonging to the multiple major functional categories of the target patient.

[0048] Specifically, the physical function category involves the evaluation of the Barthel Index, grip strength, Intensive Care Unit Mobility Scale (IMS), and Visual Analog Scale (VAS) for physical function. The Barthel Index evaluates the level of independence in 10 areas—eating, transferring from wheelchair to bed, grooming, toileting, bathing, walking, climbing stairs, dressing, bowel control, and bladder control—on a scale of 0 to 15, with the sum of these scores representing the Barthel Index. Grip strength is evaluated by measuring the strength of both hands. The IMS evaluates the progress of getting out of bed on a scale of 0 to 10. The physical function VAS involves the patient subjectively evaluating their physical function numerically. The values ​​of these evaluations are then used to obtain the values ​​of the evaluation indices.

[0049] When assessing the assessment indicators belonging to the nutrition category, evaluations are made on the BMI and SGA (Subjective Global Assessment) assessment indicators. For BMI assessment, height and weight are measured and BMI is calculated. For SGA assessment, medical history, nutritional history and physical findings are evaluated, and based on these results, the nutritional level is assessed on a three-level scale: A (good), B (moderate malnutrition), and C (severe malnutrition). The values ​​of these assessments are obtained as the values ​​of the assessment indicators.

[0050] The assessment of the cognitive function category involves the Mini Mental State Examination (MMSE), Short-Memory Questionnaire (SMQ), and cognitive function VAS. In the MMSE assessment, patients answer questions from a neuropsychological test consisting of 11 categories, and the answers to each question are given a score, with the total of these scores representing the MMSE score. In the SMQ assessment, patients answer 14 questions to measure cognitive function, and the answers to each question are given a score, with the total of these scores representing the SMQ score. In the cognitive function VAS assessment, patients subjectively evaluate their cognitive function numerically. The values ​​of these assessments are obtained as the values ​​of each assessment index.

[0051] The evaluation of the mental function category involves assessment of the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R), and the Mental Function VAS. In the HADS evaluation, patients answer seven questions about the level of anxiety and seven questions about the level of depression, and the answers to each question are given a score. The sum of the scores for the seven questions about the level of anxiety is the anxiety score, and the sum of the scores for the seven questions about the level of depression is the depression score, and the sum of these scores is the HADS score. In the IES-R assessment, patients answer eight questions regarding PTSD (post-traumatic stress disorder) intrusion symptoms, eight questions regarding PTSD avoidance symptoms, and six questions regarding PTSD hyperarousal symptoms, and each question is given a score. The sum of the scores for the eight questions regarding PTSD intrusion symptoms is the intrusion symptom score, the sum of the scores for the eight questions regarding PTSD avoidance symptoms is the avoidance symptom score, and the sum of the scores for the six questions regarding PTSD hyperarousal symptoms is the hyperarousal symptom score. The sum of these scores is the IES-R score. In the mental function VAS assessment, patients subjectively rate their mental function numerically. The values ​​of these ratings are obtained as the values ​​of the evaluation indexes.

[0052] To evaluate the evaluation indexes belonging to the family category, a health VAS (evaluation index) is evaluated. In the evaluation of the health VAS, the patient subjectively evaluates whether or not their family members have health problems ("yes" or "no"). The value of this evaluation is obtained as the value of the evaluation index.

[0053] To evaluate the evaluation indexes belonging to the stress category, an evaluation of SOC (Sense of Coherence, evaluation index) is performed. In the SOC evaluation, the patient answers questions that evaluate the degree of stress coping ability, which is divided into three categories, and the answers to each question are evaluated with a score, and the total score is the SOC score. The value of this evaluation is obtained as the value of the evaluation index.

[0054] In the evaluation of the evaluation indices belonging to the QOL category, the EQ-5D-5L and the health status VAS are evaluated. In the EQ-5D-5L evaluation, the patient answers five questions about "level of mobility," "personal care," "usual activities," "pain / discomfort," and "anxiety / depression," and the answers to each question are evaluated. In the health status VAS evaluation, the patient subjectively evaluates their health status numerically. The values ​​of these evaluations are obtained as the values ​​of the evaluation indices. In this way, functional evaluation information at the time of discharge consisting of the values ​​of evaluation indices belonging to multiple major functional categories of the target patient is obtained, and the functional evaluation at the time of discharge (S9) is performed.

[0055] In registering functional assessment information at the time of discharge (S10), the “Barthel” in the “Physical Function” category is selected in the “Functional Assessment” section of the “Menu” field on the “View / Update Intensive Care Information” screen (FIG. 7) or the “View / Update Severity Assessment Information” screen (not shown) or the “View / Update Functional Assessment Information at the Time of Discharge” screen as shown in FIG. By clicking on one or more tabs for assessment indices belonging to multiple major functional categories, including the "Index," "Grip Strength," "IMS," and "Physical Function VAS" tabs in the "Nutrition" category, the "BMI" and "SGA" tabs in the "Cognitive Function" category, the "MMSE," "SMQ," and "Cognitive Function VAS" tabs in the "Cognitive Function" category, the "HADS," "IES-R," and "Mental Function VAS" tabs in the "Mental Function" category, the "Health VAS" tab in the "Family" category, the "SOC" tab in the "Stress" category, and the "EQ-5D-5L" and "Health Status VAS" tab in the "QOL" category, the functional assessment information input / output unit displays the "View / Update Functional Assessment Information Upon Leaving Room" screen (e.g., Figure 8) corresponding to the assessment indices in each tab. Then, enter or select the value of the assessment indices in the "Functional Assessment Information" field on that screen and press the "Save" button. As a result, the functional evaluation information input / output unit inputs the value of the evaluation index, and the functional evaluation information registration unit registers the value of the evaluation index together with the patient ID and time attribute ("time of leaving the room") as a record in the functional evaluation information table, or updates the record with the value of the evaluation index. Furthermore, the functional evaluation information input / output unit requests the AP server 6 to determine whether or not to recommend a specific care type corresponding to the major function category to which the evaluation index belongs, among multiple types of care types (physical care, nutritional care, cognitive care, mental health care, and family care). In response, the care type recommendation determination unit determines whether or not to recommend a specific care type to the target patient, based on the input value of the evaluation index. If it is determined that a specific care type is required, the care type recommendation determination unit updates the PICS judgment of the record in the functional evaluation information table from the default value of "low risk" to "high risk." If it is determined that a specific care type is not required, the care type recommendation determination unit maintains the PICS judgment of the record at the default value of "low risk." The care type output unit also outputs the result of the determination of necessity in the "Nursing care plan" in the "Menu" column of the "View / update functional assessment information at time of discharge" screen (for example, FIG. 8).Specifically, when it is determined that a predetermined type of care needs to be recommended, for example, the tab for the predetermined type of care is displayed among the tabs for multiple types of care ("Physical Care," "Nutrition Care," "Cognitive Care," "Mental Care," and "Family Care") that are hidden and indicated by dashed lines in Fig. 8. This allows the predetermined type of care to be proposed as a recommended type of care for the target patient.

[0056] Specifically, when the "Barthel Index" tab in the "Physical Function" category is clicked, the "View / Update Functional Assessment Information Upon Discharge (Barthel Index for Physical Function Category)" screen shown in Figure 8 is displayed. Then, in the "Functional Assessment Information" field on that screen, the Barthel Index (assessment index) value is entered. Ten independence levels—eating, transferring from wheelchair to bed, grooming, toileting, bathing, walking, climbing stairs, dressing, bowel control, and bladder control—are selected from the corresponding pull-down menu options. Then, by pressing the "Calculate" button for "Barthel Index," the Barthel Index value is calculated based on the pull-down menu selections and entered into the corresponding text box. Then, by pressing the "Save" button, the Barthel Index value is registered or updated accordingly. If the Barthel Index value is less than 85 points, it is determined that physical care is required, and the "Physical Care" tab is displayed instead of hidden. This suggests physical care as the recommended type of care. Similarly, when the "Grip Strength" tab in the "Physical Function" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (Grip Strength for Physical Function Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, a grip strength (assessment index) value is entered and the "Save" button is pressed to register or update the grip strength value. Similarly, when the "IMS" tab in the "Physical Function" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (IMS for Physical Function Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, a value (scale) of the IMS (assessment index) is entered and the "Save" button is pressed to register or update the IMS value. Similarly, when the "Physical Function VAS" tab in the "Physical Function" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (Physical Function VAS for Physical Function Category)" screen (not shown) is displayed. Then, in the "Function Assessment Information" field on that screen, enter the value of the physical function VAS (assessment index) and press the "Save" button to register or update the physical function VAS value. In this way, the values ​​of multiple assessment indexes for physical function categories are registered.

[0057] Similarly, when the "BMI" tab in the "Nutrition" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (BMI for Nutrition Category)" screen (not shown) is displayed. Then, by entering a BMI (evaluation index) value in the "Functional Assessment Information" field on that screen and pressing the "Save" button, the BMI (evaluation index) value is registered or updated accordingly. In this case, if the BMI value is less than 18.5, it is determined that nutritional care recommendation is necessary, and the "Nutrition Care" tab is changed from a hidden state to a visible state. This suggests nutritional care as a recommended type of care. Similarly, when the "SGA" tab in the "Nutrition" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (SGA for Nutrition Category)" screen (not shown) is displayed. Then, by entering an SGA (evaluation index) value in the "Functional Assessment Information" field on that screen and pressing the "Save" button, the SGA value is registered or updated accordingly. In this case, if the SGA value (assessment level) is B (moderate malnutrition) or C (severe malnutrition), it is determined that nutritional care recommendation is necessary, and the "Nutrition Care" tab is changed from hidden to visible. This will suggest nutritional care as the recommended care type. As described above, the values ​​of multiple assessment indicators for nutrition categories are registered.

[0058] Similarly, when the "MMSE" tab in the "cognitive function" category is clicked, the "View / Update Functional Assessment Information at Time of Discharge (MMSE for Cognitive Function Category)" screen is displayed. Then, in the "Functional Assessment Information" field on that screen, the MMSE (assessment index) value is entered and the "Save" button is pressed to register or update the MMSE value. In this case, if the MMSE value (MMSE score) is 26 points or less, it is determined that cognitive care is required, and the "Cognitive Care" tab is changed from hidden to visible. This suggests cognitive care as the recommended type of care. Similarly, when the "SMQ" tab in the "cognitive function" category is clicked, the "View / Update Functional Assessment Information at Time of Discharge (SMQ for Cognitive Function Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, the SMQ (assessment index) value is entered and the "Save" button is pressed to register or update the SMQ value. Similarly, when the "Cognitive Function VAS" tab in the "Cognitive Function" category is clicked, the "View / Update Functional Assessment Information Upon Exit (Cognitive Function VAS for Cognitive Function Category)" screen (not shown) is displayed. Then, in the "Function Assessment Information" field on that screen, the cognitive function VAS (assessment index) value is entered and the "Save" button is pressed to register or update the cognitive function VAS value. As described above, the values ​​of multiple assessment indexes for the cognitive function category are registered.

[0059] Similarly, when the "HADS" tab in the "Mental Function" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (HADS for Mental Function Category)" screen (not shown) is displayed. Then, by entering a HADS (assessment index) value in the "Functional Assessment Information" field on that screen and pressing the "Save" button, the HADS value is registered or updated accordingly. In this case, if the anxiety or depression score in the HADS value is 8 points or higher, it is determined that mental health care is required, and the "Mental Health Care" tab is changed from hidden to visible. This suggests mental health care as the recommended type of care. Similarly, when the "IES-R" tab in the "Mental Function" category is clicked, a "View / Update Functional Assessment Information at Time of Exit (IES-R for Mental Function Category)" screen (not shown) is displayed. Then, by entering an IES-R (assessment index) value in the "Functional Assessment Information" field on that screen and pressing the "Save" button, the IES-R value is registered or updated accordingly. In this case, if the IES-R score is 25 or higher, it is determined that mental health care is required, and the "Mental Health Care" tab is changed from hidden to visible. This suggests mental health care as the recommended type of care. Similarly, when the "Mental Function VAS" tab in the "Mental Function" category is clicked, the "View / Update Functional Assessment Information Upon Exit (Mental Function VAS for Mental Function Category)" screen (not shown) is displayed. Then, by entering the mental function VAS (assessment index) value in the "Function Assessment Information" field on that screen and pressing the "Save" button, the mental function VAS value is registered or updated. As described above, the values ​​of multiple assessment indexes for the mental function category are registered.

[0060] Similarly, when the "Health VAS" tab in the "Family" category is clicked, the "View / Update Functional Assessment Information Upon Exit (Health VAS for Family Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, the value of the health VAS (evaluation index) is entered and the "Save" button is pressed to register or update the health VAS value. In this case, if the health VAS value (presence or absence of family health problems) is determined to be "present," it is determined that family care recommendation is necessary, and the "Family Care" tab is changed from a hidden state to a visible state. This suggests family care as the recommended type of care. As described above, the value of the evaluation index for the family category is registered.

[0061] Similarly, when the "SOC" tab for the "Stress" category is clicked, the "View / Update Functional Assessment Information Upon Leaving Room (SOC for Stress Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, enter the SOC (assessment index) value and press the "Save" button to register or update the SOC value. As described above, the value of the assessment index for the stress category is registered.

[0062] Similarly, when the "EQ-5D-5L" tab in the "QOL" category is clicked, the "View / Update Functional Assessment Information at Time of Exit (EQ-5D-5L for QOL Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, the EQ-5D-5L (assessment index) value is entered and the "Save" button is pressed to register or update the EQ-5D-5L value. Similarly, when the "Health Status VAS" tab in the "QOL" category is clicked, the "View / Update Functional Assessment Information at Time of Exit (Health Status VAS for QOL Category)" screen (not shown) is displayed. Then, in the "Functional Assessment Information" field on that screen, the health status VAS (assessment index) value is entered and the "Save" button is pressed to register or update the health status VAS value. As described above, values ​​for multiple assessment indexes for the QOL category are registered.

[0063] In this manner, functional assessment information at the time of discharge, consisting of the values ​​of one or more evaluation indices belonging to multiple major functional categories of the target patient, is registered as a record in the functional assessment information table along with the patient ID and time attribute ("time of discharge"). At this time, a determination is made as to whether multiple types of care need to be recommended. If it is determined that any of the care types need to be recommended, the PICS determination for that record is set to "high risk," and the specific care type determined to need to be recommended is proposed as the recommended care type for the target patient. In this manner, functional assessment information at the time of discharge is registered (S10). In this operational flow, all of the multiple types of care are proposed as recommended care types for the target patient according to the values ​​of the evaluation indices for multiple major functional categories in the functional assessment information at the time of discharge.

[0064] [Registering nursing care plan upon discharge (S11)] Next, as shown in Figure 3, the ICU medical staff, in consultation with the patient and their relatives, use System 1 to register a nursing care plan at the time of discharge (S11) in accordance with the type of care suggested by the registration of functional assessment information at the time of discharge (S10).

[0065] In registering the nursing care plan at the time of discharge (S11), by clicking on each of the tabs for the displayed care types (all of the multiple care types) in the "Nursing Care Plan" in the "Menu" column of the "Viewing / Updating Functional Assessment Information at the Time of Discharge" screen (e.g., FIG. 8) or the "Viewing / Updating Nursing Care Plan at the Time of Discharge" screen shown in FIG. 9, the nursing care plan input / output unit displays each "Viewing / Updating Nursing Care Plan at the Time of Discharge" screen (e.g., FIG. 9) corresponding to the care type in each tab. At this time, the nursing care plan input / output unit displays the recommended team and job type corresponding to the care type in the "Consultant" column of the "Nursing Care Plan" on the screen. In response to this, the user inputs or selects a nursing care plan for the care type in the "Nursing Care Plan" column while referring to the recommended team and job type, and then presses the "Save" button. The nursing plan input / output unit then inputs the nursing plan for that care type, and the nursing plan registration unit registers the nursing plan for that care type as a record in the nursing plan table together with the patient ID and timing attribute ("time of leaving the room"), or updates the record with the nursing plan for that care type.

[0066] Specifically, when clicking the "Physical Care" tab, the "View / Update Nursing Care Plan at Discharge (Physical Care)" screen shown in Figure 9 is displayed, and the nursing care plan for physical care is entered or selected in the "Nursing Care Plan" field. In this case, the date the nursing care plan was created (year / month / day format), the start date of care, the planned evaluation date, and the evaluation date (year / month / day format), as well as the nursing problems, nursing goals, predicted future problems, and the patient's goals (hereinafter sometimes abbreviated as "basic plan information") are entered in the corresponding text boxes. The recommended team for care consultation is also selected by checking the corresponding checkbox (rehabilitation team, respiratory support team, pressure ulcer support team, nutrition support team, dental team, psychiatric liaison team, medical consultation room, and discharge support team). Additionally, the recommended profession for the care consultant can be selected by checking the corresponding checkbox options (physical therapist, occupational therapist, respiratory therapist, certified skin and continence care nurse, nutritionist, speech and language pathologist, certified dysphagia nurse, dentist / dental hygienist, psychiatrist, psychologist, certified dementia care nurse, psychiatric nurse specialist, occupational therapist, medical social worker, and family care nurse). Note that the "Consultant" in the "Nursing Plan" column displays the recommended team (rehabilitation team, respiratory support team, and pressure ulcer support team) and recommended profession (physical therapist, occupational therapist, respiratory therapist, and certified skin and continence care nurse) according to the type of care, so the team and profession can be selected based on this. Furthermore, the necessity of 13 care items, consisting of respiratory care / respiratory rehabilitation, neuromuscular electrical stimulation, range of motion training, strength training / stretching, sitting / standing / standing / walking training, ADL / self-care enhancement, aerobic exercise (ergometer, etc.), rehabilitation leading to return to work or hobby activities, nutritional improvement, sleep improvement, rehabilitation techniques: enhancing sense of accomplishment, rehabilitation techniques: utilizing group dynamics, and other care, can be selected from the pull-down options ("needed" or "no"), and specific care for each care item selected as "needed" can be entered in the corresponding text box. After entering or selecting a nursing care plan for physical care in this way, pressing the "Save" button registers or updates the nursing care plan for that type of care.

[0067] Similarly, when clicking the "Nutrition Care" tab, the "View / Update Nursing Care Plan Upon Discharge (Nutrition Care)" screen (not shown) is displayed, and a nutrition care nursing plan is entered or selected in the "Nursing Care Plan" field. In this case, as with clicking the "Physical Care" tab, basic plan information is entered in the text boxes, and the recommended team and occupation for care consultation are selected by checking the corresponding checkboxes. Furthermore, the necessity of seven care items, consisting of mealtime environment and position adjustment, meal provision taking into consideration patient preferences, nutritional support (early enteral nutrition, oral nutritional supplements, etc.), oral and dental hygiene, swallowing training, bowel control, and other care, is selected from the corresponding pull-down options ("Needed" or "No"), and specific care for each care item selected as "Needed" is entered in the corresponding text box. After entering or selecting a nutrition care nursing plan, clicking the "Save" button registers or updates the nursing care plan for that care type.

[0068] Similarly, when clicking the "Cognitive Care" tab, the "View / Update Nursing Care Plan Upon Discharge (Cognitive Care)" screen (not shown) is displayed, and a nursing care plan for cognitive care is entered or selected in the "Nursing Care Plan" field. In this case, as with clicking the "Physical Care" tab, basic plan information is entered in the text boxes, and the recommended team and occupation for care consultation are selected by checking the corresponding checkboxes. Furthermore, the necessity of nine care items, including reality orientation, occupational therapy, adjustment of daily rhythms (activity / rest rhythm), continuation of daily habits (watching television, reading newspapers, hobbies, etc.), ensuring opportunities for interaction with others (group rehabilitation, etc.), use of reflection tools (ICU diary, daily diary, memory notebook, etc.), ensuring active interaction and dialogue with family, medication control, and other care, is selected from the corresponding pull-down options ("Needed" or "No"), and specific care for each care item selected as "Needed" is entered in the corresponding text box. In this way, by inputting or selecting a nursing care plan for cognitive care and then pressing the "Save" button, the nursing care plan for that type of care is registered or updated accordingly.

[0069] Similarly, when clicking the "Mental Care" tab, the "View / Update Nursing Care Plan at Discharge (Mental Care)" screen (not shown) is displayed, and a mental care nursing plan is entered or selected in the "Nursing Care Plan" field. In this case, as with clicking the "Physical Care" tab, basic plan information is entered in the text boxes, and the recommended team and profession for care consultation are selected by checking the corresponding checkboxes. Furthermore, the necessity of nine care items, including active listening, empathy, and affirmation, providing information on the patient's condition's prognosis, utilizing reflection tools (e.g., ICU diary, daily diary, memory notebook), filling in memory gaps and correcting distortions, providing opportunities for interaction with other post-intensive care patients (peers), ensuring active interaction and dialogue with family members, refreshing the mind (e.g., outdoor bathing, listening to music), medication control, and other care, is selected from the corresponding pull-down options ("Needed" or "No"), and specific care for each care item selected as "Needed" is entered in the corresponding text box. In this way, by inputting or selecting a nursing care plan for mental care and then pressing the "Save" button, the nursing care plan for that type of care is registered or updated accordingly.

[0070] Similarly, when clicking the "Family Care" tab, the "View / Update Nursing Care Plan at Discharge (Family Care)" screen (not shown) is displayed, and the nursing care plan for family care is entered or selected in the "Nursing Care Plan" field. In this case, as with clicking the "Physical Care" tab, basic plan information is entered in the text boxes, and the recommended team and occupation for care consultation are selected by checking the corresponding checkboxes. Furthermore, the necessity of six care items—listening to, empathizing with, and affirming the family's feelings; sharing the patient's recovery (visiting, providing photos and videos); providing information to help visualize future life; providing care for the family using the ICU diary; educating the family about life after discharge; and other care—is selected from the pull-down options ("Needed" and "No"), and specific care for each care item selected as "Needed" is entered in the corresponding text box. After entering or selecting the nursing care plan for family care, pressing the "Save" button registers or updates the nursing care plan for that care type.

[0071] In this way, the nursing care plan of the recommended care type for the target patient is registered as a record in the nursing care plan table together with the patient ID and the time attribute ("time of leaving the room").

[0072] After registering the nursing care plan for the recommended care type, click the "Summary" tab in the "Nursing Care Plan" section of the "Menu" field on the "View / Update Nursing Care Plan at Discharge" screen (e.g., Figure 9), and the summary input / output unit will display the "Register Summary at Discharge" screen shown in Figure 10. Then, in the "Summary" field on this screen, enter a summary of the patient's progress to date and any remaining issues into the corresponding text boxes as the PICS progress summary for the patient, and then press the "Save" button. The summary input / output unit then inputs the progress summary, and the summary registration unit registers the progress summary together with the patient ID and time attribute ("at discharge") as a record in the progress summary table. By registering the nursing care plan at discharge (S11) in this manner, a nursing care plan tailored to the patient's condition can be easily created.

[0073] [Registration of follow-up observations in general wards and admission / discharge information at the time of discharge (S21 and S22)] Next, as shown in Fig. 3, the target patient undergoes follow-up observation in the general ward (S21) from the time he or she leaves the ICU 20 and moves to the general ward 30 until he or she is discharged from the hospital. At this time, medical staff in the general ward (user ID: "sx0002") observe the progress of the target patient and provide treatment as necessary. Thereafter, when the target patient is discharged from the general ward 30 (in this specification, the time when a patient is discharged from the general ward may be abbreviated as "time of discharge"), medical staff in the general ward use system 1 to register admission and discharge information at the time of discharge (S22).

[0074] In registering admission / discharge information at the time of discharge (S22), first, a medical staff member in the general ward connects to the AP server 6 from the general ward terminal 30a using a web browser, and on the "Login" screen (FIG. 4) displayed on the output device, enters the user ID ("sx0002") and password previously assigned to the medical staff member in the general ward into the corresponding text boxes, and presses the "Login" button. The login information input unit then inputs the user ID and password. Based on the determination by the login processing unit, the medical staff member in the general ward logs into the system 1, and the patient management information output unit displays the "General Ward Patient Management" screen shown in FIG. 11. In response to a request from the login information input unit, the patient information acquisition unit acquires the organization ID ("toho") associated with the user ID ("sx0002") from the user information table, acquires one or more patient IDs associated with the organization ID from the access permission table, and acquires only the patient information and functional evaluation information records associated with the one or more patient IDs from the patient information table and the functional evaluation information table. The patient management information output unit then displays a list of the records in the "Patient List" field on the "General Ward Patient Management" screen (Figure 11). At this time, the record information displayed includes the patient ID, as well as the PICS assessment for each period attribute ("High Risk" or "Low Risk"), and a link is set to the patient ID of each patient record.

[0075] Next, by clicking the link for the patient ID ("pxYYYY") of the target patient included in the record displayed in the "Patient List" column, the patient information input / output unit displays the "View / Update Patient Information" screen (Figure 6). Then, by clicking the "Discharge" tab under "Time" in the "Menu" column, the "View / Update Admission / Discharge Information at Discharge" screen shown in Figure 12 is displayed by the admission / discharge information input / output unit. Next, in the "Admission / Discharge Information" column on the "View / Update Admission / Discharge Information at Discharge" screen (Figure 12), the target patient's admission date and discharge date (year / month / day format) are entered in the corresponding text boxes. Then, by pressing the "Calculate" button for "Length of Hospital Stay (days)," the calculation processor calculates the target patient's length of hospital stay (days) and enters it in the corresponding text box. The target patient's outcome is also selected from the pull-down options ("Death," "Discharge," "Transfer," "Readmission within 1 year," and "Other"). The discharge destination of the target patient is selected from the pull-down options ("Home," "Transfer," "Facility," and "Other"). The number of days (days) during the target patient's hospitalization during which they were positive for delirium is entered in the text box. The period during which the target patient was on a ventilator during hospitalization is entered in the text box. Furthermore, whether or not there will be a post-discharge visit is selected from the pull-down options ("Yes" and "No"). Next, the "Save" button in the "Admission / Discharge Information" field is pressed. The admission / discharge information input / output unit then inputs the entered or selected admission / discharge information, and the admission / discharge information registration unit registers the admission / discharge information together with the patient ID as a record in the admission / discharge information table. In this way, the admission / discharge information at the time of discharge is registered (S22).

[0076] [Functional assessment at discharge and registration of functional assessment information (S23 and S24)] Next, as shown in Figure 3, at the time of discharge, medical staff in the general ward conduct a functional assessment of the target patient at the time of discharge (S23) to obtain functional assessment information at the time of discharge, and then use System 1 to register the functional assessment information at the time of discharge (S24).

[0077] In the functional assessment at discharge (S23), similar to the functional assessment at discharge (S9), evaluation of the evaluation indicators belonging to each of the target patient's multiple major functional categories is performed. In addition, evaluation of evaluation indicators belonging to other functional categories is also performed. At this time, the level of return (evaluation indicators) is evaluated. The evaluation of the level of return to work evaluates the level of return to hobbies and entertainment (leisure activities). Specifically, the level of return to work is evaluated on a five-point scale: 1 "returned to the same occupation / workplace as before hospitalization," 2 "changed occupation / workplace as a result of hospitalization," 3 "reduced the frequency of work as a result of hospitalization," 4 "became unemployed as a result of hospitalization," and 5 "was originally unemployed and remains unemployed." In addition, the level of return to hobbies and entertainment (leisure activities) is assessed on a five-point scale: 1 "Resumed the same hobbies and entertainment activities as before hospitalization," 2 "Changed hobbies and entertainment activities as a result of hospitalization," 3 "Decreased the frequency of hobbies and entertainment activities as a result of hospitalization," 4 "No longer able to engage in hobbies and entertainment activities as a result of hospitalization," and 5 "Had no hobbies or entertainment activities to begin with, and still have no hobbies." The values ​​of these return levels are obtained as values ​​for the evaluation index for other functional categories. In this way, functional assessment information at the time of discharge is obtained, consisting of values ​​for evaluation indexes for multiple major functional categories and other functional categories for the target patient.

[0078] In registering functional assessment information at the time of discharge (S24), similar to the registration of functional assessment information at discharge (S10), by clicking on one or more tabs of evaluation indexes belonging to multiple major functional categories in the "Functional Assessment" section of the "Menu" field of the "Viewing / Updating Admission / Discharge Information at Discharge" screen (FIG. 12) or the "Viewing / Updating Functional Assessment Information at Discharge" screen as shown in FIG. 13, the functional assessment information input / output unit displays each "Viewing / Updating Functional Assessment Information at Discharge" screen (e.g., FIG. 13) corresponding to the evaluation index of each tab. Then, similar to the registration of functional assessment information at discharge (S10), by inputting or selecting the value of the evaluation index in the "Functional Assessment Information" field of the screen and pressing the "Save" button, the functional assessment information input / output unit and the functional assessment information registration unit register the value of the evaluation index together with the patient ID and timing attribute ("Time of Discharge") as a record in the functional assessment information table, or update the record with the value of the evaluation index. Next, by clicking the "Return" tab for the "Other" functional category, the functional evaluation information input / output unit will display the "View / update functional evaluation information at time of discharge (return of other categories)" screen (not shown). Then, in the "Functional evaluation information" field on that screen, enter or select the value of the evaluation index for the other functional category and press the "Save" button. This causes the functional evaluation information input / output unit and the functional evaluation information registration unit to update the record in the functional evaluation information table with the value of the evaluation index for the other functional category.

[0079] In this manner, functional assessment information at the time of discharge, consisting of the evaluation index values ​​for multiple major functional categories and other functional categories, is registered as a record in the functional assessment information table along with the patient ID and time attribute ("Time of Discharge"). At this time, as with the registration of functional assessment information at discharge (S10), a determination is made as to whether multiple types of care need to be recommended. If it is determined that any of the care types need to be recommended, the PICS judgment for that record is set to "High Risk" to distinguish it. Otherwise, the PICS judgment for that record is maintained at its default value of "Low Risk." Then, a specific care type determined to need to be recommended is proposed as the recommended care type for the target patient. In this operational flow, all of the multiple types of care are proposed as recommended care types for the target patient based on the evaluation index values ​​for multiple major functional categories in the functional assessment information at the time of discharge.

[0080] [Registering nursing care plan at discharge (S25)] Next, as shown in Figure 3, medical staff in the general ward, in consultation with the patient and their relatives, use System 1 to register a nursing care plan at the time of discharge (S25) in accordance with the type of care suggested by the registration of functional assessment information at the time of discharge (S24).

[0081] In registering the nursing care plan at discharge (S25), similar to registering the nursing care plan at discharge (S11), the user clicks on the tabs for the displayed care types (all of the multiple care types) in the "Nursing Care Plan" section of the "Menu" column of the "Viewing / Updating Functional Assessment Information at Discharge" screen (e.g., FIG. 13) or the "Viewing / Updating Nursing Care Plan at Discharge" screen shown in FIG. 14, causing the nursing care plan input / output unit to display the "Viewing / Updating Nursing Care Plan at Discharge" screen (e.g., FIG. 14) corresponding to the care type in each tab. In response, while referring to the recommended team and occupation, the user inputs or selects a nursing care plan for that care type in the "Nursing Care Plan" column, similar to registering the nursing care plan at discharge (S11), and then presses the "Save" button. The nursing care plan input / output unit and nursing care plan registration unit then register the nursing care plan for that care type as a record in the nursing care plan table together with the patient ID and timing attribute ("at the time of discharge"), or update the record with the nursing care plan for that care type. In this way, the nursing care plan of the recommended care type for the target patient is registered as a record in the nursing care plan table together with the patient ID and the timing attribute ("at the time of discharge").

[0082] After registering the nursing care plan for the recommended care type, click the "Summary" tab in the "Nursing Care Plan" section of the "Menu" field on the "View / Update Nursing Care Plan at Discharge" screen (e.g., Figure 14), which will cause the summary input / output unit to display the "Register Discharge Summary" screen shown in Figure 15. Then, in the "Summary" field on this screen, enter a summary of the patient's progress to date and any remaining issues into the appropriate text boxes as the PICS progress summary for the patient, and then click the "Save" button. The summary input / output unit and summary registration unit then register the progress summary together with the patient ID and time attribute ("at the time of discharge") as a record in the progress summary table. By registering the nursing care plan at discharge (S25) in this manner, a nursing care plan tailored to the patient's condition can be easily created.

[0083] In the above-mentioned processes from follow-up observation in the general ward (S21) to registering the nursing care plan at the time of discharge (S25), medical staff in the general ward use System 1 and, for example, by clicking the “Basic,” “Before admission,” “At admission,” and “At discharge” tabs under “Time” in the “Menu” column of the “View and update patient information” screen (Fig. 6), etc., the “View and update patient information” screen (Fig. 6), the “View and update functional assessment information before admission” screen (not shown), the “View and update functional assessment information at admission” screen (not shown), the “View and update intensive care information” screen (Fig. 7), the “View and update severity assessment information” screen (not shown), the “View and update functional assessment information at discharge” screen (e.g., Fig. 8), the “View and update nursing care plan at discharge” screen (e.g., Fig. 9), and the “Register summary at discharge” screen (Fig. 10) can be displayed, and the staff can refer to the patient information, intensive care information, functional assessment information, severity assessment information, nursing care plan, progress summary, etc. entered on these screens. This allows medical staff in general wards to easily understand and respond to patients' progress. Similarly, medical staff in the ICU can easily understand the progress of patients after they leave the ICU, and can cooperate with medical staff in general wards when necessary.

[0084] When the target patient is discharged from the hospital, the doctor creates a referral letter referring the patient to the affiliated clinic 52. The referral letter contains the patient ID ("pxYYYY") and name of the target patient as well as a user ID ("sx0004") and password assigned to the medical staff of the affiliated clinic. When creating the referral letter, the medical staff of the general ward uses the access permission assignment function of system 1 to register new access permission information, including the patient ID ("pxYYYY") of the target patient and the organization ID ("clinic01") of the affiliated clinic 52, as a record in the access permission table, as shown in FIG. 2B.

[0085] [Follow-up observation, functional assessment, and registration of functional assessment information 6 months after discharge (S31-S33)] Next, as shown in FIG. 3, after the target patient is discharged from the general ward 30, six months after he or she leaves the ICU 20, the target patient visits the affiliated clinic 52. At the affiliated clinic 52 (outpatient facility), a follow-up observation six months after discharge (S31) is conducted. At this time, medical staff at the affiliated clinic (user ID: "sx0004") observe the target patient's progress and provide treatment as needed. Furthermore, the medical staff at the affiliated clinic conducts a functional evaluation of the target patient six months after discharge (S32) to obtain functional evaluation information six months after discharge, and registers the functional evaluation information six months after discharge using the system 1 (S33).

[0086] In the functional assessment six months after discharge (S32), similar to the functional assessment at the time of discharge (S23), evaluation of the evaluation indexes belonging to each of the target patient's multiple major functional categories, as well as evaluation of evaluation indexes belonging to other functional categories, is performed. This obtains functional assessment information six months after discharge consisting of the values ​​of the evaluation indexes for the target patient's multiple major functional categories and other functional categories.

[0087] To register functional evaluation information six months after discharge (S33), first, a medical staff member of the affiliated clinic connects to the AP server 6 from the outpatient terminal 52a of the affiliated clinic using a web browser, and on the "Login" screen (Fig. 4) displayed on the output device, enters the user ID ("sx0004") and password previously assigned to the medical staff member of the affiliated clinic and written on the referral letter into the text boxes, respectively, and presses the "Login" button. The login information input unit then inputs the user ID and password, and based on the judgment of the login processing unit, the medical staff member of the affiliated clinic logs in to system 1, and the patient management information output unit displays the "Affiliated Clinic's Patient Management" screen shown in Fig. 16. In this case, in response to a request from the login information input unit, the patient information acquisition unit acquires the organization ID ("clinic01") linked to the user ID ("sx0004") from the user information table, acquires one or more patient IDs linked to the organization ID from the access permission table, and acquires only the patient information and functional evaluation information records linked to the one or more patient IDs from the patient information table and the functional evaluation information table.The patient management information output unit then displays a list of the records in the "Patient List" field on the "Affiliated Clinic Patient Management" screen (Figure 16).In this case, in addition to the patient ID, etc., the PICS judgment for each time attribute ("High Risk" or "Low Risk") is displayed as record information, and a link is set to the patient ID of each patient information.

[0088] Next, by clicking the link for the patient ID ("pxYYYY") of the target patient listed on the referral letter included in the record displayed in the "Patient List" column, the patient information input / output unit displays the "View / Update Patient Information" screen (Figure 6). Then, by clicking the "6 Months" tab under "Time" in the "Menu" column, the "Functional Assessment" in the "Menu" column displays tabs for one or more evaluation indicators belonging to multiple major functional categories and a "Return" tab under the "Other" functional category, as shown in Figure 17. Next, as in the case of registering functional assessment information at the time of discharge (S10), by clicking each of the tabs for one or more evaluation indicators belonging to multiple major functional categories, the functional assessment information input / output unit displays the "View / Update Functional Assessment Information 6 Months After Discharge" screen (e.g., Figure 17) corresponding to the evaluation indicator in each tab. Then, as in the case of registering functional assessment information at the time of discharge (S10), in the "Functional Assessment Information" column of the screen, the user inputs or selects the value of the evaluation indicator and presses the "Save" button. As a result, the functional evaluation information input / output unit and the functional evaluation information registration unit register the value of the evaluation index together with the patient ID and time attribute ("6 months after discharge") as a record in the functional evaluation information table, or update the record with the value of the evaluation index. Next, as in the case of registering functional evaluation information at the time of discharge (S24), by clicking the "Return" tab for the "Other" functional category, the functional evaluation information input / output unit displays the "View / Update Functional Evaluation Information 6 Months After Discharge (Return of Other Category)" screen (not shown). Then, as in the case of registering functional evaluation information at the time of discharge (S24), in the "Functional Evaluation Information" field on the screen, enter or select the value of the evaluation index for the other functional category, and then press the "Save" button. As a result, the functional evaluation information input / output unit and the functional evaluation information registration unit update the record in the functional evaluation information table with the value of the evaluation index for the other functional category.

[0089] In this manner, functional assessment information six months after discharge, consisting of the evaluation index values ​​for multiple major functional categories and other functional categories, is registered as a record in the functional assessment information table along with the patient ID and time attribute ("6 months after discharge"). At this time, as with the registration of functional assessment information at discharge (S10), a determination is made as to whether multiple types of care need to be recommended. If a recommendation for any of the care types is determined to be necessary, the PICS assessment for that record is set to "high risk" for distinction; otherwise, the PICS assessment for that record is maintained at its default value of "low risk." Then, a specific care type determined to be necessary is proposed as the recommended care type for the target patient. In this operational flow, all of the multiple types of care are proposed as recommended care types for the target patient based on the evaluation index values ​​for multiple major functional categories in the functional assessment information six months after discharge.

[0090] [Registering a nursing plan six months after discharge (S34)] Next, as shown in Figure 3, medical staff at the affiliated clinic, in consultation with the patient and their relatives, use System 1 to register a nursing care plan for six months after discharge (S34) in accordance with the type of care suggested by the registration of functional assessment information six months after discharge (S33).

[0091] In registering the nursing care plan six months after discharge (S34), similar to registering the nursing care plan at the time of discharge (S11), the user clicks on the tabs for the displayed care types (all of the multiple care types) in the "Nursing Care Plan" section of the "Menu" field on the "Viewing and Updating Functional Assessment Information Six Months After Discharge" screen (e.g., FIG. 17) or the "Viewing and Updating Nursing Care Plan Six Months After Discharge" screen shown in FIG. 18, causing the nursing care plan input / output unit to display the "Viewing and Updating Nursing Care Plan Six Months After Discharge" screen (e.g., FIG. 18) corresponding to the care type in each tab. In response, while referring to the recommended team and occupation, the user inputs or selects a nursing care plan for that care type in the "Nursing Care Plan" field, and then presses the "Save" button, similar to registering the nursing care plan at the time of discharge (S11). The nursing care plan input / output unit and nursing care plan registration unit then register the nursing care plan for that care type together with the patient ID and time attribute ("6 months after discharge") as a record in the nursing care plan table, or update the record with the nursing care plan for that care type. In this way, the nursing care plan of the recommended care type for the target patient is registered as a record in the nursing care plan table together with the patient ID and the time attribute ("6 months after discharge").

[0092] When registering a nursing care plan for a recommended care type in this way, the "Displaying functional progress 6 months after discharge" screen shown in FIG. 19 can be displayed by clicking the "Functional Progress" tab under "Progress" in the "Menu" column of the "View / Update Nursing Care Plan 6 Months After Discharge" screen (e.g., FIG. 18). In this case, the functional progress information output unit and the reference evaluation index output unit request the target patient's functional assessment information for multiple periods from before admission to 6 months after discharge, as well as patient information, intensive care information, and severity assessment information, from the AP server 6. The functional progress information acquisition unit and the reference evaluation index acquisition unit then acquire the target patient's functional assessment information for multiple periods, as well as patient information, intensive care information, and severity assessment information, from the functional assessment information table, patient information table, intensive care information table, and severity assessment information table as information linked to the target patient's patient ID.

[0093] Then, based on the functional assessment information of the subject patient over the multiple time periods, the functional progress information output unit displays graphs (functional progress information) of the physical function score, nutritional score, cognitive function score, and mental function score in the "functional progress information" column of the screen (FIG. 19), which respectively show the time-dependent changes in the values ​​of the evaluation indices belonging to the subject patient's physical function category, nutritional category, cognitive function category, and mental function category over the multiple time periods. Specifically, the physical function score graph shows the values ​​of the evaluation indices belonging to the subject patient's physical function category over the multiple time periods (e.g., Barthel Index, grip strength, IMS, and physical function VAS). The nutrition score graph shows the values ​​of the evaluation indices belonging to the subject patient's nutritional category over the multiple time periods (e.g., height, weight, BMI, and SGA assessment level). The cognitive function score graph shows the values ​​of the evaluation indices belonging to the subject patient's cognitive function category over the multiple time periods (e.g., MMSE score, SMQ score, and cognitive function VAS). The mental function score graph shows the values ​​of the evaluation indicators (e.g., HADS score, anxiety score, depression score, IES-R score, intrusion symptom score, avoidance symptom score, hyperarousal symptom score, and mental function VAS) belonging to the mental function category for the target patient over the multiple periods. In addition to these graphs, graphs showing the changes over time in the values ​​of the evaluation indicators belonging to the family category, the stress category, and the QOL category may also be displayed. Furthermore, in the "Functional Progress Information" column, an explanation of the meaning and threshold of the evaluation indicators belonging to the physical function category, nutrition category, cognitive function category, mental function category, etc. is displayed below the above graphs. The explanation of the threshold explains that if the value of each evaluation indicator is above (greater than) or below (less than) a predetermined threshold, a warning will be displayed in the care type tab to indicate that a specific type of care corresponding to the major function category to which the evaluation indicator belongs is required.

[0094] Furthermore, the reference evaluation index output unit displays the patient's risk factor information for PICS development, which is necessary for determining the necessity of each type of care and its associated care items, as well as specific care, in the "Reference Evaluation Index" column of the "Display of Functional Progress 6 Months After Discharge" screen (Figure 19) based on the patient's patient information, intensive care information, and severity assessment information. The reference evaluation indexes are displayed on the same screen (Figure 19) as the graph showing the time-dependent changes in the evaluation index values. Specifically, the reference evaluation indexes related to patient information include the patient's age and gender, whether or not they had a history of dementia, delirium, or psychiatric illness before admission, and whether or not they had undergone surgical treatment for their current illness. The reference evaluation indexes related to intensive care information include the duration of ICU stay, duration of mechanical ventilation, type of ICU admission, type of assisted circulation used, use of blood purification therapy, type of analgesic used, use of benzodiazepines, number of days of deep sedation, use of muscle relaxants, and whether or not they had sepsis during their stay. Furthermore, the APACHE II score of the target patient, as well as the SOFA scores at admission, on the third day, and on the seventh day, are displayed as reference evaluation indices related to the severity assessment information. Therefore, when registering a nursing care plan for the recommended care type, medical staff at the affiliated clinic, the target patient himself / herself, and his / her relatives can refer to both the graph showing the time-dependent changes in the values ​​of the evaluation indices belonging to the target patient's multiple major functional categories and the target patient's reference evaluation indices on the same screen (Figure 19), allowing them to register a nursing care plan that is in line with the target patient's detailed actual situation.

[0095] After registering the care type nursing care plan, click the "Summary" tab in the "Nursing Care Plan" section of the "Menu" field on the "View / Update Nursing Care Plan 6 Months After Discharge" screen (e.g., Figure 18). This will cause the summary input / output unit to display the "Register Summary 6 Months After Discharge" screen shown in Figure 20. Then, in the "Summary" field on this screen, enter a summary of the patient's progress to date and any remaining issues into the appropriate text boxes as the patient's PICS progress summary, and then click the "Save" button. This causes the summary input / output unit and summary registration unit to register the progress summary together with the patient ID and time attribute ("6 Months After Discharge") as a record in the progress summary table. By registering the nursing care plan 6 months after discharge (S34) in this manner, a nursing care plan tailored to the patient's condition can be easily developed.

[0096] In the above-mentioned steps from the follow-up observation six months after discharge (S31) to the registration of the nursing care plan six months after discharge (S34), the medical staff of the affiliated clinic use System 1, and by clicking the tabs "Basic," "Before admission," "At admission," "At discharge," and "At discharge" under "Time" in the "Menu" column of the "View and update patient information" screen (Fig. 6), for example, the "View and update patient information" screen (Fig. 6), the "View and update functional assessment information before admission" screen (not shown), the "View and update functional assessment information at admission" screen (not shown), the "View and update intensive care information" screen (Fig. 7), the "View and update severity assessment information" screen, and the "View and update patient information" screen can be displayed. The system displays the following screens: "Viewing and updating functional assessment information at discharge" screen (not shown), "Viewing and updating nursing care plan at discharge" screen (e.g., Figure 8), "Viewing and updating nursing care plan at discharge" screen (e.g., Figure 9), and "Registering summary at discharge," as well as the "Viewing and updating admission and discharge information at discharge" screen (Figure 12), "Viewing and updating functional assessment information at discharge" screen (Figure 13), "Viewing and updating nursing care plan at discharge" screen (Figure 14), and "Registering summary at discharge" screen (Figure 15), and allows users to refer to and respond to the patient information, intensive care information, severity assessment information, admission and discharge information, functional assessment information, nursing care plan, and progress summary entered on these screens. This allows medical staff at affiliated clinics to easily understand and respond to the patient's progress. Similarly, ICU medical staff can easily understand the patient's progress after discharge from the ICU and can cooperate with medical staff at affiliated clinics as necessary.

[0097] [Operational flow 12 months after vacating and thereafter] Next, as shown in FIG. 3, 12 months after the target patient is discharged from the ICU 20, the target patient visits the affiliated clinic 52 (outpatient facility) again, and a follow-up observation 12 months after discharge (S41) is conducted at the affiliated clinic 52. Furthermore, medical staff at the affiliated clinic conduct a functional assessment of the target patient 12 months after discharge (S42) and register the functional assessment information 12 months after discharge (S43). Next, as shown in FIG. 3, medical staff at the affiliated clinic register a nursing care plan 12 months after discharge (S44). The contents of S41 to S44 are the same as S31 to S34, respectively, except that the time attribute is "12 months after discharge." Furthermore, even after 12 months after discharge, the progress of the target patient's PICS can be tracked and shared among medical staff at the ICU, general wards, and outpatient facilities by using the system 1, for example, by periodically conducting the same processes as S31 to S34.

[0098] The above provides a detailed description of an embodiment of the PICS information sharing system according to the present invention. However, the present invention is not limited to the above-described embodiment, and various design modifications can be made without departing from the spirit of the present invention as set forth in the claims. [Explanation of symbols]

[0099] 1: PICS information sharing system, 10: Hospital with ICU, 20: ICU, 20a: ICU terminal, 30: General ward, 30a: General ward terminal, 52: Affiliated clinic, 52a: Outpatient terminal, 5: Management server, 6: Application server, 7: PICS database, 9: Web application, N: Network, 100: Electronic medical record sharing system, 105: Electronic medical record management server, 107: Electronic medical record database

Claims

1. a management server that manages PICS information including risk factor information on the onset of PICS and functional evaluation information related to PICS for patients receiving intensive care in an ICU; an ICU terminal managed in the ICU, a general ward terminal managed in a general ward to which the patient is moved after being discharged from the ICU, and an outpatient terminal managed in an outpatient facility to which the patient is treated as an outpatient after being discharged from the general ward; The ICU terminal, the general ward terminal, and the outpatient terminal are connected to the management server via a network, and are used to view and update the PICS information of the patient, The ICU terminal inputs the functional evaluation information when the patient leaves the ICU, and the management server registers the input functional evaluation information as the PICS information; the general ward terminal inputs the functional evaluation information of the patient at the time of discharge from the general ward, and the management server registers the input functional evaluation information as the PICS information; A PICS information sharing system characterized in that the outpatient terminal inputs the functional evaluation information when the patient receives medical treatment at the outpatient clinic, and the management server registers the input functional evaluation information as the PICS information.

2. the PICS information further includes a patient's PICS care plan; The ICU terminal further inputs the nursing care plan at the time of the patient's discharge from the ICU, and the management server further registers the input nursing care plan as the PICS information, The general ward terminal inputs the nursing care plan at the time of discharge of the patient from the general ward, and the management server further registers the input nursing care plan as the PICS information; The PICS information sharing system described in claim 1, characterized in that the outpatient terminal inputs the nursing care plan when the patient receives medical treatment at the outpatient clinic, and the management server further registers the input nursing care plan as the PICS information.

3. The PICS information sharing system according to claim 1 or 2, characterized in that the management server, in response to a request from any one of the ICU terminal, the general ward terminal, and the outpatient terminal, determines whether or not a specified type of care needs to be recommended for the patient's PICS based on the functional evaluation information input from that terminal, and causes the terminal to output the determination result of the necessity.

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