Remote medical support device, remote medical support system, remote medical support method, and remote medical support program

Abstract

To combine a sharing screen of patient information among a medical team, and interactive communication by a video.SOLUTION: An at-home medical examination support device comprises: a connection management unit that controls connection establishment of direct communication between a first and second terminals; and a medical examination management unit that manages medical examination information on a patient receiving a remote medical examination. The medical examination unit is configured to: generate display information for making the medical examination information display on a screen of the first terminal in accordance with a request from the first terminal having the connection to the second terminal established; embed processing of making a photographing image of a user using the first terminal photographed by the first terminal transmit to the second terminal by the direct connection into the display information; and return post-embedded display information to the first terminal.SELECTED DRAWING: Figure 12

Description

[Technical field]

[0001] The present disclosure relates to a remote medical care support device, a system, a method, and a program, and in particular to a remote medical care support device, a system, a method, and a program for supporting remote medical care. [Background technology]

[0002] Patent Document 1 discloses technology relating to a home care support system for sharing information and supporting work between medical workers, welfare workers, etc. in the area of ​​community-based comprehensive care centered on home medical care. The home care support system includes a mobile home care support terminal, a home care support viewer terminal, and a home care support server. Here, the mobile home care support terminal is a terminal carried by a medical worker such as a nurse who visits a patient's home, etc., and the home care support viewer terminal is a terminal used by a medical worker such as a doctor at a medical institution. The home care support server connects the mobile home care support terminal and the home care support viewer terminal so that they can communicate with each other, and controls communication between the terminals via a bulletin board. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2016-51365 A Summary of the Invention [Problem to be solved by the invention]

[0004] Here, in the field of remote medical care including at-home medical care, real-time communication between medical professionals such as doctors at a medical institution and patients or other medical professionals at locations (outside the medical institution) including the patient's home is beneficial. However, the technology disclosed in Patent Document 1 only involves communication via text information such as bulletin boards, and is therefore insufficient for smooth remote medical care.

[0005] The present disclosure has been made to solve such problems, and aims to provide a remote medical support device, system, method, and program that combines a shared screen of patient information between medical professionals with two-way communication via video. [Means for solving the problem]

[0006] A remote medical support device according to a first aspect of the present disclosure includes: a connection manager for controlling connection establishment for direct communication between the first and second terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal.

[0007] A remote medical support system according to a second aspect of the present disclosure includes: First and second terminals; A remote medical care support device connected to the first and second terminals via a network; Equipped with The remote medical care support device includes: A connection management unit that controls establishment of a connection for direct communication between the plurality of terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal.

[0008] A remote medical support method according to a third aspect of the present disclosure includes: The computer Controlling the establishment of a direct communication connection between the first and second terminals; Generate display information for displaying medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal.

[0009] A remote medical support program according to a fourth aspect of the present disclosure, a process for controlling the establishment of a direct communication connection between a first terminal and a second terminal; A process of generating display information for displaying medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; A process of embedding a process of transmitting a captured image of a user using the first terminal, the captured image being captured by the first terminal, to the second terminal through the direct communication in the display information; A process of returning the embedded display information to the first terminal; to be executed by the computer. Effect of the Invention

[0010] The present disclosure makes it possible to provide a remote medical support device, system, method, and program that combines a shared screen for patient information between medical professionals with two-way communication using video. [Brief description of the drawings]

[0011] [Figure 1] 1 is a block diagram showing a configuration of a remote medical support system according to a first embodiment of the present invention. [Diagram 2] 4 is a flowchart showing the flow of the remote medical support method according to the first embodiment. [Diagram 3] 4 is a flowchart showing the flow of the remote medical support method according to the first embodiment. [Figure 4] FIG. 11 is a block diagram showing the configuration of a remote medical support system according to a second embodiment of the present invention. [Diagram 5] FIG. 11 is a block diagram showing the configuration of each DB in a shared storage device according to the second embodiment. [Figure 6] FIG. 11 is a block diagram showing a configuration of a server device according to the second embodiment. [Figure 7] 11 is a flowchart illustrating a flow of login and authentication processing according to the second embodiment. [Figure 8] FIG. 11 is a sequence diagram for explaining the flow of terminal-to-terminal connection processing in the case where ICEs of two terminals according to the second embodiment are registered in the same server. [Figure 9] FIG. 11 is a sequence diagram for explaining the flow of terminal-to-terminal connection processing in the case where ICEs of two terminals according to the second embodiment are registered in the same server. [Figure 10] FIG. 11 is a sequence diagram for explaining the flow of terminal-to-terminal connection processing in a case where ICEs of two terminals according to the second embodiment are registered in different servers. [Figure 11] FIG. 11 is a sequence diagram for explaining the flow of terminal-to-terminal connection processing in a case where ICEs of two terminals according to the second embodiment are registered in different servers. [Figure 12] FIG. 11 is a block diagram showing the configuration of a remote medical support system according to a third embodiment. [Figure 13] 13 is a flowchart showing the flow of a remote medical support method according to the third embodiment. [Figure 14]FIG. 11 is a block diagram showing the configuration of a remote medical support system according to a fourth embodiment of the present invention. [Figure 15] 13 is a flowchart showing the flow of a remote medical support method according to the fourth embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] Hereinafter, embodiments of the present disclosure will be described in detail with reference to the drawings. In each drawing, the same or corresponding elements are denoted by the same reference numerals, and duplicated descriptions will be omitted as necessary for clarity of explanation.

[0013] <Embodiment 1> First, the problem to be solved in the present embodiment 1 will be described. As described above, in the field of remote medical care, it is useful to carry out real-time communication between medical professionals such as doctors at a medical institution and patients, visiting nurses, visiting caregivers, etc. at a base (remote location) different from the medical institution. Therefore, two-way communication using voice or video is required, but the client-server type shown in Patent Document 1 places a high network load in real-time communication such as video, making it difficult to apply to the field of remote medical care including home medical care, which is likely to expand rapidly in the future.

[0014] In recent years, WebRTC (Web Real-Time Communication) has become popular as a technology for directly connecting terminals via P2P (Peer to Peer) without going through a server, enabling high-speed real-time communication such as video communication.

[0015] Therefore, in remote medical care, it is possible to use the above-mentioned P2P communication to transmit two-way video and other real-time communications between terminals. For example, with WebRTC, direct communication between terminals can be established via a signaling server, which makes it possible to realize two-way video communication between terminals at higher speeds with less communication load without going through a server.

[0016] In addition, in the field of remote medical care, it is not enough to simply realize communication between terminals; it is also necessary to maintain a connection with a web system in order to share and update various medical information managed on the server. Therefore, in the field of remote medical care, it is necessary to use both client-server communication and P2P communication. Also, as mentioned above, in order to meet the increasing needs for remote medical care, it is necessary to have redundancy on the server side, especially the signaling server.

[0017] However, current signaling servers do not support redundancy sufficiently, which makes it difficult to apply P2P communication to the field of remote medical care. The reason is that the signaling server only holds pre-registered connection management information (ICE (Interactive Connectivity Establishment) and the like) used to establish a P2P communication connection in the built-in memory. Therefore, even if the signaling server is made redundant, when a first terminal requests the establishment of a P2P communication connection, if the server does not hold ICE or the like for the second terminal to which the connection request is made, the direct communication connection cannot be established.

[0018] Therefore, in the following embodiment 1, the purpose is to have a redundant connection control server perform connection processing for direct communication between any of a large number of terminals that share information with a server for remote medical treatment.

[0019] Fig. 1 is a block diagram showing the configuration of a remote medical treatment support system 1000 according to the first embodiment. The remote medical treatment support system 1000 is an information system for supporting at-home medical treatment (remote medical treatment, online medical treatment) in which a patient receives various medical treatments from a medical professional while remaining at home, etc., other than a medical institution. Here, the medical professional includes a doctor, a nurse, a physical therapist, a caregiver, a pharmacist, etc. In addition, at-home medical treatment includes medical procedures in the narrow sense, such as treatments and procedures performed by a doctor or a nurse under the doctor's instructions, as well as medical procedures in the broad sense, such as rehabilitation performed by a physical therapist, health management and medication management performed by a caregiver, etc.

[0020] The remote medical care support system 1000 includes a storage system 1, remote medical care support devices 21, 22, etc., and terminals 31, 32, etc. The storage system 1 is a group of storage devices configured with one or more storage devices. Therefore, the storage system 1 may be realized by distributing or redundancy using two or more storage devices. The storage system 1 stores usage management information 11 and connection management information 12. Note that there are two or more pieces of usage management information 11 and connection management information 12. The usage management information 11 is management information for a terminal to use various information services provided by the remote medical care support system 1000. The usage management information 11 is associated with at least a usage status 111 and a terminal ID 112. The usage status 111 is information indicating a status such as whether a specific terminal has started up and is using various information services provided by the remote medical care support system 1000 by logging in, etc. The terminal ID 112 is associated with the usage status 111 and is identification information of a specific terminal. The connection management information 12 is information used by a terminal indicated by a terminal ID 122 to establish a connection for direct communication with another terminal. The connection management information 12 associates at least destination information 121 with a terminal ID 122. The destination information 121 is address information assigned to the terminal indicated by the terminal ID 122, such as an IP (Internet Protocol) address.

[0021] The remote medical care support devices 21 and 22 are redundant computer devices, and are both connected to the storage system 1. In other words, it can be said that the storage system 1 is used as a shared disk in the remote medical care support devices 21 and 22. The remote medical care support devices 21 and 22 can be connected to terminals 31 and 32, etc., via a network N. In other words, it can be said that the remote medical care support devices 21 and 22 distribute the load for access from the terminal 31, etc., via the network N. Below, the remote medical care support device 21 will be described as a representative, and since the internal configuration of the remote medical care support device 22 is the same as that of the remote medical care support device 21, illustrations and descriptions will be omitted.

[0022] The remote medical support device 21 includes a medical management unit 211, a connection management unit 212, and a memory 213. The memory 213 is a volatile storage device, such as a RAM (Random Access Memory). The medical management unit 211 inputs and outputs medical information related to a patient receiving remote medical treatment between the terminal. For example, the medical management unit 211 is realized by a WEB application, and in response to a WEB access from a terminal, the medical management unit 211 generates a display page by referring to the storage system 1, etc., and returns the display page to the requesting terminal. In addition, the medical management unit 211 receives data input via the display page at the terminal, and stores the data in the storage system 1, etc. In response to a terminal list request from at least the first terminal, the medical management unit 211 acquires a list of terminal IDs 112 whose usage status 111 is in use from the usage management information 11 of the storage system 1, and returns the list to the first terminal. The above-mentioned medical information includes the patient's personal information, biological information, text information showing records of examinations, prescriptions, nursing care, rehabilitation, etc., images, audio data, etc., and the update dates and times of these. In addition, the list of terminal IDs may include the patient's own terminal ID.

[0023] The connection management unit 212 controls the establishment of a connection for direct communication between terminals. When the connection management unit 212 receives a registration request for connection management information in a specific terminal, the connection management unit 212 holds the connection management information (as connection management information 214) in the memory 213 of the remote medical care support device 21. In addition, the connection management unit 212 registers the connection management information (as connection management information 12) in the storage system 1. When the connection management unit 212 receives a connection management information request (an example of a request for connection establishment) including a second terminal ID of a second terminal selected from the list in the first terminal, the connection management unit 212 searches the memory 213 for the second terminal ID. When the second terminal ID does not exist in the memory 213 (when the search is a miss-hit), the connection management unit 212 searches the storage system 1 for the second terminal ID. The connection management unit 212 acquires second connection management information associated with the second terminal ID from either the memory 213 or the storage system 1 where the second terminal ID exists (where the search hit), and returns the second connection management information to the first terminal. In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the connection management unit 212 inquires of the second terminal whether or not a connection for direct communication with the first terminal is possible based on the second connection management information. Then, in response to a response of connection permission from the second terminal, the connection management unit 212 responds to the first terminal with connection permission for direct communication with the second terminal.

[0024] The remote medical assistance devices 21 and 22 each include a processor and a storage device, which are not shown in the figure. The storage device stores a remote medical assistance program, which is a computer program that implements the remote medical assistance method according to the present embodiment. The processor then reads the remote medical assistance program from the storage device into the memory 213 and executes the remote medical assistance program. As a result, the processor realizes the functions of the medical management unit 211 and the connection management unit 212.

[0025] The network N is a communication network such as the Internet or a dedicated line.

[0026] The terminals 31 and 32 are information processing terminal devices that can access the remote medical care support device 21 or 22, etc., via the network N and can use various information services provided by the remote medical care support system 1000. The terminals 31 and 32 are, for example, information processing terminals capable of wireless communication, such as tablet terminals. The terminals 31 and 32 establish a connection for direct communication via the remote medical care support device 21, etc., and perform real-time communication of video and audio through the direct communication. The terminal 31 stores a terminal ID 311 and connection management information 312 in an internal storage device (not shown). The terminal ID 311 is identification information for identifying the terminal 31, and may use a value corresponding to a telephone number. The connection management information 312 has a configuration equivalent to the above-mentioned connection management information 12, and is information necessary for the terminal 31 to establish a connection for direct communication with another terminal, and information provided to the connection destination during direct communication. Other configurations of the terminal 31 can be known, so illustration and description of other configurations will be omitted. The terminal 32 has a configuration equivalent to that of the terminal 31. Here, the terminal ID 321 is identification information for identifying the terminal 32. Also, the connection management information 322 is information necessary for the terminal 32 to establish a connection for direct communication with another terminal, and is information to be provided to the connection destination during direct communication.

[0027] 2 and 3 are flowcharts showing the flow of the remote medical treatment support method according to the first embodiment. First, the connection management unit 212 of the remote medical treatment support device 21 receives a registration request for connection management information (e.g., connection management information 312) in a specific terminal (e.g., terminal 31) from the terminal (S101). At this time, the connection management unit 212 holds the connection management information in the memory 214 of the device itself (S102). At the same time, the connection management unit 212 registers the connection management information in the storage system 1 (S103).

[0028] The remote medical treatment support device 21 may also separately accept registration of the connection management information 322 from the terminal 32. In that case, steps S102 and S103 are executed in the same manner. That is, in this case, the remote medical treatment support device 21 will hold both the connection management information 312 and 322 in the memory 213. Alternatively, the remote medical treatment support device 21 may accept registration of the connection management information 312 from the terminal 31, but may not accept registration of the connection management information 322 from the terminal 32. In this case, the remote medical treatment support device 21 will hold only the connection management information 312 in the memory 213. The same applies to the case where the remote medical treatment support device 21 accepts registration of the connection management information 322 only from the terminal 32.

[0029] Next, the medical care management unit 211 of the remote medical support device 21 receives a terminal list request from a first terminal (for example, terminal 31) (S104). In response to this, the medical care management unit 211 acquires a list of terminal IDs 112 whose usage status 111 is in use from the usage management information 11 of the storage system 1 (S105). For example, the medical care management unit 211 acquires a list including the terminal ID of terminal 32. Then, the medical care management unit 211 returns the list to the terminal 31 (S106).

[0030] Thereafter, the connection management unit 212 receives a connection management information request including a second terminal ID of a second terminal (e.g., terminal 32) selected from the list returned in step S106 by the terminal 31 (S107). In response to this, the connection management unit 212 searches the memory 213 for the second terminal ID (S108).

[0031] The connection management unit 212 determines whether or not the second terminal ID is present in the memory 213 by searching in step S108 (S109). For example, if the remote medical care support device 21 accepts a registration request for the connection management information 322 from the terminal 32 in step S101, the connection management information 322 is held in the memory 213, so it is determined that the second terminal ID is present in the memory 213 (YES in S109). Then, the connection management unit 212 acquires the second connection management information associated with the second terminal ID from the memory 213 (S110).

[0032] On the other hand, if the remote medical care support device 21 does not receive a registration request for the connection management information 322 from the terminal 32 in step S101, the connection management information 322 is not held in the memory 213, and therefore it is determined that the second terminal ID does not exist in the memory 213 (NO in S109). In this case, the connection management unit 212 searches the storage system 1 for the second terminal ID (S111). Then, the connection management unit 212 determines whether or not the second terminal ID exists in the terminal ID 122 in the connection management information 12 of the storage system 1 by the search in step S111 (S112). Note that if the result in step S112 is NO, the second connection management information cannot be acquired due to some system fraud. Therefore, in this case, the connection management unit 212 returns a message to the terminal 31 indicating that the connection is not possible (S114).

[0033] On the other hand, if it is determined in step S112 that the second terminal ID exists in the storage system 1, the connection management unit 212 acquires second connection management information associated with the second terminal ID from the storage system 1 (S113). After step S110 or S113, the connection management unit 212 returns the acquired second connection management information (for example, the connection management information 322 of the terminal 32) to the first terminal (terminal 31) (S115).

[0034] Then, the connection management unit 212 receives a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal (S116). In response, the connection management unit 212 transmits an inquiry to the second terminal as to whether or not a connection for direct communication with the first terminal is possible based on the second connection management information (S117). Then, the connection management unit 212 receives a response of connection permission from the second terminal (S118), and in response thereto, transmits a response of connection permission for direct communication with the second terminal to the first terminal (S119).

[0035] Thereby, thereafter, the terminal 31 establishes a direct communication connection with the terminal 32 using the connection management information 322 of the terminal 32, and performs real-time communication of video, audio, etc. The terminals 31 and 32 are also connected to the medical care management unit 211 of the remote medical care support device 21, etc., and input and output of medical information can be maintained by a web application, etc. Therefore, according to the first embodiment, the connection process of direct communication between any terminals among a large number of terminals that share information with the server for remote medical care can be realized by a redundant connection control server.

[0036] <Embodiment 2> The present embodiment 2 is a specific example of the above-mentioned embodiment 1. Fig. 4 is a block diagram showing a configuration of a remote medical treatment support system 2000 according to the present embodiment 2. The remote medical treatment support system 2000 includes a shared storage device 4, server devices 51, 52, etc., a load balancer 6, and tablet terminals 710, 720, and 730.

[0037] The shared storage device 4 is a storage device group composed of one or more storage devices, and may be distributed or redundant with two or more storage devices. The shared storage device 4 is connected to server devices 51, 52, etc., and is shared between the server devices 51, 52, etc. The shared storage device 4 has a DBMS (DataBase Management System) running, and includes a plurality of DB instances, namely, a usage management DB 41, a connection management DB 42, a medical personnel DB 43, a medical history DB 44, and an authority definition DB 45.

[0038] FIG. 5 is a block diagram showing the configuration of each DB in the shared storage device 4 according to the second embodiment. The usage management DB 41 is a database for managing a plurality of the above-mentioned usage management information 11. One record managed in the usage management DB 41 is information in which, for example, a user ID 411, a user attribute 412, a terminal ID 413, a usage state 414, a password 415, and a face image 416 are associated with each other. Here, the user ID 411 is identification information of a user of a specific terminal. The user attribute 412 is information indicating attributes of a user who is a related party in a remote medical treatment, for example, a doctor, a nurse, a caregiver, a pharmacist, a patient, etc. The terminal ID 413 is identification information of a terminal that can be used (operated, logged in, etc.) by a user. The usage state 414 is an example of the above-mentioned usage state 111, and is information indicating whether or not a user corresponding to the user ID 411 is using a terminal corresponding to the terminal ID 413. The password 415 is a password used for password authentication when the user ID 411 logs in. The face image 416 is face image data of the user used for face authentication when the user ID 411 logs in.

[0039] The connection management DB42 is a database for managing the ICEs 421, 422, etc. Here, the ICEs 421, etc. are an example of the connection management information 12 described above. For example, the ICE 421 is associated with a terminal ID 4211, a dynamic IP address 4212, and route information 4213. The dynamic IP address 4212 is an example of the destination information 121 described above, and is an address dynamically assigned when the terminal is started up. The route information 4213 is information on a communication route that may reach the connection destination of the P2P communication. The route information 4213 can also be a candidate for route information in the network N via which direct communication is performed. The connection management DB42 may further include an SDP (Session Description Protocol) as the connection management information.

[0040] The medical care related person DB 43 is a database for managing people involved in remote medical care for each patient. For example, a patient ID 431, a doctor ID 432, a nurse ID 433, and a caregiver ID 434 are associated with each other in one record of the medical care related person DB 43. Here, the above-mentioned user ID 411 may be used for the patient ID 431, the doctor ID 432, the nurse ID 433, and the caregiver ID 434. The same applies to the following explanations.

[0041] The medical history DB44 is a database that manages the medical information of each patient and its access authority. For example, a patient ID 441, medical information 442, access authority 443, and user ID 444 are associated with one record of the medical history DB44. Here, the patient ID 441 is the same as the above-mentioned patient ID 431. As described above, the medical information 442 includes the patient's own personal information, biometric information, text information indicating records of examination, prescription, nursing care, rehabilitation, etc., images, voice data, etc., and the update date and time of these, and the type of medical information. The access authority 443 is information indicating the type of authority, such as viewing authority, update authority, etc. The user ID 444 is identification information of a user to whom the access authority 443 is granted for the set of the patient ID 431 and the medical information 442.

[0042] The authority definition DB 45 is a database that defines users to whom access authority is granted according to the type of medical information for each patient. One record of the authority definition DB 45 is, for example, a patient ID 451, a medical information type 452, and a user ID 453 associated with each other. Here, the patient ID 451 is the same as the above-mentioned patient ID 431. The medical information type 452 is, for example, information for identifying whether the content of the medical information is the patient's own personal information, biological information, medical examination progress, etc. The user ID 453 is identification information of a user to whom access authority 443 is granted for a set of the patient ID 451 and the medical information type 452.

[0043] Returning to FIG. 4, the explanation will be continued. The server devices 51 and 52 are computer devices that are made redundant in two or more, both of which are connected to the shared storage device 4, and also receive access requests with the load being distributed by the load distribution device 6. The server device 51 has the functions of a Web / AP server 511 and a P2P connection control server 513. The Web / AP server 511 has the function of a medical care management unit 512. The P2P connection control server 513 has the functions of a Stun server 514 and a PeerJS server 515. The Stun server 514 may be replaced with a TURN server. Also, the P2P connection control server 513 or the PeerJS server 515 may be called a signaling server. Also, the Stun server 514 can be regarded as having an ICE 5141 for convenience. Also, the server device 52 has the functions of a Web / AP server 521 and a P2P connection control server 523. The P2P connection control server 523 has the functions of a Stun server 524 and a PeerJS server 525. The server device 52 has the same configuration as the server device 51, and some parts are not shown in the figure.

[0044] FIG. 6 is a block diagram showing a configuration of a server device 51 according to the second embodiment. The server device 51 includes a storage device 81, a memory 82, a communication IF unit 83, and a control unit 84. The storage device 81 is, for example, a non-volatile storage device such as a hard disk or a flash memory. The storage device 81 stores an OS (Operating System) 811, a Web server program 812, an AP (Application) server program 813, a Web application program 814, a Stun server program 815, and a PeerJS server program 816. The OS 811 is basic software that controls the overall operation of the server device 51. The Web server program 812 is an HTTP (Hypertext Transfer Protocol) server program. The AP server program 813 is middleware for executing a Web application program 814. The Web application program 814 is a program in which a process is implemented to refer to a DB in response to a request from a client, generate a dynamic Web page, return the response as a response, and update the DB in response to an input to the Web page. The Stun server program 815 is a program that implements processes such as notifying a terminal of an IP address to establish a P2P communication connection and replying to inquiries about connection management information from ICE, etc. The Stun server program 815 may be an improved version of a known Stun server program. The PeerJS server program 816 is a program that implements processes such as inquiring of a connection destination requested to establish a P2P communication connection as to whether or not a direct communication connection with the request source can be established. The PeerJS server program 816 may be an improved version of a known PeerJS server program.

[0045] The memory 82 is an example of the above-mentioned memory 213, and stores, for example, the ICE 5141. The communication IF unit 83 is an interface for inputting and outputting data from and to the outside of the server device 51.

[0046] The control unit 84 is a processor such as a CPU (Central Processing Unit) that controls each component of the server device 51. The control unit 84 reads the OS 811, the Web server program 812, the AP server program 813, the Web application program 814, the Stun server program 815, and the PeerJS server program 816 from the storage device 81 into the memory 82 and executes these programs. In this way, the control unit 84 realizes the functions of a medical care management unit 841, a terminal information processing unit 842, and a connection processing unit 843, which will be described later. The medical care management unit 841 corresponds to the above-mentioned medical care management unit 512, and is an example of the medical care management unit 211. The medical care management unit 841 is mainly realized by the Web server program 812, the AP server program 813, and the Web application program 814. The terminal information processing unit 842 and the connection processing unit 843 are examples of the above-mentioned connection management unit 212. The terminal information processing unit 842 is mainly realized by the Stun server program 815. The connection processing unit 843 is mainly realized by the PeerJS server program 816 .

[0047] Returning to Fig. 4 for further explanation, the load balancing device 6 is a device that distributes access from the tablet terminals 710, 720, 730, etc. via the network N to the server devices 51, 52, etc., thereby realizing redundancy of the connection control servers (P2P connection control servers 513, 523, etc.). For this reason, the actual access destination of the tablet terminal 710 may be switched to the server device 51 or 52 each time.

[0048] The tablet terminals 710, 720, and 730 are examples of the above-mentioned terminals 31 and 32, and are capable of input and output using a touch panel (screen). The tablet terminals 710 and the like are also equipped with a photographing means such as a camera. However, these terminals are not limited to tablets, and may be personal computers or the like. The tablet terminal 710 is a terminal present in the medical institution 71. The medical institution 71 is a clinic or the like, and is assumed to have a doctor 713 and a nurse 714 who perform remote medical care. The doctor 713 and the nurse 714 are assumed to use the tablet terminal 710. The tablet terminal 710 is equipped with a terminal application 711 and an ICE 712. The terminal application 711 is application software on the terminal side in the remote medical care support system 2000. The terminal application 711 requests a terminal list from the medical care management unit 512 via the network N, and displays the returned list on the screen. The terminal application 711 transmits a connection management information registration request and a connection management information request including a terminal ID to the Stun server 514 via the network N, receives a response, and displays it on the screen. The terminal application 711 also transmits a terminal-to-terminal connection request specifying the connection management information to the PeerJS server 515 via the network N, and in response to a response of connection permission, establishes a connection with the direct communication destination via the network N based on the route information indicated by the connection management information. The terminal application 711 then performs real-time communication of video, audio, and the like through direct communication. ICE 712 is connection management information in the tablet terminal 710.

[0049] The tablet terminal 720 is a terminal present in the patient's home 72. The patient's home 72 is a home or the like where the patient 723 resides. The caregiver 724 is a visiting caregiver dispatched from a care business office 73 or the like, and supports the remote medical treatment of the patient 723. However, the caregiver 724 is not essential for the remote medical treatment. In other words, the patient 723 may operate the tablet terminal 720 alone to receive remote medical treatment. Alternatively, other than the caregiver 724, for example, a family member or a visiting nurse may support the remote medical treatment of the patient 723. The tablet terminal 720 includes a terminal app 721 and an ICE 722. The terminal app 721 has the same functions as the terminal app 711. The ICE 722 is connection management information in the tablet terminal 720.

[0050] The tablet terminal 730 is a terminal present at a care facility 73. It is assumed that a care worker 733 and a care worker 724 work at the care facility 73. It is assumed that the care worker 733 uses the tablet terminal 730. The tablet terminal 730 includes a terminal app 731 and an ICE 732. The terminal app 731 has the same functions as the terminal app 711. The ICE 732 is connection management information for the tablet terminal 730.

[0051] Therefore, for example, a doctor 713 or a nurse 714 can perform remote medical treatment for a patient 723 by operating a tablet terminal 710 to establish a P2P communication connection with the tablet terminal 720. A caregiver 733 can perform remote medical treatment (health management, etc.) for a patient 723 by operating a tablet terminal 730 to establish a P2P communication connection with the tablet terminal 720. It goes without saying that the tablet terminals 710 and 730 can establish a P2P communication connection.

[0052] Furthermore, the tablet terminal 710 etc. transmits a registration request for its own ICE to the Stun server 514 etc. via the network N at startup and every 10 minutes while it is running.

[0053] It is also assumed that the user IDs 411 and the like for the doctor 713, nurse 714, patient 723, caregiver 724, and caregiver 733 have been registered in advance in the utilization management DB 41.

[0054] 7 is a flowchart for explaining the flow of login and authentication processing according to the second embodiment. Here, a tablet terminal 710 is taken as an example, and the description will be given assuming that the access destination from the tablet terminal 710 is the server device 51. First, the tablet terminal 710 is started up by an operation of a user (a doctor 713 or a nurse 714), and the terminal application 711 starts operating. The terminal application 711 transmits a request for a login screen to the medical care management unit 512 via the network N. In response to this, the medical care management unit 512 generates a login screen in response to the request, and transmits the login screen to the terminal application 711 via the network N (S201).

[0055] The terminal application 711 then displays the received login screen, accepts input of a user ID by user operation, and reads out the terminal ID already set in the tablet terminal 710. The terminal application 711 also uses a camera function to take a picture of the user's face and its surroundings to obtain a facial image. The terminal application 711 then transmits the user ID, terminal ID, and facial image to the medical care management unit 512 via the network N. In response, the medical care management unit 512 accepts the user ID, terminal ID, and facial image (S202).

[0056] Then, the medical care management unit 512 refers to the shared storage device 4 and determines whether the pair of the received user ID and terminal ID has been registered in the usage management DB 41 (S203). If it is determined that the pair has been registered, the medical care management unit 512 performs face authentication. That is, the medical care management unit 512 reads out the face image 416 associated with the pair of the received user ID and terminal ID from the usage management DB 41 of the shared storage device 4, and compares it with the received face image. Then, the medical care management unit 512 determines whether the face authentication has been successful (S204). Note that a known technique can be applied for the face authentication process.

[0057] If face authentication is successful in step S204, the medical care management unit 512 determines whether the user attribute is other than that of a doctor (S205). That is, the medical care management unit 512 identifies the user attribute 412 associated with the received user ID from the usage management DB 41 of the shared storage device 4, and determines whether the identified user attribute 412 is other than that of a doctor. For example, if the user is a nurse 714 (YES in S205), the process proceeds to steps S208 and S209. On the other hand, if the user is a doctor 713 (NO in S205), the medical care management unit 512 requests the tablet terminal 710 to input a password (S206).

[0058] The tablet terminal 710 accepts a password input by the user, the doctor 713, and transmits it to the medical care management unit 512 via the network N. The medical care management unit 512 then compares the received password with the password 415 in the usage management DB 41 and determines whether or not password authentication has been successful (S207). If password authentication has been successful, the process proceeds to steps S208 and S209.

[0059] That is, the medical care management unit 512 updates the usage management DB 41 by setting the usage status 414 associated with the accepted user ID to "in use" (S208). At the same time, the medical care management unit 512 transmits an initial screen after login to the tablet terminal 710 (S209). As a result, the terminal application 711 displays the received initial screen on the screen.

[0060] If the result of the determination in step S203, S204, or S207 is NO, the medical care management unit 512 transmits a message to the tablet terminal 710 indicating that the login has failed (S210).

[0061] In this way, in the login and authentication process according to the present embodiment, if the user operating the terminal is a doctor (an example of a first medical worker), not only face authentication but also password authentication is required. This makes it possible to check the use of functions for doctors, who bear a large responsibility in remote medical care, more strictly than other attributes, thereby realizing highly reliable remote medical care.

[0062] Next, the flow of establishing a connection for direct communication between terminals after two terminals log in will be described. First, the flow of the terminal-to-terminal connection process when the ICEs of two terminals are registered in the same server will be described using the sequence diagrams of Fig. 8 and Fig. 9. Here, it is assumed that tablet terminal 710 and tablet terminal 720 establish a connection for P2P communication. It is also assumed that tablet terminals 710 and 720 have completed the login and authentication process described above, and that usage status 414 of usage management DB 41 has been set to in use.

[0063] First, the tablet terminal 710 (terminal A) sends a registration request for its own connection management information, ICE 712 (ICE_A), to the Stun server via the network N (S221). At this time, the load balancer 6 transfers the registration request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 accepts the registration request from the tablet terminal 710, and holds ICE_A included in the registration request in the memory 82 (S222). The Stun server 514 also registers ICE_A in the connection management DB 42 of the shared storage device 4 (S223).

[0064] Furthermore, the tablet terminal 720 (terminal B) transmits a registration request for its own connection management information, ICE 722 (ICE_B), to the Stun server via the network N (S224). At this time too, the load balancer 6 transfers the registration request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 accepts the registration request from the tablet terminal 720, and holds ICE_B included in the registration request in memory 82 (S225). The Stun server 514 also registers ICE_B in the connection management DB 42 of the shared storage device 4 (S226).

[0065] Thereafter, the tablet terminal 710 transmits a terminal list request to the medical care management unit via the network N (S227). At this time, the load distribution device 6 transfers the terminal list request to the medical care management unit 512 in the server device 51. Therefore, in response to the reception of the terminal list request, the medical care management unit 512 searches the usage management DB 41 of the shared storage device 4 for terminal IDs whose usage status 414 is in use (S228). Here, a list including at least the terminal ID of the terminal B is searched for, and the medical care management unit 512 acquires the list from the usage management DB 41 of the shared storage device 4 (S229). Then, the medical care management unit 512 returns the acquired terminal list to the tablet terminal 710 (S230). Therefore, the tablet terminal 710 displays the received terminal list on the screen (S231).

[0066] Then, the tablet terminal 710 accepts the user's selection of terminal B (S232), and sends an ICE acquisition request for terminal B to the Stun server via network N (S233). At this time, the load balancing device 6 transfers the ICE acquisition request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 searches its own memory 82 for the terminal ID corresponding to terminal B specified in the accepted ICE acquisition request. Here, because ICE_B was held in its memory in step S225, the Stun server 514 acquires ICE_B from memory 82 (S234), and returns the acquired ICE_B to the tablet terminal 710 (S235).

[0067] In response to this, the tablet terminal 710 transmits a P2P connection request specifying the received ICE_B to the PeerJS server via the network N (S236). At this time, the load balancing device 6 transfers the P2P connection request to the PeerJS server 515 in the server device 51. Therefore, in response to the received P2P connection request, the PeerJS server 515 inquires of terminal B based on ICE_B as to whether or not a P2P connection with terminal A is possible (S237). At this time, the PeerJS server 515 may transmit ICE_A of terminal A to terminal B.

[0068] If there are no problems with the inquiry about whether or not a P2P connection with terminal A is possible, the tablet terminal 720 responds to the PeerJS server 515 with permission to connect to terminal A (S238). Note that the tablet terminal 720 may also internally hold ICE_A. Then, in response to the response of permission to connect, the PeerJS server 515 transmits a response of permission to connect to terminal B to terminal A (S239). In response to the response of permission to connect to terminal B, the tablet terminal 710 establishes a P2P connection with the tablet terminal 720 based on the dynamic IP address 4212 and route information 4213 of ICE_B (S240). Thereafter, the tablet terminals 710 and 720 can perform real-time communication of video and audio by direct communication.

[0069] Next, the flow of terminal-to-terminal connection processing when the ICEs of two terminals are registered in different servers will be explained using the sequence diagrams of Figures 10 and 11. Note that the difference from Figures 8 and 9 above is the destination to which access is allocated in the load balancer 6, and the following explanation will focus on the difference, and explanations of similar processing will be omitted as appropriate.

[0070] First, steps S221 to S223 are the same as those in FIG. 8. Then, the tablet terminal 720 (terminal B) transmits a registration request for its own connection management information, ICE 722 (ICE_B), to the Stun server via the network N (S224a). Here, the load balancer 6 transfers the registration request to the Stun server 524 in the server device 52. Therefore, the Stun server 524 accepts the registration request from the tablet terminal 720 and holds ICE_B included in the registration request in its own memory (S225a). The Stun server 524 also registers ICE_B in the connection management DB 42 of the shared storage device 4 (S226a). As a result, ICE_A is held in the memory of the Stun server 514 on the server device 51 side, and ICE_B is held in the memory of the Stun server 524 on the server device 52 side. Then, both ICE_A and ICE_B are registered in the connection management DB 42 of the shared storage device 4.

[0071] Subsequently, steps S227 to S232 are the same as those in FIG. 8. Then, the tablet terminal 710 transmits an ICE acquisition request for terminal B to the Stun server via the network N (S233). At this time, the load balancer 6 transfers the ICE acquisition request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 searches its own memory 82 for the terminal ID corresponding to terminal B specified in the received ICE acquisition request. However, here, the search for ICE_B in the memory is a miss (S234a). Therefore, the Stun server 514 issues a search request for ICE_B to the connection management DB 42 of the shared storage device 4 (S234b). As described above, ICE_B has already been registered in the connection management DB 42, so the Stun server 514 acquires ICE_B from the connection management DB 42 as the search result (S234c). Then, the Stun server 514 returns the acquired ICE_B to the tablet terminal 710 (S235). Thereafter, steps S236 to S240 are the same as those in FIG.

[0072] In this way, according to the second embodiment, ICEs can be shared reliably even if two terminals that are to communicate directly with each other have actually registered their own ICEs in a Stun server, but the registration destinations have been distributed to different redundant servers. The reason for this is that each Stun server not only holds the ICE in its own memory, but also registers the ICE in the shared storage device 4 of both servers. Also, by first referring to the memory for the ICE of the terminal specified in the ICE acquisition request, each Stun server can return the ICE more quickly if the search in memory is a hit. And even if the search in memory is a miss, the desired ICE can be quickly acquired by searching the shared storage device 4.

[0073] Next, in order to more effectively support remote medical care, it is desirable to perform the following process. First, the medical care management unit 512 accepts a request to register the user ID of a second medical worker involved in the remote medical care of a specific patient from any terminal used by a first medical worker. In this case, the medical care management unit 512 registers the user IDs of the first medical worker, the second medical worker, and the specific patient in the storage system in association with each other. For example, the medical care management unit 512 accepts a request to register the user IDs of a nurse 714 and a caregiver 724 involved in the remote medical care of a patient 723 from a tablet terminal 710 used by a doctor 713. In this case, the medical care management unit 512 registers the user IDs of the doctor 713, the nurse 714, the caregiver 724, and the patient 723 in association with each other in the medical care related person DB 43 of the shared storage device 4.

[0074] Then, the medical care management unit 512 identifies other user IDs (caregiver 724, patient 723) associated with the user ID of the nurse 714 from the medical care related person DB 43 in response to a terminal list request from the tablet terminal 710 when the nurse 714 uses it. In this case, the medical care management unit 512 acquires a list of terminal IDs 413 in the usage management DB 41 that are associated with the identified other user ID 411 and whose usage state 414 is in use, and returns the list to the tablet terminal 710. That is, in this case, the terminal ID list does not include the terminal ID of the tablet terminal 730 that can be used by the caregiver 733 who is not a remote medical care related person of the patient 723. Therefore, it is possible to exclude terminal IDs that do not require P2P connection, and also to exclude terminal IDs of other patients who are not in charge of the nurse 714. This is the same when the patient 723 operates, and information of other patients and medical workers is excluded. Therefore, it is possible to protect the privacy of the patient and avoid trouble caused by unnecessary connections between medical workers and patients. And these can be controlled by the more accountable doctors rather than by all medical professionals.

[0075] Furthermore, it is desirable that the doctor can control the access authority to the medical information. To this end, the medical care management unit 512 accepts a registration request for the medical information of the specific patient and a user ID that is permitted to access the medical information from the arbitrary terminal used by the first medical worker. In this case, the medical care management unit 512 associates the user ID of the specific patient with the medical information, grants the access authority to the medical information to the user ID that is permitted to access, and registers the medical information in the storage system. For example, the medical care management unit 512 accepts a registration request for the doctor's notes for the patient 723 and the user ID of the nurse 714 that is permitted to view the notes from the tablet terminal 710 used by the doctor 713. In this case, the medical care management unit 512 associates the patient ID 441 and the medical information 442 of the patient 723, and registers them in the medical history DB 44 by granting the user ID 444 of the nurse 714 to the access authority 443 "view".

[0076] The medical care management unit 512 then receives a request to access the medical information of the specific patient from the first terminal or the second terminal. In this case, the medical care management unit 512 acquires from the storage system, among the medical information of the specific patient, the access authority of which is assigned to the user ID currently using the requester of the access request, and returns the acquired medical information to the requester. For example, the medical care management unit 512 accepts an access request to its own medical information from a tablet terminal 720 used by a patient 723. For example, the medical care management unit 512 accepts a request to refer to the medical history of the patient 723 from a terminal application 721 in the tablet terminal 720. In this case, the medical care management unit 512 reads out only the medical information 442 associated with the patient ID 441 of the patient 723 from the medical history DB 44 that is assigned the user ID 444 of the patient 723 as the access authority 443 "view". Then, the medical care management unit 512 returns the read medical information to the tablet terminal 720. That is, in this case, the doctor's notes described above are not disclosed to the patient 723. In this way, the doctor can control the access authority to the medical information registered by the doctor. For example, depending on the content of the information, it may be desirable not to disclose the medical information of a specific patient even to a second medical worker, not the patient. Therefore, the doctor can control disclosure in detail according to the patient's condition.

[0077] In addition, the above-mentioned access authority is set individually for each medical information, so the burden of the setting operation is large for the doctor. Therefore, it is considered to automate the setting of the access authority as follows. That is, the medical care management unit 512 accepts a registration request of a user ID to be permitted to access according to the type of the medical information of the specific patient from the arbitrary terminal used by the first medical worker. In this case, the medical care management unit 512 registers the user ID of the specific patient, the type of the medical information, and the user ID permitted to access in the storage system in association with each other. For example, the medical care management unit 512 accepts a registration request of these user IDs from the tablet terminal 710 used by the doctor 713 so that the viewing permission is limited to the doctor 713, the nurse 714, and the caregiver 724 when the type of the medical information of the patient 723 is a caregiver's note. In this case, the medical care management unit 512 registers the patient ID 451 of the patient 723, the medical information type 452, and the user IDs 453 of the doctor 713, the nurse 714, and the caregiver 724 in association with each other in the authority definition DB 45.

[0078] Thereafter, it is assumed that the medical care management unit 512 receives a request to register a note on the condition of the patient 723 from the tablet terminal 720 used by the caregiver 724. In this case, the medical care management unit 512 associates the patient ID 441 of the patient 723 with the medical information 442, which is the note on the condition, and registers the user IDs 453 of the doctor 713, nurse 714, and caregiver 724, who are associated with the medical information type 452 of the patient 723, as user IDs 444 and the access authority 443 as view, in the medical history DB 44.

[0079] Then, when the medical treatment management unit 512 receives a request to view the medical information of the patient 723 from the tablet terminal 710 used by the nurse 714, it acquires from the medical treatment history DB 44, among the medical treatment information 442 of the patient 723, the medical treatment information for which the nurse 714 has been granted access permission. Then, the medical treatment management unit 512 returns the acquired medical information to the tablet terminal 710. On the other hand, when the medical treatment management unit 512 receives a request to view the patient's own medical information from the tablet terminal 720 used by the patient 723, it does not acquire from the medical treatment history DB 44 any medical treatment information for which the user ID of the patient 723 has not been granted access permission.

[0080] In this way, by having a doctor preregister the definition of access rights according to the type of medical information, access restrictions to medical information entered by users other than a doctor can be automatically set. Also, because access rights are granted for each type of medical information, doctors can reduce the effort of granting access rights to all individual pieces of medical information, which means that the granting of access rights is automated and access rights management becomes easier.

[0081] <Embodiment 3> The present embodiment 3 describes the present disclosure from a different perspective than the above-mentioned embodiment 1. Here, the problem to be solved in the present embodiment 3 is to combine a shared screen of patient information between medical professionals and two-way communication using video.

[0082] 12 is a block diagram showing a configuration of a remote medical treatment support system 3000 according to the third embodiment. The remote medical treatment support system 3000 includes at least a remote medical treatment support device 21a and terminals 31, 32, etc. The remote medical treatment support device 21a and the terminals 31, 32 are connected via a network N. The terminals 31 and 32 and the network N are the same as those in the first embodiment, etc., and therefore will not be described.

[0083] The remote medical care support device 21a includes a medical care management unit 211a and a connection management unit 212a. The medical care management unit 211a manages medical information related to patients who receive remote medical care. The connection management unit 212a controls the establishment of a connection for direct communication between terminals. The method for establishing a connection for direct communication between terminals may use a known technique, or may use the technique of the above-mentioned embodiment 1 or 2.

[0084] The medical care management unit 211a generates display information for displaying medical information on the screen of the terminal 31 in response to a request from the terminal 31 (first terminal) that has established a connection with the terminal 32 (second terminal). At that time, the medical care management unit 211a embeds in the display information a process for transmitting a captured image of the user (using the terminal 31) captured by the terminal 31 to the terminal 32 (the other party with which the connection has been established) by direct communication. Here, the "process for transmitting a captured image to the terminal 32 by direct communication" may be, for example, a code written using WebRTC. Alternatively, a two-way video communication technology between terminals by P2P communication may be used, but is not limited to this. Then, the medical care management unit 211a returns the embedded display information to the first terminal.

[0085] The remote medical assistance device 21a includes a processor, a memory, and a storage device, which are not shown in the figure. The storage device stores a remote medical assistance program, which is a computer program that implements the remote medical assistance method according to the present embodiment. The processor then reads the remote medical assistance program from the storage device into the memory and executes the remote medical assistance program. As a result, the processor realizes the functions of the medical care management unit 211a and the connection management unit 212a.

[0086] 13 is a flowchart showing the flow of the remote medical treatment support method according to the third embodiment. First, the connection management unit 212a controls the establishment of a connection for direct communication between the first and second terminals (S31). This enables, for example, the terminals 31 and 32 to communicate directly without going through the remote medical treatment support device 21a.

[0087] Next, in response to a request from the first terminal (which has established a connection with the second terminal), the medical care management unit 211a generates display information for displaying medical information on the patient undergoing remote medical care on the screen of the first terminal (S32).The medical care management unit 211a then embeds in the display information a process for transmitting a captured image of the user to the second terminal by direct communication (S33).The captured image is an image captured by the user using the first terminal by a photographing device such as a camera mounted on the first terminal which is the source of the request in S32.

[0088] Thereafter, the medical care management unit 211a returns the embedded display information to the first terminal (S34). As a result, the first terminal displays the display information received on the screen, and the first user of the first terminal can view the medical information displayed on the screen. Furthermore, the first terminal can transmit an image of the first user taken by the built-in camera to the second terminal by direct communication, by the "transmission process" embedded in the display information. Therefore, the second terminal can display the captured image received from the first terminal on the screen, and the second user of the second terminal can visually recognize the first user from the screen.

[0089] Similarly, the remote medical care support device 21a performs steps S32 to S34 in response to an access request from the second terminal, so that the second terminal can display the received display information on the screen. Therefore, the second user of the second terminal can also view the medical information displayed on the screen. In other words, the medical information including the patient information can be shared between the first and second users.

[0090] In addition, the second terminal can transmit an image of the second user captured by a built-in camera to the first terminal by direct communication through the "transmission process" embedded in the display information. Thus, the first terminal can display the captured image received from the second terminal on the screen, and the first user of the first terminal can visually recognize the second user from the screen. In other words, the first and second terminals can perform two-way communication using video through direct communication. Therefore, for example, two-way real-time communication using video is possible between a medical professional such as a doctor at a medical institution and a patient or other medical professional at a base remote from the medical institution.

[0091] In this way, according to the third embodiment, it is possible to smoothly combine a shared screen of patient information between medical staff and two-way communication using moving images.

[0092] Incidentally, the third embodiment may further include some or all of the configurations of the above-mentioned first or second embodiment. For example, the remote medical support device 21a does not necessarily need to be made redundant.

[0093] <Fourth embodiment> The present embodiment 4 describes the present disclosure from a different viewpoint than the above-mentioned embodiments 1 and 3. Here, the problem to be solved by the present embodiment 4 is to control the access authority of a specific medical professional, such as a doctor, to medical information related to a specific patient.

[0094] Fig. 14 is a block diagram showing a configuration of a remote medical treatment support system 4000 according to the fourth embodiment. The remote medical treatment support system 4000 includes at least a storage device 4a, a remote medical treatment support device 21b, and terminals 31, 32, etc. The storage device 4a and the remote medical treatment support device 21b are connected to each other. The remote medical treatment support device 21b and the terminals 31, ..., 32 are connected to each other via a network N. The terminals 31 and 32 and the network N are the same as those in the first embodiment, etc., described above, and therefore will not be described here.

[0095] The storage device 4a is a storage system composed of one or more storage devices, and may be the shared storage device 4 described above. The storage device 4a includes a usage management DB 41, a medical care related person DB 43a, and a medical care history DB 44a. The usage management DB 41 is the same as that shown in FIG. 4. The medical care related person DB 43a is associated with a patient ID 431, a related person attribute 435, and a user list 436. The related person attribute 435 is information indicating a type of a group of related people related to the medical care of a specific patient corresponding to the patient ID 431. Examples of the related person attribute 435 include medical people indicating a group of medical workers such as doctors and nurses belonging to a medical institution, a care team indicating a group of medical workers such as caregivers belonging to a care business, and patient families that are groups of patients and their families. The user list 436 is a collection of individual user IDs 437 belonging to each related person attribute described above. In other words, the user list 436 is an example of a user list belonging to the related person attribute 435 related to the medical care of a specific patient (patient ID 431).

[0096] In the medical history DB 44a, a patient ID 441a, medical information 442a, and related person attributes 443a are associated with each other. The patient ID 441a and the medical information 442a are the same as the patient ID 441 and the medical information 442 described above. The related person attributes 443a are the same as the related person attributes 435 described above.

[0097] The remote medical support device 21b includes at least a medical care management unit 211b. The medical care management unit 211b receives a registration request for the first medical information of a specific patient and the second related person attribute that allows access to the first medical information from a terminal used by a first medical worker belonging to the first related person attribute. Then, the medical care management unit 211b associates at least the second related person attribute with the first medical information and registers it in the storage device 4a. The medical care management unit 211b also receives an access request for the medical information of a specific patient from a specific terminal used by a user 437. Then, the medical care management unit 211b refers to the medical care related person DB 43a to identify the related person attribute 435 to which the user list 436 including the user 437 belongs, and acquires one or more pieces of medical information 422a associated with the identified related person attribute 435 from the medical history DB 44a. The medical care management unit 211b returns the acquired one or more pieces of medical information 442a to the specific terminal to display them on the screen of the specific terminal.

[0098] The remote medical assistance device 21b includes a processor, a memory, and a storage device, which are not shown in the figure. The storage device stores a remote medical assistance program, which is a computer program that implements the remote medical assistance method according to the present embodiment. The processor then reads the remote medical assistance program from the storage device into the memory and executes the remote medical assistance program. In this way, the processor realizes the functions of the medical care management unit 211b.

[0099] 15 is a flowchart showing the flow of the remote medical care support method according to the embodiment 4. First, the medical care management unit 211b receives a registration request for the first medical information on a specific patient and the related person attribute 443a "care team" that permits access to the first medical information from, for example, a terminal used by a doctor belonging to the medical related persons (S41).

[0100] Next, the medical care management unit 211b associates at least the related person attribute 443a "care team" with the first medical information 442a and registers it in the medical history DB 44a (S42). At this time, the medical care management unit 211b may also associate the related person attribute 443a "medical professional" with the first medical information 442a and register it in the medical history DB 44a. However, in this case, the medical care management unit 211b does not associate the related person attribute 443a "patient family" with the first medical information 442a.

[0101] Furthermore, in step S41, if the related party attribute 443a that allows access to the first medical information is associated with "patient family member", then in step S42, the medical care management unit 211b will associate the related party attribute 443a "patient family member" with the first medical information 442a and register them in the medical history DB 44a.

[0102] Next, the medical care management unit 211b receives a request to access the medical information of a specific patient from a predetermined terminal used by a predetermined user (S43). For example, it is assumed that the medical care management unit 211b receives a request to access the medical information of the patient from a terminal used by a caregiver.

[0103] At this time, the medical care management unit 211b refers to the medical care related person DB 43a to identify the related person attribute 435 to which the user list 436 including the caregiver's user ID 437 belongs (S44). If the user list 436 including the caregiver's user ID 437 is not associated with the related person attribute 435 of the patient ID 431 of the patient in the medical care related person DB 43a, it is not identified, and a message to that effect is returned to the terminal.

[0104] Here, it is assumed that the related party attribute 443a is specified in step S44, and the medical care management unit 211b subsequently acquires one or more pieces of medical care information 442a associated with the specified related party attribute 443a from the medical care history DB 44a (S45). In other words, if multiple pieces of medical care information 442a associated with the patient ID 441a of the patient have been registered in the past, and the specified related party attribute 443a is associated with multiple pieces of medical care information 442a, two or more pieces of medical care information 442a are acquired.

[0105] Then, the medical care management unit 211b returns the acquired one or more pieces of medical information 442a to a specified terminal to display them on the screen of the specified terminal (S46). As a result, the medical information is disclosed to users who have been registered in advance in the related party attribute and user list by the doctor in charge of the patient, that is, users who belong to a group to which access rights to the medical information of the patient have been granted. On the other hand, the medical information is not acquired and therefore not disclosed to users who have not been registered by the doctor in charge, that is, users who have not been granted access rights to the medical information of the patient. For example, it is possible to safely and easily realize a doctor recording comments that cannot be disclosed to the patient's family and sharing them only with medical personnel and the care team. In addition, access to the medical information of the patient can be restricted for users who are not related to the patient, even if they are medical personnel, to protect privacy.

[0106] The fourth embodiment may further include some or all of the configurations of the first to third embodiments. For example, the remote medical support device 21b does not necessarily need to be made redundant. Furthermore, the remote medical support device 21b does not necessarily need to control the establishment of a direct communication connection between terminals.

[0107] <Other embodiments> In the above embodiment, the present disclosure has been described as a hardware configuration, but is not limited to this. Any process of the present disclosure can be realized by causing a CPU (Central Processing Unit) to execute a computer program.

[0108] In the above example, the program can be stored and provided to the computer using various types of non-transitory computer readable media. The non-transitory computer readable media includes various types of tangible storage media. Examples of the non-transitory computer readable media include magnetic recording media (e.g., flexible disks, magnetic tapes, hard disk drives), magneto-optical recording media (e.g., magneto-optical disks), CD-ROM (Read Only Memory), CD-R, CD-R / W, DVD (Digital Versatile Disc), and semiconductor memory (e.g., mask ROM, PROM (Programmable ROM), EPROM (Erasable PROM), flash ROM, RAM (Random Access Memory)). The program may also be provided to the computer by various types of transitory computer readable media. Examples of the transitory computer readable media include electric signals, optical signals, and electromagnetic waves. The transitory computer readable media can provide the program to the computer via a wired communication path such as an electric wire and an optical fiber, or via a wireless communication path.

[0109] The present disclosure is not limited to the above-described embodiment, and may be modified as appropriate without departing from the spirit and scope of the present disclosure. In addition, the present disclosure may be implemented by appropriately combining the respective embodiments.

[0110] A part or all of the above-described embodiments can be described as, but is not limited to, the following supplementary notes. (Appendix A1) a connection manager for controlling connection establishment for direct communication between the first and second terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal. Remote medical support device. (Appendix A2) The connection management unit When connection management information that associates a terminal ID of a specific terminal with destination information assigned to the terminal is received, the connection management information is stored in a memory of the device itself; In response to a request from the first terminal to establish the connection with the second terminal, the second connection management information of the second terminal is returned to the first terminal, and the second terminal is inquired of whether the connection with the first terminal can be established, thereby establishing the connection between the first and second terminals. 2. A remote medical support device as described in Appendix A1. (Appendix A3) The connection management unit When the connection management information is received, the connection management information is stored in the memory, and the connection management information is registered in a storage system connected to the host device and the other redundant devices; retrieving the second connection management information from the memory in response to the request for connection establishment; When the search is a miss, searching the storage system for the second connection management information; The second connection management information is obtained from the memory or the storage system that is the subject of the search, and is returned to the first terminal. A remote medical support device as described in Appendix A2. (Appendix A4) the storage system further stores usage management information in which a usage state of the terminal is associated with a terminal ID; The medical care management unit includes: acquiring a list of the terminal IDs whose usage status is "in use" from the usage management information of the storage system in response to a terminal list request from the first terminal, and returning the list to the first terminal; The connection management unit when the first terminal receives a connection management information request including a second terminal ID of the second terminal selected from the list as a request for connection establishment, searching the memory for the second terminal ID; If the search is a miss, searching the storage system for the second terminal ID; The second connection management information associated with the second terminal ID is obtained from the memory or the storage system that is the result of the search, and is returned to the first terminal. A remote medical support device as described in Appendix A3. (Appendix A5) The connection management unit inquiring of the second terminal as to whether or not the connection with the first terminal can be established based on the second connection management information in response to a terminal-to-terminal connection request from the first terminal in which the second connection management information is specified; responding to the first terminal to allow the connection establishment with the second terminal in response to the permission response for the connection establishment from the second terminal; A remote medical support device as described in Appendix A4. (Appendix A6) The connection management information includes candidates for route information in a network via which the direct communication is passed. A remote medical support device according to any one of appendices A2 to A5. (Appendix A7) The remote medical care support device is connected to a first storage device that stores a user list belonging to a related party attribute related to medical care of a specific patient; The medical care management unit includes: in response to a request for registering first medical information related to the specific patient and a second related person attribute that permits access to the first medical information, the request being received from a terminal used by a first medical worker belonging to a first related person attribute, the first medical information being associated with at least the second related person attribute and registered in the first storage device; In response to a request for access to medical information of the specific patient received from a specific terminal used by a specific user, referring to the first storage device, identify the related party attribute to which the user list including the specific user belongs; acquiring, from the first storage device, one or more pieces of medical information associated with the identified related person attributes; generating first display information for displaying the one or more pieces of acquired medical information on a screen of the predetermined terminal; do A remote medical support device according to any one of appendices A1 to A6. (Appendix A8) the remote medical support device is connected to a second storage device that stores in advance a user ID and a password of a user who can use a specific terminal, attributes of the user ID, and a face image of the user ID in association with each other; The medical care management unit includes: During login processing of a specific terminal, a face image of a user of the terminal photographed by the specific terminal and a user ID are received; A face image associated with the accepted user ID is obtained from the second storage device. performing face authentication between the received face image and the acquired face image; If the attribute of the received user ID is a specific medical worker, after the face authentication is successful, a password authentication is requested from the specific terminal, and if the password authentication is successful, login is permitted; If an attribute of the user ID included in the received user ID is other than that of the specific medical worker, login is permitted after the face authentication is successful. A remote medical support device according to any one of appendices A1 to A7. (Appendix A9) The usage management information is further associated with a user ID that can use the terminal, The medical care management unit includes: When a request for registration of the user ID of a second medical worker involved in remote medical care of a specific patient is received from any terminal used by a first medical worker, the user IDs of the first medical worker, the second medical worker, and the specific patient are associated with each other and registered in the storage system; In response to the terminal list request from the first terminal, identify another user ID associated with the user ID of the user currently using the first terminal from within the storage system; Acquire a list of the terminal IDs of the usage management information that are associated with the specified other user ID and whose usage status is "in use"; Return the list to the first terminal. A remote medical support device as described in Appendix A4 or A5. (Appendix A10) The medical care management unit includes: when a registration request for a user ID to which access is permitted according to the type of the medical information of the specific patient is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient, the type of the medical information, and the user ID to which access is permitted are associated and registered in the storage system; When a registration request for the medical information of the specific patient is received from the first terminal or the second terminal, a user ID of the specific patient is associated with the medical information, and access authority to the medical information is granted to the user ID associated with a type of the medical information, and the medical information is registered in the storage system; When an access request for the medical information of the specific patient is received from the first terminal or the second terminal, the medical information of the specific patient for which the access authority is assigned to a user ID currently using the source of the access request is obtained from the storage system, and the obtained medical information is returned to the source of the access request. A remote medical support device as described in Appendix A9. (Appendix A11) The medical information includes biological information of the patient. A remote medical support device according to any one of appendices A1 to A10. (Appendix B1) First and second terminals; A remote medical care support device connected to the first and second terminals via a network; Equipped with The remote medical care support device includes: a connection management unit for controlling establishment of a connection for direct communication between the first and second terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal. Remote medical support system. (Appendix B2) The connection management unit When connection management information that associates a terminal ID of a specific terminal with destination information assigned to the terminal is received, the connection management information is stored in a memory of the device itself; In response to a request from the first terminal to establish the connection with the second terminal, the second connection management information of the second terminal is returned to the first terminal, and the second terminal is inquired of whether the connection with the first terminal can be established, thereby establishing the connection between the first and second terminals. A remote medical support system as described in Appendix B1. (Appendix C1) The computer Controlling the establishment of a direct communication connection between the first and second terminals; Generate display information for displaying medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal; embedding, in the display information, a process for transmitting an image of a user using the first terminal, which image is taken by the first terminal, to the second terminal through the direct communication; The embedded display information is returned to the first terminal. Methods for remote medical support. (Appendix D1) A process for controlling the establishment of a direct communication connection between a first terminal and a second terminal; A process of generating display information for displaying medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal; A process of embedding a process of transmitting a captured image of a user using the first terminal, the captured image being captured by the first terminal, to the second terminal through the direct communication in the display information; A process of returning the embedded display information to the first terminal; Have your computer run Remote medical support program. (Appendix E1) A storage device is connected to the device for storing a list of users belonging to attributes of a person involved in the medical treatment of a specific patient; in response to a registration request for first medical information related to the specific patient received from a terminal used by a first medical worker belonging to a first related person attribute and a second related person attribute that permits access to the first medical information, registering the first medical information in the storage device in association with at least the second related person attribute; In response to a request for access to the medical information of the specific patient received from a specific terminal used by a specific user, referring to the storage device, identifying the related party attribute to which the user list including the specific user belongs; acquiring, from the storage device, one or more pieces of medical information associated with the identified related person attributes; The one or more pieces of acquired medical information are returned to the specified terminal so as to be displayed on the screen of the specified terminal. A remote medical support device equipped with a medical management unit. (Appendix E2) the storage device pre-stores a user ID and a password of a user who can use the terminal, attributes of the user ID, and a face image of the user ID in association with each other; The medical care management unit includes: During login processing of the predetermined terminal, a face image of a user of the terminal photographed by the predetermined terminal and a user ID are received; A face image associated with the accepted user ID is obtained from the storage device. performing face authentication between the received face image and the acquired face image; If an attribute of the accepted user ID is the first medical worker, after the face authentication is successful, a password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted; If an attribute of the user ID included in the received user ID is other than that of the first medical worker, login is permitted after the face authentication is successful. 2. A remote medical support device as described in Appendix E1. (Appendix E3) The medical information includes biological information of the patient. A remote medical support device as described in Appendix E1 or E2. (Appendix E4) A connection management unit for controlling connection establishment for direct communication between the first and second terminals, The medical care management unit includes: Generate display information for displaying the one or more pieces of acquired medical information on a screen of the first terminal in response to the access request from the first terminal that has established the connection with the second terminal; embedding a process for transmitting an image of a user of the first terminal captured by the first terminal to the second terminal through the direct communication in the generated display information; The embedded display information is returned to the first terminal. A remote medical support device according to any one of appendices E1 to E3. (Appendix E5) The connection management unit When connection management information that associates a terminal ID of a terminal with destination information assigned to the terminal is received, the connection management information is stored in a memory of the own device; In response to a request from the first terminal to establish the connection with the second terminal, the second connection management information of the second terminal is returned to the first terminal, and the second terminal is inquired of whether the connection with the first terminal can be established, thereby establishing the connection between the first and second terminals. A remote medical support device as described in Appendix E4. (Appendix E6) The storage device is connected to the remote medical support device and to another device that is redundant with the remote medical support device; The connection management unit When the connection management information is received, the connection management information is stored in the memory and the connection management information is registered in the storage device; retrieving the second connection management information from the memory in response to the request for connection establishment; When the search is a miss, the second connection management information is searched for in the storage device; The second connection management information is obtained from the memory or the storage device that is the subject of the search, and is returned to the first terminal. A remote medical support device as described in Appendix E5. (Appendix F1) A computer connected to a storage device that stores a user list belonging to attributes of a person involved in medical treatment of a specific patient, receiving a registration request for first medical information on the specific patient and a second related person attribute that permits access to the first medical information from a terminal used by a first medical worker belonging to a first related person attribute; registering the first medical information in the storage device in association with at least the second related person attribute; receiving a request to access medical information of the specific patient from a specific terminal used by a specific user; Identifying the related person attribute to which the user list including the specific user belongs by referring to the storage device; acquiring, from the storage device, one or more pieces of medical information associated with the identified related person attributes; The one or more pieces of acquired medical information are returned to the specified terminal so as to be displayed on the screen of the specified terminal. Methods for remote medical support. (Appendix G1) A computer connected to a storage device that stores a user list belonging to attributes of a person involved in medical treatment of a specific patient, receiving a registration request for first medical information on the specific patient and a second related person attribute that permits access to the first medical information from a terminal used by a first medical worker belonging to a first related person attribute; A process of registering the first medical information in the storage device in association with at least the second related person attribute; receiving a request to access medical information of the specific patient from a specific terminal used by a specific user; A process of referring to the storage device to identify the related person attribute to which the user list including the specific user belongs; A process of acquiring one or more pieces of medical information associated with the identified related person attributes from the storage device; A process of returning the acquired one or more pieces of medical information to the specified terminal so as to display them on a screen of the specified terminal; A remote medical support program that enables the following: (Appendix H1) the device is connected to a storage system that stores usage management information in which a usage state of a terminal is associated with a terminal ID, and connection management information in which the terminal ID is associated with destination information assigned to the terminal, together with the device itself and other redundant devices; A medical care management unit that inputs and outputs medical care information related to a patient receiving remote medical care between the terminal and the medical care management unit; A connection management unit that controls establishment of a connection for direct communication between terminals; Equipped with The connection management unit When a registration request for the connection management information is received from a predetermined terminal, the connection management information is stored in a memory of the terminal and the connection management information is registered in the storage system; The medical care management unit includes: acquiring a list of the terminal IDs whose usage status is "in use" from the usage management information of the storage system in response to a terminal list request from a first terminal, and returning the list to the first terminal; The connection management unit when a connection management information request including a second terminal ID of a second terminal selected from the list is received in the first terminal, searching the memory for the second terminal ID; if the second terminal ID is not present in the memory, searching the storage system for the second terminal ID; acquiring second connection management information associated with the second terminal ID from the memory or the storage system in which the second terminal ID exists, and returning the second connection management information to the first terminal; in response to receiving from the first terminal a terminal-to-terminal connection request in which the second connection management information is designated, inquiring of the second terminal as to whether or not a connection for direct communication with the first terminal is possible based on the second connection management information; responding to the first terminal with a connection permission for direct communication with the second terminal in response to the connection permission response from the second terminal; Remote medical support device. (Appendix H2) The connection management information includes candidates for route information in a network via which the direct communication is passed. 2. A remote medical support device as described in Appendix H1. (Appendix H3) The medical information includes biological information of the patient. 2. A remote medical support device according to claim H1 or H2. (Appendix H4) The usage management information is further associated with a user ID that can use the terminal, The medical care management unit includes: When a request for registration of the user ID of a second medical worker involved in remote medical care of a specific patient is received from any terminal used by a first medical worker, the user IDs of the first medical worker, the second medical worker, and the specific patient are associated with each other and registered in the storage system; In response to the terminal list request from the first terminal, identify another user ID associated with the user ID currently using the first terminal from within the storage system; Acquire a list of the terminal IDs of the usage management information that are associated with the specified other user ID and whose usage status is "in use"; Return the list to the first terminal. A remote medical support device described in any one of appendices H1 to H3. (Appendix H5) The medical care management unit includes: when a registration request for the medical information of the specific patient and a user ID that is permitted to access the medical information is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient is associated with the medical information, and an access right to the medical information is granted to the user ID that is permitted to access the medical information, and the medical information is registered in the storage system; When an access request for the medical information of the specific patient is received from the first terminal or the second terminal, the medical information of the specific patient for which the access authority is assigned to a user ID currently using the source of the access request is obtained from the storage system, and the obtained medical information is returned to the source of the access request. 2. A remote medical support device as described in Appendix H4. (Appendix H6) The medical care management unit includes: when a registration request for a user ID to which access is permitted according to the type of the medical information of the specific patient is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient, the type of the medical information, and the user ID to which access is permitted are associated and registered in the storage system; When a registration request for the medical information of the specific patient is received from the first terminal or the second terminal, a user ID of the specific patient is associated with the medical information, and access authority to the medical information is granted to the user ID associated with a type of the medical information, and the medical information is registered in the storage system; When an access request for the medical information of the specific patient is received from the first terminal or the second terminal, the medical information of the specific patient for which the access authority is assigned to a user ID currently using the source of the access request is obtained from the storage system, and the obtained medical information is returned to the source of the access request. A remote medical support device as described in Appendix H4 or H5. (Appendix H7) In the storage system, a user ID and a password of a user who can use the terminal, attributes of the user ID, and a facial image of the user ID are registered in advance in association with each other, The medical care management unit includes: During login processing of the predetermined terminal, a face image of a user of the terminal photographed by the predetermined terminal and a user ID are received; A face image associated with the accepted user ID is obtained from the storage system. performing face authentication between the received face image and the acquired face image; If an attribute of the accepted user ID is a first medical worker, after the face authentication is successful, a password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted; If the attribute of the accepted user ID is other than that of a first medical worker, login is permitted after the face authentication is successful. A remote medical support device described in any one of appendices H1 to H6. (Appendix I1) A remote medical support device connected to a storage system that stores usage management information in which a usage state of a terminal is associated with a terminal ID and connection management information in which the terminal ID is associated with destination information assigned to the terminal, the remote medical support device being connected to the storage system together with the device itself and other redundant devices, When a registration request for the connection management information is received from a predetermined terminal, the connection management information is stored in a memory of the terminal and the connection management information is registered in the storage system; acquiring a list of the terminal IDs whose usage status is "in use" from the usage management information of the storage system in response to a terminal list request from a first terminal, and returning the list to the first terminal; when a connection management information request including a second terminal ID of a second terminal selected from the list is received in the first terminal, searching the memory for the second terminal ID; if the second terminal ID is not present in the memory, searching the storage system for the second terminal ID; acquiring second connection management information associated with the second terminal ID from the memory or the storage system in which the second terminal ID exists, and returning the second connection management information to the first terminal; in response to receiving from the first terminal a terminal-to-terminal connection request in which the second connection management information is designated, inquiring of the second terminal as to whether or not a connection for direct communication with the first terminal is possible based on the second connection management information; responding to the first terminal with a connection permission for direct communication with the second terminal in response to the connection permission response from the second terminal; Methods for remote medical support. (Appendix J1) A storage system stores usage management information in which a usage state of a terminal is associated with a terminal ID, and connection management information in which the terminal ID is associated with destination information assigned to the terminal, and the storage system stores the usage ... a process of storing the connection management information in a memory of the device itself and registering the connection management information in the storage system when a registration request for the connection management information is received from a predetermined terminal; A process of acquiring a list of the terminal IDs whose usage status is "in use" from the usage management information of the storage system in response to a terminal list request from a first terminal, and returning the list to the first terminal; a process of searching the memory for a second terminal ID of a second terminal selected from the list when a connection management information request including the second terminal ID of the second terminal selected from the list is received in the first terminal; a process of searching the storage system for the second terminal ID when the second terminal ID is not present in the memory; A process of acquiring second connection management information associated with the second terminal ID from the memory or the storage system where the second terminal ID exists, and returning the second connection management information to the first terminal; a process of inquiring of the second terminal as to whether or not a direct communication with the first terminal can be established based on the second connection management information in response to receiving a terminal-to-terminal connection request from the first terminal in which the second connection management information is specified; responding to a response of connection permission from the second terminal by sending a response of connection permission for direct communication with the second terminal to the first terminal; A remote medical support program that enables the following: [Explanation of symbols]

[0111] 1000 Remote medical support system 1. Storage System 11 Usage management information 111 Usage status 112 Terminal ID 12 Connection Management Information 121 Destination Information 122 Terminal ID 21 Remote medical support device 211 Medical Management Department 212 Connection Management Unit 213 Memory 214 Connection Management Information 22 Remote medical support device N Network 31 Terminals 311 Terminal ID 312 Connection Management Information 32 Terminals 321 Terminal ID 322 Connection Management Information 2000 Remote medical support system 4 Shared storage device 41 Usage management DB 411 User ID 412 User Attributes 413 Terminal ID 414 Usage Status 415 Password 416 Face Images 42 Connection Management DB 421 ICE 4211 Terminal ID 4212 Dynamic IP Address 4213 Route Information 422 ICE 43 Medical personnel database 431 Patient ID 432 Doctor ID 433 Nurse ID 434 Caregiver ID 44 Medical History DB 441 Patient ID 442 Medical Information 443 Access Rights 444 User ID 45 Authority definition DB 451 Patient ID 452 Medical Information Type 453 User ID 51 Server device 511 Web / AP server 512 Medical Management Department 513 P2P connection control server 514 Stun Server 5141 ICE 515 PeerJS Server 52 Server equipment 521 Web / AP server 523 P2P connection control server 524 Stun Server 525 PeerJS Server 6 Load balancer 71 Medical Institutions 710 Tablet PC 711 Terminal Apps 712 ICE 713 Doctor 714 Nurse 72 Patient's Home 720 Tablets 721 Terminal Apps 722 ICE 723 patients 724 Caregiver 73 Nursing care facilities 730 Tablets 731 Terminal Apps 732 ICE 733 Caregiver 81 Storage device 811 OS 812 Web Server Program 813 AP server program 814 Web Application Programs 815 Stun server program 816 PeerJS server program 82 Memory 83 Communication IF section 84 Control Unit 841 Medical Management Department 842 Terminal information processing unit 843 Connection Processing Unit 3000 Remote medical support system 21a Remote medical support device 211a Medical Management Department 212a Connection Management Unit 4000 Remote medical support system 21b Remote medical support device 211b Medical Management Department 4a Storage device 43a Medical personnel database 431 Patient ID 435 Related Party Attributes 436 User List 437 User ID 44a Medical history DB 441a Patient ID 442a Medical Information 443a Person Attributes

Claims

1. A connection management unit which, when receiving a terminal-to-terminal connection request from a first terminal, inquires of a second terminal as to whether or not a connection for direct communication with the first terminal is possible, and responds to the first terminal with a connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal, thereby controlling the establishment of a connection for direct communication between the first and second terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating first display information for displaying first medical information on a screen of the first terminal in response to a request from the first terminal having established a connection with the second terminal; Embedding a process for transmitting an image of a user using the first terminal, which is captured by the first terminal, to the second terminal through the direct communication into the first display information, and returning the first display information after the embedding to the first terminal; generating second display information for displaying second medical information on a screen of the second terminal in response to a request from the second terminal having established a connection with the first terminal; A process for transmitting an image of a user using the second terminal, which is taken by the second terminal, to the first terminal by the direct communication is embedded in the second display information, and the second display information after the embedding is returned to the second terminal. Remote medical support device.

2. The connection management unit When connection management information that associates a terminal ID of a specific terminal with destination information assigned to the terminal is received, the connection management information is stored in a memory of the device itself; In response to a request from the first terminal to establish the connection with the second terminal, the second connection management information of the second terminal is returned to the first terminal, the second terminal is inquired of whether the connection with the first terminal can be established, and in response to a response of connection permission from the second terminal, the first terminal is responded with a response of connection permission with the second terminal, thereby establishing the connection between the first and second terminals. The remote medical support device according to claim 1.

3. The connection management unit When the connection management information is received, the connection management information is stored in the memory, and the connection management information is registered in a storage system connected to the host device and the other redundant devices; retrieving the second connection management information from the memory in response to the request for connection establishment; When the search is a miss, searching the storage system for the second connection management information; The second connection management information is obtained from the memory or the storage system that is the subject of the search, and is returned to the first terminal. The remote medical support device according to claim 2.

4. the storage system further stores usage management information in which a usage state of the terminal is associated with a terminal ID; The medical care management unit includes: acquiring a list of the terminal IDs whose usage status is "in use" from the usage management information of the storage system in response to a terminal list request from the first terminal, and returning the list to the first terminal; The connection management unit when the first terminal receives a connection management information request including a second terminal ID of the second terminal selected from the list as a request for connection establishment, searching the memory for the second terminal ID; If the search is a miss, searching the storage system for the second terminal ID; The second connection management information associated with the second terminal ID is obtained from the memory or the storage system that is the result of the search, and is returned to the first terminal. The remote medical support device according to claim 3.

5. The connection management unit inquiring of the second terminal as to whether or not the connection with the first terminal can be established based on the second connection management information in response to a terminal-to-terminal connection request from the first terminal in which the second connection management information is specified; responding to the first terminal to allow the connection establishment with the second terminal in response to the permission response for the connection establishment from the second terminal; The remote medical support device according to claim 4.

6. The remote medical care support device is connected to a first storage device that stores a user list belonging to a related party attribute related to medical care of a specific patient; The medical care management unit includes: in response to a registration request for first medical information related to the specific patient received from a terminal used by a first medical worker belonging to a first related person attribute and a second related person attribute permitting access to the first medical information, registering the first medical information in the first storage device in association with at least the second related person attribute; In response to a request for access to medical information of the specific patient received from a specific terminal used by a specific user, referring to the first storage device, identifying the related party attribute to which the user list including the specific user belongs; Obtaining one or more pieces of medical information associated with the identified related person attributes from the first storage device; Generate first display information for displaying the one or more pieces of acquired medical information on a screen of the predetermined terminal. do The remote medical support device according to any one of claims 1 to 5.

7. the remote medical assistance device is connected to a second storage device that stores in advance a user ID and a password of a user who can use a specific terminal, attributes of the user ID, and a face image of the user ID in association with each other; The medical care management unit includes: During login processing of a specific terminal, a face image of a user of the terminal photographed by the specific terminal and a user ID are received; A face image associated with the accepted user ID is obtained from the second storage device. performing face authentication between the received face image and the acquired face image; If the attribute of the accepted user ID is a specific medical worker, after the face authentication is successful, a password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted; If the attribute of the accepted user ID is other than that of the specific medical worker, login is permitted after the face authentication is successful. The remote medical support device according to any one of claims 1 to 6.

8. First and second terminals; a remote medical care support device connected to the first and second terminals via a network; Equipped with The remote medical care support device includes: a connection management unit that, when receiving an inter-terminal connection request from the first terminal, inquires of the second terminal as to whether or not a connection for direct communication with the first terminal is possible, and responds to the first terminal with a connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal, thereby controlling the establishment of a connection for direct communication between the first and second terminals; A medical care management department that manages medical information regarding patients receiving remote medical care; Equipped with The medical care management unit includes: generating first display information for displaying first medical information on a screen of the first terminal in response to a request from the first terminal having established a connection with the second terminal; embedding, in the first display information, a process for transmitting a captured image of a user using the first terminal, the captured image being captured by the first terminal, to the second terminal through the direct communication; Returning the embedded first display information to the first terminal; generating second display information for displaying second medical information on a screen of the second terminal in response to a request from the second terminal having established a connection with the first terminal; embedding a process of transmitting an image of a user using the second terminal, the image being taken by the second terminal, to the first terminal through the direct communication in the second display information, and returning the second display information after the embedding to the second terminal; Remote medical support system.

9. The computer when receiving an inter-terminal connection request from a first terminal, inquiring of a second terminal as to whether or not a connection for direct communication with the first terminal is possible, and responding to the first terminal with a connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal, thereby controlling the establishment of a connection for direct communication between the first and second terminals; generating first display information for displaying first medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal; Embedding a process for transmitting an image of a user using the first terminal, which is captured by the first terminal, to the second terminal through the direct communication into the first display information, and returning the first display information after the embedding to the first terminal; generating second display information for displaying second medical information on a screen of the second terminal in response to a request from the second terminal having established a connection with the first terminal; A process for transmitting an image of a user using the second terminal, which is taken by the second terminal, to the first terminal by the direct communication is embedded in the second display information, and the second display information after the embedding is returned to the second terminal. Methods for remote medical support.

10. A process for controlling establishment of a connection for direct communication between a first terminal and a second terminal when a terminal-to-terminal connection request is received from a first terminal, by inquiring of a second terminal as to whether or not a connection for direct communication with the first terminal is possible, and responding to the first terminal with a connection permission for direct communication with the second terminal in response to a response of connection permission from the second terminal; A process of generating first display information for displaying first medical information on a patient receiving remote medical care on a screen of the first terminal in response to a request from the first terminal that has established the connection with the second terminal; Embedding a process for transmitting an image of a user using the first terminal, which is captured by the first terminal, to the second terminal through the direct communication into the first display information, and returning the first display information after the embedding to the first terminal; generating second display information for displaying second medical information on a screen of the second terminal in response to a request from the second terminal having established a connection with the first terminal; a process of embedding a captured image of a user using the second terminal, the captured image being transmitted to the first terminal by the direct communication, in the second display information, and returning the second display information after the embedding to the second terminal; Have your computer run Remote medical support program.

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