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

Abstract

[Problem] To more appropriately support diagnosis when diagnosis accompanied by a medical action from a remote place is performed. [Solution] A remote medical support system 1 comprises a work mechanism 25, an operation mechanism 15, an operation control unit 313, and a presentation unit 314. The work mechanism 25 is a mechanism for performing a medical action including palpation of a subject. The operation mechanism 15 is a mechanism for receiving a remote operation for the work mechanism 25 from an operator. The operation control unit 313 controls the operation of the work mechanism 25 according to the remote operation received by the operation mechanism 15, and transmits the reaction force applied to the work mechanism 25 in response to the contact of the work mechanism 25 with the subject to the operator via the operation mechanism 15 as a tactile force. The presentation unit 314 presents, to the operator, support information for supporting diagnosis based on the medical practice acquired on the work mechanism side.

Description

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

[0001] The present invention relates to a remote medical support system, a remote medical support method, and a program.

[0002] In medical settings, subjects suspected of having an illness typically travel to a medical facility to receive a diagnosis from a medical professional, such as a physician. In these cases, the medical professional, such as a physician, diagnoses the subject from a variety of perspectives, including palpation, percussion, visual inspection, and auscultation. However, depending on circumstances such as the congestion at the medical facility, a diagnosis may not be available immediately. Furthermore, in situations such as when a patient is being transported to an emergency room, when receiving a diagnosis during home medical care, or when performing emergency triage, it is difficult to receive a diagnosis from an experienced medical professional on the spot. For example, proper diagnosis using a medical device that uses ultrasound (US: Ultrasonography) depends in part on the experience of the medical professional. Considering the human resources of medical professionals, it is unrealistic to have such experienced personnel constantly on-site and available to provide diagnoses at any time.

[0003] Taking such circumstances into consideration, an example of technology for supporting medical procedures through remote control is disclosed in Patent Document 1. The technology disclosed in Patent Document 1 is said to support the work of medical personnel by controlling the behavior of the remotely controlled robot arm so that it does not move at an excessive speed even when the operator operates the robot at an excessive speed.

[0004] Japanese Patent Application Laid-Open No. 2023-034696

[0005] However, medical procedures require high operational precision. Therefore, it is considered difficult to achieve the required operational precision simply by controlling the behavior of a robot arm so that it does not move at an excessive speed, as in the technology disclosed in Patent Document 1. In other words, there is still room for improvement in order for medical professionals to remotely perform diagnoses from various perspectives, such as palpation, percussion, visual inspection, and auscultation.

[0006] The present invention has been made in view of the above circumstances, and an object of the present invention is to more appropriately support diagnosis when a diagnosis involving a medical procedure is performed remotely.

[0007] In order to solve the above problem, a remote medical support system according to one embodiment of the present invention comprises: a working mechanism for performing a medical procedure including palpation on a subject; an operating mechanism that receives remote control of the working mechanism from an operator; an operation control means that controls the operation of the working mechanism in accordance with the remote control received by the operating mechanism and transmits a reaction force applied to the working mechanism in response to the working mechanism coming into contact with the subject to the operator via the operating mechanism as a haptic sensation; and an support information presentation means that presents support information obtained by the working mechanism to the operator to support a diagnosis based on the medical procedure.

[0008] According to the present invention, when a diagnosis involving a medical procedure is performed remotely, it is possible to more appropriately support the diagnosis.

[0009] 1 is a schematic diagram showing the overall configuration of a remote medical support system 1 according to the present embodiment. FIG. 1 is a block diagram showing the hardware configuration of an operation device 10 and a working device 20. FIG. 2 is a perspective view showing an example configuration of the operation device 10 and a working device 20. FIG. 3 is a block diagram showing a hardware configuration 700, which is an example of the hardware configuration of a main control device 30 and a sub-control device 40. FIG. 4 is a block diagram showing the functional configuration of the main control device 30. FIG. 5 is a table showing an example of the data structure of a communication control table. FIG. 6 is a block diagram showing the control algorithm of an operation control unit 313. FIG. 7 is a block diagram showing the functional configuration of a sub-control device 40. FIG. 8 is a flowchart explaining the flow of operation control processing executed by the remote medical support system 1. FIG. 9 is a flowchart explaining the flow of remote medical support processing executed by the remote medical support system 1.

[0010] An example of an embodiment of the present invention will now be described with reference to the accompanying drawings.

[0011] [System Configuration] Fig. 1 is a schematic diagram showing the overall configuration of a remote medical support system 1 according to this embodiment. As shown in Fig. 1, the remote medical support system 1 is installed separately at an "operation side," which is, for example, a medical facility such as a hospital, and a "work side," which is, for example, the inside of an ambulance during emergency transport. Specifically, on the operation side, the remote medical support system 1 includes an operation device 10, a main control device 30, a display 30a, and a camera 30b. On the other hand, on the work side, the remote medical support system 1 includes a work device 20, a sub-controller 40, a display 40a, and a camera 40b.

[0012] Furthermore, the devices on the operation side and the work side are connected to each other so that they can communicate with each other. This communication may be either wired or wireless, and the communication method is not limited. In addition, the main control device 30 and the sub-control device 40 can also communicate with each other remotely via a network N. However, this network N is a public network such as the Internet, and is not a bandwidth-guaranteed network in which a predetermined communication speed is guaranteed, but rather a best-effort network in which a predetermined communication speed is not guaranteed.

[0013] FIG. 1 also illustrates an operator on the operating side, and an assistant and a subject on the working side. The operator remotely controls the operating device 10 to operate the working device 20, thereby performing a medical procedure on the subject. The operator may be, for example, a specialist or an ultrasound technician certified by the Japan Society of Ultrasound who has experience in the medical procedure. The assistant may be, for example, a non-specialist medical staff member, such as a family doctor or emergency medical team, who has little experience in the medical procedure. The subject is a person who is suffering from (or suspected of suffering from) a disease or an injury, and who undergoes the medical procedure and for whom the operator will make a diagnosis. The subject may also be, for example, a pregnant woman or a patient with a chronic disease, who requires regular checkups and follow-up observations.

[0014] In this embodiment, as shown in the "upward direction," an assistant requests the operator to perform a medical procedure on the subject. In response to this request, as shown in the "downward direction," the operator remotely performs the medical procedure on the subject.

[0015] In this remote medical support system 1, the operating device 10 operates as a master device, driving a mechanism that accepts operations from an operator. Meanwhile, the working device 20 operates as a slave device, driving a mechanism that performs a medical procedure, including palpation, on a subject. Here, a medical procedure, including palpation, on a subject includes all medical procedures, such as non-invasive palpation. For example, the working device 20 can perform a medical procedure, including palpation, on a subject by directly or indirectly contacting the subject via another attached component. When the working device 20 performs a medical procedure, including palpation, it may or may not perform a medical procedure that does not include palpation. In this case, the main control device 30 performs control (bilateral control) to transmit haptic sensations between the mechanism driven by the operating device 10 and the mechanism driven by the working device 20. As a result, the operator's operation on the operating device 10 (input of position and force) is transmitted to the mechanism driven by the working device 20, and the reaction force (response of position and force) from the working device 20 is transmitted to the mechanism driven by the operating device 10 as a force sensation.

[0016] Furthermore, the displays 30a and 40a have the function of displaying images and functioning as speakers. The cameras 30b and 40b have the function of capturing images and functioning as microphones. Images and sounds captured and collected by the camera 40b on the working side, or measurement results obtained through medical procedures, are played back on the display 30a on the operating side via the network N. Similarly, images and sounds captured and collected by the camera 30b on the operating side, or measurement results obtained through medical procedures, are played back on the display 40a on the operating side via the network N.

[0017] This allows the operator to perform medical procedures for diagnosis based on other senses (e.g., vision and hearing) in addition to the transmitted haptic sensation. In other words, the remote medical support system 1 enables medical professionals performing diagnoses remotely to make diagnoses from a variety of perspectives (e.g., palpation, percussion, visual inspection, and auscultation). Therefore, the remote medical support system 1 can solve the problem of more appropriately supporting diagnoses when performing diagnoses involving medical procedures remotely. This concludes the outline of this embodiment.

[0018] [Device Configuration] Next, the configuration of each device included in the remote medical support system 1 will be described. Fig. 2 is a block diagram showing the hardware configuration of the operation device 10 and the working device 20. As shown in Fig. 2, the operation device 10 includes an actuator 12 for driving an operation mechanism 15, a driver 11 for driving the actuator 12, and a position sensor 13 for detecting the position of a movable part of the operation mechanism 15 that is moved by being driven by the actuator 12. The operation device 10 also includes a communication unit 14 for communication between the driver 11 and the position sensor 13 and the main control device 30, and the operation mechanism 15.

[0019] On the other hand, the working device 20 also includes an actuator 22 for driving a working mechanism 25, a driver 21 for driving the actuator 22, and a position sensor 23 for detecting the position of a movable part of the working mechanism 25 that is moved by being driven by the actuator 22. The working device 20 also includes a communication unit 24 for communication between the driver 21 and the position sensor 23 and the sub-controller 40, and the working mechanism 25.

[0020] In this case, the position of the movable part of the operation mechanism 15 detected by the position sensor 13 is, for example, the position of a predetermined part of the movable part of the operation mechanism 15. However, instead of the position of the movable part of the operation mechanism 15, the position of a predetermined part of the operator operating the operation mechanism 15 may be used. Furthermore, the position of the movable part of the working mechanism 25 detected by the position sensor 23 is, for example, the position of a predetermined part of the movable part of the working mechanism 25. However, instead of the position of the movable part of the working mechanism 25, the position of a predetermined part where the working mechanism 25 comes into contact with the subject (for example, the position of the tip of the working mechanism 25) may be used.

[0021] In this embodiment, instead of detecting the position of the movable part of the operation mechanism 15 or the position of the movable part of the working mechanism 25, the rotation angle of the output shaft of each actuator may be detected by a rotary encoder built into each actuator. That is, in this embodiment, the concept of position includes an angle (e.g., the rotation angle of the output shaft of the actuator), and position-related information includes position, angle, velocity, angular velocity, acceleration, and angular acceleration. Furthermore, since position and velocity (or acceleration) or angle and angular velocity (or angular acceleration) are parameters that can be substituted by differential and integral calculations, when processing position or angle, they can be appropriately substituted with velocity or angular velocity before processing. Furthermore, although the figures show only one system of drivers, actuators, and position sensors in the operation device 10 and the working device 20, multiple systems of these may be provided depending on the number of operation mechanisms 15 and working mechanisms 25 and the number of their respective actuators.

[0022] In this configuration, the main control unit 30 outputs control commands to the driver 11 and the driver 21 based on the positions detected by the position sensors 13 and 23, thereby realizing bilateral control that transmits haptic sensations between the operation mechanism 15 of the operating device 10, which is the master device, and the working mechanism 25 of the working device 20, which is the slave device. In this case, the sub-control unit 40 plays a role in relaying the positions detected by the position sensors 23 and the control commands output by the main control unit 30 to the driver 21. A specific algorithm for realizing this control that transmits haptic sensations (bilateral control) will be described later with reference to FIG. 7 .

[0023] Fig. 3 is a perspective view showing an example configuration of the operation device 10 and the working device 20. There are no particular limitations on the shape or structure of the operation device 10 and the working device 20, but in this embodiment, as an example, it is assumed that the operation device 10 and the working device 20 have the same shape and structure, and only the functions of the operation mechanism 15 and the working mechanism 25 are different. Note that Fig. 3 does not show the hardware configuration shown in Fig. 2 (here, drivers 11, 21, actuators 12, 22, position sensors 13, 23, and communication units 14, 24).

[0024] The operating device 10 and the working device 20 are realized as devices having a link mechanism including multiple (here, three) link shafts that connect the base and the end effector in order to perform a predetermined task using the end effector. As shown in the figure, this link mechanism has a three-axis structure that is movable in the X direction in a horizontal plane, the Y direction perpendicular to the X direction in the horizontal plane, and the Z direction (i.e., the vertical direction) perpendicular to both the X and Y directions, and can move the end effector three-dimensionally by driving actuators 12, 22 realized by servo motors, air cylinders, etc.

[0025] In this case, the bases of the operating device 10 and the working device 20 are fixed to the ceiling or wall of the operating side or the working side, or to a workbench, etc. Furthermore, an operating mechanism 15 is attached to the tip of the operating device 10 as an end effector. In this embodiment, as an example, it is assumed that this operating mechanism 15 is a dummy device configured in a shape that imitates an ultrasonic probe. This operating mechanism 15 does not need to have the functionality of an ultrasonic probe, and does not need to include components such as an acoustic lens or a vibrator inside. However, it is desirable that the surface texture and weight be similar to those of an actual ultrasonic probe so that remote operation can be performed with a feeling similar to that when using an actual ultrasonic probe.

[0026] Meanwhile, a working mechanism 25 is attached to the tip of the working device 20 as an end effector. In this embodiment, as an example, it is assumed that this working mechanism 25 is an ultrasound probe commonly used in medical settings. The working mechanism 25 receives reflected ultrasound waves by being moved in a predetermined direction while in contact with the body of the subject, and is able to generate image data (hereinafter referred to as an "ultrasound image") based on the reflected ultrasound waves. The ultrasound image is played back on the working-side display 30a, and the operator can refer to this ultrasound image to observe the condition of the subject's organs and fetus.

[0027] The configuration shown in FIG. 3 is merely an example. For example, the operating device 10 and the working device 20 may have different structures, may be serial link mechanisms instead of parallel link mechanisms, and the number of axes is not limited. For example, a six-axis mechanism with greater flexibility or a two-axis mechanism with a simpler configuration may be used. Furthermore, assuming direct hand contact for palpation, the operating device 10 may be a multi-fingered device worn by the operator, and the working device 20 may be a robotic manipulator that contacts the subject. The operating device 10 and the working device 20 may be realized as a configuration specific to this embodiment, or may be realized as a general-purpose robot arm, etc. Furthermore, the operating mechanism 15 and the working device 20, which are end effectors, are not limited to ultrasound probes. They may also be other medical devices and dummy devices that mimic those medical devices. In this case, various medical devices may be detachable, and different medical devices (and dummy devices that mimic those medical devices) may be interchangeable as end effectors depending on the situation.

[0028] 4 is a block diagram showing a hardware configuration 700, which is an example of the hardware configuration of the main control device 30 or the sub-control device 40. As shown in FIG. 4, the hardware configuration 700 includes a processor 701, a ROM (Read Only Memory) 702, a RAM (Random Access Memory) 703, a bus 704, an input unit 705, an output unit 706, a storage unit 707, a communication unit 708, and a drive 709.

[0029] The processor 701 executes various processes according to a program recorded in the ROM 702 or a program loaded from the storage unit 707 to the RAM 703. The RAM 703 also stores data and the like necessary for the processor 701 to execute various processes, as appropriate.

[0030] The processor 701, ROM 702, and RAM 703 are connected to one another via a bus 704. To the bus 704, an input unit 705, an output unit 706, a storage unit 707, a communication unit 708, and a drive 709 are connected.

[0031] The input unit 705 includes input devices such as a mouse and keyboard, and accepts input of various information to the main control unit 30 and the sub-control unit 40. In this case, the input unit 705 of the main control unit 30 also accepts input of images and sounds of the operating side captured and collected by the camera 30b. On the other hand, the input unit 705 of the sub-control unit 40 also accepts input of images and sounds of the working side captured and collected by the camera 40b, as well as measurement results of the working mechanism 25 (for example, ultrasound images showing the measurement results).

[0032] The output unit 706 is composed of a display, speaker, etc., and outputs images and sounds. In this case, the output unit 706 of the main control unit 30 outputs images, sounds, measurement results, etc. from the work side received via the network N from the display 30a. On the other hand, the output unit 706 of the sub-control unit 40 outputs images, sounds, measurement results, etc. from the operation side received via the network N from the display 40a. The storage unit 707 is composed of a hard disk, DRAM (Dynamic Random Access Memory), etc., and stores various data managed by each server. The communication unit 708 controls communication with other devices via the network.

[0033] Removable media 750, such as a magnetic disk, optical disk, magneto-optical disk, or semiconductor memory, is appropriately mounted in the drive 709. Programs read from the removable media 750 by the drive 709 are installed in the storage unit 707 as needed. Note that the above hardware configuration is the basic configuration of the main control unit 30 and the sub-control unit 40, and it is possible to configure the main control unit 30 without some of the hardware, to include additional hardware, or to change the hardware implementation form.

[0034] The main control unit 30 and sub-control unit 40 having such hardware configurations cooperate to perform "motion control processing" and "telemedical support processing." Here, the motion control processing is a series of processes that control the operation of each mechanism by performing control (bilateral control) that transmits haptic sensations between the operation mechanism 15 driven by the operating device 10 and the working mechanism 25 driven by the working device 20. Also, the telemedical support processing is a series of processes that utilize the motion control processing to support remote operation in telemedicine by the operator. Note that the motion control processing is realized as a subroutine of the telemedical support processing.

[0035] 5 is a block diagram showing the functional configuration of the main control device 30. When the above-described operation control processing and remote medical support processing are performed, as shown in FIG. 5, a monitoring unit 311, a communication control unit 312, an operation control unit 313, and a presentation unit 314 function in the processor 701. In addition, a communication control table storage unit 371 and a history data storage unit 372 are formed in the storage unit 707. Data required to realize the processing is transmitted and received between these functional blocks at appropriate times, including cases not specifically mentioned below.

[0036] The monitoring unit 311 monitors the communication quality of the communication path used by the main control unit 30 and the sub-control unit 40 to send and receive data. Here, the communication path includes the network N, but as described above, this network N is a best-effort network in which a specified communication speed is not guaranteed. Therefore, the communication quality in the network N is not constant. Therefore, the monitoring unit 311 monitors values ​​indicating communication quality based on various indicators.

[0037] For example, the monitoring unit 311 transmits segments and receives ACKs between the main control unit 30 and the sub-control unit 40, and monitors the value of the round-trip time required for these transmissions and receptions. In addition, for example, when communication is performed between the main control unit 30 and the sub-control unit 40, with the time of data transmission included in the transmission parameters of the data to be transmitted for time synchronization, the monitoring unit 311 calculates and monitors the communication delay time from the difference between the time of transmission and the time of reception included in the received data. Alternatively, the monitoring unit 311 measures and monitors the packet loss rate, which indicates the rate at which packets are lost in the network, and the jitter value, which indicates fluctuations in network delay. Note that methods for measuring values ​​indicating communication quality based on these various indicators are well known to those skilled in the art, and therefore a detailed description thereof will be omitted here.

[0038] The monitoring unit 311 then outputs these monitored values ​​as the communication quality monitoring results to the communication control unit 312. Note that which value the communication control unit 312 outputs as the monitoring result to the communication control unit 312 can be set appropriately in consideration of the characteristics of the network N to be used, etc.

[0039] The communication control unit 312 changes the communication mode (i.e., communication mode) for transmitting and receiving data depending on the communication quality monitored by the monitoring unit 311. This makes it possible to support medical procedures by transmitting and receiving data in various modes depending on the communication quality, even in an environment where the communication quality is not constant. In this way, the criteria for changing the communication mode and the specific contents of the communication mode are specified in advance, for example, as a communication control table and stored in the communication control table storage unit 371. In other words, the communication control table storage unit 371 functions as a storage unit for storing the communication control table.

[0040] 6 is a table showing an example of the data structure of a communication control table. In this table, a row is provided for each communication mode. Furthermore, each column stores the setting contents corresponding to each communication mode. In this embodiment, as an example, it is assumed that there are three communication modes, namely, first communication mode, second communication mode, and third communication mode. However, this is merely an example, and more communication modes may be provided in stages, or there may be only two communication modes.

[0041] The communication control unit 312 selects a communication mode according to the communication quality monitored by the monitoring unit 311 and controls communication between the operating device 10 and the maintenance device 20 via the network N in a manner consistent with the selected communication mode. In this case, the criterion for selecting the communication mode may be, for example, comparing the communication quality monitored by the monitoring unit 311 with a preset threshold. For example, the value indicating the communication quality monitored by the monitoring unit 311 may be higher as the communication quality improves. In this case, for example, if the monitored value is equal to or greater than a first threshold ("XX" in the figure), the first communication mode is selected. Furthermore, for example, if the monitored value is less than the first threshold ("XX" in the figure) and equal to or greater than a second threshold ("YY" in the figure), the second communication mode is selected. Furthermore, for example, if the monitored value is less than the second threshold ("YY" in the figure), the third communication mode is selected. In addition, if the value indicating the communication quality monitored by the monitoring unit 311 is a value that is lower the better the communication quality, the magnitude relationship between the value indicating the communication quality and the threshold value will be the opposite of the above.

[0042] In this embodiment, the first communication mode is assumed to satisfy a predetermined communication quality (i.e., good communication quality). Furthermore, in the first communication mode, haptic sensations are transmitted bidirectionally in real time. Therefore, the first threshold value is set to a value corresponding to a communication quality sufficient for such real-time bidirectional haptic sensation transmission. For example, if the communication delay time being monitored is 20 ms, the first communication mode is selected if the delay time is less than this threshold value. Alternatively, if random packet loss is monitored, the first threshold value is set to 20% and the first communication mode is selected if the packet loss is less than this threshold value. Note that values ​​such as 20 ms and 20% are merely examples of values ​​that can be set as the first threshold value. The first threshold value can be set to any value based on various criteria, such as the environment in which this embodiment is implemented, the content of the actual medical procedure, and the accuracy required by the operator.

[0043] The second communication mode refers to a state in which communication is possible but does not satisfy a predetermined communication quality. The third communication mode refers to a state in which communication is impossible or extremely difficult. Therefore, the second threshold can be determined based on this boundary. Note that these thresholds are merely examples, and appropriate values ​​can be set depending on the type of medical procedure performed by remote control, the required accuracy, etc. The communication control unit 312 selects a communication mode in accordance with the communication quality monitored by the monitoring unit 311, and then controls communication between the operating device 10 and the working device 20 via the network N using a method defined in the communication control table. In this case, as shown in the figure, in the first communication mode, all of the haptic information, visual information, and auditory information are transmitted and received immediately (i.e., in real time) and bidirectionally.

[0044] Here, the haptic information is the value of a parameter used for controlling the transmission of haptic sensations (bilateral control) between the operation mechanism 15 driven by the operating device 10 and the working mechanism 25 driven by the working device 20. For example, the haptic information is a value indicating the position detected by the position sensor 13 or the position sensor 23, or a control command value for the driver 11 or the driver 21 calculated by the main control device 30. Other examples of the haptic information may include values ​​indicating speed, acceleration, force, impedance, etc. Furthermore, the visual information may be images of the facial expression of the operating operator, the facial expression of the working subject, or the target area of ​​the medical procedure captured by the camera 30b or the camera 40b, measurement results measured by the working mechanism 25, etc. (e.g., ultrasound images showing the measurement results), or text indicating the patient's attributes (e.g., age, gender, and symptoms) entered by the assistant into the sub-controller 40. Furthermore, the auditory information includes the voice of the operator on the operating side, the voice of the subject on the working side, and the measurement results (for example, the subject's heartbeat indicating the measurement results) collected by the working mechanism 25, etc. At least a part of this visual information and auditory information corresponds to the "support information" of the present invention.

[0045] In the first communication mode, all of this force-tactile information, visual information, and auditory information are transmitted and received in real time and in both directions in time series, so that, for example, an operator receiving this information can feel the reaction force from the actual patient based on the remote operation as a force-tactile sensation through their sense of touch. At the same time, various visual and auditory information can also be sensed visually and aurally. This allows the operator performing a diagnosis remotely to make a diagnosis from a variety of perspectives (e.g., palpation, percussion, visual inspection, and auscultation).

[0046] For example, in medical procedures using an ultrasound probe, it is important to visually inspect the ultrasound image measured by the ultrasound probe to make a diagnosis. To do so, it is necessary to contact the ultrasound probe with an appropriate amount of force and move it appropriately (e.g., back and forth in a predetermined direction). However, achieving such appropriate contact and movement is not easy and requires a technique based on the operator's (e.g., a doctor's) experience. Furthermore, if the ultrasound probe is used in an inappropriate manner, the ultrasound image itself may be inaccurate, leading to a misdiagnosis. However, the first communication aspect can assist in performing this procedure by transmitting haptic information and simultaneously presenting the ultrasound image, which is visual information. Therefore, the operator can visually inspect the ultrasound image and make a diagnosis while confirming that the procedure is being performed appropriately through tactile feedback. In other words, even if only an inexperienced assistant is present on the operating side, the operating side operator can remotely control the device and perform the medical procedure in the same manner as if they were actually performing the medical procedure face-to-face with the patient.

[0047] In addition, the operator may intentionally press the ultrasound probe against the subject's skin, regardless of whether an ultrasound image is being acquired, and make a diagnosis based on the subject's reaction to the pressure. For example, if the subject is experiencing severe pain, a diagnosis may be made based on the possibility of peritonitis. In this embodiment, the force of the pressure can be transmitted as a haptic sensation, and visual information such as the subject's facial expression and auditory information such as the subject's voice, which indicate the subject's reaction, can also be presented, making it possible to make a diagnosis using this method.

[0048] In addition, for example, communication between the operator and the assistant may be achieved by transmitting and receiving visual and auditory information such as the facial expression and voice of the operator on the operating side and the facial expression and voice of the assistant on the working side. Furthermore, for example, the remote operation itself may be supported by presenting an image of the target area of ​​the medical procedure on the subject or an image of the tip of the working mechanism 25.

[0049] In the second communication mode, all of this haptic information, visual information, and auditory information is accumulated in chronological order in the working device 20. In other words, rather than sequentially transmitting the acquired information itself (raw data), this information is accumulated and converted into a data file. This data file is then transmitted collectively. Note that in the second communication mode, in consideration of communication quality, data files are transmitted from the working side to the operating side, but transmission from the operating side to the working side is canceled. In other words, this is one-way communication.

[0050] In this case, for example, the operating device 20 is operated along a predetermined trajectory, and the resulting haptic, visual, and auditory information is transmitted to the operating side. This allows the operator to accurately perceive the information obtained by the operating side, even though the transmission of information, such as haptic information, is not in real time and time is asynchronous, resulting in a slight delay. The operator can then make a diagnosis based on this information. In addition, the operator may communicate with the assistant or the subject via a smartphone or other means over a mobile phone network, for example, to further assist in the diagnosis. Operating the operating device 20 along a predetermined trajectory may be achieved, for example, by storing haptic information for achieving the operation in the sub-controller 40 in advance and outputting it to the operating device 20. Alternatively, the assistant may directly operate the operating device 20 in response to instructions from the operator.

[0051] In the third communication mode, transmission and reception of all of the haptic information, visual information, and auditory information is stopped. In this case, the assistant may, for example, attempt to move to a location with a better communication environment or transport the patient to a nearby medical facility. In addition, the haptic information and visual information acquired by the working device 20 may be analyzed by the working sub-controller 40 using statistical methods, machine learning, or the like, so that analysis for diagnosis can be performed without relying on the assistant.

[0052] In this case, the statistical method refers to a rule-based diagnosis determined based on statistical information such as haptic and visual information accumulated in the past for various subjects. Furthermore, in this case, machine learning refers to, for example, constructing a learning model in advance that uses the above-mentioned past statistical information as input and outputs the diagnosis results at that time. Diagnosis can be made by inputting information about the subject currently being diagnosed into this learning model. In other words, even if communication is interrupted and the device is in a stand-alone state, it can support operators and assistants.

[0053] The above describes the monitoring of communication quality by the monitoring unit 311 and the selection of the communication mode by the communication control unit 312. These processes may be performed only at the beginning of the remote medical assistance process, or may be performed periodically thereafter, taking into account fluctuations in communication quality. Furthermore, in addition to automatically selecting the communication mode based on communication quality, the communication mode may be manually selected in response to the operation of the operator or assistant. For example, if the first communication mode is selected but the communication quality deteriorates and the operator begins to feel uncomfortable with remote operation, the operator may manually switch to the second communication mode, etc. Alternatively, if a capable operator is not found, the third communication mode may be selected, and then, if a capable operator is found, the assistant may manually switch to the first communication mode, etc. Furthermore, although the settings related to the communication mode are managed in a table format known as a communication control table, they may be managed in other data formats.

[0054] As described above, according to this embodiment, even in various environments where the communication quality is not constant, it is possible to support diagnosis involving medical procedures in a manner appropriate to the communication quality.

[0055] 5 , the operation control unit 313 controls the transmission of haptics between the operation mechanism 15 driven by the operating device 10 and the working mechanism 25 driven by the working device 20, thereby controlling the operation of each mechanism. To achieve this control, the communication control unit 312 acquires haptic information for achieving control in the first communication mode, etc. For example, the communication control unit 312 acquires the positions (specifically, positions or angles) of movable parts of each mechanism that are moved by driving the actuators 12, 22 from the position sensors 13, 23. The physical quantity data, such as position data, acquired by the communication control unit 312 is used as a reference value for the operation of each mechanism driven by the operating device 10 or the working device 20 in the haptic transmission algorithm.

[0056] FIG. 7 is a block diagram showing the control algorithm of the motion control unit 313. As shown in FIG. 7, the algorithm implemented in the motion control unit 313 is expressed as a control law including a functional force / velocity allocation conversion block FT, an ideal force source block FC, an ideal velocity (position) source block PC, and an inverse conversion block IFT. The control algorithm shown in FIG. 7 is described in a patent publication (Japanese Patent No. 6382203) owned by Keio University, which is the applicant of the present application. Various control algorithms described in this patent publication can also be used in this embodiment as appropriate. In this embodiment, the master device in the controlled system CS is configured by the operation device 10, and the slave device is configured by the working device 20.

[0057] The functional force / speed allocation transformation block FT defines the transformation of control energy into a velocity (position) and force range set according to the function of the controlled system CS. Specifically, the functional force / speed allocation transformation block FT defines a coordinate transformation that takes as inputs a reference value (reference value) for the function of the controlled system CS and the current position (or current angle) of the movable part of each mechanism moved by the actuators 12 and 22. This coordinate transformation generally transforms an input vector having elements of the reference value and the current position (current angle) into an output vector consisting of positions (angles) for calculating a control target value for position (angle), and also transforms an input vector having elements of the reference value and the current force into an output vector consisting of forces for calculating a control target value for force.

[0058] By setting the coordinate transformation in the functional force / speed allocation transformation block FT to a content that represents a force-tactile transmission function, it is possible to realize a force-tactile transmission function between the operation device 10 and the working device 20, or to reproduce an action that transmits a force-tactile sensation in the working device 20 without using the operation device 10. Furthermore, by setting coefficients in the elements of the transformation matrix in the coordinate transformation in the functional force / speed allocation transformation block FT, it is possible to perform scaling of the position (angle) or force.

[0059] That is, in this embodiment, the functional force / speed allocation transformation block FT "transforms" the individual variables (variables in real space) of the movable parts of each mechanism moved by the actuators 12 and 22 into a group of variables (variables in space after coordinate transformation) of the entire system that expresses the force haptic transmission function, and allocates control energy to the control energy of position (angle) and the control energy of force. That is, the coordinate transformation set in the functional force / speed allocation transformation block FT transforms real space coordinates (oblique coordinates) in which position (angle) and force are related to each other into virtual space coordinates (cartesian coordinates) in which position (angle) and force are independent of each other. Therefore, compared to the case where the individual variables (variables in real space) of the movable parts of each mechanism moved by the actuators 12 and 22 are controlled as they are, it is possible to independently assign the control energy of position (angle) and the control energy of force, i.e., to independently control the position (angle) and the force.

[0060] In this embodiment, for example, when controlling the position (angle) and force output by the operating device 10, the state value in the space after coordinate transformation can be calculated on the condition that the difference in position (angle) between the position (angle) of the movable part of each mechanism moved by driving with the actuator 12 and the input of a force calculated from these positions (angles) and the reference value serving as the basis for controlling the position (angle) and force is zero and the sum of the forces is zero (equal forces are output in opposite directions). However, the reference value serving as the basis for controlling the position (angle) and force is the position (angle) of the movable part of each mechanism moved by driving with the actuator 22 in the working device 20 and the force calculated from these positions (angles).

[0061] Similarly, in this embodiment, for example, when controlling the position (angle) and force output by the working device 20, the state value in the space after coordinate transformation can be calculated on the condition that the difference in position (angle) between the positions (angles) of the movable parts of each mechanism moved by driving with the actuator 22 and the input of a force calculated from these positions (angles) and the reference value serving as the basis for controlling the position (angle) and force is zero and the sum of the forces is zero (equal forces are output in opposite directions). However, the reference value serving as the basis for controlling the position (angle) and force is the position (angle) of the movable parts of each mechanism moved by driving with the actuator 12 in the operating device 10 and the force calculated from these positions (angles).

[0062] The ideal force source block FC is a block that performs calculations in the force domain according to the coordinate transformation defined by the functional force-velocity allocation transformation block FT. The ideal force source block FC sets a target value for force when performing calculations based on the coordinate transformation defined by the functional force-velocity allocation transformation block FT. This target value is set as a fixed value or a variable value depending on the function to be realized. For example, to achieve a function similar to the function indicated by the reference value, the target value can be set to zero. To perform scaling, the target value can be set to a value obtained by enlarging or reducing the information representing the function indicated by the reference value. The ideal force source block FC can also set an upper limit for the force energy determined by calculations in the force domain. Setting an upper limit for the force energy can, for example, limit the contact force when the operating device 20 contacts the subject, thereby preventing the operating mechanism 25 from pressing excessively hard against the subject's body.

[0063] The ideal velocity (position) source block PC performs calculations in the position (angle) domain according to the coordinate transformation defined by the functional force-velocity allocation transformation block FT. The ideal velocity (position) source block PC sets a target value for the position (angle) when performing calculations based on the coordinate transformation defined by the functional force-velocity allocation transformation block FT. This target value is set as a fixed value or a variable value depending on the function to be realized. For example, to achieve a function similar to the function indicated by the reference value, the target value can be set to zero. To perform scaling, a value obtained by enlarging or reducing the information indicating the function to be reproduced can be set. The ideal velocity (position) source block PC can also set an upper limit for the force energy determined by calculations in the position (angle) domain. Setting an upper limit for the position (angle) energy limits the distance the working device 20 can advance and retreat, preventing the working mechanism 25 and other components from pressing excessively hard against the subject's body.

[0064] The inverse transformation block IFT is a block that inversely transforms values ​​in the position (angle) and force domains into values ​​in the input domain (e.g., voltage values ​​or current values) to the controlled system CS (i.e., determines command values ​​in real space). Under this control algorithm, the main control device 30 receives time-series position (angle) detection values ​​detected by the position sensors 13 and 23. These time-series position (angle) detection values ​​represent the operation of the actuators 12 and 22, and the main control device 30 applies coordinate transformation to transmit haptic sensations to the input positions (angles) and forces derived from these positions (angles).

[0065] 5, the presentation unit 314 presents to the operator various pieces of information that the communication control unit 312 has acquired from the worker side through communication via the network N. The presentation is realized, for example, by playing visual information or audio information on the display 30a via the output unit 706. Playing back this information to the worker can assist the worker in making a diagnosis.

[0066] The history data storage unit 372 stores various information acquired by the communication control unit 312 as history data. The history data stored in the history data storage unit 372 can be used as a log of medical procedures. For example, it can be used to analyze the success or failure of a medical procedure and the time required for the medical procedure. Alternatively, it can be used as teaching material for teaching remote operation procedures to operators who have little experience with remote medical procedures.

[0067] 8 is a block diagram showing the functional configuration of the sub-control device 40. When the above-described operation control processing and remote medical support processing are performed, as shown in FIG. 8, a communication control unit 411, a data accumulation unit 412, an analysis unit 413, and a presentation unit 414 function in the processor 701. In addition, a communication control table storage unit 471 and a history data storage unit 472 are formed in the storage unit 707. Data required to realize the processing is transmitted and received between these functional blocks at appropriate times, including cases not specifically mentioned below.

[0068] The communication control unit 411 corresponds to the communication control unit 312 of the main control unit 30. The communication control unit 411 is notified of the communication mode to be selected by the communication control unit 312 of the main control unit 30. This communication mode to be selected is the same communication mode as the communication mode selected by the communication control unit 312 of the main control unit 30. Furthermore, when the communication control unit 411 selects the communication mode in response to this, it transmits and receives haptic information, visual information, and auditory information to and from the communication control unit 312 of the main control unit 30 in accordance with the content defined in the communication control table stored in the communication control table storage unit 471. However, as described above, depending on the communication mode, transmission and reception of this information is not performed.

[0069] The communication control table storage unit 471 functions as a storage unit that stores a communication control table. The communication control table stored in the communication control table storage unit 471 is the same as the communication control table stored in the communication control table storage unit 371.

[0070] The data accumulation unit 412 functions when the second communication mode is selected, and accumulates all of the haptic information, visual information, and auditory information to be transmitted in chronological order in the operating device 20. That is, the acquired information itself (raw data) is accumulated as a data file. In this case, the data accumulation unit 412 may accumulate the data using the storage area of ​​the RAM 703 or the storage area of ​​the storage unit 707. The communication control unit 411 then transmits the data file collectively at periodic intervals, etc. This allows the operator to feel each piece of information obtained by the operating device, although not in real time and with some time error, and allows for diagnosis based on this information.

[0071] The analysis unit 413 functions when the third communication mode is selected, and analyzes the haptic information and visual information acquired by the working device 20 using statistical methods, machine learning, etc. This allows analysis for diagnosis to be performed without relying on an assistant. Note that the specific content of the statistical methods, machine learning, etc. used to perform the analysis is as described above.

[0072] The presentation unit 414 presents various pieces of information that the data storage unit 412 acquires from the operating side through communication via the network N to the assistant and the subject. The presentation unit 414 also presents the analysis results by the analysis unit 413 to the assistant and the subject. The presentation is realized, for example, by playing visual information and auditory information on the display 40a via the output unit 706. Playing back this information for the assistant and the subject can support them.

[0073] The history data storage unit 472 stores various information acquired by the data accumulation unit 412 as history data. The history data stored in the history data storage unit 472 can be used as a log of medical procedures, similar to the history data stored in the history data storage unit 372 of the main control device 30. Next, the details of the processing content of each process performed by the remote medical support system 1 will be described.

[0074] [Operation Control Processing] Fig. 9 is a flowchart illustrating the flow of the operation control processing executed by the remote medical support system 1. The operation control processing is executed as a subroutine in the remote medical support processing.

[0075] In step S1, the operation control unit 313 acquires the position (angle) of the movable part of the mechanism to be moved by the actuator. In this embodiment, the mechanisms to be moved are the operation mechanism 15 and the working mechanism 25. In this case, the operation control unit 313 acquires the positions corresponding to these mechanisms from the position sensors 13 and 23 via the communication control unit 312.

[0076] In step S2, the motion control unit 313 converts the input vector in the real space into a vector in the virtual space. In step S3, the motion control unit 313 performs calculations in the velocity (position) domain and in the force domain.

[0077] In step S4, the operation control unit 313 inversely converts the values ​​in the domains of velocity (position) and force into values ​​in the domain of input to the controlled system CS (vectors in real space). In step S5, the operation control unit 313 outputs command values ​​for the actuators 12 and 22. This completes the process. However, as long as the first communication mode is being performed, the process will be performed continuously. In other words, in practice, steps S1 to S5 of the process will be repeated as long as the first communication mode is being performed.

[0078] According to the operation control process described above, the operation of each mechanism can be controlled by performing control (bilateral control) to transmit haptic sensations between the operation mechanism 15 driven by the operation device 10 and the working mechanism 25 driven by the working device 20.

[0079] 10 is a flowchart illustrating the flow of the remote medical support processing executed by the remote medical support system 1. The remote medical support processing is executed when the operation device 10 or the main control device 30 receives an instruction to start the remote medical support processing from a user such as an operator or an assistant.

[0080] In step S11, the monitoring unit 311 monitors the communication quality of the communication path used for transmitting and receiving data between the main control unit 30 and the sub-control unit 40. In step S12, the communication control unit 312 selects a communication mode depending on the communication quality monitored by the monitoring unit 311.

[0081] In step S13, the communication control unit 312 determines which communication mode is selected. If the selected communication mode is the first communication mode, it is determined to be the "first communication mode" in step S13, and the process proceeds to step S14. If the selected communication mode is the second communication mode, it is determined to be the "second communication mode" in step S13, and the process proceeds to step S17. If the selected communication mode is the third communication mode, it is determined to be the "third communication mode" in step S13, and the process proceeds to step S20.

[0082] In step S14, the communication control unit 312 and the communication control unit 411, which has been notified that the first communication mode has been selected, transmit and receive all of the haptic information, visual information, and auditory information in time series, immediately, and bidirectionally. In step S15, the operation control unit 313 executes the above-mentioned operation control process as a subroutine. Note that this operation control process is repeatedly executed while the first communication mode is being performed. In step S16, the presentation unit 314 and the presentation unit 414 present various types of information, such as visual information and auditory information.

[0083] In step S17, the data storage unit 412 stores all of the haptic information, visual information, and auditory information to be transmitted in chronological order in the working device 20 to create a data file. In step S18, the communication control unit 411 transmits the stored data files collectively. In step S19, the presentation unit 314 presents various types of information such as visual information and auditory information. In this case, haptic sensations may be transmitted to the operator via the operation mechanism 15 based on the haptic information received by the operation control unit 313.

[0084] In step S20, the analysis unit 413 analyzes the force-tactile information and visual information acquired by the working device 20 using a statistical method, machine learning, or the like. In step S21, the presentation unit 414 presents the analysis results by the analysis unit 413 to the assistant and the subject.

[0085] In step S22, the communication control unit 312 determines whether a manual operation to switch the communication mode has been accepted. If a manual operation to switch the communication mode has been accepted, step S22 is determined as Yes, and the process proceeds to step S23. On the other hand, if a manual operation to switch the communication mode has not been accepted, step S22 is determined as No, and the process proceeds to step S24. In step S23, the communication control unit 312 selects a communication mode in accordance with the accepted switching operation. Thereafter, the process returns to step S13, and the process continues based on the selected communication mode.

[0086] In step S24, the monitoring unit 311 determines whether to monitor the communication quality again. The monitoring unit 311 monitors the communication quality again, for example, when a predetermined time has elapsed since the previous monitoring or when an operation to instruct monitoring again has been received from the operator or assistant. If the communication quality is to be monitored again, the determination in step S24 is Yes, and the process returns to step S11, and the process is repeated from monitoring the communication quality again. On the other hand, if the communication quality is not to be monitored again, the determination in step S24 is No, and the process proceeds to step S25.

[0087] In step S25, the communication control unit 312 determines whether or not to terminate this process. For example, this process terminates on the condition that an operation to terminate this process is received from the operator or assistant. If this process is to be terminated, a Yes is determined in step S25, and this process terminates. On the other hand, if this process is not to be terminated, a No is determined in step S13, and the process returns to step S13, and processing based on the selected communication mode continues.

[0088] According to the remote medical assistance process described above, the motion control process can be used to assist the operator in remote operation of the remote medical assistance work.

[0089] In this way, the remote medical support system 1 controls the operation of the working mechanism 25 in response to remote operation received by the operating mechanism 15, and transmits the reaction force applied to the working mechanism 25 in response to the contact of the working mechanism 25 with the subject to the operator via the operating mechanism 15 as a haptic sensation. That is, control for transmitting haptic sensations between the operating mechanism 15 and the working mechanism 25 (i.e., bilateral control) can be performed. This allows the operator to perform diagnostic medical procedures based on haptic sensations, just as if the operator were performing medical procedures face-to-face with the subject. In addition, the presentation unit 314 presents the operator with support information acquired by the operating mechanism to support diagnosis based on the medical procedures. This allows the operator to perform diagnostic medical procedures based on senses other than haptic sensations (e.g., vision and hearing). In other words, the remote medical support system 1 enables medical professionals performing remote diagnoses to perform diagnoses from various perspectives (e.g., palpation, percussion, visual inspection, and auscultation). Therefore, the remote medical support system 1 can more appropriately support diagnosis when a diagnosis involving a medical procedure is performed remotely.

[0090] [Modifications] While the embodiments of the present invention have been described above, these embodiments are merely examples and do not limit the technical scope of the present invention. The present invention can take on various other embodiments and can be modified in various ways, such as omissions and substitutions, without departing from the spirit of the present invention.

[0091] [Variation 1] In the above-described embodiment, a situation is assumed in which an operator is present at the operating side, which is a medical facility such as a hospital, and an assistant and a subject are present at the working side, which is, for example, inside an ambulance. However, the scope of application of the present invention is not limited to this and can be applied to various other situations. For example, when the operating side is a medical facility, the working side may be the subject's home or another medical facility. Alternatively, when the operating side is a medical facility, the working side may be a different room in the same medical facility. This makes it possible to apply the present invention even when the medical facility does not have a medical professional with experience performing the medical procedure (e.g., when the medical professional specializes in a different medical department), when there is a shortage of experienced medical professionals, or when medical care is provided at home.

[0092] Furthermore, as long as communication via the network N is possible, there is no limit to the distance between the operating side and the working side. For example, the present invention can be applied even when the operating side and the working side are located in different prefectures within the same country, or when the operating side is located in one country and the working side is located overseas. For example, in the event of a disaster or other disaster occurring within the country or overseas, triage can be performed from a remote location where the disaster or other disaster has not occurred. Furthermore, the operating side and the working side may correspond in a one-to-one relationship, or in a one-to-many relationship. This allows a single operator to perform diagnoses involving medical procedures on multiple subjects in parallel or at different times.

[0093] [Variation 2] In the above-described embodiment, three communication modes are assumed. However, this is not limited to this, and more communication modes may be provided in stages. In this case, for example, the first communication mode may be further divided into stages. When communication quality is good, haptics may be transmitted so as to achieve the maximum performance possible with the control algorithm of the operation control unit 313. If communication quality subsequently deteriorates somewhat, the operation of the operating device 20 may be suppressed (i.e., the transmission of haptics may be suppressed) to stabilize the operation. For example, by lowering the control gain in the control of the operation control unit 313, the sensitivity of transmitting haptics may decrease, but the operation may still be stabilized. Alternatively, for example, the force or speed of the operating device 20 may be limited or the operation of the operating device 20 may be forcibly stopped to prevent the operating device 20 from performing unexpected operations.

[0094] Alternatively, for example, the first communication mode and the second communication mode may be further divided, and when the communication quality deteriorates, the force-tactile information may be transmitted in real time to reduce the amount of communication, but the visual information and auditory information may be transmitted as data files with a delay.

[0095] Furthermore, even in the first communication mode or the second communication mode, the analysis unit 413 may perform an analysis and present the analysis results to the operator to assist in diagnosis. Alternatively, a functional block similar to the analysis unit 413 may be provided in the main control device 30 on the operating side so that the analysis may also be performed on the operating side.

[0096] [Variation 3] In the above-described embodiment, the operation device 10 and the main control device 30 are realized as separate devices. However, this is not limiting, and for example, the operation device 10 and the main control device 30 may be realized as an integrated device and installed on the operation side. Alternatively, the working device 20 and the main control device 30 may be realized as an integrated device and installed on the work side.

[0097] Alternatively, the control of haptic transmission that was previously performed by the operation control unit 313 of the main control device 30 may be distributed between the operating device 10 and the working device 20. In this case, a function block for operation control is added to each device. The function block for operation control of each device acquires detection values ​​from its own sensor and detection values ​​from sensors of other devices, and then outputs command values ​​to its own device's driver based on the same control algorithm as the main control device 30 described above. In this way, haptic transmission between other devices may be realized. Note that the above-mentioned Modifications 1 to 3 can also be appropriately combined to form separate modifications.

[0098] [Configuration Example] As described above, the remote medical support system 1 according to this embodiment includes the working mechanism 25, the operating mechanism 15, the operation control unit 313, and the presentation unit 314. The working mechanism 25 is a mechanism for performing medical procedures, including palpation, on a subject. The operating mechanism 15 is a mechanism that receives remote control of the working mechanism 25 from an operator. The operation control unit 313 controls the operation of the working mechanism 25 in accordance with the remote control received by the operating mechanism 15, and transmits a reaction force applied to the working mechanism 25 in response to the working mechanism 25 contacting the subject to the operator via the operating mechanism 15 as a haptic sensation. The presentation unit 314 presents support information acquired by the working mechanism to the operator, which supports a diagnosis based on the medical procedure. In this way, the remote medical support system 1 controls the operation of the working mechanism 25 in accordance with the remote control received by the operating mechanism 15, and transmits a reaction force applied to the working mechanism 25 in response to the working mechanism 25 contacting the subject to the operator via the operating mechanism 15 as a haptic sensation. That is, control for transmitting haptic sensations between the operating mechanism 15 and the working mechanism 25 (i.e., bilateral control) can be performed. This allows the operator to perform diagnostic medical procedures based on haptic sensations, just as if the operator were performing the medical procedure face-to-face. In addition, the presentation unit 314 presents support information acquired by the working mechanism to the operator, which supports diagnosis based on the medical procedure. This allows the operator to perform diagnostic medical procedures based on senses other than haptic sensations (e.g., vision and hearing). In other words, the remote medical support system 1 enables medical professionals performing remote diagnoses to make diagnoses from various perspectives (e.g., palpation, percussion, visual inspection, and auscultation). Therefore, the remote medical support system 1 can more appropriately support diagnoses when performing remote diagnoses involving medical procedures.

[0099] The remote medical support system 1 further includes a monitoring unit 311 and a communication control unit 312. The monitoring unit 311 monitors the communication quality of the communication path used by the operation control unit 313 and the presentation unit 314 to transmit and receive data. The communication control unit 312 changes the mode of transmitting and receiving data depending on the communication quality monitored by the monitoring unit 311. This makes it possible to transmit and receive data in a mode appropriate for the communication quality even in various environments where the communication quality is not constant.

[0100] The communication control unit 312 is configured to transmit and receive data in chronological order immediately when the communication quality monitored by the monitoring unit 311 satisfies a predetermined communication quality, and to accumulate data in chronological order and then transmit and receive the accumulated data collectively when the communication quality monitored by the monitoring unit 311 does not satisfy the predetermined communication quality. This allows data to be transmitted and received by the most appropriate means depending on the communication quality.

[0101] The remote medical support system 1 further includes a presentation unit 414. When the communication quality monitored by the monitoring unit 311 is such that communication is difficult to execute, the presentation unit 414 performs an analysis of a diagnosis based on medical practice based on either or both of the reaction force and the support information applied to the working mechanism 25, and presents the analysis results to the working mechanism. This makes it possible to support a user (e.g., an assistant) on the working mechanism side even in a situation where communication is difficult to execute.

[0102] If the communication quality monitored by the monitoring unit 311 does not satisfy a predetermined communication quality, the operation control unit 313 suppresses the operation of the operation mechanism 25 in response to the remote operation received by the operation mechanism 15. This suppresses the influence of the communication quality and prevents the operation mechanism 25 from performing unexpected operations.

[0103] A measuring device for measuring the subject's condition is attached to the working mechanism 25, and the support information includes at least information indicating the measurement results of the measuring device. This allows the operator performing remote operation to not only obtain the measurement results of the measuring device, but also to recognize whether the measuring device is being remotely operated so that the measurement can be performed appropriately.

[0104] The operation control unit 313 controls the operation of the working mechanism 25 in response to an operation that the working mechanism 25 receives directly from another operator, instead of a remote operation that the operation mechanism 15 receives from an operator, and transmits a reaction force applied to the working mechanism 25 in response to the working mechanism 25 coming into contact with the subject as a haptic sensation to the operator via the operating mechanism 15. This allows the operator to make a diagnosis based on the haptic sensation when actually touching the subject, even in cases where remote operation is difficult.

[0105] [Realization of Functions by Hardware or Software] The function of executing the series of processes according to the above-described embodiment can be realized by hardware, software, or a combination of these. In other words, it is sufficient that the function of executing the series of processes described above is realized in any of the remote medical support systems 1, and there are no particular limitations on how this function is realized.

[0106] For example, when the function of executing the above-mentioned series of processes is realized by a processor that executes arithmetic processing, the processor that executes this arithmetic processing includes processors that are configured by various processing devices alone, such as a single processor, a multiprocessor, and a multicore processor, as well as processors that combine these various processing devices with processing circuits such as an ASIC (Application Specific Integrated Circuit) or an FPGA (Field-Programmable Gate Array).

[0107] Furthermore, for example, when the function of executing the above-described series of processes is realized by software, the program constituting the software is installed on a computer via a network or a recording medium. In this case, the computer may be a computer incorporating dedicated hardware, or may be a general-purpose computer (e.g., a general electronic device such as a general-purpose personal computer) that can execute predetermined functions by installing a program. Furthermore, the steps of writing the program may include only processes that are executed chronologically according to the order, but may also include processes that are executed in parallel or individually. Furthermore, the steps of writing the program may be executed in any order within the scope of the present invention.

[0108] A recording medium on which such a program is recorded may be provided to a user by being distributed separately from the computer main unit, or may be provided to a user in a state where it is pre-installed in the computer main unit. In this case, the storage medium distributed separately from the computer main unit is, for example, removable media 750, which may be a magnetic disk (including a floppy disk), an optical disk, or a magneto-optical disk. An optical disk may be, for example, a CD-ROM (Compact Disc-Read Only Memory), a DVD (Digital Versatile Disc), or a Blu-ray (registered trademark) Disc. An magneto-optical disk may be, for example, an MD (Mini Disc). The recording medium provided to the user in a state where it is pre-installed in the computer main body is, for example, the storage unit 707 on which the program is recorded, and is configured by an HDD (hard disk drive) or an SSD (solid state drive).

[0109] 1 Remote medical support system, 10 Operation device, 11, 21 Driver, 12, 22 Actuator, 13, 23 Position sensor, 14, 24, 708 Communication unit, 15 Operation mechanism, 20 Working device, 25 Working mechanism, 311 Monitoring unit, 312, 411 Communication control unit, 313 Motion control unit, 314, 414 Presentation unit, 371, 471 Communication control table storage unit, 372, 472 History data storage unit, 412 Data accumulation unit, 413 Analysis unit, 700 Hardware configuration, 700 Control device, 701 Processor, 702 ROM, 703 RAM, 704 Bus, 705 Input unit, 706 Output unit, 707 Storage unit, 709 Drive, 750 Removable media, CS Control target system, FT Force / speed allocation conversion block, FC Ideal force source block, PC Ideal velocity (position) source block, IFT inverse transformation block

Claims

1. A remote medical support system comprising: a working mechanism for performing a medical procedure including palpation on a subject; an operating mechanism that receives remote control of the working mechanism from an operator; an operation control means that controls the operation of the working mechanism in response to the remote control received by the operating mechanism and transmits a reaction force applied to the working mechanism in response to the working mechanism coming into contact with the subject to the operator via the operating mechanism as a haptic sensation; and an support information presentation means that presents support information obtained by the working mechanism to the operator, the support information supporting a diagnosis based on the medical procedure.

2. The remote medical support system according to claim 1, further comprising: a monitoring means for monitoring the communication quality of the communication path used by said operation control means and said support information presentation means for transmitting and receiving data; and a communication control means for varying the manner in which said data is transmitted and received depending on the communication quality monitored by said monitoring means.

3. The remote medical support system according to claim 2, characterized in that the communication control means is configured to instantly transmit and receive the data in chronological order when the communication quality monitored by the monitoring means satisfies a predetermined communication quality, and to accumulate the data in chronological order and then transmit and receive the accumulated data collectively when the communication quality monitored by the monitoring means does not satisfy the predetermined communication quality.

4. A remote medical support system as described in claim 2 or 3, further comprising an analysis result presentation means for, when the communication quality monitored by the monitoring means is such that communication is difficult to execute, performing an analysis regarding a diagnosis based on the medical procedure based on either or both of the reaction force applied to the working mechanism and the support information, and presenting the analysis result to the working mechanism.

5. The remote medical support system according to claim 2 or 3, characterized in that the operation control means suppresses the operation of the working mechanism in response to the remote operation accepted by the operating mechanism when the communication quality monitored by the monitoring means does not satisfy a predetermined communication quality.

6. A remote medical support system as claimed in any one of claims 1 to 3, characterized in that the working mechanism is equipped with a measuring device for measuring the condition of the subject, and the support information includes at least information indicating the measurement results obtained by the measuring device.

7. A remote medical support system as described in any one of claims 1 to 3, characterized in that the operation control means controls the operation of the working mechanism in response to an operation received directly by the working mechanism from another operator, instead of a remote operation received by the operating mechanism from the operator, and transmits a reaction force applied to the working mechanism in response to the working mechanism coming into contact with the subject to the operator via the operating mechanism as a haptic sensation.

8. A remote medical support method performed by a system including a working mechanism for performing a medical procedure including palpation on a subject, and an operating mechanism for receiving remote control of the working mechanism from an operator, comprising: an operation control step for controlling the operation of the working mechanism in response to the remote control received by the operating mechanism, and transmitting a reaction force applied to the working mechanism in response to the working mechanism coming into contact with the subject to the operator via the operating mechanism as a force haptic sensation; and an support information presentation step for presenting to the operator support information obtained by the working mechanism for supporting a diagnosis based on the medical procedure.

9. A program that causes a computer to control a system equipped with a working mechanism for performing medical procedures including palpation on a subject, and an operating mechanism that receives remote operation of the working mechanism from an operator, to realize an operation control function that controls the operation of the working mechanism in response to the remote operation received by the operating mechanism, and transmits a reaction force applied to the working mechanism in response to the working mechanism coming into contact with the subject to the operator via the operating mechanism as a haptic sensation, and an support information presentation function that presents support information obtained by the working mechanism to the operator to support a diagnosis based on the medical procedure.

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