【0001】[0001]
【発明の属する技術分野】本発明は、生活習慣病などの
リスクを持つ在宅療養者の健康管理や疾病の治療をネッ
トワークを介して行う在宅療養者支援システムおよび方
法に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a home care person support system and method for performing health management and treatment of diseases of home care persons having a risk of lifestyle-related diseases via a network.
【0002】[0002]
【従来の技術】現代の主要死因である心筋梗塞などの心
臓病、脳梗塞などの脳血管疾患などは生活習慣病とよば
れ、これらのほとんどが高血圧、糖尿病、脂質代謝異
常、肥満、喫煙などによってもたらされる動脈硬化が原
因である。高血圧、糖尿病、脂質代謝異常など高リスク
状態が健康診断により診断された場合、特に症状が出な
いため、日常生活を送りながら指示された頻度、時間で
の血糖など生体情報の計測、処方されたとおりの薬品の
服用、指示された運動、食事などの生活管理を行うこと
が多い。生活習慣病ではこれら生活管理がもっとも重要
な治療となる。しかし実際は日常生活での忙しさや怠慢
でこれを十分に自己管理できないために症状を悪化させ
てしまうことが非常に多い。一方これらの処方を行う医
師や薬剤師、栄養士などの医療従事者は、治療のための
さまざまな指導を行うが、患者の日常生活の中で実際に
実施されているかいちいち確認するなどの管理は時間的
に非常に困難であった。また様々な機関の様々な職種の
スタッフがそれぞれの指示、処方を行うが、療養者から
見ると、それらを一日の生活のなかでどのような手順で
こなしていったらいいか理解できず、服薬や計測を忘れ
てしまうなど、管理が十分に達成されないことが多い。2. Description of the Related Art Heart diseases such as myocardial infarction and cerebrovascular diseases such as cerebral infarction, which are the main causes of death in the present age, are called lifestyle-related diseases, and most of them are hypertension, diabetes, dyslipidemia, obesity, smoking, etc. It is caused by arteriosclerosis caused by. If a high-risk condition such as high blood pressure, diabetes, or abnormal lipid metabolism is diagnosed by physical examination, no particular symptom will appear.Therefore, we measured and prescribed biological information such as blood glucose at the frequency and time instructed during our daily lives. Often, he / she manages daily living such as taking the prescribed medicines, exercising, and eating. Lifestyle management is the most important treatment for lifestyle-related diseases. However, in reality, busyness and negligence in daily life often exacerbate the symptoms due to inability to manage this sufficiently. On the other hand, medical professionals such as doctors, pharmacists, and dietitians who give these prescriptions give various instructions for treatment, but it is time-consuming to check whether they are actually performed in the daily life of patients. It was very difficult. In addition, staff of various occupations of various institutions give their respective instructions and prescriptions, but from the perspective of the caregiver, they do not understand what procedure should be taken in their daily life, Management is often not fully achieved, such as forgetting to take medication and measuring.
【0003】現在でも患者宅に健康管理端末を置き、在
宅で健康管理を行うシステムやサービスはすでに行われ
ている。例えば、MediData(商標:セコム株式会社)な
どがこれに相当する。この端末は患者の体温、脈拍、血
圧、血糖などのバイタルサインを計測するセンサを持
ち、これらを用いて計測したデータをネットワークを介
して契約医師に送信する。またタッチパネル画面を持ち
簡単な問診のメニューが表示され、これに「はい」「い
いえ」のような入力を行い、これらのデータもあわせて
医師に送信する。医師は送られたデータを診断し、生活
指導などを行う。Even now, systems and services for putting a health care terminal in a patient's home and performing health care at home have already been provided. For example, MediData (trademark: Secom Corporation) corresponds to this. This terminal has a sensor for measuring vital signs of a patient's body temperature, pulse, blood pressure, blood sugar, etc., and transmits data measured using these to a contract doctor via a network. It also has a touch panel screen and a simple inquiry menu is displayed. Input "Yes" and "No" to this and send these data to the doctor as well. The doctor diagnoses the sent data and gives life guidance.
【0004】[0004]
【発明が解決しようとする課題】しかし、これら従来の
在宅健康管理サービス機器では、担当医師が固定になっ
ており、投薬などの処方だけでなく、栄養指導、運動療
法など細かいところまで処方をする必要もあるだけでな
く、端末側の計測のスケジューリングや問診内容までも
作成しており、これらの細かい条件まで医師が決めなけ
ればならず、これは大変な負担であった。また入力/操
作などのヒューマンインターフェイスはタッチパネルの
みであり、糖尿病などによる失明や弱視の患者が使用す
るのが非常に困難であった。在宅療養者は失明、難聴な
ど身体的に障害を持つ場合も多く、患者すべてが簡単に
使用できるようなヒューマンインターフェイスの実現は
非常に困難であった。また問診での入力は自己申告であ
り、医師へ生活パターンを報告するため、頻度が少なく
情報が欠落したり虚偽になる場合が多く、正確な処方が
難しかった。However, in these conventional home health care service devices, the doctor in charge is fixed, and not only prescriptions such as medication but also detailed instructions such as nutritional guidance and exercise therapy are prescribed. Not only is it necessary, but the scheduling of the measurement on the terminal side and the contents of the interview are also created, and the doctor has to decide these detailed conditions, which is a great burden. Further, the human interface for input / operation is only a touch panel, and it is very difficult for a patient with blindness or amblyopia due to diabetes to use it. Home caregivers often have physical disabilities such as blindness and deafness, and it has been extremely difficult to realize a human interface that all patients can easily use. In addition, the input in the interview is self-reporting, and since the life pattern is reported to the doctor, the frequency is infrequent and information is often missing or false, making accurate prescription difficult.
【0005】一方、被検体内に存在する物質の成分や濃
度を測定するための代表的な従来装置としては、血液中
もしくは体液中のグルコース濃度(血糖値)を測定する
血糖計がある。現在広く用いられている血糖計は、被検
体の指や腕などの部位の一部に針を刺して採取した少量
の血液サンプルを利用するもので、この採取した血液中
のグルコースを化学反応させてその濃度を測定する。こ
のような採血式の血糖計は携帯可能な大きさであり、糖
尿病患者の血糖値の管理に利用されている。さらに、こ
れらの装置の問題である被検者の皮膚損傷や苦痛を軽減
する目的で、微小な針やレーザを用いて痛みを伴わない
程度の微小な穴を皮膚表面に開け微量の細胞間質液を採
取して測定する方法や、皮膚表面に電圧や超音波を印加
して皮膚の浸出透過性を良くし細胞間質液等の浸出液を
抽出して測定する方法等が研究されている。また、唾液
あるいは歯肉溝液を微量採取し血糖値を測定する方法も
研究されている。On the other hand, as a typical conventional device for measuring the components and concentrations of substances existing in the subject, there is a blood glucose meter for measuring the glucose concentration (blood glucose level) in blood or body fluid. The blood glucose meter, which is widely used at present, uses a small blood sample collected by puncturing a part of the subject's finger or arm with a needle.Glucose in the collected blood is chemically reacted. Measure its concentration. Such a blood-collecting type blood glucose meter has a portable size and is used for managing the blood glucose level of diabetic patients. Furthermore, for the purpose of reducing the skin damage and pain of the subject, which is a problem of these devices, a minute needle or laser is used to open a minute hole on the skin surface that does not cause pain, and a small amount of cell stroma Studies have been conducted on a method of collecting and measuring a liquid, a method of applying a voltage or an ultrasonic wave to the skin surface to improve the permeation permeability of the skin, and extracting and measuring a permeated liquid such as interstitial fluid. Also, a method of measuring a blood glucose level by collecting a minute amount of saliva or gingival crevicular fluid has been studied.
【0006】また、グルコース等の被検体内に存在する
物質の成分や濃度を採血や細胞間質液の抽出を必要せず
に非侵襲で測定する方法としては、特公平3−4709
9号公報あるいは特公平5−58735号公報に示され
ているような電磁波を利用した方法がある。これらは近
赤外光、可視光を用いた生体物質の非侵襲分光分析方法
であり、近年注目されている方法である。このような方
法では照射した電磁波の反射波、あるいは透過波を計測
し、測定する対象の物質の特性に合わせたパラメータを
用いて解析的にその成分や濃度を求めている。パラメー
タは通常、採血などで得られた値を元にキャリブレーシ
ョンにより求められる。パラメータは患者の状態等経時
的な変化によりこまめな再キャリブレーションが必要で
あるが、このようなメンテナンスをサービス提供側であ
る医師等が自ら行うのは煩雑でもあり、医師本来の業務
以外の負担を増加させることになり、非常に非効率的で
あった。[0006] Further, as a method for non-invasively measuring the components and concentrations of substances such as glucose present in a subject without the need for blood sampling or extraction of interstitial fluid, Japanese Examined Patent Publication No. 3-4709.
There is a method using electromagnetic waves as disclosed in Japanese Patent Publication No. 9 or Japanese Patent Publication No. 5-58735. These are non-invasive spectroscopic analysis methods for biological materials using near-infrared light and visible light, and are methods that have been drawing attention in recent years. In such a method, a reflected wave or a transmitted wave of the applied electromagnetic wave is measured, and its component or concentration is analytically obtained by using parameters that match the characteristics of the substance to be measured. The parameter is usually obtained by calibration based on the value obtained by blood sampling or the like. The parameters require frequent recalibration due to changes over time in the patient's condition, etc., but it is also complicated for the doctor, etc. who is the service provider to perform such maintenance by itself, and it is a burden other than the doctor's original work. Was very inefficient.
【0007】本発明は、このような点に鑑みなされたも
ので、生活習慣病などのリスクを持つ在宅療養者に対し
てきめ細かな在宅療養支援が可能な在宅療養者支援シス
テム及び方法を提供することを目的とする。The present invention has been made in view of the above circumstances, and provides a home care person support system and method capable of providing detailed home care support to a home care person who is at risk of lifestyle-related diseases. The purpose is to
【0008】[0008]
【課題を解決するための手段】上記課題を解決するた
め、本発明の在宅療養者支援システムは、医療従事者が
療養者に関する個人情報及び医療情報を入力するための
医療従事者用端末と、この医療従事者用端末にて入力さ
れた前記療養者の個人情報及び医療情報に基づいて前記
療養者の在宅療養のための行動スケジュールを規定する
動作プロトコルを生成又は修正する動作プロトコル生成
手段と、前記生成又は修正された動作プロトコルに従っ
て前記療養者に在宅療養のための行動スケジュールを呈
示すると共に前記療養者の応答を入力するマンマシンイ
ンタフェース、前記療養者の生体情報を取得するセンサ
及び前記センサで取得された生体情報を前記医療従事者
用端末に送信する通信手段を有する療養者管理端末とを
具備してなることを特徴とする。In order to solve the above-mentioned problems, a home-care-patient support system according to the present invention comprises a medical-career terminal for a medical care worker to input personal information and medical information about a medical care-receiver, An operation protocol generating means for generating or correcting an operation protocol that defines an action schedule for home care of the medical caregiver based on personal information and medical information of the medical caregiver input at the terminal for medical staff, A man-machine interface for presenting an action schedule for home medical treatment to the medical patient according to the generated or modified operation protocol and inputting a response of the medical patient, a sensor for acquiring biological information of the medical patient, and the sensor. A medical caregiver management terminal having communication means for transmitting the acquired biometric information to the medical staff terminal. And butterflies.
【0009】また、本発明に係る在宅療養者支援方法
は、医療従事者が医療従事者用端末に療養者に関する個
人情報及び医療情報を入力するステップと、前記入力さ
れた療養者の個人情報及び医療情報に基づいて前記療養
者の在宅療養のための行動スケジュールを規定する動作
プロトコルを生成又は修正するステップと、前記生成又
は修正された動作プロトコルに従って、療養者管理端末
に前記療養者の在宅療養のための行動スケジュールを呈
示するステップと、前記療養者管理端末に対する療養者
の応答を入力するステップと、前記療養者管理端末に設
けられたセンサで前記療養者の生体情報を取得するステ
ップと、センサ及び前記センサで取得された生体情報を
前記医療従事者用端末に送信するステップとを具備して
なることを特徴とする。In addition, in the method for supporting home medical care persons according to the present invention, a step in which the medical staff inputs personal information and medical information about the medical care person to the terminal for medical care personnel, and the personal information of the medical care person inputted Generating or modifying an operation protocol that defines an action schedule for home care of the medical caregiver based on medical information, and treating the medical caregiver's home care at the medical caregiver management terminal according to the generated or modified operational protocol. A step of presenting an action schedule for, a step of inputting a response of the care giver to the care giver management terminal, a step of acquiring biometric information of the care giver with a sensor provided in the care giver management terminal, A sensor and a step of transmitting the biometric information acquired by the sensor to the medical staff terminal. .
【0010】本発明によれば、医者、看護婦、薬剤師、
栄養士等の医療従事者が入力した療養者に関する個人情
報及び医療情報に基づき、前記療養者の在宅療養のため
の行動スケジュールを規定する動作プロトコルを生成又
は修正し、療養者管理端末に動作プロトコルに基づく療
養者の在宅療養のための行動スケジュールを呈示すると
共に、前記療養者管理端末を介した応答や各種生体情報
の計測値等を医療従事者側に送信することができるの
で、在宅療養者に対するきめ細かなケアが可能であり、
また、検査値等の良好なコミュニケーションにより、療
養者には常に適切な動作プロトコルを提供することがで
きる。According to the present invention, a doctor, a nurse, a pharmacist,
Generates or modifies an operation protocol that defines an action schedule for home care for the medical caregiver based on personal information and medical information about the medical caregiver input by a medical professional such as a dietitian, and sets the operational protocol in the medical caregiver management terminal. Since it is possible to present the action schedule for home care of the medical caregiver based on it, and to transmit the response via the medical caregiver management terminal and the measured values of various biological information to the medical staff side, Careful care is possible,
In addition, good communication of test values and the like can always provide the care giver with an appropriate operation protocol.
【0011】前記医療従事者用端末から入力される医療
情報は、例えば処方に基づく投薬指示、運動指示、リハ
ビリテーションメニュー及び生体情報計測指示の少なく
とも1つを含み、前記療養者管理端末が呈示する行動ス
ケジュールは、前記投薬指示、運動指示、リハビリテー
ションメニュー及び生体情報計測指示の少なくとも1つ
に基づく服薬指示メッセージ、運動指示メッセージ、リ
ハビリテーション指示メッセージ及び生体情報計測指示
メッセージの少なくとも1つを含む。また、本発明の一
つの実施形態においては、前記医療従事者用端末は、医
師用端末、看護婦用端末、薬剤師用端末及び栄養士用端
末を含み、前記動作プロトコル生成手段は、前記医療従
事者用端末から入力された医療情報に基づき生成される
行動スケジュールに不整合が生じたときに、これを前記
医療従事者に報知して修正を促すものである。The medical information input from the medical staff terminal includes, for example, at least one of a prescription-based medication instruction, exercise instruction, rehabilitation menu, and biometric information measurement instruction, and the action presented by the care giver management terminal. The schedule includes at least one of a medication instruction message, an exercise instruction message, a rehabilitation instruction message, and a biological information measurement instruction message based on at least one of the medication instruction, exercise instruction, rehabilitation menu, and biological information measurement instruction. Further, in one embodiment of the present invention, the medical staff terminal includes a doctor terminal, a nurse terminal, a pharmacist terminal, and a dietitian terminal, and the operation protocol generating means is the medical staff. When inconsistency occurs in the action schedule generated based on the medical information input from the operating terminal, the medical staff is notified of the inconsistency and the correction is urged.
【0012】また、前記動作プロトコル生成手段は、例
えば前記療養者管理端末からの療養者の応答に基づいて
前記動作プロトコルを適宜修正したり、療養者の行動を
行動検出手段で検出し、前記行動検出手段による前記療
養者の行動の検出結果に基づいて前記動作プロトコルを
適宜修正するものである。これにより、療養者の行動状
況や体調等に応じた柔軟な行動スケジュールを生成する
ことができる。Further, the operation protocol generating means appropriately corrects the operation protocol based on, for example, the response of the medical care giver from the medical care person management terminal, or detects the behavior of the medical care person by the action detecting means, and The operation protocol is appropriately modified based on the detection result of the behavior of the care giver by the detection means. As a result, a flexible action schedule can be generated according to the action status and physical condition of the care giver.
【0013】また、療養者の特定の生体情報の真値又は
真値として扱われているデータと、前記療養者管理端末
での計測結果とが一致するような前記療養者管理端末の
パラメータを計算する手段と、このパラメータを前記療
養者管理端末に設定する手段とを更に具備するようにし
ても良い。Further, a parameter of the medical caregiver management terminal is calculated such that the true value of the specific biological information of the medical caregiver or the data treated as the true value and the measurement result of the medical care person management terminal match. And a means for setting this parameter in the care giver management terminal.
【0014】[0014]
【発明の実施の形態】以下、本発明の実施形態を図面に
基づいて説明する。図1は、本発明の一実施形態に係る
在宅療養者支援システムの全体構成例を示すブロック図
である。このシステムは、管理者(サービス事業者)側
に設けられた管理者用サーバ101と、療養者宅に設け
られた療養者管理端末102と、医療機関に設けられた
医療従事者用端末、即ち、医師用端末104、看護婦用
端末105、薬剤師用端末106、及び栄養士用端末1
07とが、公衆回線(あるいはWAN)100にて接続
されて構成される。BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a block diagram showing an example of the overall configuration of a home medical care person support system according to an embodiment of the present invention. This system includes an administrator server 101 provided on the administrator (service provider) side, a care giver management terminal 102 provided at a care giver home, and a medical care worker terminal provided at a medical institution, that is, , Doctor terminal 104, nurse terminal 105, pharmacist terminal 106, and dietitian terminal 1
07 and a public line (or WAN) 100 are connected to each other.
【0015】療養者管理端末102は、療養者との対話
機能、療養者の生体情報の取得機能及び医療機関への情
報伝送機能を有するもので、所定の動作プロトコルに従
って所定の処理を実行するCPU1021と、各種デー
タ及びアプリケーションプログラムを記憶するメモリ1
022及びハードディスクドライブ(HDD)1023
と、管理者用サーバ101及び医療従事者用端末104
〜107との間で通信を行うための通信部1024とを
備える。図2は、療養者管理端末102の外観を示す。
端末本体1020には、療養者とのマンマシンインタフ
ェースを構成する表示部1025、タッチパネル102
6、音声発生部1027、音声入力部1028、振動発
生部1029及びCCDカメラ1030が搭載されてい
る。The caregiver management terminal 102 has a function of interacting with the caregiver, a function of acquiring biometric information of the caregiver, and a function of transmitting information to a medical institution, and a CPU 1021 that executes a predetermined process according to a predetermined operation protocol. And a memory 1 for storing various data and application programs
022 and hard disk drive (HDD) 1023
And the administrator server 101 and the medical staff terminal 104
To 107, and a communication unit 1024 for communicating with each other. FIG. 2 shows the appearance of the medical care giver management terminal 102.
The terminal body 1020 includes a display unit 1025 and a touch panel 102 that form a man-machine interface with the care giver.
6, a voice generation unit 1027, a voice input unit 1028, a vibration generation unit 1029, and a CCD camera 1030 are mounted.
【0016】また、療養者管理端末102は、各種の生
体情報検出用のセンサ1031〜0136を備える。即
ち、端末102には、腕に巻き付ける腕輪センサ201
が備えられ、この腕輪センサ201には、血糖値センサ
1031、光電脈波センサ1032及び血中飽和酸素濃
度(SpO2)センサ1033を一体化した光電センサ
202と、血圧センサ1034とが内蔵されている。こ
のようなセンサは、特に糖尿病の患者向けには有効であ
る。また、鼓膜式体温計1035及び心電計(心電電
極)1036が端末本体1020にオンラインで接続さ
れている。ここで血糖値センサ1031としては、光学
的に血中のグルコース濃度を計測できるタイプのセンサ
を用いる。また、血圧センサ1034としては、通常タ
イプの他、脈波伝播時間から計測する光学式の血圧セン
サを用いてもよい。その場合、血圧センサ1034は、
血糖値センサ1031、光電脈波センサ1032、及び
血中飽和酸素濃度センサ1033などと一体化した光電
センサ202とすることができる。脈波伝播時間を計測
するためには、心電図による心拍と脈波のピークの時間
差を計測する。The care giver management terminal 102 also includes sensors 1031 to 0136 for detecting various biological information. That is, the terminal 102 has a bracelet sensor 201 to be wound around the arm.
The bracelet sensor 201 includes a photoelectric sensor 202 in which a blood glucose level sensor 1031, a photoelectric pulse wave sensor 1032, and a blood saturated oxygen concentration (SpO2) sensor 1033 are integrated, and a blood pressure sensor 1034. . Such a sensor is effective especially for diabetic patients. An eardrum thermometer 1035 and an electrocardiograph (electrocardiographic electrode) 1036 are connected to the terminal body 1020 online. Here, as the blood glucose level sensor 1031, a type of sensor that can optically measure the glucose concentration in blood is used. As the blood pressure sensor 1034, an optical blood pressure sensor that measures from the pulse wave transit time may be used in addition to the normal type. In that case, the blood pressure sensor 1034
The photoelectric sensor 202 can be integrated with the blood glucose level sensor 1031, the photoelectric pulse wave sensor 1032, the blood saturated oxygen concentration sensor 1033, and the like. In order to measure the pulse wave transit time, the time difference between the heartbeat and the pulse wave peak according to the electrocardiogram is measured.
【0017】管理者用サーバ101には、管理者用端末
1011とプロトコルデータベース(DB)1012と
が設置される。プロトコルデータベース1012には、
療養者管理端末動作プロトコルのデータが登録される。
療養者管理端末動作プロトコルとは、療養者管理端末1
02が行う、療養者に対する服薬時間や生活行動の指
示、データ計測の指示などを行う音声メッセージあるい
は画面表示の出力のタイミングおよび内容、さらに端末
102の内部での処理内容を記述するものである。これ
らは端末102上で動作するアプリケーション内に固定
で設定されるものでなく、テキストデータとして管理さ
れるため、内容変更に伴うアプリケーション自体の差し
替えや再コンパイルは不要で、テキストデータのスクリ
プトを修正、あるいは差し替えするだけでアップデート
が可能である。An administrator terminal 1011 and a protocol database (DB) 1012 are installed on the administrator server 101. The protocol database 1012 contains
Data of the caregiver management terminal operation protocol is registered.
The caregiver management terminal operating protocol is the caregiver management terminal 1
02, the timing and contents of output of a voice message or screen display for instructing a care giver to take a medical treatment, living behavior, data measurement, and the like, and processing contents inside the terminal 102 are described. Since these are not fixedly set in the application operating on the terminal 102 but are managed as text data, it is not necessary to replace or recompile the application itself when the content is changed, and the text data script is corrected. Or you can update it just by replacing it.
【0018】図3は、上記の療養者管理端末動作プロト
コルの一例を示したものである。ここでは第一の実施例
としてスケジュール固定の場合を示している。図3に示
すように、プロトコルは端末102の動作のスケジュー
ルを管理し、この時刻やイベントに従って端末102が
動作する。FIG. 3 shows an example of the above-mentioned care giver management terminal operation protocol. Here, the case where the schedule is fixed is shown as the first embodiment. As shown in FIG. 3, the protocol manages the operation schedule of the terminal 102, and the terminal 102 operates according to the time and event.
【0019】また、プロトコルデータベース1012に
は、療養者の基本情報として、療養者をキーとして関連
付けられた各療養者の過去の病状、病歴、身体状況(障
害部位、程度など)、性格、処置歴、各バイタルサイン
データの履歴、その他検査データ履歴などの医療データ
と、投薬の処方歴、それに対応した生活指導(運動、食
事、嗜好など)の履歴、療養者管理端末102での計測
処方(指示)、および療養者管理端末102の各センサ
1031〜1036にて計測された生体情報が蓄積され
る。Further, the protocol database 1012 has basic medical condition information of each medical caregiver as a key, and each medical caregiver's past medical condition, medical history, physical condition (disability site, degree, etc.), personality, treatment history are associated with each medical caregiver. , History of each vital sign data, medical data such as other test data history, prescription history of medication, history of life guidance (exercise, meal, preference, etc.) corresponding thereto, measurement prescription (instruction on the care giver management terminal 102) ), And biometric information measured by the sensors 1031 to 1036 of the care giver management terminal 102 is accumulated.
【0020】以下にシステム運用の手順を示す。全体の
流れは、図4に示すように、データ登録(S1)、プロ
トコル生成(S2)、療養者管理端末102の動作開始
(データ計測,キャリブレーション、データ転送)(S
3)、計測データ処理・評価(医師による診察、達成度
評価)(S4)、プロトコル修正(S1,S2)の流れ
となり、これらの処理を繰り返す。The procedure of system operation is shown below. As shown in FIG. 4, the overall flow is as follows: data registration (S1), protocol generation (S2), operation start of the care giver management terminal 102 (data measurement, calibration, data transfer) (S
3), measurement data processing / evaluation (examination by a doctor, achievement level evaluation) (S4), and protocol correction (S1, S2), and these processes are repeated.
【0021】在宅療養を始める際、初めに医師は療養者
の基本情報、診療データ、処方データ、生活指導データ
を診療時などに医師用端末104に入力する。他の職種
(薬剤師、栄養士、理学療法士など)も同様にそれぞれ
の処方データ、生活指導、栄養指導データをそれぞれの
機関にある端末105,106,107から入力する。
図5はこの中で特に内科医、眼科医の処方データと、栄
養士による食事療法、理学療法士によるリハビリ処方の
データの例を示す。これらと、入力された上記のような
療養者のデータと、管理者用サーバ101のメンテナン
ス情報を合わせて、プロトコルを生成する。生成される
プロトコルの一部は図5のように生成される。このよう
に各職種の処方をひとつの時間軸で順番に実行するプロ
トコルとして生成される。プロトコルは、登録された療
養者のデータをもとにシステム側が直接生成するか、管
理者側で代行して作成するか、過去の類似データを検索
し、これらから医師が選択、取得して、これをベースに
作成してもよい。When starting medical treatment at home, the doctor first inputs the basic information, medical treatment data, prescription data, and life guidance data of the medical examinee to the medical doctor terminal 104 at the time of medical treatment. Similarly, other occupations (pharmacist, nutritionist, physiotherapist, etc.) also input their respective prescription data, lifestyle guidance, and nutritional guidance data from the terminals 105, 106, 107 in their respective institutions.
FIG. 5 shows an example of prescription data of an internist and an ophthalmologist, dietary data by a dietitian, and rehabilitation prescription by a physical therapist. A protocol is generated by combining these, the input data of the medical caregiver as described above, and the maintenance information of the administrator server 101. A part of the generated protocol is generated as shown in FIG. In this way, it is generated as a protocol for sequentially executing prescriptions for each job type on one time axis. The protocol is either generated directly by the system based on the registered caregiver's data, or created on behalf of the administrator, or by searching similar data in the past, the doctor selects and acquires it from these, You may make it based on this.
【0022】システムが直接作成する場合は図6のよう
な流れとなる。入力された療養者の各データを条件に
(S11,S12,S13)、管理者用サーバ101が
あらかじめ管理者用端末1011内に持っている判定ロ
ジックに従い、プロトコルを生成する(S14)。作成
されたプロトコルは、プロトコルデータベース1012
に登録する(S15)と共に療養者管理端末102へ送
信され、端末102上に登録される(S16)。その
際、療養者の各基本情報に従い、障害により指示するメ
ディアを変更し療養者にあった呈示方法(視覚障害者で
あれば音声対話にする、など)にし、また性格により指
示方法(回数、タイミング:うるさく言われるのを嫌う
タイプの人には回数を少なくする、あるいは画面指示の
みにする、など)を変更する。そのプロトコルデータに
従い端末102は動作する(S17)。端末102は、
療養者にデータを計測する指示を行い(S18)、デー
タを収集し(S19)、収集したデータを管理者用サー
バ101に転送する(S20)。管理者用端末1011
は、転送されたデータをプロトコルデータベース101
2に登録する(S21)とともに、医師に特徴的なデー
タを抽出し、診察用データとして医師用端末104に送
信し(S22)、医師による診断を依頼する(S2
3)、医師は処方や生活指導などのデータを修正し再度
管理者用サーバ101に転送する(S24)。管理者用
サーバ101は、ここで転送された修正データに基づき
プロトコルを修正し(S25)、これを療養者管理端末
102に送信すると共にプロトコルデータベース101
2に追加登録する(S26)。療養者管理端末102で
は、修正されたプロトコルを登録し(S27)、修正さ
れたプロトコルに基づき動作を再開する(S28)。こ
のような流れを繰り返すこととなる。When the system directly creates, the flow is as shown in FIG. The protocol is generated according to the determination logic that the administrator server 101 has in advance in the administrator terminal 1011 on the basis of the inputted respective data of the care giver (S11, S12, S13) (S14). The created protocol is the protocol database 1012.
(S15) and is transmitted to the care giver management terminal 102 and registered on the terminal 102 (S16). At that time, according to each basic information of the care giver, the media indicated by the disability is changed to a presentation method suitable for the care giver (such as voice dialogue for a visually impaired person), and an instruction method (number of times, Timing: For people who don't like being annoyed less often, or just screen instructions). The terminal 102 operates according to the protocol data (S17). Terminal 102
The medical care person is instructed to measure the data (S18), the data is collected (S19), and the collected data is transferred to the administrator server 101 (S20). Administrator's terminal 1011
Transfers the transferred data to the protocol database 101.
2 (S21), the characteristic data of the doctor is extracted and transmitted as medical examination data to the medical doctor terminal 104 (S22), and a diagnosis is requested by the medical doctor (S2).
3), the doctor corrects data such as prescription and life guidance and transfers it again to the administrator server 101 (S24). The administrator server 101 corrects the protocol based on the correction data transferred here (S25), transmits it to the medical caregiver management terminal 102, and sends the protocol database 101.
2 is additionally registered (S26). In the medical care person management terminal 102, the corrected protocol is registered (S27), and the operation is restarted based on the corrected protocol (S28). Such a flow will be repeated.
【0023】類似データよりプロトコル生成を行う場合
は、図7のような流れとなる。入力された各データが管
理者用サーバ101のプロトコルデータベース1012
に転送され、これに基づき、プロトコルデータベース1
012のなかから管理者用端末1011のCPUが療養
者の類似状況データを検索する(S31)。検索された
類似状況のデータセットは医師、および看護婦用端末に
送信され(S32)、医師、看護婦はこのデータに従
い、類似状況での処方、生活指導などを参考に作成した
データを修正する(S33)。また食事指導として栄養
士が食事、運動メニューを作成し、これをそれぞれの端
末から入力する(S34)。この場合も医師と同様、療
養者の情報をプロトコルデータベース1012に送り、
類似状況データを検索、取得し(S35)、これに基づ
いてメニューを作成する(S36)。医師、看護婦、薬
剤師、栄養士など医療従事者により、上記のように作成
されたプロトコルは、作成された端末104〜107か
ら管理者用サーバ101に転送され(S37)、ここか
ら療養者管理端末102へ送信され、端末102上に登
録される(S16)。以下の流れは、図6のS17〜S
28と同じであるため、重複する処理の説明は割愛す
る。When a protocol is generated from similar data, the flow is as shown in FIG. Each input data is the protocol database 1012 of the administrator server 101.
To the protocol database 1
The CPU of the administrator terminal 1011 retrieves the similar situation data of the care giver from 012 (S31). The retrieved data set of the similar situation is transmitted to the doctor and the nurse terminal (S32), and the doctor and the nurse correct the data created by referring to the prescription and life guidance in the similar situation according to this data. (S33). As a dietary instruction, a dietitian creates a dietary and exercise menu and inputs it from each terminal (S34). In this case as well, like the doctor, the information of the care giver is sent to the protocol database 1012,
The similar situation data is searched and acquired (S35), and a menu is created based on this (S36). The protocol created as described above by a medical worker such as a doctor, a nurse, a pharmacist, and a dietitian is transferred from the created terminals 104 to 107 to the administrator server 101 (S37), and from there, the care giver management terminal. It is transmitted to 102 and registered on the terminal 102 (S16). The following flow is from S17 to S of FIG.
Since it is the same as 28, the description of the overlapping processing will be omitted.
【0024】また図5のように複数の医療従事者が一人
の患者に対して様々な処方を出している場合、これらが
競合する場合も考えられる。例えば食後30分後に血糖
値計測と投薬とリハビリが重なる場合があったとき、管
理用サーバ101が動作プロトコルを作成する際に、こ
れらを調整するため、それぞれの処方を出した医療従事
者に対して管理用サーバ101が電子メールで問い合わ
せを行い、結果を電子メールの回答で受けて、これを元
に動作プロトコルの順番を決定する。例えば上記の場合
では、内科医と理学療法士に「食後30分後に血糖値計
測と投薬とリハビリの処方が重なっていますがどのよう
な手順で行いますか? 順番を回答ください。」とメー
ルを送信する。これを受けた担当同士で相談し結果とし
て「1:血糖値計測 2:投薬 3:投薬後30分後に
リハビリ」を管理者用サーバ101に送信すると、これ
を管理者用サーバ101が解釈し、動作プロトコルに設
定する。このときの回答は予めフォーマットを決めてお
いて、このフォーマットに従って回答することで管理者
用サーバ101が解釈できるようにしている。In addition, as shown in FIG. 5, when a plurality of medical workers give various prescriptions to one patient, there is a possibility that they may compete with each other. For example, when there is a case where the blood glucose measurement, the medication, and the rehabilitation overlap 30 minutes after a meal, the management server 101 adjusts these when the operation protocol is created. Then, the management server 101 makes an inquiry by e-mail, receives the result as a reply to the e-mail, and determines the order of the operation protocols based on this. For example, in the above case, email the physician and physiotherapist, "Blood glucose level measurement, medication and rehabilitation prescription overlap 30 minutes after meal. What procedure do you take? Please reply in order." Send. When the persons in charge who received this consulted with each other and as a result sent "1: Blood glucose level measurement 2: Medication 3: Rehabilitation 30 minutes after medication" to the administrator server 101, the administrator server 101 interprets this. Set to the operation protocol. The format of the response at this time is determined in advance, and the administrator's server 101 can interpret it by responding according to this format.
【0025】上記の実施例の場合、療養者管理端末10
2はプロトコルに設定された時間通りに動作するが、別
の実施例として、音声対話にてユーザの状況を確認しな
がらプロトコルの時間を調整する場合もある。その場合
のプロトコル例を図8に示す。この場合は、音声対話で
確認されたユーザイベントと、プロトコル内にスケジュ
ーリングされたイベントとを比較し、一致したら次のス
テップへ進む流れとなる。ここでは予定したイベントが
遅れた場合、そのイベントに依存した以降のイベントが
時間をシフトする。具体的には管理者用サーバ101に
設定テーブルを設け、依存関係はその設定テーブルに設
定する。In the case of the above embodiment, the care giver management terminal 10
2 operates according to the time set in the protocol, but as another embodiment, the time of the protocol may be adjusted while confirming the user's situation by voice dialogue. An example of the protocol in that case is shown in FIG. In this case, the user event confirmed by the voice interaction is compared with the event scheduled in the protocol, and if they match, the process proceeds to the next step. Here, if a scheduled event is delayed, subsequent events that depend on that event will shift in time. Specifically, the administrator server 101 is provided with a setting table, and the dependencies are set in the setting table.
【0026】さらに別の実施例として、療養者の状況を
ウェアラブルセンサ、もしくは周囲に設置した環境側の
センサを用いて認識し、得られた状況に合わせて療養者
管理端末102を動作させるようにしても良い。本実施
例の構成を図9に、この場合のプロトコル例を図10に
示す。図9において、療養者管理端末102は、図1に
示したものと同一構成である。ウェアラブル・センサ5
01は、ベルト、腕輪、ヘッドギヤ等の形態で療養者の
身につけて、療養者の状態をモニタするためのもので、
腰部加速度センサ5011、顎部加速度センサ501
2、脈波センサ5013、音声入力部5014、CCD
カメラ5015、振動発生部5016等の各種の状態検
出センサを有する。また、ワイヤレスで計測データを療
養者管理端末102に送信するため、内部にCPU50
17、メモリ5018及び無線の通信モジュール501
9を内蔵している。As yet another embodiment, the condition of the medical caregiver is recognized using a wearable sensor or a sensor on the environment side installed in the surroundings, and the medical caregiver management terminal 102 is operated in accordance with the obtained condition. May be. FIG. 9 shows the configuration of this embodiment, and FIG. 10 shows a protocol example in this case. 9, the care giver management terminal 102 has the same configuration as that shown in FIG. Wearable sensor 5
01 is a belt, a bracelet, a headgear, and the like, which is worn on the care giver to monitor the condition of the care giver.
Lumbar acceleration sensor 5011, jaw acceleration sensor 501
2, pulse wave sensor 5013, voice input unit 5014, CCD
It has various state detection sensors such as a camera 5015 and a vibration generator 5016. Further, since the measurement data is wirelessly transmitted to the care giver management terminal 102, the CPU 50 is internally provided.
17, memory 5018 and wireless communication module 501
9 is built in.
【0027】療養者がウェアラブルセンサ501として
加速度センサを腰部(5011)および顎部(501
2)に装着し、これにより療養者の動作を認識し、療養
者の動作とスケジュールとから療養者の行動を認識す
る。このような認識処理は、例えば特願2000-069
823に開示されている。本実施例では、特願2000-
069823と同様に加速度センサ5011を腰につけ
て動作と姿勢を認識し、さらに顎にも加速度センサ50
12をつけて、顎が断続的に動く場合、食事中あるいは
会話中であると認識する。食事中か会話中かは顎の動き
に同期して発声しているかを音声入力部(マイクロフォ
ン)5014で計測することで行う。また筋電計測用の
電極を咀嚼筋上に装着し、あごの動きによる筋電から動
き(咀嚼の強さ、回数)を計測し、食事中であるかどう
かを認識しても良い。As a wearable sensor 501, the caregiver uses an acceleration sensor as a waist (5011) and a jaw (501).
2) and recognizes the motion of the medical caregiver, and recognizes the motion of the medical caregiver from the motion and schedule of the medical caregiver. Such recognition processing is performed, for example, in Japanese Patent Application No. 2000-069.
823. In this embodiment, Japanese Patent Application No. 2000-
Like the 069823, the acceleration sensor 5011 is attached to the waist to recognize the motion and posture, and the acceleration sensor 5011 is also attached to the chin.
If the user wears 12 and the jaw moves intermittently, it is recognized that he is eating or talking. Whether a person is eating or talking is measured by measuring with a voice input unit (microphone) 5014 whether or not he or she is speaking in synchronization with the movement of the jaw. Further, an electrode for measuring myoelectricity may be attached on the masticatory muscle, and the movement (the strength of mastication, the number of times) may be measured from the myoelectricity caused by the movement of the chin to recognize whether or not a person is eating.
【0028】本実施例では、図10に示すように、定時
のプロトコルだけでなく、認識された状況をイベントと
してそれぞれに対応したプロトコルが定時のプロトコル
に割り込んで動作し、予定のプロトコルは状況に合わせ
て変更される。ただし、イベント間の関係もあり、たと
えば、運動指導として「午前中に散歩30分」と指示さ
れていた場合、プロトコルとしては、上記のような食事
中認識方法により朝食を認識した場合、その後1時間後
ぐらいに「30分程度散歩してみましょう?」とメッセ
ージを出すが、その前にすでに散歩している場合(すな
わち動作「歩行」が継続している場合)はメッセージ表
示を行わない。In the present embodiment, as shown in FIG. 10, not only the fixed-time protocol but also the protocol corresponding to each of the recognized situations as an event interrupts the fixed-time protocol to operate, and the scheduled protocol changes to the situation. It will be changed accordingly. However, there is also a relationship between the events, and for example, when “30 minutes walk in the morning” is instructed as the exercise instruction, and when the breakfast is recognized by the above-mentioned in-meal recognition method as the protocol, 1 After about an hour, the message "Let's take a walk for about 30 minutes?" Is displayed, but if the user has already taken a walk before that (that is, if the motion "walking" continues), no message is displayed. .
【0029】図6のように、システムによりプロトコル
修正を行う場合は、プロトコルに沿って実施された結果
(実績)を評価し、達成度を求め、達成度を高めるよう
にプロトコルを修正する。達成度とは与えられた指示、
指導のメニューの実施割合として求める。ここでは動作
プロトコル作成前に入力された各担当(医師、看護婦、
薬剤師、栄養士)の処方を示す。以下にその手順を示
す。As shown in FIG. 6, when the protocol is corrected by the system, the result (actual result) executed according to the protocol is evaluated, the achievement level is obtained, and the protocol is corrected so as to increase the achievement level. Achievement is a given instruction,
Calculated as the implementation ratio of the guidance menu. Here, each person in charge (doctor, nurse,
Pharmacist, nutritionist) prescription. The procedure is shown below.
【0030】まず、実績データを取得する。取得方法と
しては、上記の3つの実施例のうち、1番目(プロトコ
ルが固定の場合)のと2番目(対話によりプロトコルを
シフトする場合)の場合、プロトコルに組み込んだ音声
対話、画面入力により取得する。3番目(ウェアラブル
センサにより状況認識する場合)の実施例の場合、ウェ
アラブルセンサ/環境センサにより実績データを取得す
る。First, actual data is acquired. As the acquisition method, in the case of the first (when the protocol is fixed) and the second (when the protocol is shifted by the dialogue) among the above three embodiments, the speech dialogue incorporated in the protocol and the screen input are obtained. To do. In the case of the third embodiment (when the situation is recognized by the wearable sensor), the performance data is acquired by the wearable sensor / environment sensor.
【0031】音声対話、画面入力の場合では、運動情報
の取得については、たとえば散歩の予定時間になると散
歩をしているかどうか確認し、散歩している、あるいは
散歩し終わったという回答が得られたときにその負荷状
況、時間を確認して実績として記録していく。1番目の
場合、これによりプロトコルの時間を調整することはな
いが、2番目ではこれに伴い以降のプロトコルをシフト
していく。In the case of voice interaction or screen input, for the acquisition of exercise information, for example, at the scheduled time of the walk, it is confirmed whether or not the person is taking a walk, and the answer is that the person is taking a walk or has finished taking a walk. Check the load status and time, and record it as an actual result. In the first case, this does not adjust the protocol time, but in the second case, subsequent protocols are shifted accordingly.
【0032】また食事情報の取得については、画面の対
話形式で食事内容を入力し、これらも実績データとす
る。食事内容の入力画面の例としては、図11、あるい
は図12のような画面で入力する。図11では、食事の
メニューを選択すると、療養者管理端末102上に持つ
テーブルによりメニューと各栄養分との対応関係を取得
し、それぞれの栄養分ごとの摂取量を換算し、カロリー
を計算する。図12では、各栄養分を療養者が直接画面
上のバースライダーを用いて入力する。Further, regarding the acquisition of meal information, the content of meal is input in an interactive form on the screen, and these are also used as actual data. As an example of a meal content input screen, the screen shown in FIG. 11 or 12 is used. In FIG. 11, when the menu of meal is selected, the correspondence relationship between the menu and each nutrient is acquired by the table held on the care giver management terminal 102, the intake amount of each nutrient is converted, and the calorie is calculated. In FIG. 12, the caregiver directly inputs each nutrient using the bar slider on the screen.
【0033】3番目のセンサを用いた場合では、運動情
報に関しては、散歩であれば継続歩行の時間と、加速度
センサ5011,5012の振幅、あるいは脈波センサ
5013から得られる心拍数から運動負荷を求め、運動
量を求め実績データとする。また、食事情報に関して
は、上記のようなマイクロホン、加速度センサなどを用
いて食事状況を認識し、食事内容に関しては対話にて取
得するか、画像から取得する。これらを一日、あるいは
メニューごとに集計し、その達成度を計算する。達成度
を評価し、達成度の低いメニューについては、メッセー
ジの出し方を変更し、その効果を随時確認しメッセージ
の出し方を変更していく。たとえば運動量の実績が想定
より少なかった場合、運動履歴を確認し、メッセージを
出しても運動が行われなかった場合(たとえば「(午前
中に)1時間ほど散歩しましょう」に対して、午前中に
連続歩行にならなかった場合)、メッセージをさらに厳
しい表現、あるいはメッセージ発生頻度を増加させるよ
うなプロトコル変更を行う。これらの変更のルールはテ
ーブル化してサーバ内に持ち、ユーザの性格や過去の実
績から効果的なパターンを選択する。また全体的に達成
率が悪い場合、指示方法を見直す。たとえば画面指示で
よくない場合、音声対話に切り替え、効果を比較し良い
方を採用する。In the case of using the third sensor, as for the exercise information, if it is a walk, the exercise load is calculated from the duration of continuous walking, the amplitude of the acceleration sensors 5011 and 5012, or the heart rate obtained from the pulse wave sensor 5013. Then, the amount of exercise is calculated and used as actual data. Regarding the meal information, the meal situation is recognized using the microphone, the acceleration sensor, and the like as described above, and the meal content is acquired interactively or from an image. These are totaled for one day or for each menu, and the achievement level is calculated. The degree of achievement is evaluated, and for the menu with low degree of achievement, the way of issuing a message is changed, the effect is checked at any time, and the way of issuing a message is changed. For example, if the amount of exercise is less than expected, check the exercise history, and if you do not exercise even if you give a message (for example, "Let's walk for about an hour (in the morning)", in the morning If it does not become continuous walking), express the message more severely, or change the protocol to increase the message occurrence frequency. These change rules are stored in a server as a table, and an effective pattern is selected based on the user's personality and past performance. If the overall achievement rate is poor, review the instruction method. For example, if the screen instruction is not good, switch to voice dialogue, compare the effects, and adopt the better one.
【0034】療養者管理プロトコルの修正時は、作成時
と同様に、処方された生体情報計測時間(例:個々の食
事時間に合わせて食後の時間で設定する)、患者の身体
障害状況(例:失明患者であれば音声合成、認識の
み)、性格(例:うるさく言ったほうが効くタイプなら
メッセージを多くする)とシステム管理スケジュール
(キャリブレーション等)をあわせてスケジューリング
してプロトコルを修正する。プロトコルを達成度に沿っ
て、これを改善するために修正する際、上記のような療
養者ごとの状況に合わせて修正する方向性を決める。When the caregiver management protocol is modified, as in the case of creation, the prescribed biological information measurement time (eg, set after meal according to individual meal time) and the physical disability status of the patient (eg : Correct the protocol by scheduling together with speech synthesis, recognition only for blindness patients, personality (eg, increase message if noisy type works) and system management schedule (calibration etc.). When the protocol is modified to improve it according to the degree of achievement, the direction of modification is determined according to the situation of each care recipient as described above.
【0035】また療養者管理端末にて使用するセンサの
うち、血糖センサ、光学式血圧センサなどキャリブレー
ションが必要なものについて、キャリブレーション条件
(時刻、内容)など療養者管理端末のメンテナンス情報
を管理者がプロトコルデータベースへ登録しておく。た
とえば、血糖センサは、採血して得られた血糖値を元に
同時に得られたセンサ出力の値からパラメータを校正す
るようなキャリブレーションが必要となる。Of the sensors used in the care giver management terminal, the maintenance information of the care giver management terminal such as the calibration conditions (time, contents) is managed for the sensors requiring calibration such as blood glucose sensor and optical blood pressure sensor. The person registers it in the protocol database. For example, the blood glucose sensor requires calibration to calibrate the parameters from the values of the sensor output obtained at the same time based on the blood glucose value obtained by collecting blood.
【0036】療養者管理端末102のキャリブレーショ
ンのスケジュールは療養者管理端末の動作プロトコルに
含まれる場合もある。図13に示すように、該当する日
の朝に病院へ行き、直接検査を受けるように指示するメ
ッセージを表示する(S41)ような処理がプロトコル
に含まれる。病院では採血により血糖値など詳細データ
を取得し(S42)、これと同時にキャリブレーション
用に取得した療養者管理端末の計測データセット(血糖
値計測のための元データ)をもとに療養者管理端末の出
力データ(血糖値)と採血で得られたデータ(血糖値の
真値として扱う)が一致するように、パラメータの調整
を行う(S43)。調整された新しいパラメータは、ネ
ットワークを介して療養者宅の療養者管理端末に転送さ
れ、自動的に設定される。もしくはパラメータをフロッ
ピー(登録商標)ディスク、メモリーカードなどのメデ
ィアに転送し、療養者がこれを自宅に持ち帰り、療養者
宅の療養者管理端末のスロットに挿入し、パラメータ設
定アプリケーションを起動し設定してもよい(S4
4)。The calibration schedule of the medical caregiver management terminal 102 may be included in the operation protocol of the medical caregiver management terminal. As shown in FIG. 13, the protocol includes a process of going to the hospital on the morning of the relevant day and displaying a message instructing to directly undergo the examination (S41). At the hospital, detailed data such as blood sugar level is acquired by blood sampling (S42), and at the same time, medical care person management is performed based on the measurement data set (original data for blood sugar level measurement) of the medical care person management terminal acquired for calibration. The parameters are adjusted so that the output data (blood glucose level) of the terminal and the data obtained by blood sampling (treated as the true blood glucose level) match (S43). The adjusted new parameter is transferred to the care giver management terminal at the care giver's house via the network and automatically set. Alternatively, transfer the parameters to a medium such as a floppy (registered trademark) disk or memory card, and the medical caregiver takes them home and inserts them into the medical caregiver management terminal slot at the medical caregiver's home, and activates the parameter setting application to set the parameters. May be (S4
4).
【0037】ここではキャリブレーション用の計測デー
タは通院時のものだけを用いたが、例えば過去3日間の
計測データをキャリブレーション予定日にシステムが自
動的にメディアに保存し、これを療養者が病院に持参し
てもよい。また、キャリブレーションを予めスケジュー
ルを固定するのでなく、療養者の通院時に行う場合もあ
る。療養者は通院時に採血により血糖値を計測され、そ
のデータは医師側端末104に入力される。そのときに
システムがネットワークを介して療養者宅の療養者管理
端末102から最新の計測データセット(血糖値計測の
ための元データ)を受信し、このデータをもとに採血の
データと端末による推定値が一致するように新しいパラ
メータを求め、これを上記と同様にネットワークかメデ
ィアを介して療養者宅の端末に設定する。あるいは、療
養者は通院時に直前の非侵襲の計測データセットを保存
したメディアを持参する。採血データが医師側端末から
入力されたときに持参したメディアのデータを用いて新
しいパラメータを求め、これをメディアに新たに保存す
る。このメディアを療養者宅の端末のメディア読み書き
用のスロット(図示しない)に差し込むと療養者管理端
末が新しいパラメータを認識し、これを自動的に療養者
管理端末に設定する。Here, only the measurement data for calibration was used at the time of going to the hospital, but for example, the system automatically saves the measurement data of the past 3 days in the calibration scheduled day, and the caregiver can store this. You may bring it to the hospital. In addition, the calibration may be performed when the care giver goes to the hospital instead of fixing the schedule in advance. The medical examinee measures the blood glucose level by collecting blood when visiting the hospital, and the data is input to the doctor side terminal 104. At that time, the system receives the latest measurement data set (original data for blood glucose level measurement) from the care giver management terminal 102 at the care giver's house via the network, and based on this data, the blood collection data and the terminal are used. A new parameter is obtained so that the estimated values match, and this is set in the terminal of the caregiver's home via the network or the medium as in the above. Alternatively, the care giver should bring the media containing the non-invasive measurement data set just before the visit. A new parameter is obtained using the data of the medium brought when the blood sampling data is input from the doctor side terminal, and the new parameter is newly stored in the medium. When this media is inserted into a slot (not shown) for reading and writing media in the terminal of the care giver's house, the care giver management terminal recognizes the new parameter and automatically sets it in the care giver management terminal.
【0038】もしくは、図14に示すように療養者が自
分でキャリブレーションを行う場合もある。キャリブレ
ーションが必要な日時に、端末から採血による自己血糖
計測が可能なセンサを用いて採血で血糖値を計測するよ
うに指示する(S51)。計測が終わり血糖値を端末に
入力させる(S52)。次に通常の非採血による計測を
行わせて、出力データを取得する(S53)。得られた
出力データと、採血にて計測した血糖値が一致するよう
にパラメータを調整する(S54,S55)。また時間
を置いて複数回のデータを用いて精度を向上させる必要
があるため、このような採血とパラメータ調整の作業を
決められた時間に数回行うようにプロトコルに記述され
る。Alternatively, as shown in FIG. 14, the care giver may perform the calibration by himself. At the date and time when calibration is required, the terminal is instructed to measure the blood glucose level by blood sampling using a sensor capable of self-blood glucose measurement by blood sampling (S51). After the measurement, the blood glucose level is input to the terminal (S52). Next, the output data is acquired by performing the normal non-blood sampling (S53). The parameters are adjusted so that the obtained output data and the blood glucose level measured by blood sampling match (S54, S55). Further, since it is necessary to improve the accuracy by using the data a plurality of times with a certain time interval, it is described in the protocol that such work of blood collection and parameter adjustment is performed several times at a predetermined time.
【0039】また、図15に示すように、訪問看護婦が
訪問時にキャリブレーション操作を行う場合もある。訪
問時に看護婦が採血による血糖計測を行い(S61)、
その結果を端末102に入力する(S62)、同時に非
採血の血糖計測も行い(S63)、そのデータと採血に
よるデータとが結果が一致するように端末内でパラメー
タを計算し(S64)、新しいパラメータを設定する
(S65)。もしくは、図16に示すように療養者宅で
データ収集を行い、データを管理者用サーバ101に転
送し(S71)、サーバ101にて新しいパラメータを
求めて(S72)、これを療養者管理端末102に送り
返して(S73)、設定する場合もある(S74)。Further, as shown in FIG. 15, a visiting nurse may perform a calibration operation at the time of visiting. At the time of visit, the nurse measures blood glucose by collecting blood (S61),
The result is input to the terminal 102 (S62), blood glucose measurement without blood collection is also performed (S63), and parameters are calculated in the terminal so that the data and the data obtained by blood collection match (S64). The parameters are set (S65). Alternatively, as shown in FIG. 16, data is collected at the care giver's house, the data is transferred to the administrator server 101 (S71), new parameters are obtained at the server 101 (S72), and the care giver management terminal is used. It may be sent back to 102 (S73) and set (S74).
【0040】また上記のようなキャリブレーション処理
を管理者用サーバ101にて行う場合もある。キャリブ
レーションの必要な日時等の情報を管理者用サーバ10
1が持ち、このスケジュールに基づいて、その直近に計
測された療養者管理端末102の計測データセット(血
糖値計測のための元データ)、および採血による血糖値
データを収集し管理者用サーバ102に蓄積する。この
データを用いて療養者管理端末102による計測結果が
採血による血糖値と一致するようにパラメータを修正す
る。修正したパラメータはネットワークを介して療養者
宅の端末に設定される。ここで医師、看護婦等に採血に
よる血糖値の計測を促すメッセージ配信と、療養者宅に
療養者管理端末にて血糖値を計測するようなメッセージ
配信を行ってもよい。Further, the above-described calibration process may be performed by the administrator server 101. Information such as the date and time required for calibration is stored in the administrator server 10
1 has a measurement data set (original data for blood sugar level measurement) of the care giver management terminal 102, which is most recently measured based on this schedule, and blood sugar level data by blood sampling, and collects the server 102 for manager. Accumulate in. Using this data, the parameters are corrected so that the measurement result by the care giver management terminal 102 matches the blood glucose level obtained by blood sampling. The corrected parameters are set in the terminal of the caregiver's home via the network. Here, a message may be delivered to doctors, nurses, etc. to encourage blood glucose level measurement by blood sampling, and a message may be delivered to the care giver's home such that the blood glucose level is measured at the care giver management terminal.
【0041】また、別の実施例として、作成されたプロ
トコルに含まれる薬品や食品を、それぞれの宅配業者に
発注して宅配により投薬や食事の管理を行う例について
説明する。その場合の構成図を図17に示す。また、宅
配業者との関連のフローチャートを図18に示す。病院
にてプロトコルが完成し、療養者管理端末102へ送信
処理を行う際、送信データの中に含まれる投薬情報を抽
出し(S81)、これを提携する薬品宅配業者110へ
送信する(S82)。また、食事指導データ又は食事メ
ニューを抽出し(S81)、これを食品業者に送信す
る。それぞれの業者は受信データに従い療養者宅へ薬
品、食品を宅配する(S84,S85)。食品業者の場
合、受信するデータが食事指導データだけである場合も
あり、このときは食事の具体的なメニューを作成し(S
83)、療養者に事前に承認を得るためメニューを送信
しておく(S86,S87)。As another embodiment, an example will be described in which medicines and foods included in the created protocol are ordered from respective courier companies and medication and meals are managed by courier. FIG. 17 shows a configuration diagram in that case. Further, FIG. 18 shows a flowchart relating to the delivery company. When the protocol is completed at the hospital and the transmission process is performed to the care giver management terminal 102, the medication information included in the transmission data is extracted (S81) and transmitted to the affiliated drug delivery company 110 (S82). . In addition, the meal guidance data or meal menu is extracted (S81), and this is transmitted to the food trader. Each trader delivers medicines and foods to the caregiver's home according to the received data (S84, S85). In the case of a food business operator, the data received may be only dietary guidance data. In this case, a specific menu for meals is created (S
83), the menu is transmitted to the care giver in advance for approval (S86, S87).
【0042】また、以下の実施例では、プロトコル内に
関連業者の広告を織り交ぜ、療養者管理端末102の画
面上にバナー広告として表示し、療養者、およびその家
族が関連商品のオンラインショッピングができるように
する。ここで作成するプロトコルには、関連商品のバナ
ー広告のためのリンク情報とバナーデータを図19のよ
うに組み込む。このプロトコルを受信すると、端末では
それぞれの時間に合わせて図11のようにバナー広告表
示を行う。ユーザがこれをタッチパネルで選択すると、
療養者管理端末102は、インターネット上のリンクペ
ージにアクセスし、療養者管理端末102上でWebブ
ラウザを表示し、オンラインショッピングなど関連業者
のサイトを利用することを可能とする。また管理者は広
告を療養者管理端末102上に表示することで、この関
連業者よりバナー広告料を徴収する。In the following embodiments, advertisements of related companies are interwoven in the protocol and displayed as banner advertisements on the screen of the caregiver management terminal 102 so that the caregiver and his family can shop online for related products. It can be so. In the protocol created here, link information and banner data for banner advertisement of related products are incorporated as shown in FIG. Upon receiving this protocol, the terminal displays a banner advertisement as shown in FIG. 11 according to each time. When the user selects this on the touch panel,
The medical caregiver management terminal 102 can access a link page on the Internet, display a Web browser on the medical caregiver management terminal 102, and use the sites of related businesses such as online shopping. Further, the administrator collects the banner advertisement fee from this related company by displaying the advertisement on the caregiver management terminal 102.
【0043】なお、以上の実施例で示した動作プロトコ
ルは、たとえばXMLを使ったマルチメディア同期再生
言語SMILの書式にならって図20のように記述す
る。ここでは、ひとつのメッセージ表示の場面のみを記
述している。2001年4月1日の10:00に複数の
画像と音声とテキスト15秒間、2シーン表示する例を
示している。表示だけでなく入力がある場合JavaS
criptなどで記述し、Webブラウザで動作させる
ことも可能である。The operation protocol shown in the above embodiment is described as shown in FIG. 20 according to the format of the multimedia synchronous reproduction language SMIL using XML, for example. Here, only one message display scene is described. An example is shown in which two scenes are displayed for 15 seconds for a plurality of images, sounds, and texts at 10:00 on April 1, 2001. If there is input as well as display JavaS
It is also possible to describe it in script or the like and operate it on a Web browser.
【0044】なお、上記実施例では、管理者用サーバ1
01は医療機関と独立に設置しているが、これは医療機
関がこの業務を兼ねて管理者用サーバ101を医療機関
内に設置しても、その他の処理は同様である。また医療
従事者用端末にこれが含まれてもよい。また、その他こ
こで示した実施例はあくまで一例で、この構成の限りで
ない。In the above embodiment, the administrator server 1
Although 01 is installed independently of the medical institution, even if the medical institution also installs the administrator server 101 in the medical institution for this purpose, the other processing is the same. This may also be included in the medical staff terminal. Further, the other embodiments shown here are merely examples, and the present invention is not limited to this configuration.
【0045】このように、本実施形態の在宅療養者支援
システム及び方法によれば、プロトコルデータベースに
基づき在宅療養者支援端末を制御する動作プロトコル
を、療養者の障害、性格などに合わせてきめ細かく生成
することで、医師など医療従事者の負担を低減しつつ、
きめ細かい生活指導やデータ収集が可能で、さらにメン
テナンスの自動化が可能となる。療養者にとっても様々
な医療従事者からの処方それぞれを意識して自ら管理し
なくても療養者管理端末で一元管理されるため、スムー
ズで確実なサービスを受けることができる。さらにこれ
らのサービスを行うビジネスをオンラインショッピング
や食事薬品宅配サービスと連携することで実現できる。As described above, according to the home-care-patient support system and method of the present embodiment, the operation protocol for controlling the home-care-receiver support terminal is finely generated in accordance with the disorder and personality of the care-taker based on the protocol database. By doing so, while reducing the burden on medical staff such as doctors,
Detailed life guidance and data collection are possible, and maintenance can be automated. The medical caregiver can receive a smooth and reliable service because the medical caregiver is centrally managed by the medical caregiver management terminal without having to manage each prescription from various medical staffs. Furthermore, businesses that provide these services can be realized by linking with online shopping and meal drug delivery services.
【0046】[0046]
【発明の効果】以上述べたように、本発明によれば、医
療従事者が入力した療養者に関する個人情報及び医療情
報に基づき、前記療養者の在宅療養のための行動スケジ
ュールを規定する動作プロトコルを生成又は修正し、療
養者管理端末に動作プロトコルに基づく療養者の在宅療
養のための行動スケジュールを呈示すると共に、前記療
養者管理端末を介した応答や各種生体情報の計測値等を
医療従事者側に送信することができるので、在宅療養者
に対するきめ細かなケアが可能であり、また、検査値等
の良好なコミュニケーションにより、療養者には常に適
切な動作プロトコルを提供することができる。As described above, according to the present invention, an operation protocol that defines an action schedule for home care of the medical caregiver based on personal information and medical information about the medical caregiver input by the medical staff. Is generated or corrected, and the behavior schedule for the home care of the care giver based on the operation protocol is presented to the care giver management terminal, and the response through the care giver management terminal and the measured values of various biological information are medically engaged. Since it can be transmitted to the person on the side of the caregiver, it is possible to provide detailed care to the caregiver at home, and it is possible to always provide the caregiver with an appropriate operation protocol through good communication of test values and the like.
【図1】 本発明の実施形態に係る在宅療養者支援シス
テムの全体構成を示すブロック図。FIG. 1 is a block diagram showing an overall configuration of a home medical care person support system according to an embodiment of the present invention.
【図2】 同システムにおける療養者管理端末の外観を
示す斜視図である。FIG. 2 is a perspective view showing an appearance of a medical care giver management terminal in the system.
【図3】 本発明の第1の実施例に係る動作プロトコル
の内容例を示す図。FIG. 3 is a diagram showing an example of contents of an operation protocol according to the first embodiment of the present invention.
【図4】 同システムのメインフローチャートである。FIG. 4 is a main flowchart of the system.
【図5】 同システムにおける各医療従事者が入力する
処方の例と、メンテナンススケジュールの例と、これら
を統合した動作プロトコルの例を示す図である。FIG. 5 is a diagram showing an example of a prescription input by each medical staff in the system, an example of a maintenance schedule, and an example of an operation protocol integrating these.
【図6】 同システムにおける動作プロトコルをシステ
ムが自動生成する場合のサービスのフローチャートであ
る。FIG. 6 is a flowchart of services when the system automatically generates an operation protocol in the system.
【図7】 同システムにおける動作プロトコルを医師、
看護婦、薬剤師、栄養士がマニュアルで作成する場合の
サービスのフローチャートである。FIG. 7 shows the operation protocol in the system by a doctor,
It is a flowchart of the service when a nurse, a pharmacist, and a dietitian manually create.
【図8】 本発明の第2の実施例に係る動作プロトコル
の内容例を示す図である。FIG. 8 is a diagram showing an example of contents of an operation protocol according to a second embodiment of the present invention.
【図9】 本発明の第3の実施例に係る療養者管理端末
とウェアラブルセンサの構成例を示す図である。FIG. 9 is a diagram showing a configuration example of a medical caregiver management terminal and a wearable sensor according to a third embodiment of the present invention.
【図10】 本発明の第3の実施例に係る動作プロトコ
ルの内容例を示す図である。FIG. 10 is a diagram showing an example of contents of an operation protocol according to the third embodiment of the present invention.
【図11】 療養者管理端末上に広告を示す場合の食事
内容入力画面(例1)を示す図である。FIG. 11 is a diagram showing a meal content input screen (example 1) when an advertisement is shown on the care giver management terminal.
【図12】 療養者管理端末上に広告を示す場合の食事
内容入力画面(例2)を示す図である。FIG. 12 is a diagram showing a meal content input screen (example 2) when an advertisement is shown on the care giver management terminal.
【図13】 病院でキャリブレーションを行う場合の処
理のフローチャートである。FIG. 13 is a flowchart of a process when calibration is performed in a hospital.
【図14】 自宅でキャリブレーションを行う場合(パ
ラメータを療養者管理端末内部で求める場合)の処理の
フローチャートである。FIG. 14 is a flowchart of a process when calibration is performed at home (when parameters are obtained inside the care giver management terminal).
【図15】 訪問看護婦がキャリブレーションを行う場
合(パラメータを療養者管理端末内部で求める場合)の
処理のフローチャートである。FIG. 15 is a flowchart of processing when a visiting nurse performs calibration (when parameters are obtained inside the care giver management terminal).
【図16】 訪問看護婦がキャリブレーションを行う場
合(パラメータを管理用サーバで求める場合)の処理の
フローチャートである。FIG. 16 is a flowchart of a process when a visiting nurse performs calibration (when parameters are obtained by the management server).
【図17】 各業者間のつながりを示す関係図である。FIG. 17 is a relationship diagram showing the connection between each trader.
【図18】 薬品、食品宅配業者と連携する場合の処理
の流れを示す図である。FIG. 18 is a diagram showing a flow of processing in the case of cooperating with a medicine / food delivery company.
【図19】 療養者管理端末上に広告を示す場合の動作
プロトコルの内容例を示す図である。FIG. 19 is a diagram showing an example of contents of an operation protocol when an advertisement is shown on a care giver management terminal.
【図20】 本発明における動作プロトコルの記述例を
示す図(SMILを利用した場合)である。FIG. 20 is a diagram showing a description example of an operation protocol in the present invention (when SMIL is used).
101 管理者用サーバ102 療養者管理端末104 医師用端末105 看護婦用端末106 薬剤師用端末107 栄養士用端末1011 管理者用端末1012 プロトコルデータベース201 腕輪センサ202 光電センサ1031 血糖値センサ1032 光電脈波センサ1033 血中飽和酸素濃度センサ1034 血圧センサ1035 鼓膜式体温計1036 心電電極101 Administrator server102 Caregiver management terminal104 Doctor terminal105 Terminal for nurse106 terminal for pharmacist107 Terminal for nutritionist1011 Administrator terminal1012 protocol database201 bracelet sensor202 photoelectric sensor1031 blood glucose sensor1032 Photoelectric pulse wave sensor1033 Blood saturated oxygen concentration sensor1034 blood pressure sensor1035 Eardrum thermometer1036 ECG electrode
─────────────────────────────────────────────────────フロントページの続き (51)Int.Cl.7 識別記号 FI テーマコート゛(参考) A61B 5/04 A61B 5/02 310A 5/0402 332B 5/11 337E 5/145 5/04 310M A61G 12/00 5/14 310 5/10 310Z 310J Fターム(参考) 4C017 AA09 AA12 AA16 AA20 AB02 AB10 AC26 BC11 FF30 4C027 AA00 AA02 CC00 GG05 GG07 JJ01 KK03 KK05 4C038 KK01 KK10 KL05 KL07 KM00 KX01 KY04 4C341 LL30─────────────────────────────────────────────────── ─── Continuation of front page (51) Int.Cl.7 Identification code FI theme code (reference) A61B 5/04 A61B 5/02 310A 5/0402 332B 5/11 337E 5/145 5/04 310M A61G 12 / 00 5/14 310 5/10 310Z 310J F term (reference) 4C017 AA09 AA12 AA16 AA20 AB02 AB10 AC26 BC11 FF30 4C027 AA00 AA02 CC00 GG05 GG07 JJ01 KK03 KK05 4C038 KK01 KK10 KL05 KL07 KM00 CX01 KY04 KX01 KY04 KX01 KY04 K341
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| JP2001303428AJP2003108679A (en) | 2001-09-28 | 2001-09-28 | Home care supporter system and method |
| Publication Number | Publication Date |
|---|---|
| JP2003108679Atrue JP2003108679A (en) | 2003-04-11 |
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| JP2001303428APendingJP2003108679A (en) | 2001-09-28 | 2001-09-28 | Home care supporter system and method |
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