本発明は、病院や診療所で行われた医療行為に対して発生する報酬を支払基金に請求する診療報酬明細書（レセプト）の発行に際して、適切な病名の付与を支援するシステムに関する。 The present invention relates to a system that supports the assignment of an appropriate disease name when issuing a medical fee statement (receipt) for requesting a payment fund for a fee generated for a medical practice performed in a hospital or clinic.
医療現場では患者の診察や検査などで病気の種類を判断し（病名の付与）、必要な薬剤を内服や点滴などで投与、手術や包帯交換、リハビリなどの処置を行うなどの医療行為を行い、治療を進めてゆく。月初めには、前月に行われた医療行為のリスト、病名のリストをレセプトと呼ばれる文書にまとめて支払基金に請求する。支払基金では、病名と医療行為の対応などを精査し、医療行為の不適切部分を減額（査定）した上で、医療機関に診療報酬を支払う。査定額が大きいと医療機関の経営を直撃することになる。 In the medical field, the type of illness is determined by medical examination and examination of the patient (name of the illness is given), necessary medicines are administered by oral administration or intravenous drip, and medical treatment such as surgery, bandage change, rehabilitation, etc. is performed. , Proceed with treatment. At the beginning of the month, a list of medical treatments performed in the previous month and a list of disease names are put together in a document called a receipt and billed to the payment fund. The payment fund carefully examines the name of the disease and the response to medical treatment, reduces (assess) the inappropriate part of medical treatment, and then pays medical fees to medical institutions. If the assessed amount is large, it will hit the management of the medical institution directly.
医療行為ごとに診療報酬支払の対象となる病名（適応病名）が決まっている。同様に、ある病名で診療報酬の対象（適応）となる医療行為も定められている。 The name of the disease (indication name) for which the medical fee is paid is determined for each medical practice. Similarly, medical practices that are eligible (adapted) for medical fees under a certain disease name are also defined.
レセプトの作成に当たっては、病名と対応する医療行為の関係を精査し、必要な病名をもれなく付与する、また、既に治療が終了して対応する医療行為が無くなっている病名を削除するなどの病名管理が不可欠である。
この出願に関連する先行技術文献としては次のものがある。When creating a receipt, the relationship between the disease name and the corresponding medical practice is scrutinized, the necessary disease name is given without exception, and the disease name management such as deleting the disease name for which the treatment has already been completed and the corresponding medical practice is no longer available. Is indispensable.
Prior art documents related to this application include:
医療行為ごとに定められている適応病名は多数に上り、また、病名ごとに適応のある医療行為も多岐にわたる。両者を突合して、レセプト上のすべての医療行為に関して適応病名を整備するのは容易ではない。
実際、レセプト作成期間は、医事課職員を中心に大量の残業が発生するのが普通である。
このようにしてさえも、実施された医療行為に対応する適応病名が漏れていて、査定を受けることが少なくない。
また、逆に、既に治療が終了し、対応する医療行為が無いにもかかわらず古い病名が残っているレセプトが少なくない。
レセプト作成支援システムによる高速な突合作業が望まれる所以である。
医療行為ごとの適応病名のリスト、病名ごとに適応のある医療行為のリストは膨大である。しかも、重複が多く、制度改定などで一部修正が生じると、その影響は散在している重複部分全体に及ぶため、一貫した整合性の保持には大変な労力を要する。There are many indications for each medical practice, and there are a wide variety of medical practices for each medical practice. It is not easy to match the two and develop an indication for all medical practices on the receipt.
In fact, during the receipt preparation period, a large amount of overtime is usually generated mainly by the staff of the medical department.
Even in this way, the names of indications corresponding to the medical treatments performed are often leaked and assessed.
On the contrary, there are many receipts in which the old disease name remains even though the treatment has already been completed and there is no corresponding medical treatment.
This is the reason why high-speed matching work by the receipt creation support system is desired.
The list of indications for each medical practice and the list of indications for each medical practice are enormous. Moreover, there is a lot of duplication, and if some amendments occur due to system revisions, the impact will extend to the entire scattered overlapping parts, so it will take a lot of effort to maintain consistent consistency.
本発明はかかる従来の問題点を解決するためになされたものであって、その目的とするところは、病名エントリーならびに、薬剤、検査、処置の医療行為エントリーを、階層構造を有するツリー状に配置し、共通属性をまとめて適切な階層のエントリーに記録することで、適応病名や適応医療行為に関する記録量を圧縮し、一貫性のある見通しの良い記録を行うこと（階層構造を有する病名ごと適応医療行為記録手段、階層構造を有する医療行為ごと適応病名記録手段）。前記階層構造を有する病名ごと適応医療行為記録手段、階層構造を有する医療行為ごと適応病名記録手段を用いて、レセプト内の病名リストと医療行為リストの突合を効率的かつ自動的に行い、病名漏れの医療行為の検出（医療行為適応病名検証手段）、検出された病名漏れの医療行為に対する適応病名リストの提示（医療行為適応病名提示手段）、さらに、既に治療が終了し対応する医療行為が無くなっている病名を検出し削除する病名削除提案手段を備えることで、査定のリスクの少ないレセプト作成を支援するシステムを提供することである。 The present invention has been made to solve such a conventional problem, and an object of the present invention is to arrange disease name entries and medical practice entries for drugs, tests, and treatments in a tree shape having a hierarchical structure. However, by collecting common attributes and recording them in the entry of the appropriate hierarchy, the amount of records related to the indication disease name and indication medical practice can be reduced, and consistent and clear recording can be performed (adaptation for each disease name having a hierarchical structure). Medical practice recording means, adaptive disease name recording means for each medical practice having a hierarchical structure). Using the adaptive medical practice recording means for each disease name having a hierarchical structure and the adaptive medical practice name recording means for each medical practice having a hierarchical structure, the disease name list in the receipt and the medical practice list are efficiently and automatically matched, and the disease name is omitted. Detection of medical practice (means for verifying the name of the indicated disease for medical practice), presentation of a list of indications for the detected medical practice without the name of the disease (means for presenting the name of the indicated disease for medical practice), and the corresponding medical practice has already been completed. It is to provide a system that supports the creation of a receipt with less risk of assessment by providing a disease name deletion proposal means for detecting and deleting the disease name.
前記目的を達成するための手段として、請求項１記載のレセプト作成支援システムでは、保険診療で使用が認められている病名のリストと、前記病名ごとに適応が認められている薬剤、検査、処置（以下、医療行為）を記録した病名ごと適応医療行為記録手段を備え、ある患者の限定期間内の病名と医療行為のリスト（以下、レセプトまたは診療報酬請求明細書）に対して、リストされている医療行為ごとに、当該医療行為が適応であると認められている病名があるかどうかを検索し、もし無ければ、警告を発する医療行為適応病名検証手段を備えていることを特徴とする。 As a means for achieving the above-mentioned object, in the receipt preparation support system according to claim 1, a list of disease names approved for use in medical treatment by insurance and drugs, tests, and treatments approved for each disease name. It is equipped with an adaptive medical practice recording means for each disease name that records (hereinafter, medical practice), and is listed for a list of disease names and medical practices within a limited period of a patient (hereinafter, receipt or medical fee billing statement). It is characterized in that it is equipped with a medical practice indication disease name verification means that searches for a disease name for which the medical practice is recognized as an indication for each medical practice, and if not, issues a warning.
請求項２記載のレセプト作成支援システムでは、請求項１記載のレセプト作成支援システムにおいて、前記医療行為（薬剤、検査、処置）ごとに適応が認められている病名のリストを記録した医療行為ごと適応病名記録手段を備え、前記医療行為適応病名検証手段で適応病名不存在が指摘された医療行為に対して、適応病名のリストを提示する医療行為適応病名提示手段を備えていることを特徴とする。 In the receipt preparation support system according to claim 2, in the receipt preparation support system according to claim 1, adaptation for each medical practice that records a list of disease names that are approved for each medical practice (drug, examination, treatment). It is characterized in that it is provided with a means for recording a disease name, and is provided with a means for presenting an indication for a medical practice that presents a list of indications for a medical practice for which the absence of an indication is pointed out by the medical practice indication indication means. ..
請求項３記載のレセプト作成支援システムでは、請求項２記載のレセプト作成支援システムにおいて、医療行為ごと適応病名記録手段を用いて、レセプト上の病名リストと医療行為リストの突合を行い、対応する医療行為が存在しない病名があれば、当該病名の削除を提案する病名削除提案手段を備えていることを特徴とする。 In the receipt creation support system according to claim 3, in the receipt creation support system according to claim 2, the disease name list on the receipt and the medical practice list are collated by using the indication disease name recording means for each medical practice, and the corresponding medical treatment is performed. If there is a disease name for which no action exists, it is characterized by having a disease name deletion proposal means for proposing the deletion of the disease name.
請求項４記載のレセプト作成支援システムでは、請求項１ないし３いずれか記載のレセプト作成支援システムにおいて、前記病名ごと適応医療行為記録手段は、病名ないし病名をまとめた分類名からなる病名エントリーから成り、前記病名エントリーは、（１）当該病名ないし病名をまとめた分類名に関する適応医療行為を含む属性を記録する病名エントリー属性記録手段、（２）前記病名エントリー間の親子関係を規定する病名エントリー親子関係リンク手段、（３）前記病名エントリー親子関係リンク手段を介して親の病名エントリー属性記録手段に記録されている属性を子の病名エントリー属性記録手段に継承する病名エントリー属性記録親子継承手段を有する、階層構造を有する病名ごと適応医療行為記録備えていることを特徴とする。 In the receipt creation support system according to claim 4, in the receipt creation support system according to any one of claims 1 to 3, the indication medical practice recording means for each disease name consists of a disease name entry consisting of a disease name or a classification name summarizing the disease names. , The disease name entry is (1) a disease name entry attribute recording means for recording an attribute including an adaptive medical practice related to a classification name that summarizes the disease name or the disease name, and (2) a disease name entry parent-child that defines a parent-child relationship between the disease name entries. Relationship link means, (3) It has a disease name entry attribute recording parent-child inheritance means that inherits the attributes recorded in the parent disease name entry attribute recording means to the child disease name entry attribute recording means via the disease name entry parent-child relationship link means. It is characterized by having an adaptive medical practice record for each disease name having a hierarchical structure.
請求項５記載のレセプト作成支援システムでは、請求項２ないし３いずれか記載のレセプト作成支援システムにおいて、前記医療行為ごと適応病名記録手段は、医療行為ないし医療行為をまとめた分類名からなる医療行為エントリーから成り、前記医療行為エントリーは、（１）当該医療行為ないし医療行為をまとめた分類名に関して適応病名を含む属性を記録する医療行為エントリー属性記録手段、（２）前記医療行為エントリー間の親子関係を規定する医療行為エントリー親子関係リンク手段、（３）前記医療行為エントリー親子関係リンク手段を介して親の医療行為エントリー属性記録手段に記録されている属性を子の医療行為エントリー属性記録手段に継承する医療行為エントリー属性記録親子継承手段を有する、階層構造を有する医療行為ごと適応病名記録手段備えていることを特徴とする。 In the receipt creation support system according to claim 5, in the receipt creation support system according to any one of claims 2 to 3, the indication disease name recording means for each medical practice is a medical practice consisting of a medical practice or a classification name that summarizes the medical practice. The medical practice entry consists of entries: (1) a medical practice entry attribute recording means for recording attributes including an indication disease name with respect to a classification name summarizing the medical practice or medical practice, and (2) a parent and child between the medical practice entries. Medical practice entry parent-child relationship linking means that defines the relationship, (3) The attribute recorded in the parent's medical practice entry attribute recording means via the medical practice entry parent-child relationship linking means is used as the child's medical practice entry attribute recording means. Medical practice to be inherited Entry attribute recording It is characterized by having a means for recording parent-child inheritance and having a hierarchical structure for each medical practice.
請求項６記載のレセプト作成支援システムでは、請求項１ないし５いずれか記載のレセプト作成支援システムにおいて、前記ある患者のレセプトも限定期間として６か月ないしそれ以上を設定したことを特徴とする。 The receipt preparation support system according to claim 6 is characterized in that, in the receipt preparation support system according to any one of claims 1 to 5, the receipt of a certain patient is also set as a limited period of 6 months or more.
請求項１記載のレセプト作成支援システムでは、病名のリストを備えているので、医療行為ごとに診療報酬請求が認められている適応病名が記録される。
適応医療行為記録手段を備えているので、病名ごとに適応が認められている薬剤、検査、処置（以下、医療行為）が記録される。
医療行為適応病名検証手段を備えているので、患者の限定期間内の病名と医療行為のリスト（以下、レセプトまたは診療報酬請求明細書）に対して、リストされている医療行為ごとに、当該医療行為が適応であると認められている病名があるかどうかを検索し、もし無ければ、警告を発する。Since the receipt creation support system according to claim 1 includes a list of disease names, the names of applicable diseases for which medical fee reimbursement is permitted are recorded for each medical practice.
Since it is equipped with an indication medical practice recording means, drugs, tests, and treatments (hereinafter referred to as medical actions) that are approved for each disease name are recorded.
Since it is equipped with medical treatment indication disease name verification means, the medical treatment for each medical treatment listed is based on the list of medical treatments and disease names within the limited period of the patient (hereinafter referred to as the receipt or medical fee billing statement). Search for the name of the disease for which the action is indicated, and if not, issue a warning.
請求項２記載のレセプト作成支援システムでは、適応病名記録手段を備えているので、医療行為（薬剤、検査、処置）ごとに適応が認められている病名のリストが記録される。
医療行為適応病名提示手段を備えているので、医療行為適応病名検証手段で適応病名不存在が指摘された医療行為に対して、適応病名のリストを提示する。Since the receipt creation support system according to claim 2 is provided with an indication disease name recording means, a list of disease names approved for each medical practice (drug, examination, treatment) is recorded.
Since it is equipped with a means for presenting the name of the indicated disease for medical practice, a list of the names of the indicated disease is presented for the medical practice for which the absence of the name of the indicated disease is pointed out by the means for verifying the name of the indicated disease.
請求項３記載のレセプト作成支援システムでは、病名削除提案手段を備えているので、医療行為ごと適応病名記録手段を用いて、レセプト上の病名リストと医療行為リストの突合を行い、対応する医療行為が存在しない病名があれば、当該病名の削除を提案する。 Since the receipt creation support system according to claim 3 is provided with a disease name deletion proposal means, the disease name list on the receipt and the medical practice list are collated by using the adaptive disease name recording means for each medical practice, and the corresponding medical practice is performed. If there is a disease name that does not exist, we propose to delete the disease name.
請求項４記載のレセプト作成支援システムでは、階層構造を有する病名ごと適応医療行為記録において、病名エントリーを備えているので、病名ないし病名が分類して記録される。
病名エントリー属性記録手段を備えているので、病名ないし病名をまとめた分類名に関する適応医療行為を含む属性が記録される。
病名エントリー親子関係リンク手段を備えているので、病名エントリー間の親子関係が規定される。
病名エントリー属性記録親子継承手段を備えているので、病名エントリー親子関係リンク手段を介して親の病名エントリー属性記録手段に記録されている属性を子の病名エントリー属性記録手段に継承する。In the receipt creation support system according to claim 4, since the disease name entry is provided in the adaptive medical practice record for each disease name having a hierarchical structure, the disease name or the disease name is classified and recorded.
Since it is equipped with a disease name entry attribute recording means, attributes including an adaptive medical practice related to a disease name or a classification name that summarizes the disease names are recorded.
Since the disease name entry parent-child relationship link means is provided, the parent-child relationship between the disease name entries is defined.
Since the disease name entry attribute recording parent-child inheritance means is provided, the attributes recorded in the parent disease name entry attribute recording means are inherited to the child disease name entry attribute recording means via the disease name entry parent-child relationship linking means.
請求項５記載のレセプト作成支援システムでは、階層構造を有する医療行為ごと適応病名記録手段において、医療行為エントリーを備えているので、医療行為ないしまとめた医療行為が分類して記録される。
医療行為エントリー属性記録手段を備えているので、医療行為ないし医療行為をまとめた分類名に関して適応病名を含む属性が記録される。
医療行為エントリー親子関係リンク手段を備えているので、医療行為エントリー間の親子関係が規定される。
医療行為エントリー属性記録親子継承手段を備えているので、医療行為エントリー親子関係リンク手段を介して親の医療行為エントリー属性記録手段に記録されている属性を子の医療行為エントリー属性記録手段に継承する。In the receipt creation support system according to claim 5, since the medical practice entry is provided in the adaptive disease name recording means for each medical practice having a hierarchical structure, the medical practice or the summarized medical practice is classified and recorded.
Since it is equipped with a medical practice entry attribute recording means, attributes including the indication disease name are recorded with respect to the medical practice or the classification name that summarizes the medical practice.
Medical practice entry parent-child relationship Since the linking means is provided, the parent-child relationship between medical practice entries is defined.
Since the medical practice entry attribute recording parent-child inheritance means is provided, the attributes recorded in the parent's medical practice entry attribute recording means are inherited to the child's medical practice entry attribute recording means via the medical practice entry parent-child relationship link means. ..
請求項６記載のレセプト作成支援システムでは、患者のレセプトは６か月ないしそれ以上の期間に対応可能である。 In the receipt preparation support system according to claim 6, the patient's receipt can be handled for a period of 6 months or more.
図１は、本発明のレセプト作成支援システムの全体構造の説明図である。
レセプトには、ＩＤ番号や氏名性別、生年月日などの患者ＩＤ情報に続き、当月の治療対象となった病名のリストが続く。
その後、医療行為の明細が記載される。
投与された薬剤のリスト、診断や治療方針を決め、経過を見てゆくための検査類、さらに、リハビリや手術、包帯交換などの処置のリストが記載される。
本発明のレセプト作成支援システムでは、病名ごと適応医療行為記録手段で、病名ごとに保険診療の適応があり診療報酬を請求できる医療行為のリストを、医療行為ごと適応病名記録手段で、医療行為ごとに診療報酬請求が認められている適応病名のリストが記録されている。FIG. 1 is an explanatory diagram of the overall structure of the receipt creation support system of the present invention.
The receipt will be followed by patient ID information such as ID number, name, gender, and date of birth, followed by a list of disease names treated for the month.
After that, the details of the medical practice are described.
It includes a list of drugs administered, tests to determine the diagnosis and treatment policy, and follow-up, as well as a list of procedures such as rehabilitation, surgery, and bandage change.
In the receipt creation support system of the present invention, a list of medical practices for which insurance medical treatment is applicable for each disease name and medical fees can be claimed by the adaptive medical practice recording means for each disease name can be obtained for each medical practice. A list of indications for which medical fees are allowed to be claimed is recorded in.
レセプト作成支援システムは、前記病名ごと適応医療行為記録手段、医療行為ごと適応病名記録手段の記録を用いて、レセプトの内容を精査し、レセプトにリストアップされている医療行為ごとに対応する適応病名がリストアップされているか（医療行為適応病名検証手段）を検証し、もし対応する適応病名がリストアップされていなければ当該医療行為の適応病名のリストを提示し適切な病名の付与を支援する（医療行為適応病名提示手段）。
治療期間が長くなると、既に治癒して医療行為が要らなくなった病名が出てくる。
このような不要病名が多くなると見通しが悪くなるので、不要となった病名を挙げて担当医に提案し（病名削除提案手段）たうえで、当該レセプトの病名リストから削除する病名整理を行う。The receipt creation support system uses the records of the adaptive medical practice recording means for each disease name and the adaptive disease name recording means for each medical practice to carefully examine the contents of the receipt, and the adaptive disease name corresponding to each medical practice listed in the receipt. Is listed (medical practice indication disease name verification means), and if the corresponding indication disease name is not listed, a list of indication disease names for the medical practice is presented to support the assignment of appropriate disease names ( Medical practice indication disease name presentation means).
When the treatment period becomes long, the name of the disease that has already been cured and no medical treatment is required comes out.
If the number of such unnecessary disease names increases, the outlook becomes worse. Therefore, after listing the unnecessary disease names and proposing them to the doctor in charge (disease name deletion proposal means), the disease names to be deleted from the disease name list of the receipt are arranged.
図２は、病名ごと適応医療行為記録手段の説明図である。
病名ごとに（病名エントリー）、診療報酬請求が認められている（適応がある）医療行為（適応医療行為）が、適応薬剤、適応検査、適応処置などの医療行為ごとに病名エントリー属性記録として記録されている。FIG. 2 is an explanatory diagram of an adaptive medical practice recording means for each disease name.
Medical practices (indications) for which medical fee billing is permitted (indications) for each disease name (disease name entry) are recorded as disease name entry attribute records for each medical practice such as indication drugs, indication tests, and indication treatments. Has been done.
図３は、医療行為ごと適応病名記録手段の説明図である。
医療行為ごとに（医療行為エントリー）、診療報酬請求が認められている（適応がある）病名（適応病名）が、医療行為エントリー属性記録として記録されている。FIG. 3 is an explanatory diagram of an indication disease name recording means for each medical practice.
For each medical practice (medical practice entry), the name of the disease (indication) for which medical fee billing is permitted (indication) is recorded as a medical practice entry attribute record.
図２にしても、図３にしても、個々の病名ごとの適応医療行為、医療行為ごとの適応病名には、エントリー属性の記録内容には、相互に多量の重複があることがわかる。
このままでは、属性記録が嵩張るだけでなく、見通しが悪く、さらに一部に修正が生じた際には、散在している該当部分をすべて修正しないと記録の整合性が保てなくなる。
これらは、保守コストの増大につながることは言うまでもない。In both FIG. 2 and FIG. 3, it can be seen that there is a large amount of duplication in the recorded contents of the entry attributes in the adaptive medical practice for each disease name and the adaptive disease name for each medical practice.
If nothing is done, not only will the attribute record be bulky, but the outlook will be poor, and if a partial correction occurs, the consistency of the record will not be maintained unless all the scattered relevant parts are corrected.
Needless to say, these lead to an increase in maintenance costs.
図４（ａ）は、肺炎、誤嚥性肺炎、肺結核を例にとり、病名ごと適応医療行為記録手段の記録内容を示した説明図である。大量の重複がある。
これに対して、図４（ｂ）は図４（ａ）の内容を、階層構造を持つ病名ごと適応医療行為記録手段を用いて表現した説明図である。
肺炎、誤嚥性肺炎、肺結核をまとめて「呼吸器感染症」の分類エントリーを立て、下部の共通属性を括りだし、「呼吸器感染症」の属性記録としている。
親である「呼吸器感染症」と子である肺炎、誤嚥性肺炎、肺結核は、病名エントリー親子関係リンク手段で連結されており、前記括りだされた共通属性は、病名エントリー属性記録親子継承手段により子に継承されるため、子である肺炎、誤嚥性肺炎、肺結核では、共通属性を記録する必要がない。
これにより、大幅な記録量削減が可能となり見通しが良くなる。FIG. 4A is an explanatory diagram showing the recorded contents of the adaptive medical practice recording means for each disease name, taking pneumonia, aspiration pneumonia, and pulmonary tuberculosis as examples. There is a lot of duplication.
On the other hand, FIG. 4 (b) is an explanatory diagram in which the contents of FIG. 4 (a) are expressed by using the adaptive medical practice recording means for each disease name having a hierarchical structure.
Pneumonia, aspiration pneumonia, and pulmonary tuberculosis are grouped together to create a classification entry for "respiratory tract infections," and the common attributes at the bottom are grouped together to form an attribute record for "respiratory tract infections."
The parent "respiratory tract infection" and the child pneumonia, aspiration pneumonia, and pulmonary tuberculosis are linked by the disease name entry parent-child relationship link means, and the above-mentioned common attributes are the disease name entry attribute record parent-child inheritance. Since it is inherited by the offspring by means, it is not necessary to record common attributes in the offspring of pneumonia, aspiration pneumonia, and pulmonary tuberculosis.
This makes it possible to significantly reduce the amount of recording and improve the outlook.
修正が行われた際は、その修正された内容は自動的に子の属性記録に継承されるため、１か所修正すれば良く、整合性の維持が容易である。
誤嚥性肺炎では、継承されてきた属性に、適応薬剤としてユナシンが推奨特記として、適応検査として嚥下検査、適応処置として嚥下訓練が追加されている。
肺結核においては、継承されてきた属性記録のうち、適応薬剤が、抗結核剤に置き換えられている。
その他の適応検査や適応処置は継承されてきた属性記録のままなので追加記録はない。
このように、病名エントリー属性記録親子継承手段によって属性が継承されるが、病名エントリー固有の特記事項や追加記録、置換え記録を用いることで、最小限の記録量で固有の属性を表現できる。
追加、置き換えられた病名エントリー属性記録は、その孫の病名エントリー属性記録に継承されてゆく。When a correction is made, the corrected content is automatically inherited in the attribute record of the child, so that only one place needs to be corrected, and it is easy to maintain consistency.
In aspiration pneumonia, unacin is recommended as an indication, and swallowing training is added as an indication and swallowing training as an indication to the inherited attributes.
In pulmonary tuberculosis, among the inherited attribute records, the indication drug has been replaced with an anti-tuberculosis drug.
There are no additional records as other adaptive tests and treatments remain the inherited attribute records.
In this way, the attributes are inherited by the disease name entry attribute recording parent-child inheritance means, but by using the special notes, additional records, and replacement records unique to the disease name entry, the unique attributes can be expressed with the minimum amount of recording.
The added or replaced disease name entry attribute record is inherited by the disease name entry attribute record of the grandchild.
図５(ａ)図５(ｂ)は、階層構造を有する医療行為ごと適応病名記録手段（薬剤関連部分）の説明図である。
図５(ａ)では、階層構造を持たない、医療行為（ここでは薬剤）の適応病名を並列に記録している。大量の重複がある。
これに対して、図５（ｂ）は図５（ａ）の内容を、階層構造を有する医療行為ごと適応病名記録手段を用いて表現した説明図である。
メロペネム、セファメジン、ユナシンをまとめて「抗菌薬」、ＩＮＨは「抗結核剤」の分類エントリーを立て、下部の共通属性を括りだし、「抗菌薬」、「抗結核剤」の属性記録としている。
さらに「抗菌薬」、「抗結核剤」をまとめて「微生物に作用する薬」の上位分類エントリーを設けている。
親である「微生物に作用する薬」と子である「抗菌薬」、「抗結核剤」、さらにその孫であるメロペネム、セファメジン、ユナシンないしＩＮＨは、医療行為エントリー親子関係リンク手段で連結されており、前記括りだされた共通属性は、医療行為エントリー属性記録親子継承手段により子や孫に継承されるため、子であるメロペネム、セファメジン、ユナシンないしＩＮＨでは、共通属性を記録する必要がない。5 (a) and 5 (b) are explanatory views of an indication disease name recording means (drug-related portion) for each medical practice having a hierarchical structure.
In FIG. 5A, the names of indications for medical practice (here, drugs) that do not have a hierarchical structure are recorded in parallel. There is a lot of duplication.
On the other hand, FIG. 5 (b) is an explanatory diagram expressing the contents of FIG. 5 (a) by using the indication disease name recording means for each medical practice having a hierarchical structure.
Meropenem, cefamedin, and unacin are collectively classified as "antibacterial agents", and INH has created a classification entry for "anti-tuberculosis agents", and the common attributes at the bottom are summarized and used as attribute records for "antibacterial agents" and "anti-tuberculosis agents".
Furthermore, "antibacterial agents" and "anti-tuberculosis agents" are grouped together to provide a high-ranking entry for "drugs that act on microorganisms."
The parent "drug that acts on microorganisms" and the child "antibacterial", "anti-tuberculosis", and their grandchildren meropenem, cefamedin, unacin or INH are linked by the medical practice entry parent-child relationship link means. Since the above-mentioned common attributes are inherited by the child or grandchild by the medical practice entry attribute recording parent-child inheritance means, it is not necessary to record the common attributes in the children meropenem, cefamedin, unacin or INH.
これにより、大幅な記録量削減が可能となり見通しが良くなる。
修正が行われた際は、その修正された内容は自動的に子の属性記録に継承されるため、１か所修正すれば良く、整合性の維持が容易である。
ユナシンでは、継承されてきた属性に、適応病名として誤嚥性肺炎が推奨特記として追加記録されている。
抗結核剤においては、親から継承されてきた属性記録のままなので追加記録はない。
このように、医療行為エントリー属性記録親子継承手段によって属性が継承されるが、医療行為エントリー固有の特記事項や追加記録、置換え記録を用いることで、最小限の記録量で固有の属性を表現できる。
追加、置き換えられた医療行為エントリー属性記録は、その孫の医療行為エントリー属性記録に継承されてゆく。
図５では、医療行為のうちの薬剤を例示したが、適応検査や適応処置についても、各々同様に階層構造を有する医療行為ごと適応病名記録手段を整備することにより、大幅な記録量削減が可能となり見通しが良くなる。
修正が行われた際は、その修正された内容は自動的に子の属性記録に継承されるため、１か所修正すれば良く、整合性の維持が容易である。This makes it possible to significantly reduce the amount of recording and improve the outlook.
When a correction is made, the corrected content is automatically inherited in the attribute record of the child, so that only one place needs to be corrected, and it is easy to maintain consistency.
In Unasin, aspiration pneumonia is additionally recorded as a recommended special note as an indication disease name in the inherited attributes.
For anti-tuberculosis agents, there is no additional record because the attribute record inherited from the parent remains.
In this way, the attributes are inherited by the medical practice entry attribute record parent-child inheritance means, but by using the special notes, additional records, and replacement records unique to the medical practice entry, the unique attributes can be expressed with the minimum amount of recording. ..
The added or replaced medical practice entry attribute record will be inherited by the grandchildren's medical practice entry attribute record.
Although the drugs in the medical practice are illustrated in FIG. 5, it is possible to significantly reduce the amount of records for the indication test and the indication treatment by providing the indication means for recording the name of the indication for each medical practice having the same hierarchical structure. The outlook will improve.
When a correction is made, the corrected content is automatically inherited in the attribute record of the child, so that only one place needs to be corrected, and it is easy to maintain consistency.
図６は、医療行為適応病名検証手段の説明図である。
病名ごと適応医療行為記録手段により、レセプトに挙げられている病名（図では肺炎、変形性脊椎症）ごとに適応医療行為をレセプトに記載されている医療行為を突合し、適応として対応関係にある病名と医療行為をリストアップしてゆく。
万一、適応病名のとして病名がない医療行為が発見された場合は、病名漏れとして警告を発する。
医師は、当該医療行為に対応する適応病名を付与する。
この際に、医療行為ごと適応病名記録手段の記録内容を用いて、当該行為に対して適応が認められている病名を医師などに提示すると（医療行為適応病名提示手段）有用である。
なお、ここでは病名ごと適応医療行為記録手段を用いて病名との対応を検証しているが、逆に、医療行為ごと適応病名記録手段を用いて検証してもよい。
しかし、病名リストに比して医療行為リストは長大なので、前記病名ごと適応医療行為記録手段を用いた場合に比べて、病名と医療行為の突合が激増するため、好ましいとは言えない。FIG. 6 is an explanatory diagram of a medical practice indication disease name verification means.
Indications for each disease name By the medical action recording means, the indications for each disease name (pneumonia, spondylosis deformans in the figure) listed in the receipt are collated with the medical practice described in the receipt, and the names of the diseases that are corresponding as indications. And list medical practices.
In the unlikely event that a medical practice that does not have a disease name as an indication disease name is discovered, a warning will be issued as a disease name omission.
The doctor gives the name of the indicated disease corresponding to the medical practice.
At this time, it is useful to present the name of the disease for which the indication is approved to the medical practice to a doctor or the like by using the recorded contents of the adaptive disease name recording means for each medical practice (medical practice adaptive disease name presentation means).
Here, the correspondence with the disease name is verified by using the adaptive medical practice recording means for each disease name, but conversely, the correspondence with the disease name may be verified by using the adaptive disease name recording means for each medical practice.
However, since the medical practice list is longer than the disease name list, the matching between the disease name and the medical practice increases sharply as compared with the case where the adaptive medical practice recording means for each disease name is used, which is not preferable.
図７は病名削除提案手段の説明図である。
病名（１）〜（３）、医療行為イ〜ホの適応関係を図６で検証する。
ここでは病名（２）が、対応する医療行為が見当たらないので、当該病名に対する治療は終了している可能性があるとして、医師らに病名削除を提案する（病名削除提案手段）。
医療行為の中には、数か月ごとに１回行われるものもあるので、自動削除は好ましいとは言えず、医師への確認が必要である。
説明の便宜上、レセプトは１か月分のみを挙げているが、医療行為の中には、数か月ごとに１回行われるものもあるので、６〜８か月のレセプトを通覧して検証することも有用である。FIG. 7 is an explanatory diagram of the disease name deletion proposal means.
The adaptive relationships between disease names (1) to (3) and medical practices a to e are verified with reference to FIG.
Here, since the medical practice corresponding to the disease name (2) is not found, it is considered that the treatment for the disease name may have been completed, and the doctors are proposed to delete the disease name (means for proposing the deletion of the disease name).
Since some medical practices are performed once every few months, automatic deletion is not preferable and requires confirmation with a doctor.
For convenience of explanation, the receipt is given only for one month, but some medical treatments are performed once every few months, so the receipt for 6 to 8 months is reviewed and verified. It is also useful to do.
以上、実施例を説明したが、本発明の具体的な構成は前記実施例に限定されるものではなく、発明の要旨を逸脱しない範囲の設計変更等があっても本発明に含まれる。
例えば、図の表示や内容は概念説明の便宜のために例示したもので、実用の際には、教科書や論文などに基づき正確に記録すればよい。
本明細書では、薬剤、疾患、症状所見に関しツリー構造の記録手段を設けているが、用途に応じて、一部ないし全部のエントリーを階層構造でない並列とすることもあって良い。
また、部位に関する情報などを別のエントリー群として併用してもよい。
Although the examples have been described above, the specific configuration of the present invention is not limited to the above examples, and even if there is a design change or the like within a range that does not deviate from the gist of the invention, the present invention includes the examples.
For example, the display and contents of the figure are illustrated for the convenience of conceptual explanation, and in practical use, they may be accurately recorded based on a textbook or a dissertation.
In the present specification, a tree-structured recording means is provided for drug, disease, and symptom findings, but some or all entries may be arranged in parallel instead of a hierarchical structure, depending on the application.
In addition, information about the site may be used together as another entry group.
前記目的を達成するための手段として、請求項１記載のレセプト作成支援システムでは、保険診療で使用が認められている病名のリストと、
前記病名ごとに適応が認められている薬剤、検査、処置（以下、医療行為）を記録した病名ごと適応医療行為記録手段を備え、
ある患者の限定期間内の病名と医療行為のリスト（以下、レセプトまたは診療報酬請求明細書）に対して、リストされている医療行為ごとに、当該医療行為が適応であると認められている病名があるかどうかを検索し、もし無ければ、警告を発する医療行為適応病名検証手段を備え、
前記医療行為（薬剤、検査、処置）ごとに適応が認められている病名のリストを記録した医療行為ごと適応病名記録手段を備え、
前記医療行為適応病名検証手段で適応病名不存在が指摘された医療行為に対して、適応病名のリストを提示する医療行為適応病名提示手段を備え、
前記医療行為ごと適応病名記録手段は、医療行為ないし医療行為をまとめた分類名から
なる医療行為エントリーから成り、
前記医療行為エントリーは、
（１）当該医療行為ないし医療行為をまとめた分類名に関して適応病名を含む属性を記録
する医療行為エントリー属性記録手段、
（２）前記医療行為エントリー間の親子関係を規定する医療行為エントリー親子関係リン
ク手段、
（３）前記医療行為エントリー親子関係リンク手段を介して親の医療行為エントリー属性
記録手段に記録されている属性を子の医療行為エントリー属性記録手段に継承する医療行
為エントリー属性記録親子継承手段を有する、階層構造を有する医療行為ごと適応病名記
録手段を備えていることを特徴とする。As a means for achieving the above-mentioned purpose, in the receipt preparation support system according to claim 1, a list of disease names approved for use in medical insurance is provided.
It is equipped with an indication medical practice recording means for each disease name that records drugs, tests, and treatments (hereinafter referred to as medical actions) that are approved for each disease name.
For each medical practice listed for a patient's list of medical treatments and medical treatments within a limited period (hereinafter referred to as a receipt or medical fee billing statement), the medical treatment is recognized as an indication. It has a medical treatment indication disease name verification means that searches for the presence of the disease and issues a warning if it does not exist.
A means for recording the indication of the disease name for each medical practice, which records a list of the names of the diseases for which the indication is approved for each medical practice (drug, test, treatment), is provided.
A medical practice adaptive disease name presenting means for presenting a list of adaptive disease names is provided for a medical practice in which the absence of an adaptive disease name is pointed out by the medical practice adaptive disease name verification means.
The indicated disease name recording means for each medical practice is based on the medical practice or the classification name that summarizes the medical practice.
Consists of medical practice entries
The medical practice entry is
(1) Record the attributes including the indication disease name for the medical practice or the classification name that summarizes the medical practice.
Medical practice entry attribute recording means,
(2) Medical practice entry parent-child relationship phosphorus that regulates the parent-child relationship between the medical practice entries
Means,
(3) Parent's medical practice entry attribute via the medical practice entry parent-child relationship link means
A medical line that inherits the attributes recorded in the recording means to the child's medical practice entry attribute recording means
Entry attribute record Indications for each medical practice with a hierarchical structure that has parent-child inheritance means
It is characterized by having a recording means .
請求項２記載のレセプト作成支援システムでは、保険診療で使用が認められている病名のリストと、
前記病名ごとに適応が認められている薬剤、検査、処置（以下、医療行為）を記録した病名ごと適応医療行為記録手段を備え、
ある患者の限定期間内の病名と医療行為のリスト（以下、レセプトまたは診療報酬請求明細書）に対して、リストされている医療行為ごとに、当該医療行為が適応であると認められている病名があるかどうかを検索し、もし無ければ、警告を発する医療行為適応病名検証手段を備え、
前記医療行為（薬剤、検査、処置）ごとに適応が認められている病名のリストを記録した医療行為ごと適応病名記録手段を備え、
前記医療行為適応病名検証手段で適応病名不存在が指摘された医療行為に対して、適応病名のリストを提示する医療行為適応病名提示手段を備え、
前記医療行為ごと適応病名記録手段は、医療行為ないし医療行為をまとめた分類名から
なる医療行為エントリーから成り、
前記医療行為エントリーは、
（１）当該医療行為ないし医療行為をまとめた分類名に関して適応病名を含む属性を記録
する医療行為エントリー属性記録手段、
（２）前記医療行為エントリー間の親子関係を規定する医療行為エントリー親子関係リン
ク手段、
（３）前記医療行為エントリー親子関係リンク手段を介して親の医療行為エントリー属性
記録手段に記録されている属性を子の医療行為エントリー属性記録手段に継承する医療行
為エントリー属性記録親子継承手段を有する、階層構造を有する医療行為ごと適応病名記
録手段を備えていることを特徴とする。In the receipt creation support system described in claim 2, a list of disease names approved for use in insurance medical treatment and a list of disease names are provided.
It is equipped with an indication medical practice recording means for each disease name that records drugs, tests, and treatments (hereinafter referred to as medical actions) that are approved for each disease name.
For each medical practice listed for a patient's list of medical treatments and medical treatments within a limited period (hereinafter referred to as a receipt or medical fee billing statement), the medical treatment is recognized as an indication. It has a medical treatment indication disease name verification means that searches for the presence of the disease and issues a warning if it does not exist.
A means for recording the indication of the disease name for each medical practice, which records a list of the names of the diseases for which the indication is approved for each medical practice (drug, test, treatment), is provided.
A medical practice adaptive disease name presenting means for presenting a list of adaptive disease names is provided for a medical practice in which the absence of an adaptive disease name is pointed out by the medical practice adaptive disease name verification means.
The indicated disease name recording means for each medical practice is based on the medical practice or the classification name that summarizes the medical practice.
Consists of medical practice entries
The medical practice entry is
(1) Record the attributes including the indication disease name for the medical practice or the classification name that summarizes the medical practice.
Medical practice entry attribute recording means,
(2) Medical practice entry parent-child relationship phosphorus that regulates the parent-child relationship between the medical practice entries
Means,
(3) Parent's medical practice entry attribute via the medical practice entry parent-child relationship link means
A medical line that inherits the attributes recorded in the recording means to the child's medical practice entry attribute recording means
Entry attribute record Indications for each medical practice with a hierarchical structure that has parent-child inheritance means
It is characterized by having a recording means .
請求項４記載のレセプト作成支援システムでは、請求項１ないし３いずれか記載のレセプト作成支援システムにおいて、前記ある患者のレセプトも限定期間として６か月ないしそれ以上を設定したことを特徴とする。 The receipt preparation support system according to claim 4 is characterized in that, in the receipt preparation support system according to any one of claims 1 to 3, the receipt of a certain patient is also set as a limited period of 6 months or more.
請求項１記載のレセプト作成支援システムでは、階層構造を有する病名ごと適応医療行為記録において、病名エントリーを備えているので、病名ないし病名が分類して記録される。
病名エントリー属性記録手段を備えているので、病名ないし病名をまとめた分類名に関する適応医療行為を含む属性が記録される。
病名エントリー親子関係リンク手段を備えているので、病名エントリー間の親子関係が規定される。
病名エントリー属性記録親子継承手段を備えているので、病名エントリー親子関係リンク手段を介して親の病名エントリー属性記録手段に記録されている属性を子の病名エントリー属性記録手段に継承する。In the receipt creation support system according toclaim 1 , since the disease name entry is provided in the adaptive medical practice record for each disease name having a hierarchical structure, the disease name or the disease name is classified and recorded.
Since it is equipped with a disease name entry attribute recording means, attributes including an adaptive medical practice related to a disease name or a classification name that summarizes the disease names are recorded.
Since the disease name entry parent-child relationship link means is provided, the parent-child relationship between the disease name entries is defined.
Since the disease name entry attribute recording parent-child inheritance means is provided, the attributes recorded in the parent disease name entry attribute recording means are inherited to the child disease name entry attribute recording means via the disease name entry parent-child relationship linking means.
請求項２記載のレセプト作成支援システムでは、階層構造を有する医療行為ごと適応病名記録手段において、医療行為エントリーを備えているので、医療行為ないしまとめた医療行為が分類して記録される。
医療行為エントリー属性記録手段を備えているので、医療行為ないし医療行為をまとめた分類名に関して適応病名を含む属性が記録される。
医療行為エントリー親子関係リンク手段を備えているので、医療行為エントリー間の親子関係が規定される。
医療行為エントリー属性記録親子継承手段を備えているので、医療行為エントリー親子関係リンク手段を介して親の医療行為エントリー属性記録手段に記録されている属性を子の医療行為エントリー属性記録手段に継承する。In the receipt creation support system according toclaim 2 , since the medical practice entry is provided in the adaptive disease name recording means for each medical practice having a hierarchical structure, the medical practice or the summarized medical practice is classified and recorded.
Since it is equipped with a medical practice entry attribute recording means, attributes including the indication disease name are recorded with respect to the medical practice or the classification name that summarizes the medical practice.
Medical practice entry parent-child relationship Since the linking means is provided, the parent-child relationship between medical practice entries is defined.
Since the medical practice entry attribute recording parent-child inheritance means is provided, the attributes recorded in the parent's medical practice entry attribute recording means are inherited to the child's medical practice entry attribute recording means via the medical practice entry parent-child relationship link means. ..
請求項４記載のレセプト作成支援システムでは、患者のレセプトは６か月ないしそれ以上の期間に対応可能である。In the receipt preparation support system according toclaim 4 , the patient's receipt can be handled for a period of 6 months or more.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2019076110AJP6651114B1 (en) | 2019-04-12 | 2019-04-12 | Receipt creation support system |
| PCT/JP2020/015602WO2020209236A1 (en) | 2019-04-12 | 2020-04-07 | Medical fee bill creation assistance system |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2019076110AJP6651114B1 (en) | 2019-04-12 | 2019-04-12 | Receipt creation support system |
| Publication Number | Publication Date |
|---|---|
| JP6651114B1 JP6651114B1 (en) | 2020-02-19 |
| JP2020173688Atrue JP2020173688A (en) | 2020-10-22 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2019076110AActiveJP6651114B1 (en) | 2019-04-12 | 2019-04-12 | Receipt creation support system |
| Country | Link |
|---|---|
| JP (1) | JP6651114B1 (en) |
| WO (1) | WO2020209236A1 (en) |
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| Publication number | Publication date |
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