U.S. patent application number 10/869901 was filed with the patent office on 2004-12-09 for medical instrument control system.
This patent application is currently assigned to CANON KABUSHIKI KAISHA. Invention is credited to Matsumura, Isao, Yoneyama, Yoshito.
Application Number | 20040249729 10/869901 |
Document ID | / |
Family ID | 27481727 |
Filed Date | 2004-12-09 |
United States Patent
Application |
20040249729 |
Kind Code |
A1 |
Matsumura, Isao ; et
al. |
December 9, 2004 |
Medical instrument control system
Abstract
A medical-instrument service providing system receives an online
order for a medical instrument via a communication network from a
service utilizing terminal of a medical institution, accesses a
stock control server controlled by a supplier of the medical
instrument, to check whether or not the on-order medical instrument
is in stock in the supplier. If the on-order medical instrument is
in stock in the supplier, the system instructs to deliver the
medical instrument to the medical institution. If the on-order
medical instrument is insufficient in stock, the system accesses a
stock control server, controlled by other institution than the
medical instrument, to check whether or not the instrument is in
stock, via the communication network. If the on-order medical
instrument is in stock, the system instructs to supply the medical
instrument to the medical institution from the other
institution.
Inventors: |
Matsumura, Isao; (Kanagawa,
JP) ; Yoneyama, Yoshito; (Tochigi, JP) |
Correspondence
Address: |
FITZPATRICK CELLA HARPER & SCINTO
30 ROCKEFELLER PLAZA
NEW YORK
NY
10112
US
|
Assignee: |
CANON KABUSHIKI KAISHA
Tokyo
JP
|
Family ID: |
27481727 |
Appl. No.: |
10/869901 |
Filed: |
June 18, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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10869901 |
Jun 18, 2004 |
|
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|
09978212 |
Oct 17, 2001 |
|
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|
6801913 |
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Current U.S.
Class: |
705/28 |
Current CPC
Class: |
Y10S 707/99937 20130101;
Y10S 707/99934 20130101; G16H 40/63 20180101; G16H 40/40 20180101;
G06Q 10/087 20130101; Y10S 707/99935 20130101; Y10S 707/99933
20130101; G16H 40/20 20180101; G16H 40/67 20180101 |
Class at
Publication: |
705/028 |
International
Class: |
G06F 017/60 |
Foreign Application Data
Date |
Code |
Application Number |
Oct 20, 2000 |
JP |
2000-321491 |
Oct 20, 2000 |
JP |
2000-321490 |
Oct 20, 2000 |
JP |
2000-321489 |
Oct 20, 2000 |
JP |
2000-321488 |
Claims
1-87. (Cancelled)
88. An electronic medical recording system utilizing a local area
network in a medical institution, comprising: a server that has a
database for controlling individual medical record information of
respective patients, accessible from said local area network; and
an input device that inputs information on a medical instrument
used in treatment for a patient, wherein said information on said
medical instrument inputted from said input device is recorded in
said patient's electronic medical record on said database.
89. The system according to claim 88, wherein input by said input
device is performed upon treatment for said patient.
90. The system according to claim 89, further comprising a safe
system for final check before surgery based on said information
inputted from said input device.
91. The system according to claim 90, wherein said safe system
accesses said patient's electronic medical record by utilizing said
local area network to check the record against said information
inputted from said input device.
92. The system according to claim 88, wherein said information on
said medical instrument includes a product serial code of said
medical instrument, and wherein said product serial code is
attached as a bar code to said medical instrument, further wherein
said input device includes a bar code reader that reads said bar
code.
93. The system according to claim 88, wherein said input device
includes a handy terminal, and wherein input is performed in a
place where the treatment for said patient is performed.
94. (Currently Amended) The system according to claim 88, wherein
said information on said medical instrument is transmitted to sad a
supplier of said medical instrument via the Internet or a private
communication line from said local area network in said medical
institution.
95. The system according to claim 88, wherein said medical
instrument is an implanted tool placed in a patient's body.
96. The system according to claim 88, wherein said medical
instrument is an intraocular lens, and wherein said information on
said medical instrument is attached to a package of said
intraocular lens.
97. (Currently Amended) A terminal apparatus used in a system
utilizing a local area network in a medical institution, which
includes a server that has a database for controlling individual
medical record information of respective patients accessible from
said local area network, said terminal apparatus comprising: a bar
code reader; a display; a computer that displays at least some of
information on a medical instrument to be used on said display
based on the result of reading a bar code attached to said medical
instrument by said bar code reader; and a transmitting unit which
transmits at least some of said information to said server via said
local area network.
98. The apparatus according to claim 97, further comprising a
network interface for connection with said local area network of
said medical institution.
99. The apparatus according to claim 97, wherein said terminal
apparatus is a handy terminal.
100. The apparatus according to claim 97, wherein said terminal
apparatus is used in a safe system for checking whether or not said
medical instrument to be used is proper before surgery.
101. The apparatus according to claim 97, wherein said medical
instrument is an implanted tool placed in a patient's body.
102. The apparatus according to claim 97, wherein said medical
instrument is an intraocular lens, and wherein said information on
said medical instrument is attached to a package of said
intraocular lens.
103. The apparatus according to claim 102, wherein a bar code is
presented on said medical instrument, and said bar code includes a
product serial code of said medical instrument, and wherein said
product serial code includes one or more of information from a
model, a product serial number, and a lens power of said
intraocular lens.
104. A medical safe system utilized in a medical institution,
comprising: an input device that inputs information on a medical
instrument used in treatment for a patient upon the treatment; and
a computer that checks said information on said medical instrument
inputted from said input device against said patient's electronic
medical record on an electronic medical recording system of said
medical institution.
105. The system according to claim 104, wherein said medical
instrument is an implanted tool placed in a patient's body.
106. The system according to claim 104, wherein said medical
instrument is an intraocular lens, and wherein said information on
said medical instrument is attached to a package of said
intraocular lens.
107. The system according to claim 106, wherein said information on
said medical instrument includes a product serial code of said
medical instrument, and wherein said product serial code is
attached as a bar code to said medical instrument, further wherein
said input device includes a bar code reader that reads said bar
code.
108. The system according to claim 104, wherein said input device
includes a handy terminal, and wherein input is performed in a
place where the treatment for said patient is performed.
109. The system according to claim 104, wherein said information on
said medical instrument is transmitted to a supplier of said
medical instrument via the Internet or a private communication line
from sad a local area network in said medical institution.
Description
FIELD OF THE INVENTION
[0001] The present invention relates to a system including medical
institutions such as a hospital and a medical laboratory and a
supplier to supply a medical instrument to these medical
institutions.
[0002] More particularly, the present invention relates to a method
of supplying a medical instrument to medical institutions such as
hospitals and medical laboratories and a system to check a stock
status of the medical instrument.
[0003] Further, the present invention relates to a service
providing method and service providing system to support selection
of medical instrument for medical institutions such as hospitals
and medical laboratories.
[0004] Further, the present invention relates to an electronic
medical recording system and a medical foolproof system utilized in
medical institutions such as hospitals and medical
laboratories.
[0005] Further, the present invention relates to a medical
instrument control method and control system for controlling a
medical instrument used in the medical institutions such as
hospitals and medical laboratories.
BACKGROUND OF THE INVENTION
[0006] In medical institutions such as hospitals and medical
laboratories, various medical instruments are used in surgery and
medical inspections. The medical instruments are e.g. tools,
medicine, and implanted devices including implanted tools (devices
surgically placed in the body such as an intraocular lens, a
pacemaker and artificial organs). Further, the medical institutions
use these various instruments supplied from suppliers such as
makers. Some of the instruments are stocked in the medical
institutions, and otherwise, orders for some instruments are placed
with the suppliers when required.
[0007] However, in the medical institutions, it is very troublesome
to control stocks of the medical instruments because timing of use
cannot be predicted without difficulty, and various types of
instruments are used. Generally, patients fall ill unexpectedly and
demands cannot be predicted without difficulty, and calculated
control cannot be performed. On the other hand, in the scene of
medical service, emergent surgery and inspections may be frequently
performed. Accordingly, it is a very serious object to construct a
system to quickly supply medical instruments. This is a specific
problem to the field of medical treatment.
[0008] Especially, a part of implanted tools and medicine are
degraded with time, and they are not appropriate for long-term
storage. As the medical institutions cannot hold such instruments
for a long period, they repeat ordering in accordance with
necessity. That is, a high frequency of ordering must be made.
Further, the makers must predict demands and control manufacturing
and quick supply of products so as to cover every possible
situations.
[0009] As an example of implanted tool which is degraded with time,
an intraocular lens (including an intraocular contact lens) used in
ophthalmologic surgery is known. A hospital selects a lens
appropriate to a patient's eye and uses it in the surgery. However,
intraocular lenses have various sizes and shapes corresponding to
individuality of patients, and a lens necessary for surgery is not
always stocked in the hospital. Further, if the patient's eye has
an extraordinary size and/or shape, an appropriate intraocular lens
may be out of stock even in the lens maker. However, in emergency
ophthalmologic surgery, the supply of lens must not be delayed.
[0010] Further, the medical institutions have another problem. That
is, the selection of implanted tool appropriate to a patient
greatly depends on a responsible doctor's expert knowledge and
experience, i.e., so-called know-how. In the case of intraocular
lens, a doctor of the hospital performs ophthalmologic measurement
and diagnosis on the patient, and selects an intraocular lens
having optimum size and shape for the patient based on the results
of measurement. Several mathematically-expressed selection criteria
for calculation of lens power are known. However, in some cases,
the coefficient used in the calculation may be changed in
accordance with the type of intraocular lens (difference in makers
etc.). The coefficient, corresponding to the above know-how of each
doctor, may cause a difference in type of finally-selected
intraocular lens in accordance with a numerical value determined by
the doctor. That is, how to improve the selection criteria to a
higher level and attain homogeneity is a significant problem.
[0011] Further, in the medical institutions, by virtue of the
development of recent information technology, electronization of
patients' medical records is expected. In conventional patients'
medical records, personal data, medical measured values and the
like are written, however, in electronic medical records, more
input items can be realized and detailed information on medical
products used for respective patients can be recorded. As to
surgically used tools such as implanted tools, to prevent omission
of input or input error to the electronic medical record, it is
desirable to input product information to the record on the spot of
surgery. Accordingly, one of the problems is how to realize the
on-the-spot input for prevention of omission of input or input
error.
[0012] In the case of intraocular lens as an example of implanted
tool, as described above, one intraocular lens appropriate to a
patient's eye is selected from various types of intraocular lenses.
There may be no problem if a doctor who selects a lens and a doctor
who surgically place the selected lens in the patient's eye are the
same person; otherwise, the record of lens made by the doctor who
selected the lens is the only information of intraocular lens to be
surgically placed in the patient's eye. Accordingly, to perform the
safest surgery, a foolproof system is desired to finally check an
intraocular lens to be used in surgery before the surgery, and how
to realize the system is a further problem.
SUMMARY OF THE INVENTION
[0013] The present invention has been made in consideration of the
above problems specific to the medical field, and has its object to
solve the problems related to supply of medical instruments, i.e.,
demands cannot be predicted without difficulty, and further, the
instruments must be quickly supplied, by constructing novel method
and system.
[0014] A more particular object of the present invention is to
provide method and system for online ordering for a medical
instrument by utilizing a communication network in a timely and
economical manner.
[0015] Another object of the present invention is to provide method
and system for online ordering for a medical instrument appropriate
to a patient in a simple manner by utilizing a communication
network.
[0016] Further, another object of the present invention is to
provide method and system for efficient delivery and manufacturing
control for a maker of medical instrument by utilizing a
communication network.
[0017] Further, another object of the present invention is to
provide method and system for providing an excellent after-sales
service regarding a medical instrument by utilizing a communication
network.
[0018] Further, another object of the present invention is to
provide method and system for reduction of shortage of medical
instruments by utilizing a communication network.
[0019] Further, another object of the present invention is to
provide method and system of service for supporting medical
institutions to select a medical instrument appropriate for a
patient by utilizing a communication network.
[0020] Further, another object of the present invention is to
provide method and system for providing a service to support
selection of medical instrument, with a selection criterion which
is advanced in accordance with increment in number of use of
service.
[0021] Further, another object of the present invention is to
provide method and system to foster timely development and
improvement of medical products and after-sales support service by
utilizing a communication network.
[0022] Further, another object of the present invention is to solve
the above problems related to use of medical instruments in medical
institutions by constructing a novel system.
[0023] More particularly, one of the objects of the present
invention is to provide an electronic medical recording system for
medical services to cover every possible situations for each
patient.
[0024] Further, another object of the present invention is to
provide a foolproof system upon use of medical instrument to a
patient and a terminal apparatus to realize the system.
[0025] Other features and advantages of the present invention will
be apparent from the following description taken in conjunction
with the accompanying drawings, in which like reference characters
designate the same name or similar parts throughout the figures
thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] The accompanying drawings, which are incorporated in and
constitute a part of the specification, illustrate embodiments of
the invention and, together with the description, serve to explain
the principles of the invention.
[0027] FIG. 1 is a block diagram showing a hardware network
construction of service system;
[0028] FIG. 2 is a flowchart showing a procedure in a medical
institution;
[0029] FIG. 3 is a flowchart showing a procedure of service by a
provider of medical instrument;
[0030] FIG. 4 is an example of screen image for service
selection;
[0031] FIG. 5 is an example of screen image for inputting patient
data;
[0032] FIG. 6 is an example of screen image showing a list of
search result;
[0033] FIG. 7 is an example of screen image of online new
ordering;
[0034] FIG. 8 is an example of screen image for checking online
ordering;
[0035] FIG. 9 is an example of screen image of electronic medical
record; and
[0036] FIG. 10 is an overview of product package of intraocular
lens.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0037] Preferred embodiments of the present invention will now be
described in detail in accordance with the accompanying
drawings.
[0038] In the following description, as an example of medical
instrument, an intraocular lens (IOL) placed in a patient's eye
will be used. The IOL is an example of an implanted tool placed in
a patient's body. However, the present invention is not limited to
the intraocular lens but is applicable to other implanted tools (a
pacemaker, artificial organs, dental implants, artificial bones and
the like to be placed in the body). Further, the present invention
is applicable to medical instruments selected for respective
patients such as specialized instruments used in surgery using the
above implanted tools, medicine, consumables used in examinations
and treatments, and the like.
[0039] FIG. 1 is a block diagram showing the entire construction of
information communication network including medical institutions
such as a hospital and a medical laboratory and a supplier (company
organization having a manufacturing department, a business
department, a distribution department and the like) of medical
instrument used in the medical institutions. In FIG. 1, a hospital
A (1), a hospital B (2), a medical laboratory (3) and a lens
supplier (4) (medical instrument supplier) are interconnected via
the Internet (5).
[0040] In the hospital A (1), a hospital LAN (Local Area Network)
(10) is constructed, and computer devices and medical measuring
devices held in respective clinical departments, a department A
(11), a department B (12), a department C (13) and a department D
(14), are interconnected via the LAN. If the hospital A is a
general hospital, the hospital has departments of various fields.
For example, in the field of ophthalmology, various medical
measuring devices such as a refractometer for measurement of
refraction, a keratometer (ophthalmometer) for measurement of
corneal power, an ultrasonic haploscope for measurement of axial
length, a visuscope for measurement of visual acuity, a digital
retinal camera for obtaining a fundus image, a velocimeter for
blood velocity mesurement of retinal bloodflow, a perimeter for
measurement of visual field, tonometer for measurement of ocular
pressure, and the like, are used.
[0041] The hospital LAN (10) is connected to an electronic medical
recording system (15) and a hospital stock control system (16). The
electronic medical recording system (15) has a server which
includes a database for control of all the electronized patient
information handled in the respective departments and which is
accessible from the respective departments in client/server form.
More particularly, the patient information includes patient
identification data (ID code, name and the like), examination and
treatment records (date, contents of examination, examination data,
doctor's findings, contents of treatment, medical instruments) and
the like. The medical instruments are instruments, medicine, tools
attached/placed to/in the body including implanted tools, and the
like. FIG. 9 is an example of user interface for electronic medical
recording. The above-described patient information is
displayed.
[0042] The hospital stock control system (16) has a server
including a database for control of stocked medical instruments
used in the hospital. The stock control system controls the medical
instruments by product serial code. The hospital stock control
system (16) is accessible from the respective clinical departments
and stock control department of the hospital in client/server form.
Further, as described later, the medical instrument supplier is
permitted, on some conditions, to access the hospital stock control
system (16) via an external network (in the present embodiment, the
supplier can access only data related to stock statuses of products
of the supplier). A doctor or assistant to perform treatment can
check whether or not medical instrument(s) necessary for the
treatment or examination are stocked in the hospital by accessing
the hospital stock control system (16) from an access terminal (PC
or workstation) of the department.
[0043] Similarly, in the hospital B (2) different from the hospital
A (1), a department A (21), a department B (22), a department C
(23), an electronic medical recording system (25), a hospital stock
control system (26) and the like are interconnected as a network
via a hospital LAN (20). The details of the electronic medical
recording system (25) and the hospital stock control system (26)
are the same as those in the case of the hospital A (1). The
difference from the hospital A (1) is that the hospital LAN (20) of
the hospital B (2) is connected to a further local service
providing system 24. As described later, the service providing
system 24 includes a server to provide a selection support service
to select an appropriate medical instrument from patient
information, and the server is accessible from the respective
departments of the hospital B in client/server form.
[0044] Further, in the medical laboratory (3) different from the
hospital A (1) and the hospital B (2), a department A (31), a
department B (32) and a department C (33) are interconnected as a
network via a laboratory LAN 30. The LAN is connected to a stock
control system (35) and a database system (34) holding research
data, and accessible from the respective departments in
client/server form.
[0045] The lens supplier (4) is given as an example of medical
instrument supplier. In this embodiment, it is a supplier of
intraocular lens for medical surgery as example of implanted tool.
The supplier may be any type of company as long as it is within the
scope of the present invention. For example, the supplier may be
any of other companies which supply other implanted tools (a
pacemaker, artificial organs, dental implants, artificial bones and
the like), medicine, consumables used in examinations and
treatment, and the like. In the lens supplier (4), a business
distribution department (41) (including sales and distribution
sections), a development department (42) and a manufacturing
department (43) are interconnected as a network via a company LAN
(40). The network is connected to a company stock control system
(44), an online ordering system (45), and a service providing
system (46) for supporting lens-selection and the like. The company
stock control system (44) has a server including a database for
controlling stock statuses of all the products handled by the lens
supplier. The online ordering system (45) has a server to receive
online orders for products from the medical institutions (1, 2 and
3) as customers via the Internet (5).
[0046] The service providing system (46) has a server to provide a
service to support selection of lens in correspondence with a
patient by the above customer, and provides an online service in
client/server form. The particular services will be described
later. The online ordering system (45) and the service providing
system (46) respectively have hardware constituents including a
storage device (hard disk or memory) holding a computer program
defining a procedure of the service and data group of the database,
a processor (computation device) for execution of the program, and
a network interface for connection with the LAN.
[0047] Note that instead of execution of program of all the service
functions by the processor on the server side, a program defining a
part or all of the functions of the service (, and data of the
database if necessary,) may be held on the client (service
utilizing terminal) side for execution of the function(s) by the
processor on the client side. In this case, the program executed on
the client side may be transferred via the network from the server
to the client, or may be previously installed as software to use
the service in the storage device of the client. For the sake of
quick service update, it is preferable to download the program in
form of applet from the server to the client via the network upon
every use of the service and execute the program on the client
side.
[0048] The LANs of the hospital A (1), the hospital B (2), the
medical laboratory (3) and the lens supplier (4) are connected to
the Internet (5) via a gateway (not shown) including a firewall.
For protection of privacy of patients and the hospitals, a high
level security function is necessary for use of the Internet
allowing use of public line. For this purpose, a security system
using encrypted data communication and user ID and password is
employed. To completely exclude possibility of third person's
intrusion, a private communication line (6) may be used without the
Internet for data communication between the lens supplier (4) and
the hospital (1). Further, the respective servers (46 and 45) to
provide the online ordering service and the lens-selection support
service controlled by the lens supplier (4) may be placed, not on
the LAN (40) in the lens supplier (4) but on a rental server (7)
provided on the Internet by a third person. In this case, the lens
supplier (4) performs program correction and data transfer via the
Internet (5), thus remotely controls the contents of the rental
server (7).
[0049] The hardware network construction is as described above.
Next, particular contents and procedures of the service will be
described.
[0050] FIG. 2 is a flowchart showing a standard procedure in the
medical institution (the hospital A, the hospital B or the medical
laboratory) utilizing the present service system. Since the
intraocular lens has various sizes and shapes corresponding to
individuality of patients, a doctor or examination technician, or
assistant in the respective departments is to perform an operation
to select an intraocular lens appropriate to a patient. The lens
supplier provides the lens-selection support service for selecting
a lens appropriate to a patient by utilizing various information
related to lenses owned by the company.
[0051] In FIG. 2, at step 101 (log on to service), a doctor or
examination technician or assistant in the respective departments
of the medical institution accesses the service providing server of
desired lens supplier via the LAN and the Internet from the service
utilizing terminal (PC or workstation connected to the network). At
this time, user code and password provided to the service user are
inputted, and a button of desired service is depressed. Only a
registered user (the hospital A or staff of the hospital) can log
on to the service. As shown in FIG. 4, service selection buttons
are "lens selection support" and "online ordering".
[0052] Step 102 (input patient data) and the subsequent steps are
procedure steps performed when the lens selection support service
has been selected. Patient information of a patient to take surgery
for placement of intraocular lens is inputted. FIG. 5 is an input
screen image displayed on the service utilizing terminal. If the
"lens selection support" button as shown in FIG. 4 is clicked by a
mouse of the service utilizing terminal, the screen image as shown
in FIG. 5 is displayed. Input data items are a patient ID, a
keratometric value (corneal refraction) measured by a keratometer
(refractometer), an optic axis length measured by a ultrasonic
haploscope, a post-surgery refraction of the patient's eye after
insertion of the intraocular lens, a corneal diameter, a pupil
diameter, naked eye sight, corrected eye sight, a spherical angle
upon correction, astigmatism refraction and an astigmatism axial
angle. Further, there are selection items of intraocular lens type
(CAT or PHAKIC) and insertion position (anterior chamber or
posterior chamber). These data are automatically read from the
patient's electronic record through the hospital LAN and displayed
on the screen.
[0053] The data reading from the electronic medical record is made
by a hospital network access program installed in the service
utilizing terminal. An item with no data from the electronic
medical record is displayed as blank, and the doctor inputs a
numerical value from a keyboard of the service utilizing terminal
in accordance with necessity. Further, if the doctor desires, a
numerical value of the input item, read from the electronic medical
record, can be rewritten with a different numerical value. An
execution button of "search appropriate lens" is displayed in a
lower part of the screen image, and if this button is clicked by
the mouse, the process moves to the next step 103. Further, for the
user's customizing a parameter as lens selection criterion, a
"customize parameter" button is displayed.
[0054] At step 103 (search for appropriate lens), the
lens-selection support service providing system 46 searches for an
appropriate intraocular lens in accordance with the patient data
received via the Internet and a predetermined selection criterion.
The procedure of the lens search is as described bellow.
[0055] First, a lens power appropriate to the patient's eye is
calculated by utilizing a lens power formula for selecting a lens
power which is well known in the field of ophthalmology. SRK/T
formula is one of the lens power formulas. The details of the
expression is described in John A. Retzlaff, MD et al.: "LENS
OMPLANT POWER CALCULATION (Third Edition), SLACK Incorporated.
Further, other various lens power formulas such as the Binkhorst
formula, the Colenbrander-Hoffer formula and the Regression formula
than the SRK/T formula may be used in place of the SRK/T
calculation.
[0056] Parameters used in the SRK/T calculation include a parameter
called A constant specific to an intraocular lens type, and other
parameters such as anterior chamber depth. In some cases, these
parameters should be slightly varied in accordance with intraocular
lens maker. Generally, the lens supplier provides recommended
parameter values, however, in some cases, the numerical values are
varied by respective doctors' decision, which corresponds to
so-called doctor's know-how.
[0057] In the present embodiment, when the user depresses the
"customize parameter" button, an input item for inputting a
numerical value of the above-described A constant, different from
the maker's recommended value, is displayed, and the user inputs a
numerical value and calculates a lens power. The value of the A
constant used in the lens selection calculation is automatically
recorded in the lens-selection support service providing system 46
of the lens supplier. As described later, the recommended A
constant value is obtained by averaging values from many users.
Generally, this value is used in lens power calculation.
[0058] The lens-selection support service providing system 46
obtains the lens power by the above formula, then searches the
database with the obtained value as a search condition, and further
with other patient data such as the corneal diameter data and the
pupil diameter data as other search conditions, for lenses
satisfying all the search conditions. That is, from the various
types of intraocular lenses stored in the database, lenses
satisfied "the lens type having the calculated lens power
(condition 1)" and "the lens appropriate to the patient's corneal
diameter data and pupil diameter data and the like (condition 2)"
are extracted. As a result of search, all the models of intraocular
lenses having corresponding power and lens diameter specification
are selected. In the present embodiment, as the database of the
lens-selection support service providing system includes data on
various models of intraocular lenses by plural makers as well as
data on 1 maker (the supplier itself), a search for an appropriate
intraocular lens can be made regardless of maker.
[0059] At step 104 (display search result), the result of the above
search is displayed in list form on the service utilizing terminal.
FIG. 6 is an example of the search result displayed on the display
screen of the service utilizing terminal. In this example, lenses
by different makers satisfying the search conditions are displayed
in the list, however, it may be arranged such that only models of
specific 1 maker (the supplier itself) are displayed. Further,
stock statuses, i.e., whether or not the selected intraocular
lenses are in stock, are displayed. The stocks are checked by
accessing the company stock control system (44) from the service
providing system (46) via the company LAN (40) (via the Internet in
use of rental server). The doctor finally determines a lens based
on the search result. Then the doctor opens the patient's
electronic medical record, and inputs the model, the power, a
predicted refraction value after insertion, the features of the
selected lens and the like, into the electronic medical record.
[0060] Note that if the doctor cannot find an appropriate lens from
the search result, as the process returns to the patient data input
image in FIG. 5 by depression of "re-search" button in FIG. 6, the
doctor can slightly vary the patient data values or selection
parameters and make another search. Further, if the patient's eye
is extraordinary and any of standardized lenses cannot be used, an
order can be placed for a customized lens to be manufactured in a
factory.
[0061] At step 105 (online ordering), an online service to receive
an order for an intraocular lens is provided. This service operates
in cooperation with the online ordering service system (45) of the
lens supplier on the initiative of the local server of the
hospital. The service user is not conscious of the position of the
server.
[0062] In a case where an online order is made immediately after
the search by the lens-selection support service, the "online
ordering" button is depressed in the screen image in FIG. 6 showing
the search result. Then the screen changes to an online ordering
image as shown in FIG. 7. In the screen image, 4 input items of
maker, a model name, a power and the volume of on-order lens are
displayed, and plural orders (order 1, order 2, order 3, . . . )
can be made. At normal times, the results of search by the
lens-selection support service is automatically inputted into the
respective items and displayed. Then the user deletes unnecessary
items leaving necessary ones, thereby designates on-order lens(es).
After the designation, when an "OK" button in a lower position of
the screen image is clicked, the screen changes to an order check
image as shown in FIG. 8. Note that if the "online ordering" is
selected in the service selection at the initial step 101 (FIG. 4),
the screen directly changes to an ordering image in FIG. 7 for
placement of new order. In the case of new order, as input items
are blank, desired name and numerical values are inputted into one
or plural fields of the maker, the model name, and the power, then
a desired number is inputted into the item of volume of on-order
lens (in use of pull-down menu for selection, the operability can
be improved), and an "OK" button is depressed. Then models
corresponding to the conditions are displayed in list as shown in
FIG. 8.
[0063] FIG. 8 is an example of screen image to finally check an
online order displayed on the service utilizing terminal. The stock
statuses of the respective intraocular lenses in the hospital, and
stock statuses of the lenses in the maker are automatically checked
and check results are displayed on the right side of the screen. It
may be arranged such that numerical values indicating the number of
stocked items instead of stock statuses are displayed. The data on
the stock in the hospital is provided from the hospital stock
control system (16, 26, 35), and the data on the maker stocks is
provided from the maker stock control server 44. The service user
checks the displayed contents and clicks "order", and the order is
completed. Upon completion of order, as the intraocular lens used
in treatment of the patient's eye is determined, the information of
the lens is inputted in the electronic medical record. Note that if
"cancel" is clicked, the order is cancelled. Furthermore, it is
also possible to order other medical instruments to secure the
stock. Such an order does not synchronize with the medical
record.
[0064] Regarding the intraocular lens on order by the online
ordering, process differs in accordance with its stock status in
the hospital. If the lens is stocked in the hospital, the on-order
lens, the orderer and the orderer department and the like are
recorded in the hospital stock control system, and the stock
control department of the hospital delivers the intraocular lens in
accordance with the place and time of the surgery. If the lens is
insufficient in stock, an order is automatically placed with the
online ordering system (45) of the lens supplier via the
Internet.
[0065] At step 106 (receive supplied lens), if the lens is stocked
in the hospital, the on-order lens is delivered to the doctor to
perform the surgery from the stock control department of the
hospital immediately or at necessary timing. Further, if an order
has been placed with the external supplier, the on-order lens is
supplied from the business department or distribution department of
the lens supplier to the stock control department of the hospital,
then the serial number of the product is registered in the hospital
stock control system, and the lens is delivered to the doctor at
necessary timing.
[0066] At step 107 (treatment/surgery), the supplied intraocular
lens is placed in the patient's eye.
[0067] The doctor to perform the surgery or assistant finally
checks whether or not the intraocular lens is the lens selected for
the patient, on the spot, by using a foolproof system. The
procedure of the final checking will be described. As shown in FIG.
10, a label on which a product serial code (identification code of
numerals or symbols) unique to each delivered product is printed as
a bar code, is attached to a product package in which the
intraocular lens is encapsulated. The product serial code includes
three types of information, a code identifying a model name, a
production number (serial number unique to each of products of even
the same model), and a lens power. On the label, the model name and
the lens power are described in characters so as to be visually
checked by the user.
[0068] When the package is opened, the doctor or assistant checks
the description of the label by visual observation. At the same
time, the doctor or assistant reads the bar code on the package by
a bar code reader of operation terminal at an operating room. The
operation terminal displays the lens model name and the lens power
included in the bar code. At the same time, the operation terminal
refers to the patient's electronic medical record via the hospital
LAN to check whether or not the model and the lens power of the
intraocular lens having the product serial code read by the bar
code reader correspond with the product information in the
electronic record, i.e., the lens model and the lens power of the
on-order intraocular lens selected by the doctor. Then the
operation terminal informs the doctor/assistant of the
correspondence between the data, by a screen image on the display
or a message from a speaker. The doctor checks the result of
comparison by the display or voice message and then starts the
surgery.
[0069] By this pre-surgery foolproof system, the probability of
human mistake such as use of wrong intraocular lens can be
prevented. As a particular example of the operation terminal, a
handy terminal with a built-in computer, connected to the hospital
LAN with a radio network interface or the like can be used with
excellent operability. Further, a laptop PC or desktop PC with a
network interface may be employed.
[0070] At step 108 (update medical record/selection criterion), the
patient data on the electronic medical record is updated. The
product serial code read by the bar code reader of the operation
terminal upon surgery is automatically recorded into the patient's
electronic medical record. At the same time, the product name, the
date of use, and the responsible doctor's name (user code) are also
automatically recorded in the electronic medical record. After the
surgery, if the doctor inputs comment on a usage pattern of the
intraocular lens (including quality and claim information) from the
above operation terminal or another terminal, the comments are also
recorded into the electronic medical record. Further, immediately
after or after the surgery, the patient's eye is measured by the
various measuring devices for observation of post-surgery status,
and the measured data are also recorded in the electronic medical
record through the hospital LAN.
[0071] Further, a part of the information recorded in the
electronic medical record, i.e., a part of the measured data, and
information on the product serial code, the date of use, the place
of use, the usage pattern and the like of the intraocular lens
inserted in the patient's eye are provided to the lens supplier via
the Internet. Further, the information on the stock from the
hospital stock control system 16, 26 and the company stock control
system 35 are recorded in the database of the company stock control
system of the lens supplier. Further, after the surgical
implantation of the intraocular lens, a form called a patient card
is handed to the patient from the hospital. The product serial
number is printed on the patient card. If the patient writes
personal information, comments on use of the lens, opinions and the
like in the patient card and sends it to the lens supplier, the
supplier inputs the data from the card and records the data, in
relation with the product serial number, into the above-described
database.
[0072] Further, the lens-selection support service providing system
46 on the lens supplier side re-calculates the A constant of the
above-described lens power formula (SRK/T formula) based on the
received measured data, and automatically updates data in
correspondence with the lens type. A particular method of updating
is as follows.
[0073] Now, it is assumed that a patient is a n-th service user.
The measured data of the patient (e.g., naked eye refraction=D0,
corrected refraction=D) is transmitted from the hospital. Assuming
that the maker's recommended value, the initial A constant is A0,
the value of the A constant obtained by using the above values D0
and D is A', and the lens power of the used intraocular lens is P,
the A constant is updated as follows. Note that the initial
constant A0 is weighted for 1000 patients, however, the value of
the constant may be varied.
[0074] The n-th A value is updated by:
[0075] (1) If .vertline.P.vertline..gtoreq.10 holds,
[0076] .vertline.D-D0.vertline..ltoreq.2:
A=A0.times.(1000+n-1)+A'/(1000+n- )
[0077] .vertline.D-D0.vertline..gtoreq.2: no change
[0078] (2) If 10>.vertline.P.vertline..gtoreq.5 holds,
[0079] .vertline.D-D0.vertline..ltoreq.1:
A=A0.times.(1000+n-1)+A'/(1000+n- )
[0080] .vertline.D-D0.vertline.>1: no change
[0081] (3) If P<5 holds,
[0082] .vertline.D-D0.vertline..ltoreq.0.5:
A=A0.times.(1000+n-1)+A'/(1000- +n)
[0083] .vertline.D-D0.vertline.>0.5: no change
[0084] The updated A constant is a value which reflect the many
past A constant values used by all the users of the present service
regarding the lens, i.e., the updated constant A means a
comprehensive survey of know-how regarding selection of the lens.
This A constant is used as the maker's recommended value for the
next lens power calculation. That is, the present system is a
know-how absorbing type learning system where the A constant
optimum of each of various intraocular lenses i.e. selection
criterion evolves to more reliable value as the number of times of
use and the number of users increase. Further, the doctor can check
whether or not his/her know-how is appropriate. This arrangement
increases the reliability of the lens selection, and contributes to
the homogeneity of selection by reducing variation in selection by
respective doctors.
[0085] The flow of the service viewed from the medical institution
side is as described above. FIG. 3 is a flowchart showing the
procedure of lens supply service viewed from the lens supplier
side.
[0086] At step 201 (provide lens selection online service), the
above-described online service is provided through the Internet to
the medical institutions such as the hospital A (1), the hospital B
(2) and the medical laboratory (3). The lens-selection support
service providing system (46) is placed on the server of the
company LAN of the lens supplier or the rental server (7). Access
to the server via the Internet is permitted from the service
utilizing terminal of the respective medical institutions, and the
selection of intraocular lens used in the respective medical
institutions is supported. Otherwise, as in the case of the
hospital B in FIG. 1, a program to provide the service or data may
be installed in a local service providing server of the hospital
LAN. In this case, the lens selection criterion parameter (A
constant) is updated every time the electronic medical record is
updated by the hospital after surgery, and the selection criterion
becomes more reliable as the number of times of service use
increases.
[0087] At step 202 (receive online order), an online order from the
medical institution is received. The nucleus of the online ordering
system to provide the service is constructed in the local servers
controlled by the stock control departments of the respective
hospitals, while the online ordering system (45) to handle orders
from the stock control departments is placed on the server of the
company LAN of the lens supplier or the rental server. Further, the
online ordering system (45) can access the company stock control
system (44) to obtain information on the stock in the company.
[0088] The company stock control system (44) performs centralized
control on the stocks of all the products handled by the lens
supplier. The company stock control system (44) has a database
holding various information such as product serial codes (model
names and production numbers), dates of production, places of
stocks, dates of delivery, dates of use, places of use, usage
patterns of all the products manufactured in the factory, and
comments from the medical institutions. It can be checked, from the
identification code of on-order product, whether or not the
on-order product is in stock for delivery by accessing the
database. If it is determined that the product is in stock, the
online ordering system instructs a computer of the business
department or the distribution department to deliver the on-order
product to the hospital (step 204). Under the instruction, the
business department or the distribution department immediately
delivers the on-order product to the hospital.
[0089] As the online ordering service is provided in conjunction
with the lens-selection support service, the medical institutions
can place an order for a selected lens on the spot, thus accurate
and quick ordering is realized. Considering a case where a patient
is to undertake emergency surgery using an intraocular lens and the
lens must be supplied as quick as possible, the level of urgency
can be designated upon ordering. In this case, as described below,
if the lens is insufficient in stock in the hospital and the maker,
the stock of the lens in another medical institution is
supplied.
[0090] At step 203 (check company stock), it is checked whether or
not the on-order intraocular lens is in stock in the company. If
the lens is insufficient in stock and the order is urgent, the
online ordering system checks stocks outside the company. The
system sequentially accesses the stock control systems of medical
institutions such as hospitals and laboratories around the orderer
hospital, as well as the hospital stock control system of the
orderer hospital, via the Internet, to examine whether or not the
on-order product is stocked. For this purpose, the lens supplier
has previously-assigned limited access right to at least search
stock statuses of their products in the stock control systems 16,
26 of the respective medical institutions and the company stock
control system 35.
[0091] The online ordering system sequentially searches plural
positions regarding which the system has access right. Then based
on the search results, makes a list of medical institutions having
an extra stock of the on-order product, in the order of distance
and time, from the closest institution. The system issues an
instruction, with the listed results, to the computer of the
business department or the distribution department to supply the
product (step 204). Under the instruction, the business department
or the distribution department dispatches a responsible person to a
medical institution that can supply the product most quickly, to
deliver the necessary number of products from the extra stock to
the orderer hospital. Thus, an order for lens used in an emergency
medical treatment can be handled.
[0092] Note that at step 203, when the stock control server
controlled by the medical institution is accessed from the lens
supplier, stocks of other types of intraocular lenses supplied by
the supplier in the past are examined. As a result, insufficient or
out-of-stock product(s) can be found. The online ordering system
first checks the stock of the insufficient product in the company
stock control system, and if the product is in stock, instructs the
computer of the business department or the distribution department
to voluntarily supply the product to the medical institution in
which the product is out of stock. If the product is not stocked in
the company, the system instructs the factory to manufacture the
out-of-stock product (step 205). In this manner, the system is
constructed to appropriately supply insufficient/out-of-stock
product by utilizing the lens supplier's access partly permitted to
the stock control servers of the medical institutions, thereby the
medical institutions can always obtain sufficient stocks.
[0093] At step 205 (instruct factory to manufacture lens), if the
lens is out of stock or a small amount of stock in the supplier and
the outside the company, the system instructs a computer of the
factory to manufacture the intraocular lens. The factory
manufacture the on-order product quickly and ship the product so as
to solve the shortage of the stock. Further, the system receives an
online order for a customized product for an extraordinary
patient's eye in which no standardized lens can be inserted, then
the development department designs the customized lens
corresponding to the order, and the factory manufactures the lens.
In this case, the Internet and the network of the company LAN are
utilized and quick manufacturing and supply of the product can be
performed. As shown in FIG. 10, each of pre-shipment product
packages completed in the factory has a bar code label displaying a
unique product serial code. For control of shipped products by bar
code, the company stock control system is accessed via the company
LAN from the factory computer, and records of new product serial
codes are added to the database.
[0094] As described above, a part of information recorded in the
electronic medical record in the hospital, e.g., a part of measured
data, and information on the product serial code, the date of use,
the place of use, the usage pattern and the like of the intraocular
lens inserted into the patient's eye are provided via the Internet
to the lens supplier. Further, the information on the stock status
of the product is recorded in the database of the company stock
control system of the lens supplier. Further, the information from
the patient card is also recorded in the same database. That is, by
introduction of the present system, the lens supplier can obtain
information of shipped products from the medical institutions and
perform follow-up control. As time and place of use of each shipped
product can be obtained in correspondence with the product serial
code, after-sales support for each product can be easily made.
Further, the usage pattern of the product, i.e., information on the
quality and claim and the patient's comments and opinions are
useful information for improvement of the product. These
information are stored in the database of the company stock control
system, and accessible from the development department, the
manufacturing department and the like via the company LAN. As the
useful information can be shared in the company, product
development and improvement can be quickly made. Further, the
manufacturing technology can be improved.
[0095] As described above, according to the present invention, the
problem of supply of medical instruments specific to the medical
field, that demands cannot be predicted without difficulty and
products must be quickly supplied, can be solved. That is, the
medical institution can timely receive a medical instrument, and
the supplier of medical instrument can efficiently perform delivery
and manufacturing control. That is, the introduction of the present
invention brings profits to the both medical institution and
supplier, and greatly contributes to the development of medical
industry.
[0096] Further, the present invention provides the selection
support service for medical institutions to assist accurate
selection of medical instrument regardless of experience or
knowledge of the service user.
[0097] Further, the electronic medical recording system of the
present invention can provide medical services covering details for
respective patients by utilizing a communication network. Further,
the present invention provides a foolproof system effective upon
use of medical instrument to a patient and provides a terminal
apparatus to realize the system.
[0098] Further, according to the present invention, the supplier of
medical instrument can perform follow-up control on shipped
products, thus attains timely development and improvement of
products and after-sales support.
[0099] As many apparently widely different embodiments of the
present invention can be made without departing from the spirit and
scope thereof, it is to be understood that the invention is not
limited to the specific embodiments thereof except as defined in
the appended claims.
* * * * *