Abstract:
A medical information management method capable of preventing medical information from being browsed somewhere when a client terminal is stolen or the like. A server connected to a movable client terminal via a network includes a medical information recording unit, an access control information recording unit, a client terminal location acquiring unit, a record extracting unit, and a medical information access control unit.

Description:
BACKGROUND OF THE INVENTION  
       [0001]     1. Field of the Invention  
         [0002]     The present invention relates to a medical information management method of controlling accesses to medical information by movable client terminals, and further relates to a server and a program using such a medical information management method.  
         [0003]     2. Description of a Related Art  
         [0004]     In medical institutions such as hospitals and clinics, LANs (Local Area Networks) have been provided and servers, client terminals, and various kinds of examination devices have been connected to the LANs. Further, notebook personal computers (hereinafter, also referred to as “notebook PCs”) have been used as client terminals, and doctors, nurses, or the like have carried around the notebook PCs within the hospitals.  
         [0005]     A possible problem when using the notebook PC is theft or loss of the notebook PC. When the notebook PC is thieved or lost, there is a possibility that personal information of patients is leaked. Accordingly, a technology of preventing the personal information of patients from leaking when the notebook PC is thieved or lost has been proposed.  
         [0006]     MIYO Kengo, et al., “Development of Information Environment for Ubiquitous CPR”, 23rd JCMI (Joint Conference on Medical Informatics), November, 2003, pp. 555-558 discloses that a host or server collectively manage all data in order not to leave clinical information in terminals, and further, all “my documents” directories are set to be redirected to the server in order not to leave the data created by users in terminals.  
         [0007]     According to the technology, the clinical information or data created by users are never left in the terminals. However, if a person who stole the terminal connects the stolen terminal to any available outlet within the hospital, the stolen terminal is connected to a predetermined virtual LAN according to a MAC (Medial Access Control) address. Thereby, the person who stole the terminal can browse the clinical information that is managed by the host or server or data created by users.  
       SUMMARY OF THE INVENTION  
       [0008]     The present invention has been achieved in view of the above-described points. An object of the present invention is to provide a medical information management method capable of preventing medical information from being browsed somewhere when a client terminal is stolen. A further object of the present invention is to provide a medical information management server and a medical information management program using such a medical information management method.  
         [0009]     In order to attain the above-described objects, a medical information management method according to the present invention is a method of managing medical information by using a server connected to a movable client terminal via a network, which method includes the steps of: (a) acquiring a location of the client terminal; (b) extracting a record corresponding to the location of the client terminal acquired at step (a) from a table having a plurality of records which store, in association with a plurality of locations, information for identifying medical information accessible when the client terminal exists in the respective locations; and (c) controlling access to the medical information by the client terminal based on the record extracted at step (b).  
         [0010]     Further, a medical information management server according to the present invention is a server to be connected to a movable client terminal via a network, for managing medical information, which server includes: first recording means for recording medical information; second recording means for recording a table having a plurality of records which store, in association with a plurality of locations, information for identifying medical information accessible when the client terminal exists in the respective locations; first processing means for acquiring a location of the client terminal; second processing means for extracting from the table a record corresponding to the location of the client terminal acquired by the first processing means; and third processing means for controlling access to the medical information by the client terminal based on the record extracted by the second processing means.  
         [0011]     Furthermore, a medical information management program according to the present invention is a program for managing medical information by using a server connected to a movable client terminal via a network, which program activates the server to execute the procedures of: (a) acquiring a location of the client terminal; (b) extracting a record corresponding to the location of the client terminal acquired at procedure (a) from a table having a plurality of records which store, in association with a plurality of locations, information for identifying medical information accessible when the client terminal exists in the respective locations; and (c) controlling access to the medical information by the client terminal based on the record extracted at procedure (b).  
         [0012]     According to the present invention, accessible medical information can be changed according to the location of the client terminal. Thereby, when the client terminal is stolen, the medical information can be prevented from being browsed somewhere. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0013]      FIG. 1  is a block diagram showing a medical information management system using a medical information management method according to one embodiment of the present invention;  
         [0014]      FIG. 2  is a block diagram showing a configuration of the medical information management server as shown in  FIG. 1 ;  
         [0015]      FIG. 3  shows an example of an access control information table recorded in an access control information recording unit as shown in  FIG. 2 ;  
         [0016]      FIG. 4  is a flowchart showing operation of the medical information management system as shown in  FIG. 1 ;  
         [0017]      FIG. 5  shows another example of the access control information table recorded in the access control information recording unit as shown in  FIG. 2 ; and  
         [0018]      FIG. 6  shows yet another example of the access control information table recorded in the access control information recording unit as shown in  FIG. 2 . 
     
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0019]     Hereinafter, an embodiment of the present invention will be described in detail by referring to the drawings. The same reference numerals are assigned to the same component elements and the description thereof will be omitted.  
         [0020]      FIG. 1  is a block diagram showing a configuration of a medical information management system using a medical information management method according to one embodiment of the present invention. This medical information management system is installed in a hospital  1  as an example of medical facilities. The hospital  1  has a reception/waiting room  2 , a consultation room  3 , an examination room  4 , a conference room  5 , a laboratory  6 , a nurse center  7 , a server room  8 , a patient&#39;s room (private room)  9 , and a patient&#39;s room (shared room)  10 , and a network  11  such as a LAN (Local Area Network) is provided between these rooms.  
         [0021]     A printer  12  and an access point  13  for wireless LAN connection are provided in the reception/waiting room  2 , and an access point  14  and a printer  15  are provided in the consultation room  3 . Further, in the examination room  4 , an access point  16 , a printer  17 , and an imaging modality  18  such as a radiation imaging device or an ultrasonic diagnostic device are provided. Further, in the conference room  5 , a LAN switch  19  for wired LAN connection, an RFID (Radio Frequency ID) receiver  20  for detecting RFID tags, and a printer  21  are provided. Furthermore, an access point  22  and a printer  23  are provided in the laboratory  6 , a LAN switch  24  is provided in the nurse center  7 , a medical information management server  25  according to one embodiment of the present invention is provided in the server room  8 , an access point  26  is provided in the patient&#39;s room (private room)  9 , and an access point  27  is provided in the patient&#39;s room (shared room)  10 . These devices are connected to the network  11 .  
         [0022]     Plural beds  31 ,  32 , . . . ,  3   n  are provided in the patient&#39;s room (shared room)  10 , and RFID tags, by which the beds can be uniquely identified, are respectively attached to the beds.  
         [0023]     A portable client terminal  40  (e.g., a notebook PC or the like) is placed in the consultation room  3 , and a doctor, nurse or the like performs medical services such as practice or nursing by carrying the client terminal  40  around in the hospital  1  and operating it. Although only one client terminal  40  is shown in  FIG. 1 , plural client terminals can be placed and used within the hospital  1 . Further, although the client terminal  40  is carried within the hospital  1  in the embodiment, the client terminal  40  may be carried outside the hospital  1  for use in home nursing or home care.  
         [0024]      FIG. 2  is a block diagram showing a configuration of the medical information management server. As shown in  FIG. 2 , the medical information management server  25  includes a medical information recording unit  51 , an access control information recording unit  52 , a client terminal location acquiring unit  53 , a record extracting unit  54 , and a medical information access control unit  55 .  
         [0025]     The medical information recording unit  51  records various medical information such as electronic clinical chart database for storing electronic clinical charts which preserve information on diagnosis, prescription or the like with respect to each case, a medical image database for storing image data on medical images generated by the imaging modality  18  ( FIG. 1 ), a visiting patient reception database for storing information on the visiting order of the visiting patients, consultation departments or the like, and so on.  
         [0026]     The access control information recording unit  52  records an access control information table for identifying accessible medical information according to the location of the client terminal  40  within the hospital  1  among the medical information recorded in the medical information recording unit  51 .  
         [0027]      FIG. 3  shows an example of the access control information table recorded in the access control information recording unit  52 . As shown in  FIG. 3 , the access control information table has a field for storing locations of the client terminal and a field for storing information for identifying medical information accessible when the client terminal exists in the respective locations.  
         [0028]     For example, when the client terminal  40  is located in the reception/waiting room  2 , the client terminal  40  is accessible to the visiting patient reception database (DB). When the client terminal  40  is located in the consultation room  3 , the client terminal  40  is accessible to the electronic clinical chart database (DB). When the client terminal  40  is located in the examination room  4 , the client terminal  40  is accessible to the medical image database (DB).  
         [0029]     Further, when the client terminal  40  is located in the conference room  5  or laboratory  6 , the client terminal  40  is accessible to all medical information. When the client terminal  40  is located in the nurse center  7 , the client terminal  40  is accessible to the clinical charts of all patients. When the client terminal  40  is located in the patient&#39;s room (private room)  9 , the client terminal  40  is accessible to the clinical chart of the patient hospitalized in the patient&#39;s room (private room)  9 .  
         [0030]     Furthermore, when the client terminal  40  is located at the bed  31  in the patient&#39;s room (shared room)  10 , the client terminal  40  is accessible to the clinical chart of the patient hospitalized in the bed  31  in the patient&#39;s room (shared room)  10 . When the client terminal  40  is located at the bed  32  in the patient&#39;s room (shared room)  10 , the client terminal  40  is accessible to the clinical chart of the patient hospitalized in the bed  32  in the patient&#39;s room (shared room)  10 .  
         [0031]     By the way, in  FIG. 3 , in association with the locations of the client terminal, information for identifying accessible medical information when the client terminal exists in the respective locations is stored, however, in association with the locations of the client terminal and time or time period, information for identifying accessible medical information when the client terminal exists in the respective locations at that time or in that time period may be stored. For example, since the time period for the round of the patient&#39;s rooms is generally determined (e.g., in the afternoon or the like), if the access to the medical information from the patient&#39;s room (private room)  9  and the patient&#39;s room (shared room)  10  can be made possible in that time period only, the security can be improved. Further, the access to the medical information from the examination room or a rehabilitation room may be made possible only in the examination time period or rehabilitation time period. Furthermore, the access to the medical information from outside of the hospital  1  may be made possible only in visiting time periods of the home nursing or home care.  
         [0032]     When the access control information table as shown in  FIG. 3  is generated, the location may be designated by displaying a floor plan of the hospital  1  on a display screen and selecting a desired room or the like on the floor plan. Further, by utilizing a shift management application program or the like, doctors, nurses and soon who can work at a desired time or in a desired time period may be displayed in a list so as to select a doctor or the like who is accessible to the medical information on the list. For example, a condition for the access to the medical information may be set as follows. In the case where doctor A goes the round on a certain day, only doctor A can access the medical information in the patient&#39;s room (private room)  9  and the patient&#39;s room (shared room)  10  during that day. Further, in the case where doctor B works the night shift on a certain day, doctor B is banned from accessing the medical information except for the emergency response during that day.  
         [0033]     When the access control information table for the access to the medical information from the outside of the hospital  1  is generated for the home nursing, by utilizing a map display application program or navigation application program, the location may be designated by displaying a map image on the display screen and selecting a desired location on the map image. Further, by utilizing a shift management application program or the like, doctors, nurses and so on who can work at a desired time or in a desired time period is displayed in a list, and a doctor or the like who is accessible to medical information may be selected on the list.  
         [0034]     Referring to  FIG. 2  again, the client terminal location acquiring unit  53  acquires the location of the client terminal  40 . The location of the client terminal  40  can be acquired by using an IP (Internet Protocol) address assigned to the client terminal  40 ,for example. As shown in  FIG. 1 , the client terminal  40  is connected to the network  11  via the access point  13  in the reception/waiting room  2 , via the access point  14  in the consultation room  3 , via the access point  16  in the examination room  4 , via the LAN switch  19  in the conference room  5 , via the access point  22  in the laboratory  6 , via the LAN switch  24  in the nurse center  7 , via the access point  26  in the patient&#39;s room (private room)  9  and via the access point  27  in the patient&#39;s room (shared room)  10 . These access points or LAN switches assign IP addresses within respective predetermined ranges to the client terminal  40  by the DHCP (Dynamic Host Configuration Protocol) function, and therefore, the location of the client terminal  40  can be acquired according to the IP address assigned to the client terminal  40 .  
         [0035]     For example, the access point  13  is assigned an IP address within the range from “192.168.0.1” to “192.168.0.10”, and the access point  14  is assigned an IP address within the range from “192.168.0.11” to “192.168.0.20”. Thereby, the client terminal location acquiring unit  53  can acquire the location of the client terminal  40  in the reception/waiting room  2  when the IP address “192.168.0.5” is assigned to the client terminal  40 .  
         [0036]     By the way, an IP address may be assigned to the client terminal  40  by the medical information management server instead of the access point or LAN switch. Alternatively, a DHCP server may be separately provided.  
         [0037]     Further, in the case where a predetermined RFID tag has been attached to the client terminal  40 , the client terminal  40  can be identified as to be located within the conference room  5  by the RFID receiver  20 . Although the RFID receiver  20  is provided only in the conference room  5  in  FIG. 1 , RFID receivers may be provided in the other rooms.  
         [0038]     Furthermore, in the case where the RFID receiver has been mounted to the client terminal  40 , the client terminal  40  detects that it is located at any one of the beds  31 ,  32 , . . . ,  3   n  in the patient&#39;s room (shared room)  10  for itself. Although the RFID tags are attached only to the beds  31 ,  32 , . . . ,  3   n  in the patient&#39;s room (shared room)  10  in  FIG. 1 , RFID tags may be attached to the other rooms. Moreover, in place of the RFID tag, an entrance card, a paper on which a barcode is printed, and so on may be used.  
         [0039]     Thus, the location of the client terminal  40  can be directly acquired by the medical information management server  25 , or, after the client terminal  40  acquires the location of itself, it can inform the location to the medical information management server  25 .  
         [0040]     Referring to  FIG. 2  again, the record extracting unit  54  extracts a record corresponding to the location of the client terminal  40  acquired by the client terminal location acquiring unit  53  from the access control information table. The medical information access control unit  55  performs access control to the medical information by the client terminal  40  based on the record extracted by the record extracting unit  54 .  
         [0041]     By the way, the client terminal location acquiring unit  53 , the record extracting unit  54 , and the medical information access control unit  55  shown in  FIG. 2  may be formed by a CPU and software (medical information management program). The program, medical information, and access control information table can be recorded in a recording medium such as a hard disk, a flexible disk, an MO, an MT, a RAM, a CD-RW, or a DVD-RAM.  
         [0042]     As below, the operation of the medical information management system will be described by referring to FIGS.  1  to  4 .  FIG. 4  is a flowchart showing the operation of the medical information management system.  
         [0043]     First, a user such as a doctor or nurse moves the client terminal  40  to a desired location and arranges it. In the case where a wired LAN is used, the user connects the client terminal  40  to the LAN switch by using a LAN cable. When a wireless LAN is used, negotiation is performed between the client terminal  40  and the access point.  
         [0044]     When the client terminal  40  has been moved and arranged, the client terminal location acquiring unit  53  of the medical information management server  25  acquires the location of the client terminal  40  (step S 11 ). As described above, the location of the client terminal  40  may be acquired by using an IP address, an RFID tag, a barcode and so on. Further, the medical information management server  25  may directly acquire the location of the client terminal  40 , or the client terminal  40  may detect the location of itself and inform the location to the medical information management server  25 .  
         [0045]     Then, the record extracting unit  54  of the medical information management server  25  extracts a record corresponding to the location of the client terminal  40  acquired at step S 11  from the access control information table (step S 12 ). For example, when the client terminal  40  is located in the consultation room  3 , the record extracting unit  54  extracts the second record in the access control information table as shown in  FIG. 3 .  
         [0046]     Then, the medical information access control unit  55  of the medical information management server  25  controls the access to the medical information by the client terminal  40  based on the record extracted by the record extracting unit  54  (step S 13 ). Thereby, for example, in the case where the client terminal  40  is located in the consultation room  3 , the client terminal  40  can access the electronic clinical chart data base. Here, the user such as a doctor operates the client terminal  40 , and the client terminal  40  requests the access to the electronic clinical chart data base to the medical information management server  25  according to the operation of the user, and displays or prints out the content of the electronic clinical chart desired by the user (step S 21 ). The user such as a doctor conducts medical services while watching the content of the electronic chart. By the way, the medical information that has been inputted to the client terminal  40  may be recorded in the medical information recording unit  51  within the medical information management server  25 .  
         [0047]     At this time, displayed items, input/selection items, the display screen design and so on may be changed according to the location of the client terminal  40 . Further, some kind of program may be executed by the client terminal  40 . Alternatively, the medical information management server  25  may execute some kind of program and cause the client terminal  40  to display the result.  
         [0048]     Afterwards, when the user such as a doctor moves to another room, the user carries and arranges the client terminal  40 . Thereby, the user can access medical information accessible in the other room.  
         [0049]     Thus, accessible medical information can be changed according to the location of the client terminal  40 . Thereby, for example, even when the client terminal  40  placed in the consultation room  3  is thieved by someone, the access to the electronic clinical chart database or the like can be prevented in the reception/waiting room  2 .  
         [0050]     Further, when the client terminal  40  is located at the bed  31  of the patient&#39;s room (shared room)  10 , the client terminal  40  can access only the electronic clinical chart of the patient in the bed  31  of the patient&#39;s room (shared room)  10 . Thereby, when the doctor or the like looks away for several seconds, the patient in the bed  31  can be prevented from stealing a glance at the electronic clinical chart of the patient in the bed  32 .  
         [0051]     In the embodiment, the network  11  may be connected to a wide area network (e.g., Internet or the like) via a gateway having a firewall function. Further, the medical information management server  25  maybe provided in an external data center or the like instead of the hospital  1 , and connected to the network  11  via a wide area network. Furthermore, the access control to the medical information may be performed in a unit of a hospital, a building, a floor, a location in a room, a desk, a vicinity of a device and so on instead of a room.  
         [0052]     Also, in the embodiment, a notebook personal computer is used as the client terminal  40 , however, a tablet PC, PDA, desktop personal computer or the like may be used.  
         [0053]     Further, in the access control information table, as shown in  FIG. 5 , information for identifying accessible medical information may be recorded according to the respective locations of the client terminal, respective MAC (Media Access Control) addresses of the client terminal, respective user IDs, and respective group IDs. Thereby, security can be improved. Here, in place of the MAC addresses, node names, host names or computer names of the client terminal may be used. For the purpose, the MAC address of the client terminal, the user ID, the group ID, or the node name, host name or computer name of the client terminal are acquired at step S 11 , and a record containing the information acquired at step S 11  is extracted at step S 12 .  
         [0054]     Furthermore, as shown in  FIG. 5 , in addition to the information for identifying accessible medical information, the operation environment may be set in association with the client terminal. In this example, printers for printing out and home directories have been set.  
         [0055]     In  FIG. 5 , information for identifying accessible medical information is recorded in association with the respective locations of the client terminal, the respective MAC addresses of the client terminal, the respective user IDs and the respective group Ids. However, the information for identifying accessible medical information may be recorded in association with the respective locations of the client terminal and the respective MAC addresses of the client terminal, or the respective locations of the client terminal and the respective user IDs, or the respective locations of the client terminal and the respective group IDs, or the respective locations of the client terminal and the respective user IDs and the respective group IDs, or the like.  
         [0056]     Alternatively, information for identifying accessible medical information may be stored in association with the respective locations of the client terminal, the respective MAC addresses of the client terminal, the respective user IDs, the respective group IDs and the respective times or time periods.  
         [0057]     Further, a card reader is connected to the client terminal, and a personal ID card or the like of the doctor or the like may be read in place of the user IDs and the group IDs. Furthermore, as an emergency response, the medical information cannot be accessed unless plural IDs are inputted while the medical information can be accessed by inputting one user ID normally.  
         [0058]     As a modification of the embodiment, in the access control information table, as shown in  FIG. 6 , information for identifying accessible medical information may be recorded according to the respective moving routes of the client terminal.  
         [0059]     For example, when the client terminal moves from the conference room  5  to the patient&#39;s room (private room)  9 , the client terminal is made accessible to the electronic clinical chart of the hospitalized patient in the patient&#39;s room (private room)  9  (step S 13 ). Further, by predicting that the client terminal then moves to the bed  31  in the patient&#39;s room (shared room)  10 , preparation may be made to transmit the electronic clinical chart of the hospitalized patient in the bed  31  in the patient&#39;s room (shared room)  10  to the client terminal. As the preparation, for example, the electronic clinical chart of the hospitalized patient in the bed  31  may be read from a hard disk drive and buffered in a transmission buffer, or the electronic clinical chart of the hospitalized patient in the bed  31  may be transmitted to a non-rendered area of a VRAM (Video RAM) of the client terminal. Thereby, the access to the medical information can be made faster.  
         [0060]     In the modification of the embodiment, the access to the medical information may be controlled according to combinations of the respective moving routes of the client terminal, the respective MAC addresses of the client terminal, the respective user IDs and/or the respective group IDs. Further, when the client terminal is located within the examination room  4 , the client terminal may be allowed to execute a console program for operating the imaging modality. Furthermore, one client terminal may function as a server for providing data to other client terminals and/or the medical information management server  25 .