Patent Publication Number: US-2013238361-A1

Title: Medical information managing system, medical information managing apparatus, and medical information displaying apparatus

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a Continuation Application of No. PCT/JP2012/051228, filed on Jan. 20, 2012, and the PCT application is based upon and claims the benefit of priority from Japanese Patent Application No. 2011-9816, filed on Jan. 20, 2011, the entire contents of which are incorporated herein by reference. 
    
    
     FIELD 
     An embodiment as an aspect of the present invention relates to a medical information managing system, a medical information managing apparatus, and a medical information displaying apparatus that executes a medical application for displaying medical data to thereby display the medical data. 
     BACKGROUND 
     A medical information managing system includes a medical image generating apparatus such as an X-ray computed tomographic (CT) apparatus and a magnetic resonance imaging (MRI) apparatus, various servers, and a client terminal. Examples of the various servers include a medical image storing apparatus, a medical report (radiogram interpretation report) storing apparatus, and an electronic medical chart storing apparatus. The medical image generating apparatus, the various servers, and the client terminal are communicably connected to one another through a network. 
     The medical image storing apparatus stores a medical image of a patient acquired by the medical image generating apparatus. A healthcare professional (hereinafter, referred to as “operator”) refers to a medical image displayed on the client terminal, writes medical findings about the medical image into a medical report creating screen displayed on the client terminal, and creates a medical report. The created medical report is recorded in the medical report storing apparatus. 
     Medical data from each server is displayed on the client terminal by a medical application provided by each server. Accordingly, screens of a large number of medical applications are displayed on the client terminal. The medical applications displayed on the client terminal are roughly classified into an image displaying application provided by the medical image storing apparatus, a report creating application provided by the medical report storing apparatus, and an electronic medical chart displaying application provided by the electronic medical chart storing apparatus. The image displaying application is further divided into a 2D image displaying application and a 3D image displaying application. Further, in the case where medical applications in the same classification are provided by a plurality of makers, for example, a first medical image storing apparatus that provides a first image displaying application and a second medical image storing apparatus that provides a second image displaying application may exist in some cases, so that the client terminal executes many kinds of applications. 
     When the operator creates a medical report, the client terminal uses the image displaying application that is a medical application provided by the medical image storing apparatus, in order to display a medical image necessary to create the medical report. When the operator creates the medical report, the client terminal also displays various pieces of medical data necessary to create the medical report, in addition to the medical image. For example, the client terminal collects and displays the medical data with the use of the report creating application that is a medical application provided by the medical report storing apparatus, and the electronic medical chart displaying application that is a medical application provided by the electronic medical chart storing apparatus. 
     Some medical applications link with one another using a patient identification (ID). For example, if the client terminal displays a medical report of a first patient using the report creating application, the image displaying application automatically links with the report creating application, and displays a medical image of the first patient. Such an automatic linkage of the medical applications provides consistency of a patient displayed by each medical application. 
     In a normal state of the client terminal that uses a plurality of medical applications that link with one another using a patient ID, basically, all the medical applications always display medical data of the same patient. In the client terminal, all the medical applications always display the medical data of the same patient at the beginning, but the linkage of the plurality of medical applications does not function normally due to factors such as a lock of a medical application, a shutdown of a network, and a down of each managing apparatus, and the client terminal may come into a dangerous state (in which the plurality of medical applications display different patients). For example, the client terminal unfavorably displays a medical report of a first patient using the report creating application while displaying a medical image of a second patient using the image displaying application. 
     In the case where the plurality of medical applications display different patients, the client terminal displays pieces of medical data of the different patients on the same screen. Hence, the operator has trouble in selecting only medical data of a desired patient, for example, medical data of a second patient from the large number of pieces of medical data displayed on the client terminal, resulting in a decrease in creation efficiency of a medical report. 
     In addition, in the case where the plurality of medical applications display different patients, the operator may even write findings about a medical image of a second patient into a medical report creating screen of a first patient, in case of his/her lack of attention. As a result, an operator who refers to the created medical report may make a wrong diagnosis. 
     The present invention has an object to improve efficiency of operator&#39;s work in a medical information managing system including a client terminal by informing the operator of a dangerous state, a warning state and their countermeasures, even in the case where different patient IDs are displayed on a plurality of screens corresponding to a plurality of medical applications that are required to have an identity of a patient therebetween. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In accompanying drawings, 
         FIG. 1  is a schematic diagram illustrating a configuration of a medical information managing system according to the present embodiment; 
         FIG. 2  is a schematic diagram illustrating configurations of servers and a client terminal included in the medical information managing system according to the present embodiment; 
         FIG. 3  is a diagram illustrating attribute data stored in an attribute storing device of the client terminal; 
         FIG. 4  is a schematic diagram illustrating a modified example of configurations of the servers and the client terminal included in the medical information managing system according to the present embodiment; 
         FIG. 5  is a diagram illustrating attribute data stored in an attribute storing device of a medical image storing apparatus; 
         FIG. 6  is a diagram illustrating attribute data stored in an attribute storing device of a medical report storing apparatus; 
         FIG. 7  is a block diagram illustrating a first function of the medical information managing system according to the present embodiment; 
         FIG. 8  is a diagram illustrating an example of a medical image displaying screen and a medical report creating screen that are displayed on a displaying device and concern a required patient ID; 
         FIG. 9  is a diagram to explain procedures of identifying a patient; 
         FIG. 10  is a conceptual diagram to explain a method of comparing a plurality of pieces of patient information displayed by a plurality of medical applications; 
         FIG. 11  is a diagram illustrating an example of a normal state and a dangerous state displayed on the displaying device; 
         FIG. 12  is a diagram illustrating a first example of the dangerous state displayed on the displaying device; 
         FIG. 13  is a diagram illustrating a second example of the dangerous state displayed on the displaying device; 
         FIG. 14  is a block diagram illustrating a second function of the medical information managing system according to the present embodiment; 
         FIG. 15  is a diagram illustrating a first example of a warning state displayed on the displaying device; and 
         FIG. 16  is a diagram illustrating a second example of the warning state displayed on the displaying device. 
     
    
    
     DETAILED DESCRIPTION 
     A medical information managing system, a medical information managing apparatus, and a medical information displaying apparatus according to the present embodiment is described with reference to the attached drawings. 
     To solve the above-described problems, the present embodiments provide the medical information managing system includes: a display instructing unit configured to generate data of a screen that shows medical data concerning patient information and to instruct a display device to display the screen if the medical data concerning the patient information is acquired from a storing device and if a medical application for displaying the acquired medical data is executed; and an identity determining unit configured to determine, if a plurality of the medical applications are executed, an identity of a plurality of pieces of patient information corresponding to the respective medical applications. 
     To solve the above-described problems, the present embodiments provide the medical information managing apparatus includes: a display instructing unit configured to generate data of a screen that shows medical data concerning patient information and to instruct an outside medical information displaying apparatus to display the screen if the medical data concerning the patient information is acquired from a storing device and if a medical application for displaying the acquired medical data is executed; and an identity determining unit configured to determine, if a plurality of the medical applications are executed, an identity of a plurality of pieces of patient information corresponding to the respective medical applications. 
     To solve the above-described problems, the present embodiments provide the medical information displaying apparatus includes: a display instructing unit configured to generate data of a screen that shows medical data concerning patient information and to instruct a display device to display the screen if the medical data concerning the patient information is acquired from a storing device and if a medical application for displaying the acquired medical data is executed; and an identity determining unit configured to determine, if a plurality of the medical applications are executed, an identity of a plurality of pieces of patient information corresponding to the respective medical applications. 
       FIG. 1  is a schematic diagram illustrating a configuration of a medical information managing system according to the present embodiment. 
       FIG. 1  illustrates a medical information managing system  1  according to the present embodiment. The medical information managing system  1  includes a medical image generating apparatus (modality)  11 , a server  12 , and a client terminal  13 . Examples of the server  12  include a medical image storing apparatus  12   a , a medical report storing apparatus  12   b , and an electronic medical chart storing apparatus  12   c . The medical image generating apparatus (modality)  11 , the server  12 , and the client terminal  13  can communicate with one another through a network N such as a local area network (LAN). Note that the medical information managing system  1  may include a plurality of the medical image generating apparatuses (modalities)  11 , the servers  12 , and/or the client terminals  13 . 
     The medical image generating apparatus  11  photographs an examination region of a patient as an object, and generates a medical image of the examination region as medical data. The generated medical image is transmitted as DICOM data to the medical image storing apparatus  12   a.    
     The medical image storing apparatus  12   a  as the server  12  stores the medical image transmitted from the medical image generating apparatus  11 , and manages the medical image in the form of a database. 
     The medical report storing apparatus  12   b  as the server  12  stores a medical report as medical data into which findings and the like about the medical image are written, and manages the medical report in the form of a database. 
     The electronic medical chart storing apparatus  12   c  as the server  12  stores an electronic medical chart as medical data into which a disease name, contents of a medical interview, and the like are written, and manages the electronic medical chart in the form of a database. 
     In order to enable an operator to create a medical report, the client terminal  13  receives and displays the medical data such as the medical image, the medical report, and the electronic medical chart stored in the respective servers  12 , in accordance with an instruction of the operator. 
     The medical data from each server  12  is displayed on the client terminal  13  by executing a medical application provided by each server  12 . Accordingly, screens of a large number of medical applications are displayed on the client terminal  13  using the large number of medical applications. The medical applications provided by the servers  12  are roughly classified into: an image displaying application provided by the medical image storing apparatus  12   a ; a report creating application provided by the medical report storing apparatus  12   b ; and an electronic medical chart displaying application provided by the electronic medical chart storing apparatus  12   c . The image displaying application is further divided into a 2D image displaying application and a 3D image displaying application. Further, in the case where medical applications in the same classification are provided by a plurality of makers, for example, a first medical image storing apparatus that provides a first image displaying application and a second medical image storing apparatus that provides a second image displaying application may exist as the medical image storing apparatus  12   a  in the same classification in some cases, so that the client terminal  13  displays screens of various kinds of medical applications. 
       FIG. 2  is a schematic diagram illustrating configurations of the servers  12  and the client terminal  13  included in the medical information managing system  1  according to the present embodiment. Note that, in  FIG. 2 , the medical image storing apparatus  12   a  and the medical report storing apparatus  12   b  of the servers  12  are described as an example. 
     The medical image storing apparatus  12   a  includes a processing device (CPU)  31 , a memory  32 , a receiving device  33 , a medical image database (DB)  34 , a medical application storing device  35 , and a transmitting device  36 . 
     The processing device  31  is a control unit having a large-scale integration (LSI) circuit configuration in which an electronic circuit formed of a semiconductor is sealed in a package having a plurality of terminals. The processing device  31  executes programs stored in the memory  32  and the medical application storing device  35 . The processing device  31  executes a medical application stored in the medical application storing device  35 , to thereby provide a screen and logic of the executed medical application and a medical image stored in the medical image DB  34  to the client terminal  13  through the transmitting device  36 . In addition, the processing device  31  functions as a system (DBMS) that manages the medical image DB  34 , and implements processes such as sharing, protection, search, and update of a medical image as the medical data. 
     The memory  32  is a memory device including a read only memory (ROM) and a random access memory (RAM). The memory  32  is used as a working memory of the processing device  31  and is also used to temporarily store data. 
     The receiving device  33  receives medical data transmitted from the client terminal  13 . 
     The medical image DB  34  stores a medical image as the medical data. 
     The medical application storing device  35  stores the image displaying application as a medical application for providing a medical image to the client terminal  13 . 
     The transmitting device  36  transmits medical data to the client terminal  13 . 
     The medical report storing apparatus  12   b  includes a processing device (CPU)  41 , a memory  42 , a receiving device  43 , a medical report DB  44 , a medical application storing device  45 , and a transmitting device  46 . 
     The processing device  41  is a control unit having the large-scale integration circuit configuration in which an electronic circuit formed of a semiconductor is sealed in a package having a plurality of terminals, similarly to the processing device  31 . The processing device  41  executes programs stored in the memory  42  and the medical application storing device  45 . The processing device  41  executes a medical application stored in the medical application storing device  45 , to thereby provide a screen and logic of the executed medical application and a medical report stored in the medical report DB  44  to the client terminal  13  through the transmitting device  46 . In addition, the processing device  41  functions as a system that manages the medical report DB  44 , and implements processes such as sharing, protection, search, and update of a medical report as the medical data. 
     The memory  42  is a memory device including a ROM and a RAM, similarly to the memory  32 . The memory  42  is used as a working memory of the processing device  41  and is also used to temporarily store data. 
     The receiving device  43  receives medical data transmitted from the client terminal  13 , similarly to the receiving device  33 . 
     The medical report DB  44  stores a medical report as the medical data. 
     The medical application storing device  45  stores the report creating application as a medical application for providing a report application to the client terminal  13 . 
     The transmitting device  46  transmits data to the client terminal  13 , similarly to the transmitting device  36 . 
     The medical image storing apparatus  12   a  and the medical report storing apparatus  12   b  link with each other using a patient ID through the processing devices  31  and  41 . 
     The client terminal  13  includes a processing device (CPU)  51 , a memory  52 , an input device  53 , a displaying device  54 , a transmitting device  55 , a receiving device  56 , an attribute storing device  57 , and a monitoring device  58 . 
     The processing device  51  is a control unit having the large-scale integration circuit configuration in which an electronic circuit formed of a semiconductor is sealed in a package having a plurality of terminals. If the operator operates the input device  53  to thereby input a command, the processing device  51  executes a program stored in the memory  52 . The processing device  51  provides a graphical user interface (GUI) that uses many graphics for displaying information for the operator on the displaying device  54  and enables the operator to perform a basic operation using the input device  53 . 
     The memory  52  is a memory device including a ROM and a RAM. The memory  52  is used as a working memory of the processing device  51  and is also used to temporarily store data. 
     The input device  53  is a pointing device that can be operated by the operator, and an input signal according to the operation is transmitted to the processing device  51 . 
     The displaying device  54  includes an image synthesizing circuit, a video random access memory (VRAM), and a display, which are not illustrated. The displaying device  54  displays a screen of each medical application provided through the receiving device  56 . 
     The transmitting device  55  transmits a display request (request) of medical data created by the processing device  51  to the receiving device  33  of the medical image storing apparatus  12   a  and the receiving device  43  of the medical report storing apparatus  12   b . The transmitting device  55  also transmits the medical data created by the processing device  51  to the receiving device  33  of the medical image storing apparatus  12   a  and the receiving device  43  of the medical report storing apparatus  12   b.    
     The receiving device  56  receives a screen and logic of an executed medical application and medical data requested to be displayed, from the transmitting device  36  of the medical image storing apparatus  12   a  or the transmitting device  46  of the medical report storing apparatus  12   b.    
     The attribute storing device  57  stores attribute data concerning a medical application for displaying, on the screen, discrimination information of a patient such as a patient identification (ID), among medical applications executed by the server  12 . The attribute data of the medical application is set in advance by an operator or a service staff. The attribute data of the medical application contains at least necessity data of identity determination of a displayed patient and displaying region data as described with reference to  FIG. 3 . 
     As illustrated in  FIG. 10  to be described later, the monitoring device  58  compares a patient ID (M 1234 ) transmitted from an examination list application with a patient ID transmitted from the image displaying application, and also compares the patient ID (M 1234 ) transmitted from the examination list application with a patient ID transmitted from the report creating application, to thereby determine whether or not the image displaying application and the report creating application each display the patient ID (M 1234 ) requested to be displayed. That is, the monitoring device  58  determines whether or not a mismatch between the patient IDs occurs. The monitoring device  58  may actively acquire the patient IDs from the examination list application, the image displaying application, and the report creating application, instead of passively acquiring the patient IDs from the respective applications. 
       FIG. 3  is a diagram illustrating the attribute data stored in the attribute storing device  57  of the client terminal  13 . 
     As illustrated in  FIG. 3 , the attribute data of the medical application contains the necessity data indicating whether or not this medical application requires having an identity of a displayed patient between this medical application and another medical application. 
     Some medical applications provide to the client terminal  13  display a patient ID, and other medical applications provided thereto do not display a patient ID. Examples of the former medical applications include: the image displaying application (ID: viewer) executed by the medical image storing apparatus  12   a ; the report creating application (ID: report) and a similar disease case searching application (ID: similar image seach) executed by the medical report storing apparatus  12   b ; and the electronic medical chart displaying application (ID: chart) executed by the electronic medical chart storing apparatus  12   c  (illustrated in  FIG. 1 ). Here, in the case as illustrated in a lower part of  FIG. 3  where the medical information managing system  1  includes a plurality of the servers  12  in the same classification, for example, a plurality of the medical image storing apparatuses  12   a , the attribute data of the medical application contains the necessity data for each image displaying application (ID: No. 1 _viewer, No. 2 _viewer) of the plurality of medical image storing apparatuses  12   a.    
     Meanwhile, examples of the latter medical applications include: a disease case information displaying application (ID: disease_info) for displaying disease case information; and an administrative information displaying application for displaying administrative information in a hospital. In the first place, the latter medical applications do not need to be required to have the identity of the displayed patient between these latter medical applications and another medical application. 
     Further, some former medical applications are required to have the identity of the displayed patient between these former medical applications and another medical application, and other former medical applications are not required to have the same. For example, the similar disease case searching application executed by the medical report storing apparatus  12   b  is a medical application for searching for and displaying medical images with findings that are similar to image findings about a patient whose radiogram is currently interpreted, and patients of the medical images as search results do not require being identical with each other. 
     As illustrated in  FIG. 3 , the attribute data of the medical application further contains the displaying region data of a patient ID on a screen of an executed medical application. The displaying region data is designated on the screen of the executed medical application using an x-coordinate (x), a y-coordinate (y), a width (w), and a height (h). Note that the displaying region data does not necessarily need to be fixed values, and may be a formula for calculating the displaying region. As illustrated in  FIG. 3 , the image displaying application (ID: viewer) as the medical application is set so as to display the patient ID using displaying region data “x: 10, y: 10, w: 300, h: 50” on the screen. 
     Note that, in  FIG. 2 , the client terminal  13  includes the attribute storing device  57  that collectively stores pieces of attribute data of the medical application, but the present embodiment is not limited thereto. For example, another apparatus connected to the network N may include the attribute storing device  57 . Alternatively, for example, each server  12  may include the attribute storing device  57  together with the medical application. 
       FIG. 4  is a schematic diagram illustrating a modified example of configurations of the servers  12  and the client terminal  13  included in the medical information managing system  1  according to the present embodiment. 
     The medical image storing apparatus  12   a  includes the processing device  31 , the memory  32 , the receiving device  33 , the medical image DB  34 , the medical application storing device  35 , the transmitting device  36 , and an attribute storing device  57   a . Note that, in  FIG. 4 , the same components as those in  FIG. 2  are denoted by the same reference signs, and description thereof is omitted. 
     The attribute storing device  57   a  stores only attribute data concerning the medical application stored in the medical application storing device  35 , among the pieces of attribute data stored in the attribute storing device  57  illustrated in  FIG. 2 . The medical application storing device  35  of the medical image storing apparatus  12   a  illustrated in  FIG. 4  stores the image displaying application as the medical application, and hence the attribute storing device  57   a  stores only the attribute data concerning the image displaying application. The attribute data stored in the attribute storing device  57   a  is illustrated in  FIG. 5 . 
     The medical report storing apparatus  12   b  includes the processing device  41 , the memory  42 , the receiving device  43 , the medical report DB  44 , the medical application storing device  45 , the transmitting device  46 , and an attribute storing device  57   b.    
     The attribute storing device  57   b  stores only attribute data concerning the medical application stored in the medical application storing device  45 , among the pieces of attribute data stored in the attribute storing device  57  illustrated in  FIG. 2 . The medical application storing device  45  of the medical report storing apparatus  12   b  illustrated in  FIG. 4  stores the report creating application as the medical application, and hence the attribute storing device  57   b  stores only the attribute data concerning the report creating application. The attribute data stored in the attribute storing device  57   b  is illustrated in  FIG. 6 . 
       FIG. 7  is a block diagram illustrating a first function of the medical information managing system  1  according to the present embodiment. 
     When the processing device  51  illustrated in  FIG. 2  executes a program, as illustrated in  FIG. 7 , the client terminal  13  functions as a patient setting unit  61 , an application screen display instructing unit  62 , an application ID identifying unit  63 , an identity necessity determining unit  64 , a number-of-applications calculating unit  65 , an on-screen patient identifying unit  66 , an identity determining unit  67 , a determination result display instructing unit  68 , and a record instructing unit  69 . Note that the entirety or a part of the components  61  to  69  of the client terminal  13  may be included in the client terminal  13  in the form of hardware. In addition, the entirety or a part of the components  61  to  69  may be included in any of the servers  12 . 
     The patient setting unit  61  has a function of setting a patient (patient ID) for which a medical report should be created, on the basis of an input signal that is inputted by the operator through the input device  53  with the use of an examination list screen (examination list application) and the like. 
     The application screen display instructing unit  62  has: a function of transmitting, to the server  12 , a display request of medical data corresponding to the patient ID set by the patient setting unit  61 ; and a function of receiving: a screen and logic of a medical application executed for displaying medical data requested to be displayed; and the medical data requested to be displayed, to thereby instruct the displaying device  54  to display the screen of the executed application. For example, the application screen display instructing unit  62  receives: a screen and logic of the image displaying application executed for displaying a medical image corresponding to the patient ID set by the patient setting unit  61 ; and the medical image requested to be displayed, from the medical image storing apparatus  12   a , to thereby instruct the displaying device  54  to display the screen of the executed image displaying application. The application screen display instructing unit  62  also receives: a screen and logic of the report creating application executed for displaying a medical report corresponding to the patient ID set by the patient setting unit  61 ; and the medical report requested to be displayed, from the medical report storing apparatus  12   b , to thereby instruct the displaying device  54  to display the screen of the executed report creating application. An example of a medical image displaying screen Ii and a medical report creating screen Ir that are displayed on the displaying device  54  and concern a required patient ID (ID: M 1234 ) is illustrated in  FIG. 8 . 
     The application ID identifying unit  63  has a function of identifying an ID of a medical application that is received from the server  12  by the application screen display instructing unit  62 , at timing at which a screen is displayed by a display instruction from the application screen display instructing unit  62  or in a predetermined cycle. The medical application ID is identified using information of a process and information of association with the medical application ID. The information of association is given in advance by an operator or a service staff. 
     A typical process of identifying a medical application ID by the application ID identifying unit  63  is performed in the following manner. The application ID identifying unit  63  acquires a list of processes of the medical application received by the application screen display instructing unit  62 . Each process includes information such as a name managed by an operating system (OS) and a path name of an executable file. The application ID identifying unit  63  acquires information of each process from the OS, and identifies the medical application ID on the basis of information of association between the acquired information and the medical application ID. Note that a medical application that is not associated with the medical application ID is excluded from targets of the identity determination of the displayed patient. 
     The identity necessity determining unit  64  has a function of determining whether or not the medical application having the medical application ID identified by the application ID identifying unit  63  must have the identity of the displayed patient between this medical application and another medical application, on the basis of the attribute data that corresponds to the medical application ID identified by the application ID identifying unit  63  and is stored in the attribute storing device  57 . For example, the identity necessity determining unit  64  refers to the attribute data of the image displaying application stored in the attribute storing device  57 , and determines whether or not the image displaying application must have the identity of the displayed patient between this image displaying application and the report creating application. Similarly, the identity necessity determining unit  64  refers to the attribute data of the report creating application stored in the attribute storing device  57 , and determines whether or not the report creating application must have the identity of the displayed patient between this report creating application and the image displaying application. 
     The number-of-applications calculating unit  65  has a function of calculating the number of medical applications that are determined by the identity necessity determining unit  64  as being required to have the identity of the displayed patient. In the case where the number of medical applications that are determined by the identity necessity determining unit  64  as being required to have the identity of the displayed patient is 0 or 1, the number-of-applications calculating unit  65  stands by for setting of a patient ID by the patient setting unit  61 . 
     The on-screen patient identifying unit  66  has a function of identifying, if the number of medical applications calculated by the number-of-applications calculating unit  65  that are determined as being required to have the identity of the displayed patient is more than one, a plurality of pieces of patient information, for example, patient IDs, that are actually displayed on a plurality of screens corresponding to the respective medical applications that are determined as being required to have the identity of the displayed patient. 
     In principle, the medical application that displays a patient ID always displays the patient ID that identifies the patient within the screen of the medical application, in order to prevent the operator from making a wrong diagnosis. 
       FIG. 9  is a diagram to explain procedures of identifying a patient. 
     As illustrated in an upper part of  FIG. 9 , the displaying device  54  displays a plurality of screens that concern a required patient ID (ID: M 1234 ) and correspond to respective medical applications that are required to have the identity of the displayed patient, for example, the medical image displaying screen Ii and the medical report creating screen Ir. The attribute storing device  57  stores displaying region data of the patient ID on the medical image displaying screen Ii and displaying region data of the patient ID on the medical report creating screen Ir. 
     As illustrated in a middle part of  FIG. 9 , the displaying region of the patient ID on the medical report creating screen Ir is captured on the basis of the medical report creating screen Ir illustrated in the upper part of  FIG. 9  and the displaying region data of the report creating application. Then, an optical character reader (OCR) is applied to the captured image, and a character string included in the captured image is extracted as illustrated in a lower part of  FIG. 9 . The extracted character string is identified as the patient ID of the patient being displayed on the medical report creating screen Ir. Also for the medical image displaying screen Ii, the extracted character string is identified as the patient ID of the patient being displayed on the medical image displaying screen Ii, similarly to the medical report creating screen Ir. 
     The identity determining unit  67  illustrated in  FIG. 7  has a function of determining the identity of a plurality of pieces of patient information corresponding to respective screens that are actually displayed in accordance with a plurality of display instructions obtained by executing a plurality of medical applications. The identity determining unit  67  compares the plurality of pieces of patient information, for example, patient IDs, that are identified by the on-screen patient identifying unit  66  and correspond to the respective screens, to thereby determine whether or not a mismatch between the patient IDs occurs. The identity determining unit  67  determines whether the client terminal  13  is in a normal state in which a plurality of screens of the same patient ID are displayed on the displaying device  54 , or a dangerous state in which a plurality of screens of different patient IDs are displayed on the displaying device  54  in spite of the fact that the identity of the displayed patient is required. In the case of the normal state, the identity determining unit  67  stands by for setting of a patient ID by the patient setting unit  61 . 
     Note that description is given above of the case where the on-screen patient identifying unit  66  identifies the plurality of patient IDs actually displayed on the plurality of screens, on the basis of the displaying region data contained in the attribute data stored in the attribute storing device  57  and where the identity determining unit  67  compares the plurality of patient IDs actually displayed on the plurality of screens, but the present embodiment is not limited thereto. Another example is described with reference to  FIG. 10 . 
       FIG. 10  is a conceptual diagram to explain a method of comparing a plurality of pieces of patient information displayed by a plurality of medical applications. 
     As illustrated in  FIG. 10 , the image displaying application (ID: viewer) and the report creating application (ID: report) are executed in response to a display request of the patient ID (M 1234 ) that is set on the examination list screen (examination list application) by the patient setting unit  61 , and the screen illustrated in  FIG. 8  is displayed on the displaying device  54 . In addition, the examination list application transmits, to the monitoring device  58 , a message to the effect that the display request of the patient ID (M 1234 ) has been made. 
     Meanwhile, the image displaying application and the report creating application each transmit the patient ID actually displayed on the screen to the monitoring device  58 . At this time, by means of a monitoring application, the monitoring device  58  compares the patient ID (M 1234 ) of the display request transmitted from the examination list application with the actually displayed patient ID transmitted from the image displaying application, and also compares the patient ID (M 1234 ) of the display request transmitted from the examination list application with the actually displayed patient ID transmitted from the report creating application. In this way, the monitoring device  58  determines whether or not the image displaying application and the report creating application each display the patient ID (M 1234 ) requested to be displayed. That is, the monitoring device  58  determines whether or not a mismatch between the patient IDs occurs. 
     Alternatively, the image displaying application and the report creating application each transmit the patient ID actually displayed on the screen to the monitoring device  58 . At this time, by means of the monitoring application, the monitoring device  58  compares the actually displayed patient ID transmitted from the image displaying application with the actually displayed patient ID transmitted from the report creating application. In this way, the monitoring device  58  determines whether or not the image displaying application and the report creating application each display the patient ID (M 1234 ) requested to be displayed. 
       FIG. 11  is a diagram illustrating an example of the normal state and the dangerous state displayed on the displaying device  54 . 
     An upper part of  FIG. 11  illustrates a combination example of the patient IDs that is determined as the normal state by the identity determining unit  67 . In the upper part of  FIG. 11 , the patient ID displayed by the image displaying application (ID: viewer) is identical with the patient ID displayed by the report creating application (ID: report). 
     A lower part of  FIG. 11  illustrates a combination example of the patient IDs that is determined as the dangerous state by the identity determining unit  67 . In the lower part of  FIG. 11 , the patient ID displayed by the image displaying application (ID: viewer) is different from the patient ID displayed by the report creating application (ID: report). 
     The determination result display instructing unit  68  illustrated in  FIG. 7  has a function of instructing, if the determination result by the identity determining unit  67  shows that the client terminal  13  is in the dangerous state, the displaying device  54  to display this fact. If the dangerous state is displayed on the displaying device  54 , the determination result display instructing unit  68  stands by for setting of a patient ID by the patient setting unit  61 . 
       FIG. 12  is a diagram illustrating a first example of the dangerous state displayed on the displaying device  54 . 
     The example illustrated in  FIG. 12  shows the dangerous state displayed for the operator, in which the image displaying application (ID: viewer) and the report creating application (ID: report) display different patient IDs as illustrated in the lower part of  FIG. 11 . In the example illustrated in  FIG. 12 , countermeasures to be taken by the operator are displayed in addition to the dangerous state and contents of the dangerous state, on the screen (illustrated in  FIG. 8 ) that is displayed on the displaying device  54  by the application screen display instructing unit  62 . Accordingly, the operator can recognize the displayed dangerous state while viewing the screen that is displayed on the displaying device  54  by the application screen display instructing unit  62 . 
       FIG. 13  is a diagram illustrating a second example of the dangerous state displayed on the displaying device  54 . 
     The example illustrated in  FIG. 13  shows the dangerous state displayed for the operator, in which the image displaying application (ID: viewer) and the report creating application (ID: report) display different patient IDs as illustrated in the lower part of  FIG. 11 . In the example illustrated in  FIG. 13 , a portion of the entire screen (illustrated in  FIG. 8 ) that is displayed on the displaying device  54  by the application screen display instructing unit  62  is masked, the portion being other than the patient ID portion that is desired to be reported to the operator. Further, an “OK” button is placed on the screen. Then, the entire screen on the displaying device  54  is locked until the operator who operates the input device  53  pushes the “OK” button on the screen. If the operator pushes the “OK” button on the screen, the masking is cancelled, and the determination result display instructing unit  68  stands by for setting of a patient ID by the patient setting unit  61 . Accordingly, the operator can recognize the displayed dangerous state while viewing the screen that is displayed on the displaying device  54  by the application screen display instructing unit  62 . 
     According to the displaying methods illustrated in  FIG. 12  and  FIG. 13 , the dangerous state, in which the identity of the displayed patient does not exist between a plurality of medical applications that are required to have the identity of the displayed patient, can be easily reported to the operator. 
     The record instructing unit  69  illustrated in  FIG. 7  has a function of instructing, if the identity determining unit  67  determines that the client terminal  13  is in the dangerous state, the memory  52  and the like to record the dangerous state of the client terminal  13 . A recording destination of the record instructing unit  69  is an event log or a document (a report and the like) being created in the corresponding state. Information recorded by the record instructing unit  69  contains at least occurrence of the dangerous state, occurrence time, and contents of the dangerous state. In addition, when the operator refers to a document being created in the dangerous state, the information recorded by the record instructing unit  69  may be presented to the operator in order to inform the operator of the fact that contents thereof may include a wrong diagnosis. 
       FIG. 14  is a block diagram illustrating a second function of the medical information managing system  1  according to the present embodiment. 
     When the processing device  51  illustrated in  FIG. 2  executes a program, as illustrated in  FIG. 14 , the client terminal  13  functions as the patient setting unit  61 , the application screen display instructing unit  62 , the application ID identifying unit  63 , the identity necessity determining unit  64 , the number-of-applications calculating unit  65 , the on-screen patient identifying unit  66 , the identity determining unit  67 , a warning state determining unit  70 , a determination result display instructing unit  71 , and a record instructing unit  72 . Note that the entirety or a part of the components  61  to  67  and  70  to  72  of the client terminal  13  may be included in the client terminal  13  in the form of hardware. In addition, the entirety or a part of the components  61  to  67  and  70  to  72  may be included in any of the servers  12 . In  FIG. 14 , the same components as those in FIG.  7  are denoted by the same reference signs, and description thereof is omitted. 
     The warning state determining unit  70  has a function of determining whether the normal state determined by the identity determining unit  67  is a normal state kept in the future or a warning state in which the client terminal  13  may come into the dangerous state in the future, according to future prospects of the current normal state on the basis of a process state of the client terminal  13 . The warning state determining unit  70  determines whether the normal state determined by the identity determining unit  67  is the normal state kept in the future corresponding to a state where the process of the client terminal  13  is not locked or is the warning state where the process has no response. In the case of this warning state, the medical application locks the process. 
     The determination result display instructing unit  71  has a function of instructing, if the determination result by the identity determining unit  67  or the warning state determining unit  70  shows that the client terminal  13  is in the dangerous state or the warning state, the displaying device  54  to display this fact. If the dangerous state or the warning state is displayed on the displaying device  54 , the determination result display instructing unit  71  stands by for setting of a patient ID by the patient setting unit  61 . 
       FIG. 15  is a diagram illustrating a first example of the warning state displayed on the displaying device  54 . 
     The example illustrated in  FIG. 15  shows the warning state displayed for the operator, in which the process has no response although the client terminal  13  is in the normal state where the image displaying application (ID: viewer) and the report creating application (ID: report) display the same patient ID as illustrated in the upper part of  FIG. 11 . In the example illustrated in  FIG. 15 , countermeasures to be taken by the operator are displayed in addition to the warning state and contents of the warning state, on the screen (illustrated in  FIG. 8 ) that is displayed on the displaying device  54  by the application screen display instructing unit  62 . Accordingly, the operator can recognize the displayed warning state while viewing the screen that is displayed on the displaying device  54  by the application screen display instructing unit  62 . 
     Alternatively, the warning state determining unit  70  illustrated in  FIG. 14  has a function of determining whether the normal state determined by the identity determining unit  67  is a normal state kept in the future or a warning state in which the client terminal  13  may come into the dangerous state in the future, according to future prospects of the current normal state on the basis of an echo response from the server  12 . The warning state determining unit  70  determines whether the normal state determined by the identity determining unit  67  is the normal state kept in the future corresponding to a state where a response to an echo request to the server  12  is obtained or is the warning state corresponding to a state where no response to the echo request to the server  12  is obtained. In the case of this warning state, the server  12  has been down. 
     Alternatively, the warning state determining unit  70  has a function of determining, if a plurality of the client terminals  13  exist, whether the normal state determined by the identity determining unit  67  is a normal state kept in the future or a warning state in which the client terminal  13  may come into the dangerous state in the future, according to future prospects of the current normal state on the basis of an echo response from another client terminal. The warning state determining unit  70  determines whether the normal state determined by the identity determining unit  67  is the normal state kept in the future corresponding to a state where a response to an echo request to the another client terminal is obtained or is the warning state corresponding to a state where no response to the echo request to the another client terminal is obtained. In the case of this warning state, the network N has been shut down. 
       FIG. 16  is a diagram illustrating a second example of the warning state displayed on the displaying device  54 . 
     The example illustrated in  FIG. 16  shows the warning state displayed for the operator, in which the network N is in an abnormal state although the client terminal  13  is in the normal state where the image displaying application (ID: viewer) and the report creating application (ID: report) display the same patient ID as illustrated in the upper part of  FIG. 11 . In the example illustrated in  FIG. 16 , countermeasures to be taken by the operator are displayed in addition to the warning state and contents of the warning state, on the screen (illustrated in  FIG. 8 ) that is displayed on the displaying device  54  by the application screen display instructing unit  62 . Accordingly, the operator can recognize the displayed warning state while viewing the screen that is displayed on the displaying device  54  by the application screen display instructing unit  62 . Further, the display of the dangerous state illustrated in  FIG. 13  can be applied to the display of the warning state. 
     The record instructing unit  72  illustrated in  FIG. 14  has a function of recording the dangerous state or the warning state of the client terminal  13  if the identity determining unit  67  determines that the client terminal  13  is in the dangerous state or if the warning state determining unit  70  determines that the client terminal  13  is in the warning state. A recording destination of the record instructing unit  72  is an event log or a document (a report and the like) being created in the corresponding state. Information recorded by the record instructing unit  72  contains at least occurrence of the dangerous state or the warning state, occurrence time, and contents of the dangerous state or the warning state. In addition, when the operator refers to a document being created in the dangerous state or the warning state, the information recorded by the record instructing unit  72  may be presented to the operator in order to inform the operator of the fact that contents thereof may include a wrong diagnosis. 
     Note that the medical information managing system  1  according to the present embodiment is described on the assumption that each medical application cannot display a plurality of pieces of patient information at the same time, that is, one medical application can display patient information of only one person at the same time. 
     Alternatively, the present embodiment can be expanded so as to cover a medical application that can display a plurality of pieces of patient information at the same time. In this case, the plurality of pieces of patient information are identified within a screen of the one medical application, and the identity of the patient is determined using the plurality of pieces of identified patient information. That is, in the case where one medical application displays pieces of patient information of two different persons, the client terminal  13  comes into the dangerous state at the moment at which a screen of the one medical application is displayed. 
     In the medical information managing system  1  according to the present embodiment, even in the case where different patient IDs are displayed on a plurality of screens corresponding to respective medical applications that are required to have the identity of the patient therebetween, the dangerous state, the warning state, and their countermeasures can be reported to the operator, so efficiency of operator&#39;s work can be improved. 
     Further, in the medical information managing system  1  according to the present embodiment, even in the case where different patient IDs are displayed on a plurality of screens corresponding to respective medical applications that are required to have the identity of the patient therebetween, the dangerous state and the warning state can be reported to the operator, so a risk of patient mix-up by the operator can be reduced. 
     Note that the above-mentioned embodiment is based on the assumption that the medical data from each server  12  is displayed on the client terminal  13  by executing the medical application provided by each server  12 . The medical application does not necessarily need to be provided by each server  12 , and may be stored in the client terminal  13  itself. In this case, the medical application storing devices  35  and  45  and the medical image DBs  34  and  44  included in the respective servers  12  illustrated in  FIG. 2  also exist in the client terminal  13 . Then, the processing device  51  executes a medical application stored in the medical application storing device of the client terminal  13 , to thereby display a screen and logic of the executed medical application and a medical image stored in the medical image DB  34 ,  44  or the medical image DB of the client terminal  13 . Also in such an embodiment, the attribute storing device  57  manages an attribute of the medical application stored in the client terminal  13 , whereby an effect similar to that of the above-mentioned embodiment can be obtained. 
     While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.