Patent Publication Number: US-2016239616-A1

Title: Medical support system, method and apparatus for medical care

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims priority under 35 USC 119 from Japanese Patent Application No. 2015-025389, filed 12 Feb. 2015, the disclosure of which is incorporated by reference herein. 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a medical support system, method and apparatus for medical care. More particularly, the present invention relates to a medical support system, method and apparatus for medical care, in which plural sets of timeline information of medical care for one common patient can be viewed and utilized easily. 
     2. Description Related to the Prior Art 
     In case an injury or acute disease occurs to a person, he or she as a patient requires medical care of a doctor. An ambulance is used to transport the patient to a hospital by emergency action of paramedics. The patient is diagnosed and treated medically in the hospital in emergency medicine. The doctor in the hospital sees and checks up the patient to find symptoms of the injury, disease or disorder. Treatment of the patient is performed after deciding a plan of the treatment on the basis of the diagnosis. In the emergency medicine, doctors, nurses and other medical professionals perform intervention to the patient in a medical team in a rapid manner. There is conception of sharing medical care information between the doctors, nurses and other medical professionals for the purpose of effectively performing medical care to the patient. 
     U.S. Pat. Pub. No. 2009/222,286 (corresponding to JP-A 2009-518732) discloses a medical support system. A medical support server apparatus generates timeline information (workflow information) in which the medical care information, such as a diagnostic image and progress note of the patient, is arranged and managed along a timeline bar of a time sequence. The server apparatus transmits the timeline information to plural client terminal apparatuses used by the doctors, nurses and other medical professionals. In the medical support system, the medical care information of the patient is registered with the timeline information. It is possible for the doctors, nurses and other medical professionals to share the medical care information of the patient by use of the timeline information. Progress of a medical condition of the patient can be grasped readily with high visual perceptibility. 
     The medical care information of one patient is registered in one set of the timeline information. Plural sets of the timeline information are managed by use of case IDs which are allocated to respectively patients by the hospital where the patients are cared. Also, information of the doctors, nurses and other medical professionals is registered with the timeline information on a condition of permission of access to the timeline information. 
     However, the timeline information is managed by each one of medical service providers such as a hospital in the medical support system in U.S. Pat. Pub. No. 2009/222,286. There is a problem in impossibility of using the timeline information for a medical professional in one of the medical service providers after creation of the timeline information in a different one of the medical service providers, even though plural sets of the timeline information have been generated for the same patient. 
     Let the patient be transported to a hospital by the ambulance. The paramedics in an ambulance crew or paramedic team perform prehospital treatment to the patient in an emergency site where the ambulance has arrived. The ambulance crew constitutes one of the medical service providers for medical care of the patient. In case the patient is transported to a first hospital facility by the ambulance crew, the patient is cared in the first hospital facility as a succeeding one of the medical service providers. Furthermore, in case the patient is transferred to a second hospital facility different from the first hospital facility, the patient is cared in the second hospital facility as another one of the medical service providers. The timeline information can be created by each one of the ambulance crew, the first hospital facility and the second hospital facility. Thus, three sets of the timeline information become created for the same patient as a result of medical care in the three medical service providers. 
     In the medical care for the patient, information of the past medical care for him or her is very important. For example, medical care information of the ambulance crew is important in the first hospital facility. Medical care information of the ambulance crew and the first hospital facility is important in the second hospital facility. 
     In the medical support system of U.S. Pat. Pub. No. 2009/222,286, the timeline information is produced in each one of the medical service providers. Assuming that there is agreement between the first and second hospital facilities, the timeline information may be exchanged between the medical support systems of the first and second hospital facilities by use of network connection or the like. However, the timeline information is managed by use of the ID information allocated by each one of the medical service providers exclusively. It is impossible in a second one of the medical service providers to specify the timeline information provided from a first one of the medical service providers, because the case ID of a patient of the first medical service provider cannot be used in the second medical service provider. The use of the timeline information is very difficult, as specific information of the patient, such as a name, age, sex and address, must be used for identification for the purpose of utilizing the timeline information of the other medical service provider. 
     SUMMARY OF THE INVENTION 
     In view of the foregoing problems, an object of the present invention is to provide a medical support system, method and apparatus for medical care, in which plural sets of timeline information of medical care for one common patient can be viewed and utilized easily. 
     In order to achieve the above and other objects and advantages of this invention, a medical support system for providing timeline information having medical care information of a patient arranged in a time sequence for use in medical care of the patient is provided. A timeline entry device registers the timeline information in a storage medium in association with biometric information for identifying the patient. A timeline readout device reads out the timeline information from the storage medium by search upon identity verification of the biometric information. There is an information distributor for information distribution of the timeline information being read out. 
     Preferably, furthermore, a timeline matching device operates upon acquiring plural sets of the timeline information with identity verification of the biometric information, and generates multi-user timeline information by matching the plural sets of the timeline information in the time sequence. 
     Preferably, the timeline entry device registers associated information in association with the timeline information, and the associated information is used for determining permission of access to the timeline information. 
     Preferably, the associated information includes at least one of user information of a user permitted to perform access to the timeline information, and area information of an area in which information distribution of the timeline information is possible. 
     Preferably, furthermore, a specifying device operates upon receiving a request from a requester among plural users, and selectively specifies the timeline information to which the requester is permitted to perform access according to the associated information, to transmit the timeline information to the requester. 
     Preferably, location information of the requester is acquired by a GPS locator, and transmitted from the requester together with the request. The specifying device specifies the timeline information of accessibility by use of the location information and the area information. 
     Preferably, the timeline entry device is provided with the timeline information by each of plural medical service providers for the medical care of the patient. The information distributor performs information sharing of the timeline information between the medical service providers. 
     Preferably, the medical service providers include an ambulance crew and at least one hospital facility. Preferably, there are plural server apparatuses each of which includes the timeline entry device, the timeline readout device and the timeline matching device. 
     Preferably, the plural server apparatuses include a first server apparatus for outputting a request for reading out the timeline information. A second server apparatus reads out the timeline information by referring to the biometric information in response to outputting the request for readout, for transmitting the timeline information to the first server apparatus by use of the information distributor. 
     Preferably, the biometric information is fingerprint information. 
     Preferably, the timeline entry device receives an entry request for newly entering the timeline information in association with the biometric information, and newly generates the timeline information upon receiving the entry request. 
     Preferably, furthermore, a local server apparatus outputs a request for reading out the timeline information. A medical support server apparatus includes the timeline entry device, the timeline readout device and the timeline matching device, reads out the timeline information by referring to the biometric information in response to outputting the request for readout, and transmits the timeline information to the first server apparatus by use of the information distributor. 
     Also, a medical support method for providing timeline information having medical care information of a patient arranged in a time sequence for use in medical care of the patient is provided. An entry request for newly entering the timeline information in association with biometric information for identifying the patient is received. The timeline information is newly generated upon receiving the entry request. The timeline information is registered in a storage medium in association with the biometric information. The timeline information from the storage medium is read out by search upon identity verification of the biometric information. Information distribution of the timeline information being read out is performed. 
     Also, a medical support apparatus for providing timeline information having medical care information of a patient arranged in a time sequence for use in medical care of the patient is provided. A request processing unit receives an entry request for newly entering the timeline information in association with biometric information for identifying the patient. A timeline generator newly generates the timeline information upon receiving the entry request. A timeline entry device registers the timeline information in a storage medium in association with the biometric information. A timeline readout device reads out the timeline information from the storage medium by search upon identity verification of the biometric information. There is an information distributor for information distribution of the timeline information being read out. 
     Consequently, plural sets of timeline information of medical care for one common patient can be viewed and utilized easily, because biometric information can be utilized to read out and specify timeline information suitably. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above objects and advantages of the present invention will become more apparent from the following detailed description when read in connection with the accompanying drawings, in which:  FIG. 1  is a block diagram schematically illustrating an emergency medicine system; 
         FIG. 2  is a block diagram schematically illustrating a medical support system; 
         FIG. 3  is a block diagram schematically illustrating arrangement of circuit devices in a medical support server apparatus; 
         FIG. 4  is a block diagram schematically illustrating circuit device in a portable terminal device and a hospital terminal apparatus; 
         FIG. 5  is a data chart illustrating various sets of timeline information; 
         FIGS. 6A, 6B and 6C  are block diagrams schematically illustrating respectively server apparatuses; 
         FIG. 7  is a data chart illustrating generation of multi-user timeline information; 
         FIG. 8  is a block diagram schematically illustrating the medical support server apparatus; 
         FIG. 9  is a flow chart illustrating a flow of using timeline information; 
         FIG. 10  is a flow chart illustrating information distribution of timeline information from a hospital server apparatus and medical support server apparatus; 
         FIG. 11  is a block diagram schematically illustrating another preferred medical support server apparatus having a specifying device; 
         FIG. 12  is a data chart illustrating information distribution of timeline information only of access permission; 
         FIG. 13  is a block diagram schematically illustrating use of GPS location information; 
         FIG. 14  is a data chart illustrating a system timeline database combined with the server apparatus; 
         FIG. 15  is a block diagram schematically illustrating use of each one of server apparatuses for a medical support server apparatus; 
         FIG. 16  is a block diagram schematically illustrating information distribution of timeline information from one server apparatus to another server apparatus as requester. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S) OF THE PRESENT INVENTION 
     First Embodiment 
     In  FIG. 1 , an emergency medicine system is illustrated. 
     Assuming that an acute disease or serious injury occurs to a body of a person, an ambulance with paramedics is called urgently for transporting the person to a hospital as a medical service provider, so that a doctor can perform medical care to the person in the emergency medicine. The emergency medicine system includes a medical center  11  of a local community, an emergency response organization  12  (emergency command center or central headquarter), a first hospital facility  13 , a second hospital facility  14  and the like. Although each of the emergency response organization  12 , and the first and second hospital facilities  13  and  14  is one entity in  FIG. 1  for simplicity in the drawing, it is possible that each of the emergency response organization  12 , and the first and second hospital facilities  13  and  14  is two or more. The medical center  11  is a comprehensive medical facility, such as a medical center for liaison with plural medical service providers in a particular local area. 
     The emergency response organization  12  receives an urgent call from the patient P, his or her family, passer-by or the like in an emergency site  15 , and locally specifies the emergency site by recognizing information according to the call. The emergency response organization  12  instructs an emergency service agency (fire station or the like) near to the emergency site  15  to dispatch an ambulance  16  to the patient P. An ambulance crew  17  or paramedic team inclusive of plural paramedics F (emergency medical technicians) is organized by the emergency service agency, and dispatches the ambulance  16 . The ambulance crew  17  arrives at the emergency site  15 , treats the patient P for prehospital treatment, and picks him or her in the ambulance  16 . The emergency response organization  12  and the ambulance crew  17  in combination are a medical service provider for prehospital treatment to the patient P. The ambulance crew  17  calls the first hospital facility  13  and asks for medical care of the patient P. In case the first hospital facility  13  approves the care of the patient P, the ambulance crew  17  transports him or her to the first hospital facility  13 . 
     The first hospital facility  13  is an emergency hospital having medical instruments and systems for emergency medicine, to perform medical care of a patient P (patient body). A doctor D 1  at the first hospital facility  13  cares the patient P transported by paramedics. The second hospital facility  14  is a specialized hospital for specialized and advanced medical care for serious patients for which the first hospital facility  13  cannot perform medical care sufficiently. A doctor D 2  at the second hospital facility  14  cares the patient P transferred from the first hospital facility  13 . 
     Each one of the ambulance crew  17 , and the first and second hospital facilities  13  and  14  as medical service providers creates timeline information (workflow information), in which medical care information related to diagnosis and treatment for the patient P is arranged and recorded in a time sequence. The medical care information in the timeline information includes information of medical care in the past and also information of planned medical care in the future. 
     Emergency timeline information TL 0  is related to medical care information of medical care performed by the ambulance crew  17 . First hospital timeline information TL 1  is related to medical care information of medical care performed in the first hospital facility  13 . Second hospital timeline information TL 2  is related to medical care information of medical care performed in the second hospital facility  14 . 
     A medical support system  10  is a system for sharing plural sets of timeline information between plural medical service providers for the same patient P, for example, emergency timeline information TL 0 , first hospital timeline information TL 1  and second hospital timeline information TL 2 . The medical support system  10  makes it possible easily to provide timeline information from other medical service providers in relation to the same patient P. 
     In  FIG. 2 , the medical support system  10  includes a medical support server apparatus  21 , an emergency server apparatus  22  and hospital server apparatuses  23  and  24 . The medical support server apparatus  21  is installed in the medical center  11 . The emergency server apparatus  22  (local server apparatus) is installed in the emergency response organization  12 . The hospital server apparatuses  23  and  24  (local server apparatuses) are respectively installed in the first and second hospital facilities  13  and  14 . The emergency server apparatus  22  produces emergency timeline information TL 0 . The hospital server apparatus  23  produces first hospital timeline information TL 1 . The hospital server apparatus  24  produces second hospital timeline information TL 2 . 
     The emergency server apparatus  22  is combined with an emergency database  42  or DB. The hospital server apparatus  23  is combined with a hospital database  43  or DB. The hospital server apparatus  24  is combined with a hospital database  44  or DB. In the plural server apparatuses  22 ,  23  and  24 , generated timeline information TL 0 , TL 1  and TL 2  is stored in respectively the plural databases  42 ,  43  and  44  as storage medium. 
     The medical support server apparatus  21  acquires the timeline information TL 0 , TL 1  and TL 2  from the emergency server apparatus  22  and the hospital server apparatuses  23  and  24 , and distributes the timeline information TL 0 , TL 1  and TL 2  to medical service providers other than sources of the information. For example, the medical support server apparatus  21  transmits the emergency timeline information TL 0  to the first hospital facility  13  after generation in the emergency server apparatus  22  according to a request from the first hospital facility  13 . 
     A communication network  30  connects the emergency server apparatus  22 , and the hospital server apparatuses  23  and  24  to the medical support system  10 . Examples of the communication network  30  are the Internet, mobile communication network and the like. 
     At least one portable terminal device  26  becomes connected to the emergency server apparatus  22  communicably for use by a paramedic F. Also, hospital terminal apparatuses  27  and  28  or local terminals become connected to the hospital server apparatuses  23  and  24  communicably for use by medical professionals, such as the doctors D 1  and D 2  at the first and second hospital facilities  13  and  14 . The plural server apparatuses  22 ,  23  and  24  generate timeline information TL 0 , TL 1  and TL 2  according to requests from the plural terminal apparatuses  26 ,  27  and  28  in relation to newly entering the timeline information. 
     The portable terminal device  26  is used by each of plural paramedics F in the ambulance crew  17 , for example, a smart phone, tablet computer and the like. The portable terminal device  26  transmits a request for newly entering emergency timeline information TL 0  to the emergency server apparatus  22  of the emergency response organization  12  by use of the communication network  30 . The portable terminal device  26  transmits a request to the emergency server apparatus  22  for registering medical care information of the patient P collected in the emergency site  15  by the paramedic F. The emergency server apparatus  22  registers the medical care information from the portable terminal device  26  with the emergency timeline information TL 0  in a sequence of reception according to the request for registration. 
     The medical care information includes vital information, message information (comment), images and the like. The vital information includes a blood pressure, respiratory rate, body temperature, electrocardiogram and the like of the patient P. The message information is text of description of the emergency site  15  or the patient P and input by the paramedic F. The images are still images or moving images of the body of the patient P or the emergency site  15 . Also, the message information includes triage information related to emergency of medical care by consideration of the paramedic F for the patient P. To acquire the medical care information, it is possible to utilize an imaging function of a camera in the portable terminal device  26 . Also, description can be input by voice assuming that the portable terminal device  26  has a microphone and audio recorder for inputting the voice. It is possible to record voice of other persons, for example, the patient P, witnesses and the like in the emergency site  15  as an interview relevant to the emergency medicine. 
     The portable terminal device  26  can perform access to the emergency server apparatus  22  to receive information distribution of the emergency timeline information TL 0  for the purpose of viewing the registered emergency timeline information TL 0 . To this end, the portable terminal device  26  transmits a request to the emergency server apparatus  22  for the information distribution of the emergency timeline information TL 0 . 
     In the same manner as the portable terminal device  26 , the hospital server apparatuses  23  and  24  of medical service providers having the hospital terminal apparatuses  27  and  28  receive transmission of a request for newly generating first and second hospital timeline information TL 1  and TL 2  or a request for registering medical care information. Doctors D 1  and D 2  transmit requests to the hospital server apparatuses  23  and  24  by use of the hospital terminal apparatuses  27  and  28 , the requests including a request for registering the medical care information of a result of a diagnostic test for the patient P or a result of a diagnostic test such as images upon occurrence of the diagnostic test. The hospital server apparatuses  23  and  24  register (add) the received medical care information according to the request for registration with the first or second hospital timeline information TL 1  or TL 2 . 
     The hospital terminal apparatuses  27  and  28  are communicable to perform access to the hospital server apparatuses  23  and  24  and send a request for information distribution of the timeline information TL 0 , TL 1  and TL 2  in order to view the first hospital timeline information TL 1  and second hospital timeline information TL 2 . 
     The medical support server apparatus  21  performs medical support by a function (service) for sharing the timeline information between plural medical service providers. Each of the plural terminal apparatuses  26 ,  27  and  28  or users is allowed by the medical support server apparatus  21  to view timeline information of medical service providers other than those associated with the plural terminal apparatuses  26 ,  27  and  28 . 
     For example, the hospital terminal apparatus  27  at the first hospital facility  13  utilizes the medical support server apparatus  21 , and can view the first hospital timeline information TL 1  registered in the hospital server apparatus  23 , and also the emergency timeline information TL 0  and second hospital timeline information TL 2  registered in the emergency server apparatus  22  at the emergency response organization  12  and in the hospital server apparatus  24  at the second hospital facility  14 . Also, the portable terminal device  26  can view the first hospital timeline information TL 1  and second hospital timeline information TL 2  in addition to the emergency timeline information TL 0 . The hospital terminal apparatus  28  can view the emergency timeline information TL 0  and first hospital timeline information TL 1  in addition to the second hospital timeline information TL 2 . 
     In  FIG. 3 , each one of the medical support server apparatus  21 , the server apparatuses  22 ,  23  and  24 , the portable terminal device  26 , and the hospital terminal apparatuses  27  and  28  is constituted by a computer basically in an equal structure. The computer includes a CPU  31  (central processing unit), a non-transitory memory  32 , a non-transitory storage medium  33  or storage device, a communication interface  34  and a user interface  36  for inputs and outputs. A data bus  37  interconnects those circuit devices. An example of the user interface  36  includes a display panel  38  and an input device  39 , such as a keyboard and a mouse. Also, the terminal apparatus can be a portable terminal apparatus, for example, a smart phone, tablet computer and the like. The user interface  36  can be a touchscreen display panel including a display panel and a touchscreen device. 
     An example of the storage medium  33  is a hard disk drive (HDD). An application program  40  or AP and a control program are stored in the storage medium  33 . Also, a disk array having plural HDDs is combined with a server apparatus for database by way of the storage medium  33 , which is discrete from the HDD for storing the programs. Note that the disk array can be incorporated in the server apparatus, but may be an external unit separate from the server apparatus and connected to the same by use of a cable, network or the like. 
     The memory  32  is a working memory for the CPU  31  to perform tasks, and constituted by a RAM (random access memory). The CPU  31  loads the memory  32  with a control program stored in the storage medium  33 , and controls various circuit devices in the computer by performing the tasks according to the control program. The communication interface  34  (information distributor) is a network interface for control and communication with the communication network  30 . 
     In  FIG. 4 , a client program for medical support is installed as the application program  40  in the storage medium  33  of each of the plural terminal apparatuses  26 ,  27  and  28 . A request generator  50  is established in the CPU  31  by running the client program in the plural terminal apparatuses  26 ,  27  and  28 , and generates a request for newly entering timeline information, a request for registering medical care information, and a request for information distribution of the timeline information. 
     A menu page  51  is displayed on the display panel  38  upon running the client program in the CPU  31 . The menu page  51  includes an enter button  51 A, a register button  51 B, a specific timeline button  51 C or normal timeline button, and a multi-user timeline button  51 D or multi-user workflow button (combined timeline button) by way of a timeline matching device. The enter button  51 A is operable for creating timeline information (TL) of a time sequence. The register button  51 B is used for registering medical care information. The specific timeline button  51 C is used for viewing specific timeline information. The multi-user timeline button  51 D is used for viewing multi-user timeline information (combined timeline information). 
     An entry page (not shown) is displayed on the display panel  38  upon manipulation of the enter button  51 A for inputting a request for new entry. In the entry page, message information is displayed for encouraging a patient P to input fingerprint information. A fingerprint input device  53  is connectable to the plural terminal apparatuses  26 ,  27  and  28  wirelessly or in a wired manner. The fingerprint input device  53  is constructed in the same manner as a well-known fingerprint sensor for use in a fingerprint authorization system. A reader  53 A in the fingerprint input device  53  reads a fingerprint of the patient&#39;s finger, so that the fingerprint input device  53  sends fingerprint information or image data of the fingerprint to the plural terminal apparatuses  26 ,  27  and  28 . The fingerprint information is biometric information for identifying the patient P. 
     In the entry page, an input action is performed to request new entry. The request generator  50  generates the request for the new entry of timeline information with attachment of fingerprint information. The request for the new entry is transmitted to the plural server apparatuses  22 ,  23  and  24 . In the portable terminal device  26 , the request is transmitted to the emergency server apparatus  22 . In the hospital terminal apparatus  27 , the request is transmitted to the hospital server apparatus  23 . 
     The timeline information, being generated in the plural server apparatuses  22 ,  23  and  24 , is registered in the plural databases  42 ,  43  and  44  in a tagged form with the fingerprint information. For the new entry of the timeline information, a case ID is generated by the plural server apparatuses  22 ,  23  and  24 , and registered with the fingerprint information in a tagged form for the generated timeline information. 
     To register (add) the medical care information with the timeline information, the register button  51 B in the menu page  51  is manipulated. A patient list (not shown) is displayed by use of the register button  51 B, inclusive of the registered timeline information. The patient list includes names of patients and their case IDs. A selected one of the patients is designated manually in the patient list. In case transmission is instructed by selecting the registered medical care information, the request generator  50  generates a request for registration together with the case ID of the selected patient P and the selected medical care information. The request is transmitted to the plural server apparatuses  22 ,  23  and  24 . The plural server apparatuses  22 ,  23  and  24  register the medical care information with the timeline information of the designated case ID. 
     In  FIG. 5 , examples of the timeline information TL 0 , TL 1  and TL 2  are illustrated. A reference sign TA denotes a timeline bar of a time sequence. A reference sign MI denotes medical care information. The medical care information MI is recorded serially along the timeline bar TA of the time sequence. Examples of case IDs from medical service providers in the timeline information TL 0 , TL 1  and TL 2  are A-001, H1-001 and H2-001. In the medical service providers (users), the timeline information TL 0 , TL 1  and TL 2  is managed by use of the case IDs. 
     In the menu page  51  of  FIG. 4 , the specific timeline button  51 C is a button for viewing the timeline information in the medical service providers from the plural terminal apparatuses  26 ,  27  and  28 . A patient list (not shown) is displayed in the menu page  51  with the registered timeline information. The patient list contains names and case IDs of patients. A patient P of interest is designated among the patients in the patient list. In case the request for the information distribution is instructed, the request generator  50  generates a normal request for the information distribution together with the case ID of the designated patient P. 
     The plural server apparatuses  22 ,  23  and  24 , upon receiving the normal request for the information distribution, search the timeline information of the designated case ID, and transmit this to the requester. Thus, the timeline information can be shared and viewed by the plural terminal apparatuses  26 ,  27  and  28 . 
     The multi-user timeline button  51 D is used for viewing multi-user timeline information in which timeline information registered for other medical service providers is added to the specific timeline information of the first medical service provider in relation to the same patient P (patient body). Press of the multi-user timeline button  51 D causes a patient list to appear in the same manner as the specific timeline button  51 C to designate a case ID in the patient list. Upon transmission of a request for information distribution of the multi-user timeline information, the request generator  50  generates a request for the information distribution of the multi-user timeline information with the case ID of the designated patient P. 
     The request for the information distribution of the multi-user timeline information is transmitted to the plural server apparatuses  22 ,  23  and  24 . In response to this, the plural server apparatuses  22 ,  23  and  24  utilize the medical support server apparatus  21  and acquire timeline information created by other medical service providers in relation to the designated patient P in the request. To this end, fingerprint information registered with the timeline information is used. Each of the plural server apparatuses  22 ,  23  and  24  generates multi-user timeline information by combining the timeline information created by other medical service providers and the first timeline information generated in the server apparatus  22 ,  23  or  24 . The multi-user timeline information is transmitted to the requester or terminal apparatus of the request for the information distribution. It is possible to view the timeline information in the plural terminal apparatuses  26 ,  27  and  28 . 
     The application program  40  is a server program installed in the emergency server apparatus  22  and the hospital server apparatuses  23  and  24  for generating and managing timeline information. The server program is a subsidiary program or component included in the medical support computer-executable program. 
     In  FIGS. 6A, 6B and 6C  for the plural server apparatuses  22 ,  23  and  24 , a timeline manager  54  or workflow manager, and a timeline entry device  55  or workflow entry device (timeline registration unit) are established in the CPU  31  by running the server program in cooperation with the memory  32 . The timeline entry device  55  is a request processing unit for receiving the request for new entry from the plural terminal apparatuses  26 ,  27  and  28 . Also, the timeline entry device  55  is a timeline generator, which newly generates the timeline information of the patient P upon receiving the request from the plural terminal apparatuses  26 ,  27  and  28 , and stores the timeline information in the plural databases  42 ,  43  and  44 . 
     At the same time, the timeline information and fingerprint information of the patient P combined with the request for new entry are registered in a tagged form with one another. Also, the timeline entry device  55  generates a case ID for use in medical service providers upon newly generating the timeline information, and registers the case ID, fingerprint information and timeline information in a tagged form. The timeline entry device  55  receives a request for registering medical care information, and registers (adds) the medical care information with the timeline information. Thus, the plural databases  42 ,  43  and  44  are caused to store timeline information of plural patients for the respective medical service providers. 
     The timeline manager  54  receives the request for information distribution from the plural terminal apparatuses  26 , and  28 , and transmits the timeline information of the designated case ID to the requester or the terminal apparatus  26 ,  27  or  28 . Assuming that the request for the information distribution is normal, one of plural sets of the timeline information with verification of the case ID is searched from the plural databases  42 ,  43  and  44 , to transmit the searched set of the timeline information. 
     For the request for the information distribution of the multi-user timeline information, the timeline manager  54  acquires fingerprint information corresponding to the designated case ID from the plural databases  42 ,  43  and  44 . The timeline manager  54  generates the request for the information distribution with attachment of the acquired fingerprint information, and transmits the request for the information distribution to the medical support server apparatus  21  in relation to the timeline information with identity verification of the fingerprint information among the plural sets of the timeline information created by the other medical service providers. Assuming that timeline information of another medical service provider with identity verification of the fingerprint information is searched and read out in the medical support server apparatus  21 , the timeline manager  54  acquires the timeline information as a search result. 
     In  FIG. 7 , the timeline manager  54  generates multi-user timeline information TLX (combined timeline information) by combining timeline information of other medical service providers (users) with timeline information of the first medical service provider. For matching operation or combining operation of the timeline information, elements of plural workflows are arranged in a time sequence. Time information is acquired from calendar date information recorded in the timeline information. A sequence of the matching operation is determined according to the calendar date information. In case plural sets of the timeline information with the equal fingerprint information (biometric information) are read out by the search, the timeline manager  54  operates as a timeline matching device for generating the multi-user timeline information by use of the plural sets of the timeline information. 
     The timeline manager  54  upon receiving the request for search (readout) from the medical support server apparatus  21  searches timeline information from the plural databases  42 ,  43  and  44  of the medical service providers with identity verification of the fingerprint information included in the request for the search. The timeline manager  54  transmits a search result to the medical support server apparatus  21 . 
     A server program as the application program  40  is installed in the medical support server apparatus  21  for searching timeline information created by plural medical service providers. The server program is a main program component included in the medical support program, which is constituted by the server program and subsidiary programs for the plural server apparatuses  22 ,  23  and  24 . In  FIG. 8 , a timeline readout device  63  or workflow readout device (timeline searcher) is established in the CPU  31  in the medical support server apparatus  21  with the memory  32  by running the server program in the medical support server apparatus  21 . Also, the timeline readout device  63  operates as a transmission controller (information distributor) for controlling the information distribution of the searched timeline information. 
     In  FIG. 8 , the multi-user timeline information TLX is distributed in response to the request of the information distribution of the multi-user timeline information TLX from the hospital terminal apparatus  28  at the second hospital facility  14 . The timeline readout device  63  of the medical support server apparatus  21  searches the timeline information created by the plural medical service providers. In response to the request for the information distribution from the hospital server apparatus  24  at the second hospital facility  14 , the timeline information 
     TL 0  and TL 1  is searched from the emergency server apparatus  22  at the emergency response organization  12  and the hospital server apparatus  23  at the first hospital facility  13  as medical service providers other than the second hospital facility  14  as a requester of the request. The timeline readout device  63  transmits the request for the search to the emergency server apparatus  22  and the hospital server apparatus  23  with attachment of the fingerprint information. 
     The emergency server apparatus  22  and the hospital server apparatus  23  search timeline information TL 0  and TL 1  from the emergency database  42  and the hospital database  43  with identity verification of the fingerprint information. The searched timeline information TL 0  and TL 1  is transmitted to the medical support server apparatus  21  as search results. The timeline readout device  63  distributes the timeline information TL 0  and TL 1  or the search results to the hospital server apparatus  24  of the requester. In the hospital server apparatus  24 , the timeline manager  54  generates multi-user timeline information TLX according to the timeline information TL 0  and TL 2  of other medical service providers (users) from the medical support server apparatus  21 , and transmits this to the hospital terminal apparatus  28 . 
     The operation of the embodiment is described now. In  FIG. 9 , the emergency response organization  12  is called for urgent action of emergency medicine. The ambulance crew  17  inclusive of paramedics F moves rapidly to the emergency site  15 . One of the paramedics F at the emergency site  15  registers timeline information by use of the portable terminal device  26  for the purpose of inputting medical care information of a patient P. To this end, the menu page  51  in  FIG. 4  is used for entering inputs for newly generating the timeline information. Guide information is displayed in the menu page  51 . According to this, fingerprint information of the patient P is input to the portable terminal device  26  by use of the fingerprint input device  53  in a step S 10 . A request for newly generating the timeline information is generated upon inputting the fingerprint information together with the fingerprint information. The portable terminal device  26  transmits the request for the new entry to the emergency server apparatus  22  in a step S 11 . 
     The emergency server apparatus  22 , upon receiving the request for the new entry in a step S 12 , generates emergency timeline information TL 0  in a step S 13 , and generates a case ID in a step S 14 . The emergency server apparatus  22  registers the emergency timeline information TL 0  in the emergency database  42  by associating the fingerprint information and the case ID according to the request, in a step S 15 . 
     Then the portable terminal device  26  registers (adds) the medical care information. The menu page  51  is used to enter inputs for registering the medical care information. In the patient list, a case ID is designated to transmit a request to the emergency server apparatus  22  for registering the medical care information in a step S 16 . The emergency server apparatus  22  registers the medical care information (service item) with the emergency timeline information TL 0  of the designated case ID according to the request in a step S 17 . 
     In case the ambulance crew  17  transports the patient P to the first hospital facility  13 , the hospital terminal apparatus  27  and the hospital server apparatus  23  generate the first hospital timeline information TL 1  in the first hospital facility  13  in the same manner for registration. In case the patient P is transferred to the second hospital facility  14 , the hospital terminal apparatus  28  and the hospital server apparatus  24  generate the second hospital timeline information TL 2  in the second hospital facility  14  in the same manner for registration. 
     Assuming that the doctor D 2  of the second hospital facility  14  wishes to view the second hospital timeline information TL 2  of the patient P as illustrated in  FIG. 10 , he or she operates the hospital terminal apparatus  28  to transmit a normal request for information distribution to the hospital server apparatus  24  by entry of the case ID. The hospital server apparatus  24  upon receiving the request for the information distribution searches the second hospital timeline information TL 2  of the entered case ID from the hospital database  44 , and transmits the second hospital timeline information TL 2  to the hospital terminal apparatus  28 . 
     Assuming that the doctor D 2  wishes to view timeline information retrospectively before the transfer of the patient P to the second hospital facility  14 , the hospital terminal apparatus  28  transmits a request for the information distribution of the multi-user timeline information (combined timeline information) for the case ID to the hospital server apparatus  24 . 
     The hospital server apparatus  24  in response to this request reads out fingerprint information from the hospital database  44  in correspondence with the designated case ID, and transmits a request for the information distribution to the medical support server apparatus  21  with attachment of the fingerprint information. 
     The medical support server apparatus  21  upon receiving the request for the information distribution transmits a request for search (readout) with the fingerprint information to medical service providers other than the second hospital facility  14  as a requester of the request, namely, to the emergency response organization  12  and the first hospital facility  13 . The emergency server apparatus  22  and the hospital server apparatus  24  upon receiving the request for the search perform the search of the timeline information TL 0  and TL 1  with identity verification of the attached fingerprint information, and transmit a search result to the medical support server apparatus  21 . The medical support server apparatus  21  distributes the emergency timeline information TL 0  and second hospital timeline information TL 2  to the hospital server apparatus  24  as requester. 
     The hospital server apparatus  24  generates the multi-user timeline information TLX by combining the timeline information TL 0  and TL 1  of the other medical service providers (users) from the medical support server apparatus  21  with the timeline information TL 2  with identity verification of the fingerprint information in the hospital database  44 . The multi-user timeline information TLX is transmitted to the hospital terminal apparatus  28  as a requester. Thus, the doctor D 2  can view the timeline information retrospectively in relation to the patient P prior to the transfer to the second hospital facility  14 . 
     In  FIG. 10 , the hospital terminal apparatus  28  at the second hospital facility  14  generates a request for the information distribution for searching and viewing timeline information of other medical service providers. However, it is possible to generate a request for the information distribution from the portable terminal device  26  or the hospital terminal apparatus  27  of the first hospital facility  13  or the paramedic F, in order to search and view timeline information of other medical service providers. 
     As described heretofore, the medical support system  10  of the invention can register the fingerprint information with the timeline information in a tagged form, and search and transmit timeline information with identity verification of the fingerprint information. The fingerprint information is biometric information for identifying the patient P unlike the case ID generated specifically by one of the medical service providers. It is possible with the fingerprint information relatively easily to acquire timeline information created by other medical service providers for the same patient, in comparison with utilization of personal information such as a name, age, sex, address and the like for identifying the patient. 
     Consequently, it is possible easily to view and share plural sets of timeline information created in the medical service providers even upon occurrence of changeover between those for performing medical care to the patient P, such as the ambulance crew  17 , and the first and second hospital facilities  13  and  14 . 
     Furthermore, visual perceptibility of plural sets of the timeline information can be set high by matching operation or combining operation of the plural sets of the timeline information along the timeline bar of a time sequence upon identity verification in the biometric information. The matching operation is typically effective in the case of a high number of the sets of the timeline information. 
     Second Embodiment 
     The medical support server apparatus  21  in the first embodiment performs the information distribution of all the timeline information in correspondence with the fingerprint information. In contrast, a second preferred embodiment in  FIGS. 11 and 12  has a function of access restriction for each one of sets of the timeline information. 
     In  FIG. 11 , associated information (specific information or key information) for access restriction for each set of the timeline information is registered in a tagged form in the plural databases  42 ,  43  and  44  in the plural server apparatuses  22 ,  23  and  24 . The associated information is combined with flag information of “access permission”. Examples of the associated information are service provider IDs, for example, hospitals A and B. For example, a terminal apparatus at the hospital A is permitted to perform access, but one at the hospital B is disabled to perform access. Assuming that the access is free without the restriction, “ALL” is designated for access permission, which is indicated at the emergency timeline information TL 0  with a case ID of A-001. 
     Also, a specifying device  66  is provided in the medical support server apparatus  21  for operation by running a server program for medical support. The timeline readout device  63  searches and reads out timeline information. The specifying device  66  specifies the timeline information to which a requester or user of the request of the information distribution is permitted to perform access, according to the associated information combined with the timeline information being read out. 
     For example, a terminal apparatus of a hospital A receives a request for the information distribution of a requester of the request. Then the timeline readout device  63  in the medical support server apparatus  21  acquires timeline information from the plural databases  42 ,  43  and  44  of the medical service providers upon identity verification of the fingerprint information. One of the sets of the timeline information read out by the timeline readout device  63  is detected by the specifying device  66  for accessibility to the requester of the request. 
     Specifically, the specifying device  66  reads out hospital information (service provider ID) of a medical service provider of the requester of the request from the request for information distribution, for example, the hospital A. The specifying device  66  detects the timeline information with accessibility from the hospital A. The second hospital timeline information TL 2  in the hospital database  44  at the second hospital facility  14  is inhibited from being accessed by the hospital A in the access restriction. Thus, the specifying device  66  judges that the emergency timeline information TL 0  and the first hospital timeline information TL 1  are timeline information to which the hospital A is permitted to perform access. 
     In  FIG. 12 , the timeline information with accessibility is transmitted to a server apparatus at the hospital A as a requester. The server apparatus combines plural sets of the timeline information to generate multi-user timeline information TLX, which is transmitted to the terminal apparatus of the requester. In short, the access permission is determined according to the associated information in addition to the identity verification of the fingerprint information. Only the timeline information with the access permission is distributed. 
     Examples of the associated information (specific information or key information) include a service provider ID of a medical service provider, and a professional category, such as a doctor, nurse and the like. Access restriction can be so determined that the doctor is permitted to view the timeline information, but that the nurse is disabled from viewing the timeline information. Furthermore, a data amount of the available timeline information can be set larger for a doctor with permitted access in relation to medical care of a patient, but can be set smaller for a nurse, technician, paramedic and the like with limited access in relation to the medical care. 
     A further example of the user information can be a terminal ID of a terminal apparatus used by a medical professional, such as a doctor, nurse or the like. The access restriction can be set up specifically by each professional. Examples of the user information can be the service provider ID, professional category and terminal ID for recognizing a user permitted to use timeline information. Also, two or more of the types of the user information can be used in combination, for example, the terminal ID and the professional category. 
     Furthermore, associated information (specific information or key information) for use in access restriction can be area information for possibility of transmitting the timeline information in place of the use information. 
     In  FIG. 13 , a GPS locator  67  is provided in each of the portable terminal device  26  and the hospital terminal apparatuses  27  and  28 . GPS location information received by the GPS locator  67  in the plural terminal apparatuses  26 ,  27  and  28  is associated with a request for the information distribution output by the plural terminal apparatuses  26 ,  27  and  28  together with the fingerprint information of the patient P. Note that the hospital terminal apparatus  28  transmits the request for the information distribution in  FIG. 13 , in combination with the GPS location information of an on-site location in the second hospital facility  14 . 
     The specifying device  66  specifies the timeline information to which a requester or user can perform access, according to the GPS location information combined with the request for the information distribution. Multi-user timeline information is generated from the timeline information with access permission after the specification in the specifying device  66 . 
     Third Embodiment 
     In  FIG. 14  for a third preferred embodiment, a system timeline database  41  or system workflow database or DB is combined with the medical support server apparatus  21  for storing various sets of timeline information created by plural medical service providers in a comprehensive manner. The timeline information upon being registered in the plural server apparatuses  22 ,  23  and  24  is uploaded to the medical support server apparatus  21  readily after the registration. The medical support server apparatus  21  searches and reads the plural sets of the timeline information of the same patient P from the system timeline database  41  by checking the fingerprint information associated with a request for information distribution. 
     Fourth Embodiment 
     In  FIGS. 15 and 16 , a fourth preferred embodiment is illustrated. The plural server apparatuses  22 ,  23  and  24  are used as medical support server apparatuses without installing a medical support server apparatus discrete from the plural server apparatuses  22 - 24 . In  FIG. 16 , the timeline readout device  63  is disposed in the plural server apparatuses  22 ,  23  and  24 . Upon receiving a request for the information distribution of timeline information from a terminal apparatus, the timeline readout device  63  (searcher) in the plural server apparatuses  22 ,  23  and  24  transmits a request for search (readout) to other medical service providers. Fingerprint information of a patient of interest is combined with the request for the search. 
     In the same manner as the first embodiment, the plural server apparatuses  22 ,  23  and  24  receiving the request for the search perform the search of the timeline information with identity verification of the associated fingerprint information, and transmits the searched timeline information to the requester or server apparatus. Thus, the plural server apparatuses  22 ,  23  and  24  can acquire the timeline information of the plural medical service providers. In short, the timeline manager  54 , the timeline entry device  55  and the timeline readout device  63  are established in each of the plural server apparatuses  22 ,  23  and  24 . 
     In the above embodiments, the multi-user timeline information is generated from the plural sets of the timeline information. However, it is unnecessary to generate multi-user timeline information. The plural sets of the timeline information can be transmitted to a requester of the request as a terminal apparatus without generating the multi-user timeline information. 
     In the above embodiments, the requests for the new entry and for the information distribution are generated upon each time of the changeover between the medical service providers where the patient is transported or transferred. However, the invention is not limited. For example, one terminal apparatus can be allocated with a patient at the time of starting first medical care by an ambulance crew. Even upon occurrence of changeover between the medical service providers, the same terminal apparatus can be continuously used for the same patient. 
     To this end, the common terminal apparatus performs access to server apparatuses of different medical service providers to register timeline information of the medical care information. For example, it is necessary incessantly to monitor vital information of a patient assuming that he or she is seriously sick. Even in case there occurs changeover from one medical service provider to another, it is possible to monitor the vital information by continuously using the same common terminal apparatus, to register the vital information with the timeline information. 
     It is preferable to combine the location information with the request for the new entry to be transmitted from the same terminal apparatus, and to change the type of the timeline information to be registered according to the location information. For example, let the location information express a location outside the hospital facility. Emergency timeline information is registered in an emergency timeline information database. Also, let the location information express an on-site location in first or second hospital facility. First or second hospital timeline information is registered in respectively a first or second hospital timeline information database. Furthermore, the emergency timeline information can be generated by transmitting a request for the new entry in combination with the location information outside the hospital facility during transfer from the first hospital facility to the second hospital facility. Note that the location information for combination with the request for the new entry is preferably GPS location information in the same manner as  FIG. 13 . 
     In the above embodiments, the request for the new entry and the request for the information distribution are generated by the emergency terminal apparatus or hospital terminal apparatus in each of the medical service providers. However, the terminal apparatus is not limited, and can be a triage apparatus, vital sign measurement apparatus, diagnostic imaging apparatus and the like. Such an apparatus can have functions for generating and transmitting the request for the new entry and the request for the information distribution. In the embodiments, the biometric information is the fingerprint information. However, other examples of the biometric information of a patient can be used, such as a palm print, iris pattern of a pupil, veins of a palm, voice print, and the like. Also, two or more examples of the biometric information can be combined for use. This is effective in raising precision in identifying each of the patients. 
     In the above embodiments, the ambulance crew is constituted by the paramedics. However, emergency medical technicians (EMT) and the like can be included. In the above embodiments, a vehicle for the emergency medicine is the ambulance. However, a helicopter, aircraft and the like for medical use can be used instead of the ambulance. In the above embodiments, the medical service providers for diagnosis and treatment are the hospital facilities. However, a clinic, sanatorium and other facilities can perform medical care instead of the hospital facilities. 
     Furthermore, it is possible in the medical support system for use with timeline information of the invention to combine known structures of a workflow system for use with workflow information, time charts, timetables, electronic medical records (EMRs) and the like. 
     According to one embodiment mode of the invention, a non-transitory computer readable medium for storing a computer-executable program is provided, the computer-executable program enabling execution of computer instructions to perform operations for providing timeline information having medical care information of a patient arranged in a time sequence for use in medical care of the patient. The operations include receiving an entry request for newly entering the timeline information in association with biometric information for identifying the patient. The operations include newly generating the timeline information upon receiving the entry request. The operations include registering the timeline information in a storage medium in association with the biometric information. The operations include reading out the timeline information from the storage medium by search upon identity verification of the biometric information. The operations include performing information distribution of the timeline information being read out. 
     Although the present invention has been fully described by way of the preferred embodiments thereof with reference to the accompanying drawings, various changes and modifications will be apparent to those having skill in this field. Therefore, unless otherwise these changes and modifications depart from the scope of the present invention, they should be construed as included therein.