Abstract:
An examination management system according to the present invention compares an examining information relating to a predetermined examination with an examining target information corresponding to the examination, when the examination is conducted. If a predetermined condition is met, an input of the matter as the result of the comparison is permitted. When the matter is input, the matter is recorded.

Description:
CROSS-REFERENCE TO RELATED APPLICATION  
       [0001]     This application claims benefits of Japanese Application No. 2003-403701 filed in Japan on Dec. 2, 2003, the contents of which are incorporated by this reference.  
       BACKGROUND OF THE INVENTION  
       [0002]     1. Field of the Invention  
         [0003]     The present invention relates to an examination management system which manages the medical examination.  
         [0004]     2. Description of the Related Art  
         [0005]     Japanese Unexamined Patent Application Publication No. 2002-73615 discloses a conventional system which enables the input and reference of information in accordance with a working flow of the endoscope examination. According to the conventional art, conducting information on the examination can be inputted and the inputted conducting information can be secondarily used.  
         [0006]     Incidentally, in the examining operation of the endoscope examination, information generated in the medical action is not sufficiently secondarily used, and medical experts cannot clearly grasp the efficiency and improvement of medical action. That is, if one examination is the same type of examination with the same examining time, the examining time varies depending on factors including the examining experience or technique of doctors and the patient state and therefore the time factor for examination is not grasped.  
       SUMMARY OF THE INVENTION  
       [0007]     Briefly, in an examination management system according to the present invention, upon conducting a predetermined examination, an examining time for the examination is compared with an examining target time corresponding to the examination. When the examining time is over the examining target time, the input of a reason of examination-time-limit-over is permitted. Further, when the reason is inputted, the reason is recorded.  
         [0008]     Additional features and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The features and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0009]      FIG. 1  is a block diagram showing the structure of an endoscope examination management system according to the most preferable embodiment of the present invention;  
         [0010]      FIG. 2  is a diagram showing the software structure of the endoscope examination management system according to the embodiment;  
         [0011]      FIG. 3  is a diagram showing start and end screens of the system which is developed in the endoscope examination management system according to the embodiment;  
         [0012]      FIG. 4  is a diagram showing the structure of tables/masters which are managed in a database in a server in the endoscope examination management system according to the embodiment;  
         [0013]      FIG. 5  is a diagram showing a main screen for examination which is developed in the endoscope examination management system according to the embodiment;  
         [0014]      FIG. 6  is a diagram showing a yet-to-be shot list screen which is developed in the endoscope examination management system according to the embodiment;  
         [0015]      FIG. 7  is a flowchart showing an examining flow in the endoscope examination management system according to the embodiment;  
         [0016]      FIG. 8  is a diagram showing a shooting screen which is developed in the endoscope examination management system according to the embodiment;  
         [0017]      FIG. 9  is a diagram showing a screen of an examination-time-limit-over reason which is developed in the endoscope examination management system according to the embodiment;  
         [0018]      FIG. 10  is a flowchart showing the shooting operation in the endoscope examination management system according to the embodiment;  
         [0019]      FIG. 11  is a diagram showing a statistics and history screen which is developed in the endoscope examination management system according to the embodiment;  
         [0020]      FIG. 12  is a diagram showing a list screen of the examination-time-limit-over reason which is developed in the endoscope examination management system according to the embodiment;  
         [0021]      FIG. 13  is a diagram showing a management function screen which is developed in the endoscope examination management system according to the embodiment; and  
         [0022]      FIG. 14  is a flowchart for explaining the flow of estimating a factor of an examination-time-limit-over in the endoscope examination management system according to the embodiment. 
     
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0023]     Hereinbelow, a description is given of a preferable embodiment with reference to the drawings.  
         [0024]      FIG. 1  is a block diagram showing the structure of an endoscope examination management system according to the most preferable embodiment of the present invention.  
         [0025]     Mainly, the endoscope examining system comprises: a GW (gateway)  1  which exchanges data to another section in a hospital; a receiving terminal  2  which receives the examination; an input/examining terminal  3  which performs the examination; a search terminal  4  which displays and inputs an image and various information; and a server  5  which records data. The devices are connected by a network (LAN) distributed by a HUB  7 .  
         [0026]     Further, the devices have, as the basic structure, a personal computer  8 , a PC monitor  9 , a keyboard  10 , and a mouse  11 , and are connected to the network via a LAN card  18  provided for the personal computer  8 .  
         [0027]     The GW  1  has a UPS (uninterruptible power supply)  15  in addition to the basic structure, thus responding to the uninterruptible power supply. The receiving terminal  2  has a magnetic card reader  12  in addition to the basic structure. Further, the receiving terminal  2  is arranged at the reception desk or the like in the section to be used for the reception of the examination.  
         [0028]     The input/examining terminal  3  comprises the magnetic card reader  12  and a compressing/decompressing device  13 , in addition to the basic structure. The compressing/decompressing device  13  is connected to an electric endoscope device  14  via a video cable and a communication cable. The compressing/decompressing device  13  is connected to the personal computer  8  via an I/F card  19  arranged in the personal computer  8 . The input/examining terminal  3  is used in the examination and therefore is arranged in an examination room.  
         [0029]     The search terminal  4  has only the basic structure, and is arranged in a conference room or the like because it is mainly used for conference operation. The server  5  has the basic structure and further has the UPS  15  which responds to the uninterruptible power supply.  
         [0030]     Although not shown in detail, the electric endoscope device  14  is similar to a general electric endoscope device and has an electric endoscope and a processor device for processing and outputting a video signal. The electric endoscope comprises a long inserting portion which is inserted in the body cavity and an operating portion arranged at the rear end of the inserting portion. The operating portion has a release switch for instructing the release operation, and the pressing operation of the release switch enables the image to be recorded.  
         [0031]      FIG. 2  is a diagram showing the software structure of the endoscope examination management system.  
         [0032]     Various application software and databases are installed and are operated in the hard disks in the devices. GW application software  20  is operated on the GW  1 .  
         [0033]     A database  21  is operated on a hard disk  24  of the server  5 . Further, the hard disk  24  records and stores a compressed image  22  which is picked-up by the input/examining terminal  3  and report information  23  for examination.  
         [0034]     Software structure of the receiving terminal  2 , input/examining terminal  3 , and search terminal  4  is common thereamong. Main application software  27  is operated on the receiving terminal  2 , input/examining terminal  3 , and search terminal  4 . The main application software  27  mainly comprises: an examination DLL (dynamic link library)  29 ; a conference DLL  30 ; statistics and history DLL  31 ; and a management function DLL  28 . A hard disk  35  temporarily stores a compressed image  36 .  
         [0035]     As mentioned above, since the software structure of the receiving terminal  2 , input/examining terminal  3 , and search terminal  4  is common, the using purposes thereof vary depending on the installing place. However, unlike the receiving terminal  2  and search terminal  4 , the compressing/decompressing device  13  for compressing/decompressing the image is connected only to the input/examining terminal  3  and the image pick-up operation is possible in the examination in the input/examining terminal  3 . A compressing/decompressing device program  37  is operated on the compressing/decompressing device  13  and a compressed image  38  is temporarily stored in a memory in the compressing/decompressing device  13 . The compressing/decompressing device  13  is connected to the electric endoscope device  14 .  
         [0036]     Next, a description is given of the operation of the endoscope examination management system. First, a description is given of information on the examination and the type of information which is managed by the system. The information managed by the system mainly has the following types of 1 to 4.  
         [0037]     1. Patient Information  
         [0038]     Patient Basic Information  
         [0039]     This is information for specifying one patient, and includes “patient ID”, “name”, “date of birth”, “sex”, and the like. The “patient ID” is a number, uniquely corresponding to the patient for the purpose of identifying the patient.  
         [0040]     Patient Profile Information  
         [0041]     This is information indicating the characteristics and state of the patient, and includes “blood type”, “height/weight”, “allergy”, “disability”, “infection”, “disorder and notices”, “specimen examining result”, “premedication information”, and the like.  
         [0042]     2. Examination Request Information  
         [0043]     This is information on an examining request (order) in the case of examining an order to an endoscope section from another diagnostic section. Specifically, order key information (“order number”, “ordering date”, etc.), request side information (“request section name”, “request doctor name”, “request date”, etc.), order information (“request disease name”, “examining purpose”, “examination type”, “examining item”, “examined portion”, “comment”, “scheme image”, etc.), examination reservation information (“examining date”, “conducting time”, etc.). This information is sent to the system of section from an HIS (hospital information system). The order key information uniquely specifies one examining order.  
         [0044]     3. Examination Conducting Information (Accounting Information)  
         [0045]     This is information on examination conducting content, and includes “conducting date”, “conducting member”, “conducting place”, “manual”, “drug”, “equipment”, and the like. The information on the conducted “manual” and the used “drug” and “equipment” is used for accounting. This is sent to the HIS from the system of the endoscope section, and is processed by an HIS accounting system.  
         [0046]     4. Examining Result Information (Report and Report Information)  
         [0047]     This is information on the examining result, corresponding to a report for the examining request, and includes “report date”, “reporter”, “diagnosis”, “findings”, “treatment”, “comment”, “notes and instruction after examination”, “image”, “scheme image”, and the like. This information is referred to by a medical image filing system in the endoscope section, and is sent to the HIS from the system, thereby enabling referring to in the systems of the sections. Therefore, the examining result (report) of the section for ordering the examination is referred to.  
         [0048]     Next, the transition of functional screens will be described.  
         [0049]     On a system start/end screen  101  shown in  FIG. 3 , an examination icon  52 , a conference icon  53 , a statistics and history icon  54 , and a management function icon  55  are selected, corresponding to the DLLs  28  to  31  in the main application software  27 . Further, a user ID and a password are inputted for log in. Then, the functions start.  
         [0050]      FIG. 4  shows the structure of tables/masters managed by the database  21  in the server  5 . The user ID and the password are managed on a stuff master  151 . The inputted user ID and password are compared with the managed ones and, if they match each other, the user is identified and the functions start. The user ID is not selectively inputted by a combo box or the like, but is directly inputted, and the troublesomeness of selection is improved. On the system start/end screen  101 , an end button  57  (refer to  FIG. 3 ) is selected, thereby enabling ending the system.  
         [0051]      FIG. 5  is a diagram showing the start of a main screen  58  for examination by selecting the examination icon  52 . Icons corresponding the examinations are arranged on the left of screen, and are selected, thereby enabling starting the screens. The main screen  58  for examination includes: a patient reception icon  59 ; a pre-treatment input icon  60 ; a shooting icon  61 ; a conduct and input icon  62 ; a report input icon  63 ; an examination list icon  64 ; and an examination order button  100 .  
         [0052]     &lt;Shooting&gt; 
         [0053]     The shooting icon  61  is selected, thereby enabling starting a yet-to-be shot list screen  81  as shown in  FIG. 6 . The yet-to-be shot list screen  81  displays an examination list  82  for yet-to-be shot (examination list for yet-to-be shot and completion of reception is displayed by referring to an examination table  65  (refer to  FIG. 4 ) in the database  21 ).  
         [0054]     By selecting one of the yet-to-be shot list screen  81 , a shooting screen  83  (refer to  FIG. 8 , which will be described later) for the examination is opened.  
         [0055]     Next, the operation will be described in accordance with the examining flow.  FIG. 7  shows the examining flow.  
         [0056]     &lt;Step S 1 &gt; 
         [0057]     The examining order is issued from another diagnostic section to the endoscope section and then the patient information (patient basic information and patient profile information) and the examining request information (order information, request side information, and examination reservation information) are sent from the HIS. Further, the examination management system receives the information.  
         [0058]     &lt;Step S 2 &gt; 
         [0059]     In the examination management system, the reservation is managed based on the received examination reservation information, and the examination list that is scheduled is displayed with the state of the examination. An order detail checking screen (not shown) starts in order to guide the order contents.  
         [0060]     &lt;Step S 3 &gt; 
         [0061]     Next, a description is given of the screen for pre-treatment of the examination such as anesthesia to the patient. A pre-treatment input screen (not shown) starts in order to input data of the pre-treatment.  
         [0062]     &lt;Step S 4 &gt; 
         [0063]     Next, the shooting operation in step S 4  in  FIG. 7  will be described.  
         [0064]     The shooting screen  83  starts, thereby enabling capturing the image.  FIG. 8  shows the shooting screen  83 . The shooting screen displays: the patient information and the examining request information displayed on the left of screen; and information  125  on examination room/examining device, a shot image display area  126 , and an input area  127  of examination conducting information displayed on the right of screen.  
         [0065]     The shooting screen  83  is displayed, thereby enabling sending the patient information onto the input/examining terminal  3  arranged in the examination room. Further, the patient information is displayed on the connected electric endoscope device  14 .  
         [0066]     Furthermore, the magnetic card reader  12  is connected to the input/examining terminal  3  and therefore a magnetic card of the patient is inserted and the patient basic information is inputted. Thus, the input patient basic information is collated with those in the examination list. The assignment (pull-in) of examination to the terminals is automatically controlled.  
         [0067]     After ending the transmission of the patient information using the examining device, the examination is ready to be conducted and the shooting operation starts by pressing a shooting button  68 .  
         [0068]     The shot image display area  126  sequentially displays reduced images  136  which are shot every release operation by the electric endoscope device  14 .  
         [0069]     In the release operation, the shot image is first captured in the compressing/decompressing device  13 , and is subjected to image compression processing. The compressed image is temporarily stored in the memory in the compressing/decompressing device  13  together with the patient basic information, and is transferred into the personal computer  8  of the input/examining terminal  3 . If the image transfer fails due to the disconnection of cable, the image is temporarily stored in the memory of the compressing/decompressing device  13  and therefore the shooting operation continues without interruption.  
         [0070]     The image transferred in the personal computer  8  of the input/examining terminal  3  is temporarily stored in the hard disk  35 , and is transferred into the hard disk  24  of the server  5 . Here, if the image transfer fails due to the disconnection of cable, the image data is stored in the hard disk  35  of the input/examining terminal  3  and therefore the interruption of the shooting operation is also prevented.  
         [0071]     The reduced images  136  of the shot image display area  126  are displayed by decompressing and displaying the compressed image  36  recorded to the hard disk  35 .  
         [0072]     By pressing the end button of examination of the electric endoscope device  14 , the shooting operation ends, and status information of the examination managed in the examination table  65  in the database  21  enters a shooting end state.  
         [0073]     The shooting operation in the examination is controlled by the examination DLL  29  in the main application software  27  on the input/examining terminal  3 .  
         [0074]     The shot image has a corresponding relation to the examination on the examination table  65 , and pointer information indicating the storage position on an image management table  152  (refer to  FIG. 4 ) is registered.  
         [0075]     Further, on the shooting screen, the following information (1) to (5) is inputted in addition to the information on the image shooting.  
         [0076]     This information is not conventionally inputted from the shooting screen, and data needs to be inputted from another screen after the examination.  
         [0077]     According to the present invention, the information can be inputted from the shooting screen, thereby enabling improving the input efficiency and preventing an input error without failure.  
         [0078]     (1) Conducting Doctor  
         [0079]     An input button  129  of a conducting doctor is pressed, thereby enabling opening a window for selecting the doctor name who conducts the examination. After selecting the doctor name, the information is registered to a conducting table  153  (refer to  FIG. 4 ) in the database  21 . Since the examination is often conducted by a plurality of members, the plurality of conducting doctors can be selected.  
         [0080]     (2) Scope in Use  
         [0081]     A scope input button  130  is pressed, thereby enabling opening a window for selecting a scope used for examination (a selecting candidate is obtained from a scope master  156  (refer to  FIG. 4 ) in the database  21 , and is displayed). After selecting the using scope, the information is registered to an examining scope table  157  (refer to  FIG. 4 ) in the database  21 . The scope may be exchanged during the operation and therefore a plurality of scopes can be registered.  
         [0082]     (3) Shooting Start Time  
         [0083]     The time for opening the shooting screen is displayed beside a start button  131 . The start button  131  is pressed, thereby enabling opening a window for inputting the shooting start time and thus the time can be changed. The shooting start time registered in the examination table  65  in the database  21 .  
         [0084]     (4) Shooting End Time  
         [0085]     An end button of the examination on the electric endoscope device  14  is pressed, thereby enabling displaying the time for ending the examination beside an end button  132 . Also, the end button  132  is pressed, thereby enabling opening a window for inputting the shooting end time and thus the shooting end time can be changed. The shooting end time is registered in the examination table  65  in the database  21 .  
         [0086]     Further, at the timing for registering the shooting end time, the actual examining time starting from the shooting start time is calculated, and is compared with an examining target time of an examining target master  158  in the database  21 . When the difference between the actual examining time and the examining target time, a screen  300  of examination-time-limit-over reason for inputting the difference reason is displayed (refer to  FIG. 9 , which will be described later).  
         [0087]     (5) Examining Item  
         [0088]     An examining item button  133  is pressed, thereby enabling opening a window for selecting and inputting the examining item. The examining item is selected, thereby enabling registering the selected examining item in the examination table  65  in the database  21 .  
         [0089]     The difference is caused between the examining item designated at the examination order time and the examining item that is actually conducted. In consideration of the difference, the actually-conducted examining item is selected on the shooting screen, and is registered (in the case of actually conducting the treatment because the lesion portion is found, though the screening is predetermined at the order timing).  
         [0090]     The (3) shooting start time and (4) shooting end time are automatically registered, assuming that the patient ID is inputted from the electric endoscope device  14  without opening the shooting screen and the patient is examined.  
         [0091]     Under the following control, the registration and control operations of the times are executed.  
         [0092]     Shooting Start Time  
         [0093]     Case 1: The time for opening the shooting screen is registered.  
         [0094]     Case 2: The more accurate time which is to be recorded after opening the shooting screen is inputted by using the start button  131 .  
         [0095]     Case 3: The time for recording a first image is registered in the case of conducting the shooting operation without opening the shooting screen.  
         [0096]     Shooting End Time  
         [0097]     Case 1: The time for ending the examination or the time for turning-off the power of the observing device is registered from the electric endoscope device  14 .  
         [0098]     Case 2: The more accurate time which is to be recorded after opening the shooting screen is inputted by using the end button  132 , not starting from the processing of Case 1.  
         [0099]     Case 3: The same processing as that in Case 1 is performed in the case of conducting the shooting operation without opening the shooting screen.  
         [0100]     Case 4: After registering the time, the actual examining time starting from the shooting start time is calculated, and is calculated and compared with the pre-registered examining target time. When the actual examining time is over the examining target time, the screen  300  of examination-time-limit-over reason for inputting the difference reason is displayed.  
         [0101]     When the actual examining time is over the examining target time, the screen  300  of examination-time-limit-over reason starts.  FIG. 9  shows the screen  300  of examination-time-limit-over reason.  
         [0102]     From the screen  300  of examination-time-limit-over reason, an examination type  301 , a doctor name  302 , and an examination-time-limit-over reason  303  are inputted, and are registered to a table  159  of examination-time-limit-over reason (refer to  FIG. 4 ) in the database  21 .  
         [0103]     The input operation of the examination-time-limit-over reason is controlled under the following conditions.  
         [0104]     (1) The input operation is possible under such a condition that the examining target time has already been registered.  
         [0105]     (2) The input operation is possible under such a condition that the examining start time and the examining end time are registered in the shooting operation.  
         [0106]     (3) The examining target time is compared with the examining time and then the examining time is over the examining target time.  
         [0107]     The conditions are set to collect time factors for examination.  
         [0108]     &lt;Step S 5 &gt; 
         [0109]     In step S 5  in  FIG. 7 , a conducting input screen (not shown) starts, thereby enabling inputting the conducting information.  
         [0110]     &lt;Step S 6 &gt; 
         [0111]     In step S 6  in  FIG. 7 , the patient information and the examining request information are displayed on a report input screen (not shown). In addition, the contents of the examining report (findings and treatment, diagnosis, and comment) is registered on the right.  
         [0112]     &lt;Step S 7 &gt; 
         [0113]     The report information is referred to in the system of the endoscope section, and is sent to the HIS via the LAN by the GW  1 . Thus, the report information is referred to in the electronic medical chart system of the HIS.  
         [0114]     Further, in addition to the registration and transmission of report, pathological order is issued (in step S 10 ) based on the report information.  
         [0115]      FIG. 10  is flowchart additionally having a detailed flow of picking-up the above-mentioned processing in step S 4  from the work flow shown in  FIG. 7  and of steps when the examining time is over the examining target time.  
         [0116]     The time factors for examination are inputted on the shooting screen  83  in the description of step S 4  and then the operation thereof will be described with reference to  FIG. 10 .  
         [0117]     The shooting screen  83  starts, and the image is captured in step S 21 . In step S 22 , reduced images  136  are sequentially displayed on the screen. In step S 23 , a desired one of the reduced images  136  is clicked by the mouse. In step S 24 , an optional window of the organ names is displayed. In step S 25 , the proper organ name is selected from the optional window. In step S 26 , data on the organ name and an image number are registered to a selected image table  160  (refer to  FIG. 4 ) in the database  21 . Here, before pressing the examining end button, the image is selected as an example. However, in step S 27 , the end button  132  is pressed and the selection and input may be repeated on the shooting screen  83  just after the end of shooting operation (in steps S 21  to S 27 ).  
         [0118]     The shooting screen  83  starts and then the time for opening the shooting screen is displayed beside the start button  131 . The start button  131  is pressed and thus a window for inputting the shooting start time and the time can be changed. The end button  132  is pressed and then the time for ending the examination is displayed beside the end button  132 . The end button  132  is pressed and thus a window for inputting the shooting end time is opened and the time can be changed.  
         [0119]     In step S 27 , the end button  132  is pressed. Then, in step S 28 , the actual examining time starting from the shooting start time is calculated and then is compared with the examining target times which have already been registered of the examining target master  158  in the database  21 .  
         [0120]     In step S 29 , when the examining time is over the examining target time, the screen  300  of examination-time-limit-over reason for inputting the difference reason is displayed. In step S 30 , the examination-time-limit-over reason is inputted. Then, in step S 31 , the reason of examination-time-limit-over is registered in the table  159  of examination-time-limit-over reason in the database  21 . The examination-time-limit-over reason which is inputted/displayed can be changed.  
         [0121]     Those control operations are performed in the examination DLL  29  of the main application software  27  on the search terminal  4  (or input/examining terminal  3 ). The display information is called from the database  21 . The edited and inputted information is registered to the database  21 .  
         [0122]     Next, a description is given of the function for outputting the list of examination-time-limit-over by the statistics and history function.  
         [0123]      FIG. 11  is a diagram showing a statistics and history screen which starts when the statistics and history icon  54  is selected for log-in on the system start/end screen  101 . An icon  210  for outputting the list of examination-time-limit-over is prepared on the left of screen, and a function for displaying the list of examination-time-limit-over.  
         [0124]     The icon  210  for outputting the list of examination-time-limit-over is selected and then a screen  304  of the list of examination-time-limit-over reason is displayed.  FIG. 12  shows the screen  304  of the list of examination-time-limit-over reason.  
         [0125]     On the screen  304  of the list of examination-time-limit-over reason, the search term for collecting the examination-time-limit-over reason is inputted. The search start date and the search end date are inputted on a search start date column  305  and a search end date column  306 , thereby enabling collecting the examination-time-limit-over reason within the search term and displaying a collected result  307 . A print button  308  is pressed, thereby enabling printing the collected result  307 .  
         [0126]     On the screen  304  of the list of examination-time-limit-over reason, the actual examining time is compared with the examining target time on the shooting screen  83  and the difference reason to the examining target time is registered. Therefore, the examination-time-limit-over reason is collected and the collected result  307  is calculated.  
         [0127]     Next, a description is given of a master setting function serving as a management function.  
         [0128]      FIG. 13  is a diagram showing a management function screen which starts upon selecting a management function icon  55  for log-in on the system start/end screen  101 . Icons  212  for selecting the management functions are provided on the left of screen. The master setting button is pressed, thereby enabling operating the master setting function.  
         [0129]     The master setting function enables the registration, change, and withdrawal of the examining target time or the like every examination type as well as the type of master examination and the examining item. Further, the master setting function accesses the contents of the examining target master  158  in the database  21 .  
         [0130]     As described above, according to the embodiment, the examining target time is set in advance. Therefore, the actual examining time can be compared with the examining target time on the shooting screen and the difference factor is inputted on the screen for inputting the examination-time-limit-over reason. Thus, the information on the medical action is accurately collected.  
         [0131]     Further, the information inputted on the screen for inputting the examination-time-limit-over reason is displayed on the screen of the list of examination-time-limit-over reason. Consequently, the solution to eliminate the time difference factor is accurately evaluated.  
         [0132]      FIG. 14  is a flowchart for explaining the flow of estimating the factor of an examination-time-limit-over according to the embodiment. The information at the timing for the generating the medical action is collected as the collecting information according to the embodiment. The examination-time-limit-over reason for the same type of examination is clearly and easily obtained and analyzed. The medical service member grasps the difference reason and easily performs the improvement.  
         [0133]     That is, referring to  FIG. 14 , in step S 101 , the examining target is set. In step S 102 , the information is inputted at the timing for generating the actual medical action and the examination conducting information is compared with the examining target. In step S 103 , information on the well-grounded difference is obtained. In step S 104 , the solution of the difference factor is estimated, the medical service member repeats the review and check of the operation, and thus the operation is improved.  
         [0134]     The present invention is not limited to the above-mentioned embodiment and can be modified without departing from the essentials of the present invention.  
         [0135]     Further, any embodiment which is obtained by partly combining the embodiment belongs to the present invention.  
         [0136]     In this invention, it is apparent that working modes different in a wide range can be formed on this basis of this invention without departing form the spirit and scope of the invention. This invention is not restricted by any specific embodiment except being limited by the appended claims.