Patent Description:
An electrocardiogram is widely used in diagnosis of heart diseases such as angina (cardiac infarction) and abnormal cardiac rhythm. Heart diseases do not always appear in electrocardiograms as abnormalities. An abnormality appears in an electrocardiogram upon occurrence of an attack, and thus, an electrocardiogram when an attack does not occur cannot be distinguished from a normal electrocardiogram. Thus, an examination of taking an electrocardiogram for a long period under stress of exercise and in daily life is performed. Typically, a Holter electrocardiogram examination for <NUM> hours is widely performed as an electrocardiogram examination for a long period. While this electrocardiogram examination is common, missing of a heart disease is pointed out also in the electrocardiogram examination for <NUM> hours, and a long-term electrocardiogram examination for one week or longer is desired.

As a method for recording an electrocardiogram comfortably and easily under a daily living environment, there is a method for putting a wear on which electrodes and measurement equipment are loaded on a subject and measuring biological signals of the subject. According to this method, the subject can be subjected to measurement for a long period equal to or longer than one week in a comfortable environment. Meanwhile, it is important to prepare a wear fitted for the subject. For example, in a case where a size of the wear is not fitted, electrodes are not fixed at appropriate positions with an appropriate pressure when the subject puts on the wear, which results in failing to obtain stable information with less noise. Further, in the Holter electrocardiogram examination in related art, a subject needs to visit the hospital a number of times (for example, equal to or more than four times) from when a doctor makes a diagnosis until when the subject receives feedback of an examination result, which is heavy load on the subject. Thus, an examination method with less load on the subject is desired.

Meanwhile, as a method for supporting an examination of a patient in a daily living environment, there is a support system of medical equipment disclosed in <CIT>. In this system, an information provision site determines medical equipment to be provided to a patient at home on the basis of information in accordance with a result of counseling with the patient at home and transmits information regarding the determined medical equipment to a server of a medical equipment support company. The medical equipment support company specifies medical equipment to be provided to the patient at home on the basis of the information received at the server and delivers the specified medical equipment to the patient at home. In this manner, this system provides support of the medical equipment to the patient at home. However, there is no disclosure in <CIT> regarding how medical equipment suitable for the patient at home is specifically determined. Particularly, there is no disclosure regarding how an electrocardiogram examination of the patient at home is supported.

Document <CIT> discloses a method and a system for automatic garment sizing using a video, the garment including ECG equipment and electrodes.

Document <CIT> discloses a garment with ECG equipment and electrodes, and further includes means for transmitting the recorded ECG data to an external apparatus for analysis.

The present invention provides an examination support method and an examination support system for supporting an electrocardiogram examination utilizing a wear which measures biological signals of a subject.

The invention is defined by the appended claims <NUM>-<NUM>.

According to the present invention, it is possible to provide an examination support method and an examination support system which can efficiently perform a series of procedure regarding an electrocardiogram examination while reducing load on a subject.

Outline of the present embodiment will be described first. A subject visits a medical institution, and a doctor diagnoses the subject. In a case where the doctor judges that the subject is suspected to have a heart disease such as angina (cardiac infarction) and abnormal cardiac rhythm, the doctor determines to perform a Holter electrocardiogram examination (hereinafter, an electrocardiogram examination) according to the present embodiment and prescribes an electrocardiogram examination. A laboratory technician measures a body size of the subject as information necessary for determining the size of the measurement wear (wear) to be put on and obtains size information on the subject including an under bust size. Health personnel (a doctor, a laboratory technician or other health personnel to whom the doctor provides directions) of the medical institution orders a wear to be put on the subject to a medical equipment sales agency using an information processing apparatus. The health personnel also notifies the size information on the subject upon ordering. The agency determines a wear of a size appropriate for the subject on the basis of the size information on the subject and sends the determined wear of the size to the subject along with an instruction manual. The subject who has received the wear puts on the wear along the instruction manual and measures biological signals (electrocardiogram signals) during a measurement period (for example, one week). After the measurement period, the subject sends back the wear which the subject has put on to the medical equipment sales agency. The medical equipment sales agency reads out measurement data from measurement equipment (cardiography equipment) loaded on the wear and requests analysis of the readout measurement data to an electrocardiographic analysis institution. The electrocardiographic analysis institution analyzes the measurement data and creates an analysis report. The medical institution receives the analysis report from the electrocardiographic analysis institution, and the doctor diagnoses a state of the subject using the analysis report.

The present embodiment provides an examination support method and an examination support system for efficiently performing a series of procedure regarding an electrocardiogram examination as described above while reducing load on a subject.

An embodiment of the present invention will be described in detail below with reference to the drawings.

<FIG> is a block diagram illustrating an entire configuration of an examination support system according to the present embodiment. The examination support system in <FIG> includes an information processing apparatus <NUM> disposed at a medical institution, an order reception apparatus <NUM>, a data processing apparatus <NUM> and an inventory management apparatus <NUM> disposed at a medical equipment sales agency, an analysis apparatus <NUM> disposed at an analysis center, a communication terminal <NUM> of the subject and a communication network <NUM>.

The medical institution is an institution which provides medical service including an electrocardiogram examination, and the like, to the subject. As an example, the medical institution is a hospital, and the subject is a patient who is to undergo an electrocardiogram examination. A doctor diagnoses the subject, and in a case where the doctor judges that the subject is suspected to have a heart disease such as abnormal cardiac rhythm, the doctor determines to perform an electrocardiogram examination and prescribes the electrocardiogram examination.

The electrocardiogram examination uses a measurement wear (hereinafter, a wear) on which measurement equipment (cardiography equipment) which measures action potential or an action current of cardiac muscle associated with beat of a heart as a biological signal of the subject is loaded. The subject puts on the wear during a measurement period. The measurement period is determined by the doctor and is approximately from one to two weeks as an example. Measurement data recorded by the cardiography equipment is called an electrocardiogram. To order a wear to be put on the subject, a laboratory technician measures the body size of the subject as information necessary for determining the size of the wear. However, the measurement may be performed by the doctor or other health personnel to whom the doctor provides directions. Further, measurement may be performed using a measurement apparatus which automatically measures the body size, or the laboratory technician, or the like, may manually measure the body size using a measuring tape.

Measurement items of the body size include a body height, a chest measurement, under bust, a shoulder width, a sitting height, a body weight, and the like. The measurement items do not have to include all of these and may include other items. However, it is assumed in the present embodiment that the measurement items include at least under bust.

Here, a wear to be used in the present embodiment will be described.

<FIG> is a front view of a wear <NUM>. <FIG> is a view of a reverse side (side in contact with the skin) of a front body of the wear <NUM>. The wear <NUM> includes cardiography equipment <NUM> which is measurement equipment, electrodes <NUM>, <NUM> and <NUM> (<FIG>), and a wear body portion <NUM>. Medical equipment in the present embodiment includes the cardiography equipment <NUM> and the electrodes <NUM>, <NUM> and <NUM>.

The wear body portion <NUM> includes a front body <NUM> and a rear body <NUM>. The front body <NUM> is connected to the rear body <NUM> with two shoulder belts (shoulder straps) <NUM> illustrated in <FIG>, and the front body <NUM> is separated from the rear body <NUM> at both sides (side portions). The cardiography equipment <NUM> is loaded at the center of a torso portion of the front body <NUM>. On the rear side of the torso portion of the front body <NUM> on which the cardiography equipment <NUM> is loaded, electrodes <NUM>, <NUM> and <NUM> (<FIG>) which make contact with the skin of the subject are attached.

These electrodes <NUM>, <NUM> and <NUM> are arranged on the basis of CC5 which is one of induction methods of the Holter electrocardiogram examination. The cardiography equipment <NUM> and the electrodes <NUM>, <NUM> and <NUM> are located around the under bust of the wearer when the wearer puts on the wear. The electrode <NUM> becomes a positive electrode, the electrode <NUM> becomes a negative electrode, and the electrode <NUM> becomes an earth electrode. The electrodes <NUM>, <NUM> and <NUM> are constituted with conductive fiber as an example. However, the electrodes <NUM>, <NUM> and <NUM> are not limited to conductive fiber, and may be adhesive films including a conductive material. A size and a shape of the electrodes <NUM>, <NUM> and <NUM> are not particularly limited as long as the electrodes can detect biological signals. While not illustrated, the respective electrodes <NUM>, <NUM> and <NUM> are connected to a connector <NUM> (see <FIG>) of the cardiography equipment <NUM> with a lead line. These wiring portions are covered with an electronic insulating member <NUM>.

The electrodes <NUM>, <NUM> and <NUM> may be detachable from the front body <NUM>. Further, the cardiography equipment <NUM> may be detachable from the wear body portion <NUM> via the connector <NUM> (see <FIG>). By detaching at least the cardiography equipment <NUM> among the cardiography equipment <NUM> and the electrodes <NUM> to <NUM> from the wear body portion <NUM>, it is possible to wash the wear. As the connector <NUM>, a socket, or the like, which is typically used in connection of cords can be used as an example. A plurality of metal dot buttons which can fix the cardiography equipment <NUM> at the wear body portion <NUM> at the same time may be used.

The cardiography equipment <NUM> includes a chargeable battery and can record electrocardiogram data (measurement data) for one or two weeks, or more weeks without being additionally charged, in a state where the battery is fully charged. The cardiography equipment <NUM> includes a storage which can store all data measured during one or two weeks or more weeks. The cardiography equipment <NUM> includes a communication device which performs communication with apparatuses such as a computer wiredly or wirelessly. The communication device has a function of connecting with the apparatus wiredly or wirelessly and transmitting the measurement data stored in the storage to the apparatus. Further, the cardiography equipment <NUM> includes a display <NUM> which displays data. The cardiography equipment <NUM> can display an operation state of the cardiography equipment <NUM> at the display <NUM> during operation. The subject can grasp whether or not the cardiography equipment <NUM> normally operates, that is, whether or not measurement is normally performed by confirming the display <NUM> during the measurement period.

At the torso portion of the front body <NUM>, a hook and loop fastener B side (loop side) <NUM> is sewed so that a flat rubber embedded in the rear body <NUM> can be fixed with an equal extension degree in accordance with the size of the under bust of the wearer. Further, side tabs <NUM> are attached at both ends of the torso portion of the rear body <NUM>. The front body <NUM> is connected to the rear body <NUM> at both sides (side portions) by a hook and loop fastener A side (hook side) provided on a rear side of the side tabs <NUM> being fixed with the hook and loop fastener B side <NUM> of the front body <NUM>. When the hook and loop fastener A side is fixed, the side tabs <NUM> are located around the under bust. The hook and loop fastener A side and the hook and loop fastener B side <NUM> function as a size adjustment mechanism for adjusting a pressure when the subject puts on the wear. While the present embodiment includes two right and left size adjustment mechanisms, the number of size adjustment mechanisms may be one or three or more.

A plurality of stitches <NUM> are provided on the hook and loop fastener B side <NUM> at intervals to make it easier to understand fastened positions of the side tabs <NUM>. The stitches <NUM> correspond to scales indicating candidates for fastened positions of the side tabs <NUM> (adjustment positions for positioning). However, the side tabs <NUM> do not have to be fastened at the positions of scales and may be fastened at positions between scales. Further, one stitch <NUM> may be provided instead of a plurality of stitches <NUM> being provided. The stitches <NUM> are constituted with colored yarn different from color of the hook and loop fastener B side <NUM> as an example.

An interval of scales is equal to or greater than <NUM> and equal to or less than <NUM> at each of the right and left size adjustment mechanisms as an example. In a case where there is one size adjustment mechanism, the interval of scales is equal to or greater than <NUM> and equal to or less than <NUM> as an example.

<FIG> is an enlarged view of the hook and loop fastener (B side) of the front body <NUM>. <FIG> illustrates an example of a wear of M size which is to be applied to a size of the under bust of the subject from <NUM> to <NUM>. The subject fastens tips of the side tabs <NUM> at appropriate positions (fastened positions) in accordance with the size of the under bust. For example, in a case where the size of the under bust of the subject is <NUM>, the subject fastens the tips of the right and left side tabs <NUM> so as to be respectively aligned with positions of the second stitches from the connector <NUM> of the cardiography equipment <NUM>. Further, in a case where the size of the under bust is <NUM>, the subject fastens the tips of the side tabs <NUM> so as to be aligned with positions moved from positions of the first stitches to the second stitches by <NUM>. In the present embodiment, the wear is provided to the subject in a state where the fastened positions are marked (see <FIG> which will be described later) so as to prevent the subject from fastening the tips of the side tabs <NUM> at wrong positions or to prevent the subject from forgetting the fastened positions.

<FIG> is a rear view of the wear <NUM>. A flat rubber is embedded into the torso portion <NUM> of the rear body <NUM> as an elastic body <NUM>. As an example, by setting a length of the elastic body <NUM> at equal to or higher than <NUM>% and equal to or less than <NUM>% of the under bust of the subject, it is possible to acquire biological signals while the electrodes <NUM>, <NUM> and <NUM> supported at the wear body portion <NUM> make contact with the skin of the subject with an appropriate pressure, that is, without the subject feeling strong compression by putting on the wear. Further, the elastic body <NUM> is approximately from <NUM> to <NUM> wide as an example. The elastic body <NUM> requires force equal to or greater than 3N and equal to or less than 9N to extend in a long axis direction by <NUM>% as an example. Further, the elastic body <NUM> requires force equal to or greater than 2N and equal to or less than 6N to extend in the long axis direction by <NUM>% as an example.

While <FIG> illustrates an example of the wear of the M size which is to be applied to the size of the under bust of <NUM> to <NUM>, a plurality of sizes are prepared in accordance with ranges of the size of the under bust. As an example, an S size is prepared for the size of the under bust of <NUM> to <NUM>, and an L size is prepared for <NUM> to <NUM>. A size of the wear body portion (a length (height) in a longitudinal direction and a length (width) in a lateral direction on paper in <FIG>) is different depending on a difference in a size of the wear. Further, in each size, the hook and loop fastener (B side) and respective stitches on the hook and loop fastener (B side) are arranged so as to be able to fix the side tabs at appropriate positions in accordance with the size of the under bust of the wearer. Numerical values described here are merely an example. For example, the size of the wear may be prepared for each size range such as <NUM> in place of <NUM>. Further, the ranges of the under bust may overlap between sizes. For example, the M size may be prepared for <NUM> to <NUM>, and the L size may be prepared for <NUM> to <NUM>. Further, other sizes such as an SS size or an LL size may be provided. Still further, only two sizes may be provided for the wear.

The doctor, the laboratory technician or other health personnel orders a wear to the medical equipment sales agency with which they have partnership in advance using the information processing apparatus <NUM>. Hereinafter, a person who operates the information processing apparatus <NUM> will be referred to as an operator. The operator inputs information necessary for ordering the wear to the information processing apparatus <NUM> and transmits order information on the wear to the order reception apparatus <NUM> of the medical equipment sales agency using the information processing apparatus <NUM>. Note that in a case where a plurality of doctors and laboratory technicians, and the like, operate the information processing apparatus <NUM>, the information processing apparatuses operated by the respective persons may be the same apparatus or may be different apparatuses having similar functions.

As illustrated in <FIG>, the information processing apparatus <NUM> includes an input device <NUM>, a display <NUM>, a storage <NUM>, a communication device <NUM> and an order generator <NUM>. A hardware configuration of the information processing apparatus <NUM> is similar to that of a typical computer including a processor such as a CPU, a storage apparatus, a display apparatus, an input apparatus, a communication interface, and the like.

The input device <NUM> is an apparatus for inputting data, and, for example, is a mouse, a keyboard, a touch panel, or the like. The input device <NUM> may be a speech input device such as a microphone which performs input using speech. Examples of data to be input can include instruction information by the operator, information on the subject, or the like.

The display <NUM> is a display apparatus which displays data, and is, for example, a liquid crystal display apparatus, an organic EL display apparatus, a CRT display apparatus, or the like.

The storage <NUM> is an apparatus which stores data. The storage <NUM> stores data input from the input device <NUM>. Further, the storage <NUM> stores various kinds of application (such as an operating system (OS) and order application) necessary for implementing operation of the present embodiment. Further, the storage <NUM> may store information on the subject as an electronic medical record. Further, the storage <NUM> may store data generated by the order generator <NUM> which will be described later, and data received at the communication device <NUM>. Specific examples of the storage <NUM> can include a memory apparatus, a hard disk, an SSD, or the like. The storage <NUM> may be connected from outside so as to be detachable via a connection interface (such as a USB port and a memory slot) provided at the information processing apparatus <NUM>.

The communication device <NUM> is connected to the communication network <NUM> wiredly or wirelessly and performs communication with other apparatuses in accordance with communication protocol. Specific examples of other apparatuses can include the order reception apparatus <NUM>, the data processing apparatus <NUM>, the analysis apparatus <NUM> and the communication terminal <NUM>.

The order generator <NUM> generates an order input screen for ordering a wear and causes the order input screen to be displayed at the display <NUM>. The order generator <NUM> is implemented by a processor such as a CPU being caused to execute the order application. The operator inputs information necessary for ordering on the order input screen via the input device <NUM>.

<FIG> illustrates an example of the order input screen. The order input screen includes a plurality of input items including an ID of the subject, name of the subject, size information on the subject, shipping address of the wear (for example, a dwelling place or address of the subject) and remarks. Today's date is displayed as date of order at an upper right portion of the screen. Arbitrary information is input in the remarks. For example, date and time at which the subject desires to receive the wear may be designated and input. Information (such as name) of the medical equipment sales agency may be displayed on this order input screen. Further, email address information on the order reception apparatus <NUM> may be displayed. A transmission instruction is provided to the order application by the operator entering data at respective input items and clicking an order button <NUM>.

The order application generates order information on the wear upon receipt of the transmission instruction from the operator. The order information includes various kinds of information input on the order input screen as an example. The order generator <NUM> outputs the generated order information to the communication device <NUM>. The communication device <NUM> transmits the order information to the order reception apparatus <NUM> via the communication network <NUM>. The order information is transmitted by email as an example. In this case, email address information on the order reception apparatus <NUM> which is a transmission destination of the order information may be set in advance in the order application or may be input by the operator on the order input screen.

A transmission method of the order information is not limited to email. For example, a web server for receiving orders may be provided on the order reception apparatus <NUM> side, and the order generator <NUM> may access an URL of the web server. In this case, the order information is transmitted to the order reception apparatus <NUM> by the operator inputting information necessary for ordering from a screen which is provided by the web server and which is displayed at the display <NUM> of the information processing apparatus <NUM>. Alternatively, the order generator <NUM> may transmit the order information via fax machine connected to the information processing apparatus <NUM> via a network. In this case, the fax machine may transmit the order information in a form of an electronic file to the order reception apparatus <NUM>. Alternatively, the order generator <NUM> may transmit the order information to a printer connected to the information processing apparatus <NUM> via a network and may cause the printer to print the order information. In this case, the operator may send a sheet which describes the order information to the medical equipment sales agency by mail or by courier or by fax.

A function of inputting an order on a screen of an electronic medical record of the subject may be provided. In this case, the screen of the electronic medical record can be used as the order input screen. In this event, a function of inputting an order instruction such as an order button or order menu is added on the screen of the electronic medical record. In a case where the electronic medical record does not include part of items required for ordering the wear, it is only necessary to add the items to the electronic medical record.

The medical equipment sales agency is a medical equipment sales company. The medical equipment sales company accepts an order of the wear from the medical institution (information processing apparatus <NUM>). The medical equipment sales company determines a size of the wear to be provided to the subject and fastened positions of the side tabs using the order reception apparatus <NUM>. The medical equipment sales agency prepares the wear of the determined size, marks the determined fastened positions of the side tabs and sends the wear to the subject.

In more detail, the order reception apparatus <NUM> includes an input device <NUM>, a display <NUM>, a storage <NUM>, a communication device <NUM>, a wear selector <NUM>, and a shipment instruction device <NUM>. A hardware configuration of the order reception apparatus <NUM> is similar to that of a typical computer including a processor such as a CPU, a storage apparatus, a display apparatus, an input apparatus, a communication interface, and the like. The order reception apparatus <NUM> is operated by a staff of the medical equipment sales agency.

The input device <NUM>, the display <NUM>, the storage <NUM>, and the communication device <NUM> have functions similar to those of the input device, the display, the storage and the communication device of the information processing apparatus <NUM> except content or a type of data or application to be dealt with.

The communication device <NUM> passes the order information received from the information processing apparatus <NUM> to order reception application. The order reception application holds the order information which has received so far. The order reception application displays a list of the order information. The staff selects unprocessed order information and displays content of the selected order information on a screen. The staff activates wear selection application for determining a size of the wear and the fastened positions of the side tabs appropriate for the subject. The wear selection application is executed by a processor such as a CPU. By this means, functions of the wear selector <NUM> are implemented. The wear selector <NUM> displays a screen of the wear selection application (wear selection screen) at the display <NUM>.

<FIG> illustrates an example of the wear selection screen. Content of the selected order information is displayed on the wear selection screen. Further, a wear selection button <NUM> to be used by the staff to give an instruction of wear selection and calculation of the fastened positions and a shipment button <NUM> for shipment of the wear are disposed. Further, the wear selection screen includes a field <NUM> for storing information on an optimal wear size calculated for the subject, and a field <NUM> for storing information on optimal fastened positions determined for the subject. At this point, no value is stored in the fields <NUM> and <NUM>.

When the staff clicks the wear selection button <NUM>, a wear selection instruction is provided to the wear selection application. The wear selection application selects a size of the wear optimal for the subject and calculates optimal fastened positions of the side tabs on the basis of the size information on the subject.

In the present embodiment, the size of the wear and the fastened positions are determined on the basis of the under bust size of the subject. As an example, the wear size includes S, M and L. A plurality of fastened positions are set in accordance with each size. For example, in an example of the size M illustrated in <FIG>, the fastened positions are set at <NUM> intervals for the under bust from <NUM> to <NUM>. A setting example of the fastened positions will be described below. PM<NUM>, PM<NUM>,. , PM<NUM> are identifiers of the respective fastened positions.

Also in a case of the size S, a plurality of fastened positions PS<NUM>, PS<NUM>,. , PS<NUM> are set at <NUM> intervals in a range of the under bust from <NUM> to <NUM> in a similar manner. Also in a case of the size L, a plurality of fastened positions PL<NUM>, PL<NUM>,. , PL<NUM> are set at <NUM> intervals in a range of the under bust from <NUM> to <NUM>. While an example where the fastened positions are set at <NUM> intervals has been described here, the interval may be <NUM>, or may be other values. It is only necessary to determine the interval in accordance with granularity of a measurement size of the under bust.

The wear selection application holds correspondence information in which sizes of the wear are associated with the fastened positions of the side tabs for each under bust size as an example. The correspondence information may have a table form or may be embedded in the wear selection application as a program code.

The wear selection application determines the size of the wear and the fastened positions of the side tabs which are optimal for the subject on the basis of the under bust size of the subject and the above-described correspondence information. For example, in a case where the under bust size of the subject is <NUM>, the wear selection application determines that the wear size optimal for the subject is M, and the fastened positions of the side tabs optimal for the subject are PM<NUM>. The wear selection application stores values indicating the determined wear size and the determined fastened positions of the side tabs in the fields <NUM> and <NUM> on the wear selection screen.

<FIG> illustrates an example where the values indicating the size of the wear and the fastened positions determined by the wear selection application are stored in the fields <NUM> and <NUM> on the wear selection screen. The wear size M and the fastened positions PM<NUM> of the side tabs are determined for the subject.

While the size of the wear and the fastened positions of the side tabs have been determined on the basis of the under bust size here, a determination method is not limited to this. For example, the size of the wear and the fastened positions of the side tabs may be determined further using at least one of a body height, a chest measurement, a sitting height and a body weight of the subject. For example, the size of the wear and the fastened positions of the side tabs may be calculated on the basis of the under bust and the chest measurement. As described above, the size is not limited to S, M and L, and more or less sizes may be provided.

Further, the size of the wear and the fastened positions of the side tabs may be determined by the staff. In this case, the staff determines the size of the wear and the fastened positions of the side tabs from the above-described correspondence information on the basis of the under bust size of the subject. The staff inputs values of the determined wear size and fastened positions in the fields <NUM> and <NUM>.

After the values of the wear size and the fastened positions are stored in the fields <NUM> and <NUM>, a shipment screen for performing shipment procedure is displayed by the staff clicking the shipment button <NUM>.

<FIG> illustrates an example of the shipment screen. The staff prepares the wear and marks the fastened positions with the content displayed on the shipment screen and sends an electrocardiogram measurement set including the wear on which the marks are provided, an instruction manual, and the like, to the subject, specifically, as follows.

After the staff confirms the wear size and the fastened positions of the side tabs optimal for the subject, the staff operates the inventory management apparatus <NUM> to confirm whether or not the wear of the size is left in stock. The inventory management apparatus <NUM> is an apparatus for managing inventory of the wears which are stored for each size within a warehouse <NUM>. The inventory management apparatus <NUM> is a computer including an input apparatus, a display apparatus, a processor such as a CPU and a communication apparatus. The staff picks up the wear of the size of the subject from the warehouse <NUM> after confirming whether or not the wear is left in stock and marks the fastened positions for the subject on the wear. The fastened positions may be marked with a felt pen, with yarn of specific color, with an arrow mark or using other methods.

<FIG> illustrates an example where the positions of the second stitches (PM<NUM>) on the wear of the size M illustrated in <FIG> are marked. Marks <NUM> are provided at the second stitches.

The fastened positions may be marked with machine which is prepared for marking as well as being marked by the staff. For example, data indicating the fastened positions are input to the machine, and the wear on which the marks are to be provided is placed at the machine. The machine automatically provides marks on the wear by the staff giving a marking instruction to the machine. The data indicating the fastened positions may be automatically input to the machine by the machine being made to coordinate with the order reception apparatus <NUM> or the inventory management apparatus <NUM>.

The wears on which the respective fastened positions (PS<NUM> to PS<NUM> in a case of the S size, PM<NUM> to PM<NUM> in a case of the M size, and PL<NUM> to PL<NUM> in a case of the L size) are marked may be prepared in advance and stored in the warehouse <NUM>. In this case, the staff only requires to pick up the wear of the size of the subject, on which the fastened positions determined for the subject are marked from the warehouse <NUM>.

While the order reception apparatus <NUM> and the inventory management apparatus <NUM> are separately provided in <FIG>, the order reception apparatus <NUM> and the inventory management apparatus <NUM> may be integrated by the functions of the inventory management apparatus <NUM> being added to the order reception apparatus <NUM>. Further, the inventory management apparatus <NUM> does not have to be provided.

The staff packages the electrocardiogram measurement set including the wear on which the marks are provided, the instruction manual, and the like, and sends the set to the subject at shipment address of the subject. The set may be sent by courier or by mail or other ways. Note that an invoice to be pasted on the package may be automatically printed by the shipment application, the wear selection application, or the like, outputting shipment information on the subject to a printer at a predetermined timing (for example, at a timing at which a shipment instruction is given) or may be created through operation by the operator.

While the staff picks up the wear from the warehouse and packages and sends the wear here, all or part of these series of operation can be automatically performed by utilizing a drone or an autonomous driving car.

For example, an automated conveyance apparatus (which may be a mobile robot, a belt conveyer or other types of apparatuses) which coordinates with the order reception apparatus <NUM> or the inventory management apparatus <NUM> may be provided in the warehouse <NUM> and may be caused to convey wears in the warehouse <NUM>. For example, in a case where the shipment button <NUM> is clicked on the wear selection screen, a conveyance instruction is transmitted from the order reception apparatus <NUM> to the automated conveyance apparatus directly or via the inventory management apparatus <NUM> at the same time or before or after the shipment screen is displayed. The automated conveyance apparatus automatically picks up the wear of the size designated in the conveyance instruction from a shelf on which wears are stored for each size and places the wear to a predetermined location. The staff picks up the wear from the predetermined location.

Further, in a case where wears with marks are stored, the automated conveyance apparatus automatically passes the conveyed wear to an automated packaging apparatus. The automated packaging apparatus packages the wear and creates and pastes an invoice. The automated packaging apparatus passes the package to an automated transfer apparatus (such as a drone and an autonomous driving car) and the automated transfer apparatus automatically sends the package to the shipment address of the subject. The shipment address may be transmitted from the inventory management apparatus <NUM> or the order reception apparatus <NUM> to the automated transfer apparatus or may be read by the automated transfer apparatus from the invoice. There are various possible methods for sending the wear to the subject after the wear size and the fastened positions optimal for the subject are determined in this manner, and any method may be used.

The subject receives the electrocardiogram measurement set sent from the medical equipment sales agency. The subject puts on the wear in accordance with the instruction manual included in the package and explanation received from the health personnel (such as the doctor and the laboratory technician) of the medical institution in advance and records an electrocardiogram. For example, the subject puts on the wear directly on the skin of the upper body and aligns the tips of the side tabs with the marked positions to thereby fix the wear on the body.

<FIG> is a view of the subject seen from a diagonally forward right direction when the subject puts on the wear <NUM>. <FIG> is a rear view of the subject seen from a diagonally backward left direction when the subject puts on the wear <NUM>. Misalignment of the wear body portion <NUM> is prevented because the front body <NUM> is connected to the rear body <NUM> with the shoulder belt <NUM>. The wear of the size appropriate for the subject is provided, and the subject fixes the tips of the side tabs at appropriate fastened positions, so that the electrodes <NUM>, <NUM> and <NUM> (<FIG>) make contact with the skin of the subject with an appropriate pressure. The subject therefore does not feel strong compression by putting on the wear. This enables the subject to record an electrocardiogram in a comfortable environment and enables biological signals of the subject to be acquired at an appropriate level which allows correct electrocardiographic analysis. Further, marking of the fastened positions allows the subject to easily understand the positions where the side tabs <NUM> are to be fastened.

The subject activates the cardiography equipment by powering on the cardiography equipment before or after putting on the wear. By this means, measurement is started. The measurement is performed for a measurement period (for example, one week) determined on the basis of the diagnosis by the doctor. The subject keeps the wear on and intermittently performs measurement except a limited period while the subject changes his/her clothes, takes a bath, or the like. In a case where the cardiography equipment and the electrodes are detachable from the wear, the subject may detach the cardiography equipment and the electrodes from the wear and may wash or clean a wear portion.

The subject has the communication terminal <NUM>. The communication terminal <NUM> is a terminal such as a smartphone, a mobile phone, a tablet terminal, a notebook personal computer (PC) and a desktop PC. The subject may contact the health personnel (such as the doctor and the laboratory technician) of the medical institution or the staff of the medical equipment sales agency using the communication terminal <NUM> by email, by phone, or the like.

The subject returns the wear which the subject has put on to the medical equipment sales agency after the measurement period. The wear may be returned using a method designated by the medical equipment sales agency in advance such as by mail or by courier. In a similar manner to a case where the wear is sent to the subject, the wear may be returned using a drone, an autonomous driving car, or the like. The cardiography equipment may have a built-in timer, sound source and speaker, and may notify end of the measurement period to the subject with the timer. In place of or in addition to the sound source and the speaker, the cardiography equipment may include a vibrator and may notify end of the measurement period to the subject by driving the vibrator. The subject makes settings of the timer upon start of measurement as an example. Further, information on the measurement period may be notified from the information processing apparatus <NUM> to the order reception apparatus <NUM>, and instructions which describe the measurement period may be included in the electrocardiogram measurement set sent to the subject. In a case where a duration of the measurement period is determined in advance, operation of notifying the information on the measurement period from the information processing apparatus <NUM> to the order reception apparatus <NUM> is not required.

The data processing apparatus <NUM> of the medical equipment sales agency includes an input device <NUM>, a display <NUM>, a storage <NUM>, a communication device <NUM>, a reader <NUM>, and an analysis request device <NUM>. A hardware configuration of the data processing apparatus <NUM> is similar to that of a typical computer including a processor such as a CPU, a storage apparatus, a display apparatus, an input apparatus, a communication interface, and the like. The data processing apparatus <NUM> may be the same hardware apparatus as the order reception apparatus <NUM> or the inventory management apparatus <NUM> or may be a hardware apparatus different from the order reception apparatus <NUM> or the inventory management apparatus <NUM>. The data processing apparatus <NUM> is operated by the staff of the medical equipment sales agency.

The input device <NUM>, the display <NUM>, the storage <NUM>, and the communication device <NUM> have functions similar to those of the input device, the display, the storage and the communication device of the information processing apparatus <NUM> or the order reception apparatus <NUM> except content or a type of data or application to be dealt with.

The staff connects the cardiography equipment loaded on the wear returned from the subject to the reader <NUM> wiredly or wirelessly and causes the reader <NUM> to read out measurement data (electrocardiogram data) stored in the cardiography equipment. The reader <NUM> writes the read measurement data in the storage <NUM> as an electrocardiographic file. Further, the reader <NUM> may write the read data in a computer readable recording medium. Examples of the recording medium can include a CD-R, a USB memory, an SSD, a memory card, and the like.

There are various configurations where the reader <NUM> reads out measurement data from the cardiography equipment. For example, the measurement data may be read out from the cardiography equipment through wireless local area network (LAN) communication, Bluetooth, near field communication, or the like. Further, the reader <NUM> may be connected to the cardiography equipment wiredly using a serial cable, or the like, and the measurement data may be transmitted from the cardiography equipment to the reader <NUM> through serial transfer. Further, a dedicated data transfer scheme may be defined, and the measurement data may be transferred in accordance with this scheme. The measurement data may be transferred using a method other than the methods described here.

The analysis request device <NUM> is implemented by a processor such as a CPU being caused to execute analysis request application. The staff selects the measurement data (electrocardiographic file) for which an analysis request is to be made and gives an instruction to generate and transmit analysis request information via a user interface screen provided by the analysis request application.

The analysis request device <NUM> generates analysis request information for requesting analysis of the electrocardiogram for the measurement data selected by the staff. The analysis request information includes the measurement data for which an analysis request is to be made, information on the subject, and the like. The information on the subject may include name and an ID of the subject or may include only an ID. The analysis request device <NUM> outputs the generated analysis request information to the communication device <NUM>.

The communication device <NUM> transmits the received analysis request information to an analysis apparatus <NUM> of the electrocardiographic analysis institution via the communication network <NUM>. Any method may be used to transmit the analysis request information to the analysis apparatus <NUM>. The analysis request information may be transmitted by e-mail or may be transmitted using a file exchange system or may be uploaded to a dedicated web server prepared at the electrocardiographic analysis institution. Further, the analysis request information to be transmitted may be encrypted.

While the analysis request information is transmitted via the communication network <NUM> here, a recording medium in which the measurement data is stored and an analysis request form may be transmitted to the electrocardiographic analysis institution by mail, by courier, or the like. Further, the measurement data and the analysis request form may be transmitted to the electrocardiographic analysis institution by fax. The measurement data and the analysis request form may be provided to the electrocardiographic analysis institution using other methods.

The analysis apparatus <NUM> provided at the electrocardiographic analysis institution receives the analysis request information from the data processing apparatus <NUM>. A hardware configuration of the analysis apparatus <NUM> is similar to that of a typical computer including a processor such as CPU, a storage apparatus, a display apparatus, an input apparatus, a communication interface, and the like. The analysis apparatus <NUM> is operated by a staff of the electrocardiographic analysis institution.

The staff operates the analysis apparatus <NUM> to display the analysis request information received from the data processing apparatus <NUM> on a screen. The analysis apparatus <NUM> is equipped with electrocardiographic analysis application. The staff activates the electrocardiographic analysis application, causes the electrocardiographic analysis application to load the measurement data included in the analysis request information and execute analysis processing. The analysis apparatus <NUM> displays an analysis result on a screen.

The analysis apparatus <NUM> creates an analysis report on the basis of the analysis result. The analysis report includes information on the measurement period of the subject, information on the subject, the analysis result of the electrocardiogram, and the like, as an example.

<FIG> illustrate part of the analysis report. <FIG> illustrates a front cover portion of the analysis report in which overview of the analysis result is summarized. Measurement results of heart rate information, premature ventricular contraction (PVC), premature atrial contraction (PAC), an ST level, auricular fibrillation and auricular flutter are summarized in one page. A stable electrocardiogram which can be analyzed is obtained during a long period. <FIG> illustrates one of measured waveforms recorded in the analysis report. <FIG> illustrates compressed waveforms which indicate the electrocardiogram of one hour summarized on one page.

The staff operates the analysis apparatus <NUM> to transmit data of the analysis report to the information processing apparatus <NUM>. The data of the analysis report may be transmitted by email, may be transmitted using a file exchange system or may be uploaded to a dedicated web server of the medical institution. The data of the analysis report to be transmitted may be encrypted.

The doctor displays the received analysis report on a screen and diagnoses a state of the subject on the basis of the electrocardiogram and the analysis result. The doctor enters the result of the diagnosis in, for example, the electronic medical record. The doctor interviews the subject upon next visit to the hospital and tells the diagnosis result. In a case where the subject has a heart disease (abnormal cardiac rhythm) as a result of the diagnosis, the doctor discusses and determines courses of treatment in the future with the subject.

While the data of the analysis report is transmitted to the information processing apparatus <NUM> via the communication network <NUM> here, a recording medium including the data of the analysis report may be sent to the medical institution by mail, by courier, or the like. Alternatively, the data of the analysis report may be transmitted by fax. The analysis report may be provided using other methods.

Further, the electrocardiographic analysis institution may transmit the data of the analysis report to the medical institution via the medical equipment sales agency. In this case, the communication device <NUM> of the data processing apparatus <NUM> receives the data of the analysis report from the analysis apparatus <NUM> and stores the received data in the storage <NUM>. The staff operates the data processing apparatus <NUM> to transmit the data of the analysis report to the information processing apparatus <NUM>. The communication device <NUM> of the information processing apparatus <NUM> receives the data of the analysis report transmitted from the data processing apparatus <NUM> and stores the received data in the storage <NUM>. The doctor displays the received analysis report and diagnoses a state of the subject on the basis of the electrocardiogram and the analysis result.

<FIG> is a sequence diagram of a specific example of the whole operation regarding the examination support system according to the present embodiment.

The subject visits the medical institution (S11). The doctor of the medical institution diagnoses the subject and enters the diagnosis result in the medical record. The medical record may be an electronic medical record or a paper medical record. The doctor judges that the subject is suspected to have a heart disease such as abnormal cardiac rhythm, determines to perform an electrocardiogram examination (Holter electrocardiogram examination) and issues a request form for Holter electrocardiogram examination. The request form may be issued using, for example, a request form print function provided at the electronic medical record. The doctor or the health personnel to whom the doctor provides directions gives an examination reception file including the request form to the subject. The subject presents the examination reception file to an examination room.

The laboratory technician measures the body size (such as under bust) of the subject and obtains size information including the under bust size (S12). Further, the laboratory technician explains how to use the wear which the subject puts on in the electrocardiogram examination and a measurement period. Then, the subject goes home (S13).

The doctor, the laboratory technician or other health personnel orders an electrocardiogram measurement set including the wear from the order screen using the information processing apparatus <NUM>. Specifically, the doctor, the laboratory technician or other health personnel inputs the size of the under bust, name, an ID, shipment address, or the like, of the subject on the order screen. The information processing apparatus <NUM> transmits the order information on the electrocardiogram measurement set to the order reception apparatus <NUM> of the medical equipment sales agency (S14).

The order reception apparatus <NUM> receives the order information. The staff of the medical equipment sales agency activates the wear selection application of the order reception apparatus <NUM>, inputs the size information (including at least the under bust) of the subject in the wear selection application and causes the wear selection application to calculate the wear size and the fastened positions (S15). The staff picks up the wear of the calculated size from the warehouse and marks the fastened positions (S16). In a case where the marks are provided on the wear in advance, the staff only requires to pick up the wear on which the fastened positions are marked from the warehouse and does not have to do marking work. The staff sends the electrocardiogram measurement set including the wear on which the marks are provided, the instruction manual, and the like, to the subject (S17). Note that it is also possible to send the wear to the subject in a state where the fastened positions are not marked. In this case, the electrocardiogram measurement set may include a notification which notifies the fastened positions to the subject. Alternatively, data of the fastened positions may be transmitted from the order reception apparatus <NUM>, the inventory management apparatus <NUM>, or the like, to the communication terminal <NUM> via the communication network <NUM>.

The subject receives the electrocardiogram measurement set sent from the medical equipment sales agency. The subject puts on the wear in accordance with the instruction manual included in the electrocardiogram measurement set and explanation as to how to use the wear received from the health personnel (such as the doctor and the laboratory technician) in advance and records an electrocardiogram during the measurement period (S18). Specifically, the subject puts on the wear on the naked upper body and aligns the tips of the side tabs with the marked positions to thereby fix the wear on the body. The subject puts off the wear after the measurement period ends and returns the wear to the medical equipment sales agency (S19). It is also possible to return only the cardiography equipment loaded on the wear without returning the wear body portion or return the wear body portion at a later date.

The medical equipment sales agency receives the wear returned from the subject and causes the reader <NUM> of the data processing apparatus <NUM> to read out the measurement data (electrocardiographic data) stored in the cardiography equipment of the wear. The data processing apparatus <NUM> transmits analysis request information including the readout measurement data (electrocardiographic file) to the analysis apparatus <NUM> of the electrocardiographic analysis institution (S20).

The information processing apparatus <NUM> receives data of the analysis report including the analysis result from the analysis apparatus <NUM> (S21). The doctor of the medical institution diagnoses a state of the subject on the basis of the analysis result described in the analysis report. The doctor enters the diagnosis result in, for example, the electronic medical record. The doctor interviews the subject who visits the hospital (S22) and tells the diagnosis result. In a case where it is recognized as a result of the diagnosis that the subject has a heart disease (abnormal cardiac rhythm), the doctor discusses and determines courses of treatment in the future with the subject.

According to the present embodiment, the subject only requires to put on the wear sent from the medical equipment sales agency, record an electrocardiogram and return the wear which the subject has put on to the medical equipment sales agency after measurement, so that it is possible to reduce the number of times the subject visits the medical institution. In related art, for example, the subject needs to visit the hospital at least twice in addition to the first diagnosis and the diagnosis after the examination so as to have electrodes loaded on measurement positions of the body and have the electrodes removed after <NUM> hours. In contrast, in the present embodiment, the subject only requires to put on the sent wear and return the wear which the subject has put on and does not have to visit the hospital for loading and removal of electrodes, so that it is possible to reduce the number of times of visiting the hospital. It is therefore possible to reduce load on the subject.

Further, according to the present embodiment, the wear of the size appropriate for the subject is provided, so that it is possible to stably dispose the electrodes at correct positions and perform measurement comfortably and easily while allowing the subject himself/herself to easily put on and off the wear. Further, the positions where the tips of the side tabs are to be fastened are marked on the wear, so that the subject can fix the electrodes on the body with an appropriate pressure by fixing the tips of the side tabs at the marked positions. It is easy to always stably hold the electrode positions and the pressure, so that it is possible to record an electrocardiogram for a long period beyond <NUM> hours comfortably and with high accuracy.

Further, according to the present embodiment, it is possible to save work for loading of the electrodes on the subject and technical guidance by the medical institution which has been required in the Holter electrocardiogram examination for <NUM> hours in related art. It is therefore possible to reduce load on the medical institution. Further, the medical equipment is owned by the medical equipment sales agency and does not have to be owned by the medical institution, so that it is possible to reduce load on the medical institution also in this viewpoint.

Further, according to the present embodiment, the wear body portion can be cleaned and reused, so that it is possible to reduce the number of wears in stock and expect reduction in overall medical expenses.

In the above-described embodiment, the subject returns the wear which the subject has put on to the medical equipment sales agency and the medical equipment sales agency reads out measurement data from the wear. In the present modified example <NUM>, the measurement data (electrocardiographic data) stored in a storage (such as a memory apparatus) inside the measurement equipment is transferred to the communication terminal <NUM> on the basis of operation by the subject, and the transferred measurement data is transmitted from the communication terminal <NUM> to the data processing apparatus <NUM>. This enables the medical equipment sales agency to collect the measurement data early, so that the medical equipment sales agency can make an analysis request to the electrocardiographic analysis institution early. This enables the doctor to obtain the analysis report earlier.

While in the above-described embodiment, the medical institution (information processing apparatus <NUM>) transmits the order information to the medical equipment sales agency, the subject may transmit the order information using the communication terminal <NUM>. In this case, the communication terminal <NUM> is equipped with application for creating and transmitting the order information, and the subject inputs size information such as the under bust size to the application.

While in the above-described embodiment, the wear selector <NUM> of the order reception apparatus <NUM> calculates the wear size and the fastened positions, in a case where the medical institution keeps wears for trial fitting, at least one of the wear size and the fastened positions may be determined at the medical institution in step S12. In this case, a function for allowing input of at least one of the wear size and the fastened positions to the order input screen is provided at the order generator <NUM>. The order generator <NUM> of the information processing apparatus <NUM> then calculates at least one of the wear size and the fastened positions from the under bust size, or the like. The information processing apparatus <NUM> transmits order information including the determined wear size and fastened positions to the order reception apparatus <NUM>.

While in the above-described embodiment, the medical equipment sales agency sends the electrocardiogram measurement set to the subject, in a case where the medical institution also plays a role as a wear sales agency, the medical institution may send the electrocardiogram measurement set. In this case, the medical institution determines the wear size and the fastened positions in accordance with modified example <NUM>. Further, the subject may return the wear to the medical institution. Further, the medical institution may read out measurement data from the wear and may make an analysis request to the electrocardiographic analysis institution.

Claim 1:
An examination support method for supporting an electrocardiogram examination of a subject using a wear on which medical equipment including electrocardiography equipment, a plurality of electrodes and one or more size adjustment mechanisms are loaded, the examination support method comprising the consecutive steps of:
measuring (S12) body size information including an underbust size of the subject using a first measurement apparatus;
ordering (S14) a wear using an information processing apparatus (<NUM>), the ordering including transmitting order instruction information including the body size information to an order reception apparatus (<NUM>);
selecting a wear to be put on the subject from a plurality of wears of a plurality of sizes on a basis of the underbust size of the subject received by the order reception apparatus;
determining (<NUM>, <NUM>), by the order reception apparatus (<NUM>), an adjustment position (RP1-<NUM>, PM1-<NUM>, PJ-<NUM>) of the one or more size adjustment mechanisms on the wear based on the underbust size;
sending (S16, S17) the selected wear on which the adjustment position is indicated to the subject;
putting (S18) the wear on a torso portion of the subject;
adjusting a pressure on the torso portion of the subject by positioning the one or more size adjustment mechanisms at the adjustment position;
performing electrocardiogram measurements for a period during which the subject is wearing the wear;
returning the wear (S19);
connecting a data processing apparatus wiredly or wirelessly with the medical equipment loaded on the returned wear and reading out electrocardiogram measurement data measured for the period during which the subject has put on the wear;
reguesting (S20) electrocardiographic analysis by transmitting the electrocardiogram measurement data to an analysis apparatus (<NUM>) for electrocardiographic analysis; and
performing (S21, S22) the electrocardiogram examination by the analysis apparatus.