JP2022017659A - Remote auscultation system, remote auscultation program, and remote auscultation method - Google Patents

Abstract

To provide a new remote auscultation system, a new remote auscultation program, and a new remote auscultation method capable of executing stable sound communication, which can be achieved at low cost.SOLUTION: A remote auscultation system includes: a step for imaging a patient by an information communication terminal on a patient's side and transmitting the image data to an information communication terminal on a doctor's side through the Internet; a sound communication step for transmitting and receiving a sound with the information communication terminal on the doctor's side through a telephone line of the information communication terminal on the patient's side; an auscultation step for acquiring a biological sound of the patient by a stethoscope; and a step for acquiring a biological sound of an arbitrary frequency by filtering the acquired biological sound and transmitting it to the information communication terminal on the doctor's side. Thereby, remote medical treatment can be achieved at low cost, and stable sound communication can be executed so that accuracy of an examination can be improved.SELECTED DRAWING: Figure 1

Description

The present invention relates to a remote auscultation system, a remote auscultation program, and a remote auscultation method performed using an information communication line such as the Internet or a telephone line or an information communication terminal such as a smartphone or a tablet.

Visiting medical care and home visits by doctors are indispensable for patients who have difficulty in going to the hospital, such as the elderly living in areas with inconvenient transportation and residents of elderly housing with care facilities. However, the burden on doctors and medical personnel in home-visit medical care and home visits becomes considerably heavier as the number of patients and destinations increase due to the declining birthrate and aging population in recent years. Therefore, the importance of telemedicine, in which doctors remotely examine patients using existing information and communication lines, is increasing.

Telemedicine is generally one of the medical treatment methods using an information communication line such as a telephone line or the Internet and an information communication terminal, and various methods have been conventionally proposed. For example, the following Patent Documents 1 and 2 disclose a remote auscultation method for transmitting an auscultation sound such as a patient's heart sound to a remote location by an existing telephone line. Further, in the following Patent Document 3, a remote doctor and a patient's computer are connected via the Internet, and biological sounds and images acquired by a stethoscope on the patient's side are transmitted to a remote doctor via the Internet. The medical care system is disclosed.

Japanese Unexamined Patent Publication No. 59-32443 Japanese Unexamined Patent Publication No. 2002-301666 Japanese Unexamined Patent Publication No. 2001-309916

However, although the existing telephone line is excellent in the stability of two-way voice communication, it is difficult to transmit data having a large amount of information such as an image. On the other hand, on the Internet, it is relatively easy to transmit data with a large amount of information such as images, but the communication speed and quality are unstable, and there are concerns about voice time lag and communication disconnection in two-way communication. be. Further, in a system such as Patent Document 3, a dedicated device is required on the patient side as well, but it is not easy for the patient to operate the system, and the introduction cost of the device may be high.

Therefore, the present invention has been devised to solve these problems, and an object thereof is a new remote auscultation system and a remote auscultation program capable of performing stable voice communication and realizing remote auscultation at low cost. It provides a remote auscultation method.

In order to solve the above problems, the first invention is a remote auscultation system in which an information communication terminal on the doctor side and an information communication terminal on the patient side are connected by an information communication line, and the information communication terminal on the patient side is a patient. Voice communication for transmitting and receiving voice between the image data transmission means for photographing the image and transmitting the image data to the information communication terminal on the doctor's side via the Internet and the information and communication terminal on the doctor's side via a telephone line. In addition to being provided with means, the information and communication terminal on the patient side is equipped with a hearing device for acquiring the patient's biological sound and filtering the biological sound obtained by the hearing device to acquire the biological sound of an arbitrary frequency. It is a remote auscultation system characterized by being connected to a auscultation device for transmitting to a voice communication means.

According to such a configuration, first, a patient is photographed in a state where the doctor and the patient or the caregiver of the patient communicate with each other by voice via a telephone line, and the image data is transmitted to the doctor side via the Internet. As a result, the doctor can remotely and roughly know the patient's condition from the image data.

Next, the doctor explains to the patient himself or his caregiver how to operate the stethoscope and the auscultation device while photographing the patient, and to the patient himself or the patient's caregiver, the stethoscope and the auscultation device. Have them perform the operation, and acquire the biological sound acquired by the stethoscope and the auscultation device via the telephone line. As a result, the doctor can stably obtain high-quality biological sound, so that the patient's auscultation can be realized remotely and accurately.

Since this auscultation device can filter and acquire biological sounds in an arbitrary frequency range, accurate auscultation can be performed without being affected by voice deterioration during communication. Further, by transmitting an image on the Internet, it is possible to efficiently transmit data having a large amount of information. On the other hand, by transmitting voice and biological sound via a telephone line, stable communication can be performed without concern about voice time lag and communication disconnection in two-way communication.

According to the first aspect of the present invention, the auscultation apparatus includes a filtering unit that filters biological sounds acquired by the stethoscope to select desired frequency sounds, a transmission / reception unit, and a volume adjusting unit. It is a remote auscultation system characterized by being equipped with. According to such a configuration, the patient or the caregiver can accurately operate the stethoscope and the auscultation apparatus while talking with the doctor in real time.

According to a third aspect of the invention, in the second invention, the filtering unit includes a first mode switch for acquiring a biological sound of less than 100 Hz, a second mode switch for acquiring a biological sound of 100 to 1000 Hz, and a 1000 Hz. It is a remote auscultation system characterized by being provided with a third mode switch for acquiring a biological sound exceeding the above. In this way, by filtering the biological sound acquired by the stethoscope in the frequency range of three stages, it is possible to perform the optimum auscultation operation according to the medical condition.

In the fourth aspect of the invention, in any one of the first to third aspects, the auscultation apparatus is provided with a display unit for displaying an image of a human body and an image showing a predetermined part in the human body image by a numerical value. It is a remote auscultation system characterized by being equipped. According to such a configuration, the patient or his / her caregiver can accurately operate the stethoscope only by showing the number in the human body image of the part to be auscultated by the doctor instructing the operation.

The fifth invention is a remote auscultation program used for a remote auscultation system in which a computer on the doctor's side and a computer on the patient's side are connected by an information communication line. An image data transmission means for transmitting the image to the information communication terminal on the doctor's side via the Internet, a voice communication means for transmitting and receiving voice between the information and communication terminal on the doctor's side via a telephone line, and a patient's biological sound. It is a remote auscultation program characterized in that it functions as an auscultation means for acquiring a biological sound of an arbitrary frequency and transmitting it to the voice communication means. According to such a remote auscultation program, it becomes possible to use an existing telephone line, the Internet, a general-purpose smart phone or a personal computer, and the first invention can be realized at low cost.

The sixth invention is a remote auscultation method in which an information communication terminal on the doctor side and an information communication terminal on the patient side are connected by an information communication line, and the patient is photographed by the information communication terminal on the patient side and the image data is captured. Voice communication for transmitting and receiving voice between the image data transmission step to be transmitted to the information communication terminal on the doctor side via the Internet and the information communication terminal on the doctor side via the telephone line of the information communication terminal on the patient side. The step, the auscultation step of acquiring the patient's biological sound with an auscultation device, and the biological sound obtained in the auscultation step are filtered to acquire the biological sound of an arbitrary frequency and transmitted to the information communication terminal on the doctor's side. It is a remote auscultation method including a biological sound transmission step. According to such a remote auscultation method, the same actions and effects as those of the first invention can be exhibited.

According to the present invention, since the biological sound in an arbitrary frequency range can be filtered and acquired, accurate auscultation can be performed without being affected by voice deterioration during communication. Further, by transmitting an image on the Internet, it is possible to efficiently transmit data having a large amount of information. On the other hand, by transmitting voice and biological sound via a telephone line, stable communication can be performed without concern about voice time lag and communication disconnection in two-way communication. Further, the present invention makes it possible to use an existing telephone line, the Internet, and a general-purpose smart phone or a personal computer, so that the system can be realized at low cost.

It is an overall view which shows one embodiment of the remote auscultation system 100 which concerns on this invention. It is an external view which shows the structure of the auscultation apparatus 200. It is a block diagram which shows the structure of auscultation apparatus 200. It is explanatory drawing which shows an example of the display part 234. It is a hardware block diagram of a smart phone 300. It is a hardware block diagram of the personal computer 400 and the management server 600. It is a block diagram which shows each function of a smart phone 300, a personal computer 400, and a management server 600. It is a flowchart which shows the flow of the process of the remote auscultation method which concerns on this invention.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 shows an embodiment of the remote auscultation system 100 according to the present invention. As shown in the figure, the remote auscultation system 100 includes an information communication terminal (smartphone, computer) 300 installed on the patient side receiving the remote auscultation, a stethoscope 200, a stethoscope 210, and a doctor performing the remote auscultation (a doctor (smartphone, computer)). It is mainly composed of an information communication terminal (personal computer, computer) 400 and a telephone 500 installed on the hospital) side, and a management server 600 installed on the doctor side or the Internet N.

As the information communication terminal 300 installed on the patient side, a general-purpose electronic device currently widely used, such as a smart phone or a tablet terminal having a photographing function and a communication function, can be used. Then, as shown in FIG. 5, the hardware configuration is such that the internal devices such as the arithmetic unit (CPU) 301, the main storage device (RAM) 302, the clock (CLC) 303, and the internal storage device (ROM) 304 are connected by the bus 305. While connecting, it is connected to external devices such as the Internet N, camera 307, monitor / touch panel 308, speaker / microphone 309, button / switch 310, and various sensors (not shown) via the interface (I / F) 306. It consists of a connected computer system that allows input and output of information.

In addition, at least in addition to the OS (Operating System), various software such as a general-purpose web browser (web browser) is installed in the information communication terminal 300, and the Internet N (information communication line) is connected by wireless or wired communication. Two-way communication is possible with the information communication terminal (personal computer) 400 on the doctor's side by connecting. In addition, application software provided by the management server 600 is also installed in the information communication terminal 300, so that the functions described later can be realized on the software.

Further, the information communication terminal 300 is equipped with a voice communication function, and is used as an information communication terminal on the doctor's side via a dedicated telephone line network T (information communication line) provided by a domestic and foreign telecommunications carrier. It is possible to make a voice call with one telephone 500. The telephone 500 installed on the doctor's side may be a smart phone or a mobile phone, in addition to the conventional fixed-line telephone dedicated to telephone calls.

The management server 600 and the information communication terminal 400 installed on the doctor side are both general-purpose information processing such as personal computers and workstations in which various software such as an OS (Operating System) and a general-purpose web browser (web browser) are installed. It consists of a device. Then, as shown in FIG. 6, the hardware configuration is such that internal devices such as a computing device (CPU) 401, a clock (CLC) 402, a main storage device (RAM) 403, and an internal storage device (ROM) 404 are connected by a bus 405. While connecting, information is sent to and from an external device such as an Internet N, an input device (keyboard, mouse, etc.) 408, a display device (display) 409, and a database (external storage device) 407 via an interface (I / F) 406. It consists of a connected computer system that allows input and output of.

FIG. 7 is a block diagram showing each function realized by the hardware and software (program) of the information communication terminal (smartphone) 300, the information communication terminal (personal computer) 400, and the management server 600. As shown in the figure, first, the smart phone 300 on the patient side includes an image data transmission means 310, a voice communication means 311, an auscultation means 312, a communication means 313, an input / output means 314, etc., which will be described later by the hardware and software (program). It has a function to realize each means.

On the other hand, the personal computer 400 installed on the doctor side has a function of realizing each means such as the communication means 410 and the input / output means 412. Further, the management server 600 has a function of realizing an application providing means 610 for providing application software and a data management means 611 for managing patient data and the like in order to realize the present invention.

As shown in FIG. 2, the stethoscope 210 includes a chest piece 211 that comes into contact with the patient's body and a tube 212 that extends from the chest piece 211. A microphone (not shown) for acquiring the patient's biological sound is built in the chest piece 211, and the output signal is input to the auscultation device 200 via a signal cable (not shown) in the tube 212. It has become like.

As shown in FIG. 2, the auscultation apparatus 200 has a box-shaped housing 230 provided with a mode changeover switch 231, a volume adjusting unit 232, and a display unit (panel) 234. FIG. 3 is a block diagram showing the internal structure of the auscultation apparatus 200. As shown in the figure, a microphone insertion port 241 and an earphone insertion port 242 are provided on the surface of the housing 230, and the microphone terminal of the stethoscope 210 is inserted into the microphone insertion port 241. ing. On the other hand, as shown in FIG. 2, the terminal of the headset 220 in which the headphone 221 and the microphone 222 are integrated is inserted into the earphone insertion port 242.

As shown in FIG. 3, the housing 230 includes a pair of amplifier circuits (AMP) 251,252, a filtering unit (bandpass filter: BPF) 253, a signal level adjustment circuit (VR) 254, and a connection circuit ( IF) 255 is built-in. Then, after the biological sound input from the microphone insertion port 241 is amplified by the amplifier circuit (AMP) 251 and then the signal is filtered by the filtering unit (BPF) 253, the biological sound in a specific frequency range is acquired.

After that, the biological sound that has passed through the band filter (PF) 253 is output-adjusted by the signal level adjusting circuit (VR) 254 and the amplifier circuit (AMP) 252, and then input to the smart phone 300. .. The audio signal can be easily input to the smart phone 300 by inserting the cable 256 extending from the housing 230 into the earphone jack that is standard equipment of most smart phones 300.

The band filter (BPF) 253 has a function of dividing the biological sound input from the stethoscope 210 into three bands, and can be arbitrarily operated by the mode changeover switch 231 shown in FIG. There is. That is, when the mode changeover switch 231 shown in FIG. 2 presses the mode 1 switch, which is the first mode switch, the low-pass filter function is exerted to block the biological sound having a frequency exceeding 100 Hz and the biological sound having a frequency exceeding 100 Hz. It is designed to selectively pass only.

When the mode 2 switch, which is the second mode switch, is pressed, the bandpass filter function is exerted to block the biological sound having a frequency of less than 100 Hz and exceeding 1000 Hz, and only the biological sound having a frequency in the range of 100 Hz to 1000 Hz. When the third mode switch, mode 3, is pressed, the high-pass filter function is exerted to block biological sounds with frequencies below 1000 Hz, and only biological sounds with frequencies above 1000 Hz. Is designed to pass selectively. The volume adjusting unit 232 is interlocked with the signal level adjusting circuit (VR) 254, and the output volume can be manually adjusted arbitrarily by turning the knob.

As shown in FIG. 4, the display unit 234 includes a human body image showing a part of the human body to which the stethoscope 210 is applied and a number indicating the part. That is, the display unit 234 displays a human body illustration of the chest (front) of the upper body of the human body and a human body illustration of the back (back), and each illustration shows the part of the body to which the stethoscope 210 is applied. A number indicating the part is described. In the example of the figure, eight parts on the left and right are indicated by black circles in a figure eight shape from the neck to both sides of the chest and back, and numbers 1 to 8 are assigned to each black circle. Then, the same illustration displayed on the display unit 234 exists as a printed matter on the doctor side or is displayed on the monitor of the personal computer 400 or the like.

Next, the flow of the remote medical treatment method by the remote auscultation system 100 according to the present invention having such a configuration will be described with reference to the flowchart of FIG. First, when the date and time reserved in advance is reached on the doctor side, the personal computer 400 is activated and a call is made from the telephone 500 to the patient side via the telephone line network T (step S100). On the patient side who receives this call (received power), the patient himself or his / her caregiver activates a predetermined application from the smart phone 300 and connects to the personal computer 400 on the doctor side via the Internet N (step S202). When the appointment date and time arrives, the patient may call the doctor to start the remote examination.

Next, on the patient side, the patient himself or his / her caregivers point the camera of the smart phone 300 at the patient and take a picture of the patient's condition (step S204). The captured image (video) data of the patient is sent to the doctor side via the Internet N and displayed on the personal computer 400 (steps S206 and S102). The doctor who sees this image conducts necessary interviews and inspections, and then explains the operation of the stethoscope 210 and the auscultation apparatus 200 using the telephone line network T (step S104). Of course, at the time of this interview and inspection, physical information such as heart rate and blood pressure in a normal examination is also notified.

The patients themselves or their caregivers who intend to receive the operation guidance of the doctor activate the auscultation device 200 and attach the headset 220 to the head to prepare for it (step S208). By wearing the headset 220, you are freed from the call operation by the smart phone 300. When ready, the doctor will number the part of the body to which the stethoscope 210 will be applied. Then, the patient himself or his / her caregiver who received the instruction confirms the designated part with the illustration of the display unit 234, puts the stethoscope 210 at the position, and starts the auscultation (step S210). Since this state is sent to the doctor as an image at any time, if the position is deviated, accurate positioning can be performed by notifying the patient or his / her caregiver at any time.

Then, the biological sound acquired by the stethoscope 210 is sent to the smart phone 300 via the stethoscope device 200 and sent to the doctor side via the telephone line network T (step S212). The doctor who receives this biological sound will listen to the biological sound on the telephone 500. At this time, in order to selectively listen to the desired biological sound, the patient himself or his caregiver is asked to switch modes and the volume. Instruct operations such as adjustment.

For example, in the case of inspiratory sound in the lungs, since it mainly consists of high frequency components exceeding 1000 Hz, the patient himself or his caregiver was asked to press the mode 3 switch to send a biological sound with the low and medium frequency components removed. Get it. In the case of heart sounds, since they mainly consist of frequency components in the range of 100 Hz to 1000 Hz, the patient or his / her caregiver is asked to press the mode 2 switch to send the biological sound from which the low / high frequency components have been removed. The patient's health condition is diagnosed from the biological sound (step S108).

As a result, the doctor can remotely and accurately acquire the desired biological sound without actually operating the stethoscope 210 or the device on the spot (where the patient is). Then, when the same operation is performed sequentially while changing the position of the stethoscope 210 and the auscultation is completed, the diagnosis result is recorded (step S108), advice on lifestyle and diet, issuance of necessary prescription, next time. Make an appointment for a medical examination and end the telemedicine.

As described above, since the remote auscultation system 100 according to the present invention can filter and acquire the biological sound of an arbitrary frequency, accurate auscultation can be performed without being affected by voice deterioration during communication. Further, by transmitting the photographed image of the patient via the Internet N, even data having a large amount of information can be efficiently transmitted.

On the other hand, by transmitting the call voice and the biological sound via the telephone line network T, stable communication can be performed without fear of voice time lag and communication disconnection in two-way communication such as the Internet N. Further, since the present invention can be easily realized by using the existing telephone line network T, the Internet N, and a general-purpose smart phone 300 or a personal computer 400 in terms of hardware, the system can be realized at low cost.

100 ... Remote auscultation system 200 ... Stethoscope 210 ... Stethoscope 230 ... Housing 231 ... Mode changeover switch 232 ... Volume control unit 234 ... Display unit 300 ... Information communication terminal (smartphone)
310 ... Image data transmission means 311 ... Voice communication means 312 ... Auscultation means 400 ... Information communication terminal (personal computer)
600 ... Management server N ... Internet (information communication line)
T ... Telephone line network (information communication line)

Claims (6)

It is a remote auscultation system that connects the information communication terminal on the doctor side and the information communication terminal on the patient side with an information communication line.
The information communication terminal on the patient side is an image data transmission means for photographing a patient and transmitting the image data to the information communication terminal on the doctor side via the Internet, and an information communication terminal on the doctor side via a telephone line. It is equipped with a voice communication means for transmitting and receiving voice to and from.
A stethoscope that acquires the patient's biological sound and a biological sound obtained by the stethoscope are filtered to acquire the biological sound of an arbitrary frequency and transmitted to the voice communication means to the information communication terminal on the patient side. A remote auscultation system characterized by being connected to a stethoscope. In the remote auscultation system according to claim 1,
The auscultation apparatus is a remote auscultation system including a filtering unit for filtering biological sounds acquired by the stethoscope and selecting biological sounds in a desired frequency range, and a volume adjusting unit. In the remote auscultation system according to claim 2,
The filtering unit includes a first mode switch that acquires a biological sound of 100 Hz or less, a second mode switch that acquires a biological sound of 100 to 1000 Hz, and a third mode switch that acquires a biological sound of 1000 Hz or higher. A remote auscultation system characterized by being equipped with. In the remote auscultation system according to any one of claims 1 to 3.
The auscultation apparatus is a remote auscultation system including a display unit that displays an image of a human body and an image showing a predetermined part in the human body image by a number. A remote auscultation program used for a remote auscultation system in which a doctor's computer and a patient's computer are connected via an information communication line.
The computer of the patient side has an image data transmission means for photographing the patient and transmitting the image data to the information communication terminal of the doctor side via the Internet, and the information communication terminal of the doctor side via a telephone line. A remote auscultation program characterized by functioning as a voice communication means for transmitting and receiving voice between and auscultation means for filtering a patient's biological sound to acquire a biological sound of an arbitrary frequency and transmitting the biological sound to the voice communication means. It is a remote auscultation method in which the information communication terminal on the doctor side and the information communication terminal on the patient side are connected by an information communication line.
An image data transmission step of photographing a patient with the information communication terminal on the patient side and transmitting the image data to the information communication terminal on the doctor side via the Internet.
A voice communication step of transmitting and receiving voice to and from the information communication terminal of the doctor side via the telephone line of the information communication terminal of the patient side, and
Auscultation steps to acquire the patient's biological sound with a stethoscope,
A remote auscultation method comprising: filtering the biological sound obtained in the auscultation step, acquiring the biological sound of an arbitrary frequency, and transmitting the biological sound to the information communication terminal on the doctor's side.

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