Hospital information systems based on object technology and graphical user interfaces are becoming common. Use of a set of basic components with particular functions such as icons, buttons and controls has enabled flexibility of layout and a wide variety of visual designs of the window. Optimizing the visual design of the window seems to be important to improve the end-user environment. In this study, objective methods to evaluate the visual design of the window in terms of perceptibility of the window were considered and applied to early and later versions of the order entry system of our hospital information system. Relative size of data display area, relative size of components, font faces used in the window, adequacy of grouping of components and positional consistency of components were quantified as indices of perceptibility. These indices could depict differences in window design between versions indicating applicability for quantitative evaluation of the visual design of the window. Factors affecting perceptibility of the window were discussed and the importance of the consistency of the window design was emphasized. It seems important to consider these factors in developing and refining user interface design and layout of the window.

 This paper will report the development of nursing knowledge for maternity care on the Internet and its practical use. This support system for maternal nursing is composed of four domains: medical knowledge, nursing knowledge, patient education, and access to other related sites. Each educational item was developed with computer applications available on the market: Power Point, Persuasion, Publisher, File Maker Pro and so on. This support system is composed of the most up-to-date information from Japan and the U.S. and it includes many colorful pictures for students to understand easily. In the past, each educational item was accessible only through the original application. Now, we have integrated all of the information on the Internet making it accessible from any Internet terminal. When we put our support system on the Internet, it became very useful for nursing students preparing for class, studying, and reviewing. They also accessed the system from the maternity ward during their clinical practice. As it is easy to access, it helped refresh their memory. As a result, their impression of clinical practice changed. They felt satisfaction and gained self-confidence in clinical practice. As for the staff of the maternity ward, the support system useful for them to plan each patient’s care and to have current knowledge readily available so they can provide high quality patient care.

 We investigated 117 Japanese academic journals and checked “notes for authors” on copyright and related articles, in January 2000. Only 46.2% journals had some comments about copyright. All of the journals wrote publisher has copyright, although some journals (18.5%) wrote author also has copyright. But there were no journals that explained the details of copyright. In regard to computers, 12.0% of journals that wrote about databases, and 5.1% of journals wrote about Internet Web sites. Especially in journals that were published by academic associations, only 1.5% of journals wrote about databases or Web sites. In using academic journals on the Internet, there were many problems related to copyright.

 Effective use of hospital laboratory data is at issue in Japan. We addressed the problem using Intranet home pages providing two kinds of information. One is for enhancing cooperation between clinicians and laboratory members, and includes the rules of examination orders, the measurement methods, and the calibration data of laboratory machines. Another is for adding values to the laboratory data, and reflects the infection control status in the hospital; this is in extracted collection of data from the microbiology laboratory, the pharmacy, and admission/discharge databases, providing a view from patients, dates, wards, types of samples, microorganisms, administered antibiotics, and diagnoses. The home pages brought benefits to both laboratory members and clinicians in regard to controlling the instruments and taking measures to prevent infection in the hospital. These results suggest that effective use of hospital laboratory data contributes to the advanced and efficient care.

 Cox’s proportional hazard model is now widely used to evaluate prognostic factors of diseases. But it has been often pointed out that the Cox’s method is sometimes not sufficient because it assumes temporally constant effects of prognostic factors on the disease process. In this paper we developed a new evaluation method of prognostic factors, based on the more detailed modeling of the course of the disease. This method describes the disease process by longitudinal Markov model (temporal succession of simple Markov model) and the prognostic factors are evaluated by the multiple logistic regression analysis.

 Stage II breast cancer is chosen as the subject in this study. Data are retrospective ones, collected in National Cancer Center Central Hospital.

 As first step, a longitudinal Markov model was constructed to describe the longitudinal disease state transition of a breast cancer. Then based on the detailed investigation of the longitudinal change of transition probability between each disease state, we discriminated the breast cancer patients by two groups, good and poor prognosis one, by using a nonparametric test. We extracted a patient group who showed a recurrence for the first two and a half years as the poor prognosis group (p < 0.05), which corresponds to clinical accepted view.

 As second step, a multiple logistic regression analysis was applied to evaluate prognostic factors that contribute the discrimination between good and poor prognostic group, and the results were obtained that three factors (n-classification of pathological diagnosis, ductal spread, and existence of estrogen receptor) were considered as the major prognostic factors for the early death in Stage II breast cancer.

 These results well correspond to the clinically accepted view concerning the prognostic factors of breast cancer, so that this method would be an efficient quantification method to transform clinical impressions to objective evidences in prognosis of diseases.

 This paper describes a method to comprehend the welfare of the aged in different area in a graphic form.

 Since April 2000, the health service for elderly people has been introduced. However, there are several problems such as differentials fare between regions. The statistical data for characterizing the each area are complex and it is generally difficult to understand the results.

 Therefore in the graph presented here, a face form presents the vital statistics and a body style presents the welfare.

 By using this method the characteristics of each area could be compared with each other as a whole. Furthermore it also facilitate the understanding of sequential changes. As an example, the data of Tokushima prefecture are presented.

 In giving outpatients information related to their medication (“Medication Consultation”), we have prepared and utilized the “Medication Consultation Recording Sheet” to validate at least the minimum information that was offered by pharmacists and to record the information obtained from patients so that the quality of pharmacists’ service as an information provider may be maintained.

 A new system that incorporates the information on this “Medication Consultation Recording Sheet” in a database was constructed so that the information will be managed more simply and uniformly, consultation records may be searched more rapidly, and the resultant database information may be shared among pharmacists through the management of the in-hospital LAN environment.

 The database thus constructed may be accessed through a WWW browser at a terminal in the hospital and can be examined or searched by using a password.

 By employing this system, a survey was conducted on the usage of the “Medication Consultation Service” (a total of 627 occasions) between April and December 1998. On 409 occasions (65%), instructions related to medication were given out actively, while for the remainder, the patients received instructions passively. Among 409 patients who received guidance on medication, 14 utilized the service more than once; 13 (93%) received instructions from different pharmacists at each occasion; and 10 (71%) received repeated instructions on the same drug. These findings suggested a need for a system by which the information on the “Medication Consultation Recording Sheets” can be searched and shared by pharmacists. By managing the records of explanations given on medication on the in hospital network and sharing the contents of the information that has been given out by individual pharmacists, it became possible to maintain the integrity of the medication consultations given to patients. It was proven at the same time that the system can be used as an information-providing medium for the appropriate use of medication.