Several methods have been proposed which enable healthcare providers to share and exchange medical information. Most of them, however, refer to specifications about protocols and the standardization of medical terminology has been fairly under way of carrying on. It must be essential and urgent task to standardize medical terminology both for developing electronic medical record systems and for exchanging clinical data electronically. Against this background, strenuous efforts have been done for compiling a standard lexicon that can be utilized commonly among all the medical providers. It would rather be a practical solution to unify terminology in terms of standardized medical concept in a manner that allows medical providers to represent medical terminology freely to some extent according to their application. Thus the author proposes a method of exchanging medical terminology between medical providers by means of standardized concept combined with proprietary terminology. The availability of this method is evaluated from the viewpoint of information sharing through the adoption to MERIT-9 patient data referral and MML standard.

 HL7 (Health Level Seven) RIM (Reference Information Model) version 1.0 was released in January 2001. HL7 version 3 messages to be developed in future are to be based on this HL7 RIM. HL7 version 3 messages are semantically regarded as a superset of HL7 version 2.x messages. Therefore, HL7 version 2.x messages, the most familiar healthcare information exchange protocol at present are naturally mapped to HL7 RIM. This leads to a guarantee of the interchangeability between HL7 version 2.x messages and version 3.x messages.

 In addition to HL7 messages, J-MIX (The Japanese Set of Identifiers for Medical Record Exchange), MERIT-9 (MEdical Records, Images, Texts – Information eXchange), and MML (Medical Markup Language) are communication protocols that are often used for healthcare information exchanges in Japan. However, interchangeability among them is not yet trivial. Such a situation is a serious obstacle to implementing a large-scale healthcare information network in Japan. One of the solutions to build interchangeability is the development of a translator from one protocol to another. This solution requires at least ₅C₂ (=10) bi-directional protocol translators, development and maintenance of which would be labour intensive.

 Our approach is to make HL7 RIM serve as an intermediate language for translation between the other protocols. Advantages of our approach are less cost for development (only 3 bi-directional protocol translators) and clear division of responsibility for development (each protocol developer being responsible for developing translating rules from/to HL7 RIM).

 In this paper, we illustrate our strategy to map J-MIX, MERIT-9, and MML to HL7 RIM and demonstrate its effectiveness by examples of translating typical parts of the three protocols to HL7 RIM. This paper is the initial step in the process of unification of the existing healthcare information exchange protocols.

 The Healthcare Statistical Data Element Dictionary is under development to improve comparability of healthcare statistics, across organizations and applications. The data elements are defined according to an International standard. In order to make the contents of the dictionary open to public the dictionary is developed using the Web technology. We describe the objective and the structure of the dictionary, and discuss some issues involved in the representation of relationship among the entities.

 We developed an information sharing system by recording the results of in company periodic health examinations on a database at our centre with the cooperation of companies that have contracts with the Kokura Medical Association. Member doctors of the Association can share this information. Shared information includes text information, chest X-ray images, double contrast gastrography and electrocardiograms.

 Registered doctors access the database centre by ISDN and check workers medical information using browser software. A registered IC card is needed to gain access. The centre has distributed magnetic cards to companies staff and their identification is verified by card information.

 This system enables the sharing of medical information within the Kokura Medical Association and contributes the better regional medical service.

 The data library of Japan Down Syndrome Network is a database system which is constructed in the view of supporting people relating Down syndrome. Since the establishment in 1997, thousands of people have visited this system via the Internet. The system is designed to provide appropriate information about the syndrome, including issues on welfare, education and so on. In this article, we outline the operating tools for the system, the contents, the managements, and the state of use.

 This study focuses on the feasibility of the sharing system for electronic patients’ records(EPRs) between medical institutions in Korea. The sharing system purposes to provide the patients with the better health care by using the technology of information and telecommunication. The study covers the analysis of current and prospective hospital information systems and the attitude-demand survey of patients and medical personnel to communicating patients’ information. While the current computerization status of medical institutions is pretty low, but their prospect is high enough. In addition, few tertiary hospitals already established the network of hospitals and clinics, and were communicating their EPRs. The sharing system was socially accepted by patients and medical personnel, and also economically justified. Therefore, the sharing system approach is judged to be feasible. However, the essential prerequisites need to be solved before the main steps of establishing the system. This system will provide the patients healthcare services of better quality, the researchers and government officers evidence-based knowledge and statistics, and will ultimately contribute to the reduced healthcare expenditure in Korea.

 JIRA (Japan Assoc. for Imaging Radiation Apparatus) and JAHIS (Japan Assoc. of Healthcare Information Systems) collaborated to promote more use of DICOM standard for image examination order entry.

 Transfer of order information between imaging modalities and hospital information systems needs standardized codes for image examination details, i.e. examination modality, region and direction. We studied codes which DICOM standard provides and found out that they have not enough detail for use in Japan. Therefore, we created standardized codes for above purposes, guaranteeing local expansions.

 In an effort to standardize a drug-code, we carried out a fundamental examination of drug names. We began by itemizing terms according to name (trade-mark) type, and other factors and subdivided them into 23 elemental groups, basing our analysis on each element. Although there is a need to standardize drug names, it was necessary for the names of drugs to be abbreviated for clinical efficiency. It was also assumed that we needed to be careful for similarity of drug names from the viewpoint of risk management and we tried to examine this similarity based on stem words in product names. As a result we decided it was useful to carry out an objective evaluation of degrees of similarity in drug names. For standardization, it became clear that analysis and rearrangement were necessary to provide a method to reach results.

 The possibility of the prescription ordering system on the risk management strategy related to drug therapy was investigated. In a prescription order ring system, the effect is accepted in error prevention because prescription is not completed unless all of required items are input and it is readable by printing the prescription sheets. However, there is a difference in prescribing procedure between the drugs for injection and the drugs for oral and external application, and the standard name for products registered into a drug basic master for the ordering system does not exist. So there are also many problems which should be solved towards standardization. Moreover, it may be considered that a new decision-making support functions such as “the prescription support window function” is useful as a tool for risk management.

 The development of risk management activities is now encouraged for Japanese healthcare institutions due to frequent occurrence of medical adverse events. As a tool of risk management, Osaka University Hospital has developed the computerized incident reporting, which can detect preventable events. The goal of this system is to promote voluntary reports on potential adverse events by clinical and administrative staff in the hospital and to use these findings for the prevention of errors and negligence. The system was developed based on WWW Client/Server architecture and placed in the intranet of hospital information systems. A report is registered through the form interface of WWW browser, not requiring names of staff and patients because noninjurious events are subject to reporting. The system helps analyzing root causes of events by structured data inputs as well as sharing the risk-related information across different disciplines, which results in timely decision making for improvement. Many incidents have been reported by various professionals, and already utilized for preventive interventions. Computerized incident reporting can be a great system that has enhanced timely and proactive response to potential adverse events.

 Making a good physical management system of materials in a hospital is one of the key factors for the success of the hospital management. It is however very difficult to accomplish this because of several reasons. One of the reasons may come from the characteristics of the hospital that all the materials needed in emergency cases should be available at any time. Preparing a good deal of materials only for this future possibility of use is the main cause of creating dead stock. SPD(Supply Processing and Distribution by suppliers) tactics is sometimes used in this case. It is, however, very difficult to fully incorporate the commercially available bar codes, such as EAN128, since the items supplied by SPD are usually not included in the code tables needed in the physical management system of the hospital. In this paper we developed an integrated physical management system, covering both the supplier's system and that of the hospital. By this new system, all the materials used in the hospital can be controlled by the commercially available bar codes, and a smart mechanism of reducing the dead stocks is also systematized.

 The conventional bed side data entry terminals, for example, Notebook Computer, PDA and Wireless handy terminal are not the best solution for the hospital information systems of Electronic Patient Record era. They belong to medical staff not to patients. The needs of bed side terminal is always increasing. It is difficult to use so many terminals that realize portability, high performance, and low cost at the same time.

 Bed-side computer for every patient provides many advantages in the field of risk management, patient amenity, and disclosure of electronic patient record. That integrates TV and Web-based terminal. There are two approaches. The highly customized PC-based terminal is optimal solution for bed side needs. On the other hand, the consumer TV game console with broadband (100Mbps) adapter provides basic function by extremely low cost.

 The Reference Information Model (RIM) provided by Health Level Seven is one of the most practical information models for the healthcare domains. It can be used as a shared reference model for healthcare information systems. However, inconsistent application of the RIM decreases the benefit of it as a common reference model and it makes difficult to achieve a sufficient level of interoperability. This paper presents a derivation process of data models based on the RIM in the development of a patient profile data server. We then discuss a set of practical guidelines for designing data models based on the RIM. The result shows that deriving data models directly from the RIM and clearly separating the data models from the RIM are effective for achieving the temporal and geographical interoperability among hospital information systems.

 It is commonly agreed that a medical information system plays a significant role in risk management. In infection control, the medical staffs must prevent the hospital acquired infection by following the manuals and the their knowledge of the epidemiological data for MRSA, VRE, syphilis, tuberculosis, HCV and HIV accumulated to the HIS (Hospital Information System). On the other hand, patients’ information should be protected from any third party. According to these needs, the system has been updated so that the history of the positive MRSA is displayed regardless of the latest outcome as a patient’s profile and that the positive results of an HIV test cannot be seen on the display, taking into account of the privacy. The authors suggest that both the exact disclosure and the protection of patents’ information should be achieved simultaneously by the medical information system and that the staffs of the Division of Medical Informatics should actively participate in the ITC(Infection Control Team).

 The purpose of this study is to develop the set of identifiers in electronic nursing data. The present study has been organized by JAMI, the Research Group of Nursing Summary Network since 1998. We invented version alpha through four steps. To evaluate version alpha, we used 1) the feasibility of our new invented data set in nursing station and in hospital, 2) accountability of the findings from the trial operation and 3) Adaptability of already used standard data set. From these findings we concluded the necessity of development of new version.

 We have developed a hospital information system for risk management in Kagoshima University hospital. The system provides a medical act and task management in hospitals. The medication and blood transfusion safety issue requires automation and verification at the point of act.

 The point of act system requires too using bar-coding and bedside care support system by note PC. From the viewpoint of risk management, Hospital Information System need to perform basic roll to avoid these medication and blood transfusion errors.

 In this report, we described risk management system about the operative abstract and evaluation.

 In these days many hospitals and clinics are introducing electronic patient record systems. Because of that, it is becoming very important to construct a standard code set of disease names. There are already several code sets and in these sets huge number of disease names, almost 30 thousand, is included. In that situation if we classify disease names into any thesaurus, it is not easy to look up words. In this work we aim to construct a system where everyone concerning to medical care can make own minimal code set of disease names.

 For any busy departments, such as the Ear-Nose and Throat (ENT) department, the Electronic Medical Record (EMR) of the present style is sometimes considered as impossible to realize without a future breakthrough of techniques for outpatients. One of the reasons may come from a time consuming process of data entry of the clinical information, which is crucial for keeping up the busy daily patient care. It has, however, not known the true figures how the clinicians of ENT department consider about the use of EMR. To know this, we made a survey among ENT members and held a symposium on this subject. And this report is a result of these works.