At Kumamoto University hospital, the income and expenditure according to departments has been calculated since 2000 by using “the Hospital Management Data Entry System.” Accounting the income and expenditure according to departments was useful to know rough properties and profitability of departments and sections in a hospital. However, it was sometimes too rough and was not practical in the real decision making scene. Since 2002, the calculation of the income and expenditure according to diseases, which is more useful to the staff in medical scene, has been tried. As there was no practical information of the name of disease in electronic this time, approximately 600 cases of about 60 diseases in 20 departments were chosen as samples. Individual meetings were held with departments on the basis of analysis result. We examined the present conditions of the departments and future plans of medical care with the delegates of the departments at the meetings. And the plans on the basis of the conclusions of these discussions were carried out in medical scenes, and the same calculations were carried out half year later. The individual meetings with departments were held again, and the change of management state of departments was reviewed.

 By comparison between 2001 and the first half of 2002, hospitalization was shortened and profitability was improved in most diseases. The tendency of change in the object diseases was grasped concretely. However, the balance turned worse in some departments adversely, and the deviation between these results was not able to be explained enough only by this analysis.

 System replacement in order to improve the performance per cost in hospital works is inevitable for a hospital using hospital information system (HIS). Such replacement of HIS tends to become large scale in these days. It is extremely important task for a hospital to make a replacement plan and accomplish the replacement without giving any inconvenience to the daily hospital works. However, it is generally required to deal with various problems in a replacement process within extremely limited time. In this paper, we have investigated the case at Kochi Medical School hospital as an example, and considered problems common in general replacement process and proposed methods to solve them. We have found 1) committee to make top down decisions, 2) early decision of clear basic policy for the new system, 3) start of works which is possible prior to the bit, 4) adaptation of mature and reliable technology and widely used soft wares, 5) system balance, 6) grasp of the data structure in old system, 7) reduction of the data transfer time from old system to new system by dividing the data transfer process, 8) large scale rehearsal in realistic condition, 9) preparation of help desks and help persons on the cut over day, 10) special division and staffs to concentrate various tasks from the planning to the end of replacement, are important.

 We have been developing a tele-health system to share medical and health information among medical facilities and institutions by utilizing multi-media information technologies. We completed a development of collaboration tool, termed MediaCollaborator, which enables sharing motion images as well as still images among two or more people over a TCP/IP network. This paper presents some issues of MediaCollaborator first and then explains our approach to them. We developed a method to overcome the issues and implemented it as two software components: (1) a database to manage files of motion and still images and other documents; (2) a server system to integrate the database and MediaCollaborator. We show how the components work with MediaCollaborator in detail. We are certain that our system is less expensive, portable, flexible to integrate other software and technologies, and easy to use.

 Long-term care insurance (LTCI) introduced an electronic bill claim system since its beginning in 2000. Although the data derived from the system would have potentials to provide useful information for health policy research and decision making, the system suffers several structural limitations. In this study, we newly developed a LTCI data warehouse which had two layers to overcome current structural limitations. In the first layer based on a relational database, the latest claim data were chosen through queries. In the next layer, the data were further summarized for analyses. The developed data warehouse enabled to easily retrieve and merge of selective information items, and extended linkage with information from other database. Some examples were presented to show how this feature of the data warehouse helps descriptive and analytic evaluation of LTCI performance.

 Informed consent is regarded to be very important in clinical practice today. Some systems to support it with bedside-terminals are being developed, but few studies that introduced such systems reported the evaluation by patients so far. This paper reports an evaluation of services on bedside-terminals by inpatients at the University of Tokyo Hospital. From the questionnaires, we found that they are willing to take more information services using the bedside-terminals. There are little announcement about the usage of the service and they don’t use them so much. We also found that the information about doctors in charge of inpatients are relatively required, that there are some troubles with the input devices and the position of the terminals and etc. To make the services better, we must evaluate how patients feel with such services and devices.

 A personalized dynamic database (PDD) system is proposed for preventing diseases and improving wellness. In this database system, daily health and life data input through mobile phone are transferred to web application server via the Internet. A web application server provides a data reference service visualizing health and life data graphically on the mobile phone display, and a data mining service notifies users of some important rules between the health data and life data. The database system can afford user’s original data items registration in addition to default health and life data items (data-types of these original data items can also be registered by users). The server also provides mailing service for assisting user’s data input. Users can easily input their daily health and life data by responding to mailing inquiries.