We have developed a system measuring a range of motion of hand, using image analysis of the monitor image transfered by a tele-rehabilitation-system. Occupational therapists and physical therapists reported that this system was useful enough when it was applied for healthy individuals.

 However, we also pointed out that it was still insufficient to evaluate the progress toward recovery of patients. The authors examined the detection axis model by the cluster analysis, to examine patients with rehabilitation in high precision. Our past methods of measuring a range of motion involved two axes, one on basic level and the other on movement level. The proposed method uses three axes. We added an axis based on the palm. We have compared these two measuring methods which are the two axes model and the three axes current one. We have compared them in measuring a range of motion with nine patients.

 The result shows that the three axes method has enough capabilities to detect a range of motion of hand with sufficient precision.

 This paper introduces a Web system for submitting and refereeing papers, which is built by using Server Side Script. The system consists of four sub-systems specialty designed to match the workflows of authors, managers, referees, and editorial staff in case of editing the journal of Japan Association for Medical Informatics (JAMI). It is expected to reduce greatly the workload, cost and time, which was otherwise needed during the course of refereeing and editing of papers. Applying the system to the case of JAMI conference, it was proved that the system contributed much on the editing process, of about one months of reducing the time.

 Recently, new network communication systems, generally called DV over IP that can transmit a real-time high quality digital video over the Internet have been established and introduced to consumer usages. In this study, we evaluated three DV over IP systems whether they are suitable for using telemedicine. Then we applied one of the above systems to experiments of remote diagnosis of colon endoscopy. Using Japan Gigabit Network which is one of broadest networks in Japan for academic purposes constructed by Japanese government, we transmitted real time endoscopic motion pictures of four patients with colon disease in a remote hospital to our university hospital. The transmission images and sounds were good enough to make correct tele-diagnoses. No serious transmission delay which disturbed the doctors’ communications was observed. Therefore, we consider the DV transmission systems are likely to be used for tele-diagnoses and tele-consultations of daily endoscopy if the Broadband Internet spreads to local hospitals.

 In Japan, many hospitals have introduced Clinical Paths (CPs) to improve the patient care processes since CP is an effective tool for care management. How to practice into benchmark tests between CPs adopted in various hospitals is a very important issue. However, it is so difficult to carry out benchmark tests because there exists no standardized manner or rule to describe CP. To address this issue, we introduced a describing rule of prescription part of CPs in XML. Based on this describing rule, we developed a benchmark test system enables quantitative evaluations between plural numbers of hospitals in terms of pharmaceutical prices.

 For preventing side effect, several medicines need various periodical inspection such as a blood test and so on. Besides in today’s medical treatment economy situation, it is important to investigate the effect administered medicine of the medicine prescribed for the patient in order to perform cheaper and more effective medical treatment. In recent years, the system which coped to these subjects using the technique of a data warehouse or data mining is developed with the data accumulated by electronic Karte. Our hospital team developed the system, which verifies the inspection and medication status of a specific medicine, using the clinical inspection, prescription and injection data received from the order system in the medicine section. Thereby, improvement in the further rational use of drugs was attained using the popular data transmission method from the order system to the medicine section this system will contribute to prescription rationalization and the information easily.

 By unifying and simplifying the system for the management of various kinds of medical information in different sections of a hospital, our team has developed a method of accessing useful information for the support of medical care and hospital management. We developed a Caché server created by Japan DynaSystems Inc., which was made to accumulate different medical information, and built a data warehouse. And we finally succeeded a system, in which medical records can be referred to by one hospitalization unit using a web form. Moreover, needed data in the Caché server was shifted to a Microsoft SQLServer2000. We also developed a system (CUBE) that allows multiple-dimension analysis through the use of Analysis Services, acts as a tool or function in the SQLServer2000. When we searched for information regarding patient number or condition, relevant patient care records could easily be accessed by the web form system. Such information could also be analyzed by PivotTable of Microsoft Excel even under the complex condition of the multiple-dimension analysis system. The structure of these systems and their evaluation are described in this paper. The further development and possibilities of the system is also discussed.

 The most important current issue of Japanese hospitals is good management based on objective data toward more efficient medical care. However, the biggest obstacle has been the lack of data in a electronic standard format. The purpose of this study is to explore the possibility of utilizing the data from “the electronic health insurance reimbursement system,” which was developed for a hospital to submit the insurance claim in the standard electronic format. Although the data from this system is not intended for the hospital management, the data could be utilized for various important hospital management analysis, and if a small number of additional data item are combined, almost all necessary management analyses became possible. Since the data can be easily obtained without the burden of a hospital, this system will be a useful management method for hospitals.