In order to evaluate the cost and effect quantitatively in the feasibility study of deploying video-conferencing systems in prefectural medical associations, we developed and applied a cost-effect model to Hokkaido Medical Association (HMA). We introduced a typical model specification for the videoconferencing systems and evaluated the effect by the reduction of the distance and time of transportation, assuming some fixed replacement ratios, which indicate what ratio of the existing meetings is to be replaced by the videoconferences. As for the cost, we evaluated the accumulated cost savings for several consecutive years in terms of the following five parameters: the travel expenses, the travel expense reduction factor, the initial system construction cost, the communications charge, and the replacement ratio. As the result, we obtained the estimate that the accumulated cost savings would exceed the system construction and operation cost in two (three) years if the replacement ratio is 100% (50%). We conclude that the deployment of videoconferencing systems to HMA is desirable from the cost-effect perspectives.

 We developed an electronic patient record (EPR) sharing system called EMInet in Matsudo City, Japan where 42 medical facilities are connected. The network is composed of a server machine located at a computer center which is connected to each medical facility with the NTT Local IP network (private network) using SSL (Secure Socket Layer) so that the medical staff can look into and input the record in the Web browser. Firstly, a family physician and patient decide the facilities where EPR is shared and only the staff of those facilities permitted by the patient can access into the patient’s EPR. Secondly, the patient can ask to access into his EPR in other facilities with his e-card to identify himself. By using this system, it works well especially in the home care relationship between doctors and nurses beyond the immediate facility. Some data in one’s medical record include sensitive and private matters only necessary for the home doctor. From our experience, it became evident that it is not practical to transfer and open all the contents of one’s original record to the EPR sharing system.

 This paper examines the economic evaluation of the tele-home-care system by CVM (Contingent Valuation Method). The economic benefit analyzed here is based upon WTP (Willingness to pay), and we surveyed to users of the system in Kamaishi City and Nishiaizu Town. We compare WTP and other characteristics of two regions. The main difference is that the former charges ¥2,500 to the users, but the latter does not.

 After controlling user properties, the difference between WTP per user per month in these regions is quite small. We find that whether users pay or not, the evaluation about tele-home-care system is not different. Thus, this paper suggests that user charges such as ¥2,500 can be required so as to implement the tele-home-care system.

 Adequate Treatment of Osteoporosis (A-TOP) Study Group, which is an organization for investigator initiated clinical trials and is constituted in order to collect the evidences necessary for the treatments of osteoporosis in Japan, develops a server/client system that can be applicable for multi-center randomized comparative studies. This system is placed in University Medical Information Network (UMIN) Center, and provides the services including subject allocation and registration, logic check, and follow-up to the participating doctors on a nationwide scale on the Internet. In addition, the supporting system by Site Management Organization (SMO) is prepared to assist the practicing doctors who routinely treat patient with osteoporosis in collecting the data.

 The combination with the Internet system and supporting system developed by A-TOP Study Group can be one of useful devices for investigator-initiated clinical trials that may expand in various medical fields in future.

 Shinshu University Hospital has developed a new container storage management system. In Japan, this is the first system which linked with a reservation system for surgical operations. Instrument containers for a scheduled operation can be reserved by doctors using a terminal computer. Information of container contents can be displayed and searched with a web-based browser. To maintain high level of cleanliness, the warehouse was built into a closed space. Using the system it is easy to manage expiration date of sterilized instruments. Reserved containers in the system can be transported automatically to a clean area on the day of operation. This automated-warehouse container system synchronizing with surgical operation schedule gives us many benefits to manage instruments for operations.

 The feasibility of the introduction of the ordering and reporting systems of the nuclear medicine test was reported. In the developed ordering system, the interval of the tests and the half-life of the isotopes are automatically calculated such that the test is capable of performing with no influences of residual radioisotopes. The management of data of order, purchase, arrival, and consumption of isotopes is unified in accordance with the new law regarding the management of the radioisotopes. Simultaneously, we have developed a computerized reporting system linked to the ordering system by the groupware. One of the designs for developing the system is that the information of the test and patients’ profiles are imported automatically from the HIS. Another is the seamless system that unifies an order and report forms so that the radiologists can make a report sharing the demands of client doctors. Since the service-in in July, 2001, the systems contributed to the efficiency in the division in reduction of manual works. It was confirmed that the system helped the client doctors by online report reference along with the non-stop reservation. The number of the tests during five months increased compared with that before introduction of the system. From these observations, it is concluded that these systems function effectively.

 We have developed a fast volume rendering method by superimposing polygons on which slice data of CT images are pasted. Because the thickness of the polygons is zero, when the angle between the normal line of the polygons and the direction of our sight becomes larger, it discloses the side where the texture is not pasted, making the resolution of the three dimension images less clear. We solved this problem by preparing textures in 6 directions and switching them according to the direction of our sight. As only a small amount of calculation is required in this method, we can reconstruct three dimensional displays rapidly even with a conventional PC.