For electronic exchange of medical information between hospitals, it is necessary to standardize data formats. In Japan, however, exchanges of medical information are still underdevelopment, resulting in few hospitals which actually have their medical information exchanged with each other. This paper is to introduce a new approach of sharing patients’ data among hospitals and of solving the problem in which allowing of each hospital own format of patients’ medical record. Our proposed system accepts XML-documented patient records and transforms them into a common schema through the style sheet that is being designed at present. Because we adopt a XML format, the users are able to easily get the information among medical facilities. The largest characteristics of this system include; (1) the automatic creation of an appropriate structure of the database from the XML schema information for each hospital, so that it can be possible to store any records of XML format for which XML schema information is known in advance, (2) it facilitates a dynamic control of information flow by introduction of an idea of standardized interface structure, (3) and due to these properties, the system can reduce costs that another electronic medical record system has to pay to partake, (4) and it is easy to increase numbers of hospitals shared DB with a common XML schema.

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 Purposes: A continuous survey has been conducted over seven years concerning students’ information literacy in case of medical informatics lecture in Hokkaido University. The paper is to report the results and the trends of the survey. Methods: The students of the fifth grade who majored in medicine and the second grade who majored in nursing and radiological technology were selected as the survey subjects. The survey was taken annually from 1998 to 2004. The survey questions concerning information literacy included the following: (1) the knowledge of terms of “Byte”, “Order entry system”, and so on. (2) the possession rate of a personal computer(PC). (3) the utilization frequency of e-mail. Results and Discussion: It became clear that there is a difference of the knowledge for informatics terms among the student’s major. The PC possession ratio for the medical students was 90%, for nursing students and for radiological technology students was 70-80%. The number of students who own a PC for exclusive use has increase rapidly from 1999 to 2001. The routine use of e-mail by students showed a similar tendency of PC possession. We think that in the future it will be necessary to consider the students’ information literacy while constructing the curriculum for a specialty.

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 Mobile web log which can receive and transmit images from cellular phones have been attracting wider at ention. However, their use in medical care presents a problem of security with regard to privacy. In order to overcome this problem I added a security capability making it simple and easy to utilize mobile blogs for home medical examinations and treatment. When sending patient treatment data from a cellular phone, the data is automatically saved and form compatibility ensures access by any number of other medical staff. It is possible, I think, to make extensive use of this system because of its suitability and convenience in home health care situations.

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 Computers are often used for data entry systems, such as patients’ information management, reservation of inspection or medical examination. Nurses often have to input patients’ information at bed sides as duty. Although in this information era, there are few opportunities to study network structure and the importance of data, or taking up computer management on an individual level in the information processing education at nursing schools. When students use their individual terminal, we think that it is suitable, also in order to master operation of information-and-telecommunications apparatus and structure, and to be able to improve the consciousness which studies the handling of an electric device and information and to be aware of the importance of data control. Therefore, we developed the learning support system using personal digital assistants for nursing schools, and have done an experiment to check usability of the system. It was proved by repeating the foundation of a computer, and study of network technical related knowledge as a custom as a result of the experiment that the knowledge over apparatus could be mastered.

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 The ultrasonography is lagging in introduction of a filling system including a report in comparison with radiation.
 The difference in a workflow with radiation and an immature input support tool are mentioned as main factors.
 In promoting systematization with ultrasonography, cooperation of an ultrasonic maker was obtained.
 The speech recognition tool was introduced in equipment and the trial for conversion of the workflow to facilitate view input during inspection was performed.
 It was useful for an abdominal part, a circulatory organ and report creation.
 Even if the chance ultrasonically improved from a workflow is left aside and one thinks from the source input which is the foundations of systematization, the view input under inspection with the workflow suits most the real time nature which is the trait of ultrasonography.
 A quick report gathers the working efficiency of inspection, enables increase in an inspection frame and reducing duration for reservation.
 It is desirable to acquire increase-in-income due to systematization promotion.
 It was thought that an ultrasonic real-time report had high utility as a new inspection style which observed the workflow.

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 Number of HIS terminal is increasing in CPOE(Computerized Provider Order Entry)-EMR(Electronic Medical Record) era. Many hospitals employ thin clients instead of fully-equipped computers as HIS terminals. However, in Japan, few hospitals use thin clients.
 Hospitals in Japan have insufficient number of client computers although typical Japanese CPOE system has a lot of screen depth. Staffs have to logout from their computer on job interruption. It takes much time to resume to the original working screen.
 Several parameters in job interruption and recovery compared between conventional CPOE and CPOE under remote-desktop environment. Parameters consist of number of mouse clicks, distance of mouse movement, number of screens and processing time. In some conditions, conventional system took 40 seconds to interrupt a job and return to original screen. It was 10 seconds to close a session and reopen on the remote-desktop clients. Some problems have to be overcome such as job session management and database record lock.
 Server based computing and Blade PC system could reduce working insuf iciency as well as TCO(total cost of ownership) of HIS.

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 A bill of the treatment procedure in health insurance has been manually calculated by the total of the charge of treatment, medicine, and medical material. Among these, the charge of treatment was the claim to a “procedure” without substance, and was difficult to systematize. It aimed at construction of the system which generates the treatment claim information from the clinical information system(CIS). In order to gather treatment claim from CIS, treatment claim code column was added to each item in the master of CIS. After medical-examination record is completed, the item which has a medical-affairs code in the column was sampled, and then the treatment claim bill is created. Comparing the insurance claim points of a handwriting check bill and of the system, the average of the treatment claim derived from the system was 13,493 points, and the average of the handwriting check was 6,893 points. It is concluded that this system was effective in calculation of the charge of disposal.

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