Now in Japan, because of the falling birthrate and the growing numbers of nuclear families, it is difficult for family members to monitor the health condition of elderly people. Therefore, the development of alarm systems for elderly people living alone will be needed. We developed an automatic alarm system using pyroelectric infrared sensors for the elderly living alone. The system can estimate unusual states of the elderly and send alarm messages to their family members automatically. In automatic detection of unusual states, we used staying periods of the elderly in rooms and non-response intervals of infrared sensors. We had applied the system to 4 subjects experimentally over 1 year, and as a result, we can prove that an alarm call state occurred one or two times per week for each subject. Although this result is not an actual health problem, we can certify that our system can detect unusual states, and provide communication opportunities by sending alarm messages to family members thus decreasing anxious feelings of families living separately from their elderly relatives.

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 This paper describes a medical consultation support system that we developed for life-style related diseases and discusses its expected effect. This system is a Web application that can be economically used by multiple medical clinics through the Internet. The system has smart input, a graphical visualization function for blood examination results, an automatic documentation function for medical reports and high information security. After experimental evaluation on its usability and consultation times by using the system, we estimate its affect on decreasing patient waiting time and the economical effects obtained from the system. As a result, as the system can reduce consultation time, so medical clinics can increase income from consultations that more than offsets the initial and running costs of the system, and at the same time reduce patient waiting time.

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 Sapporo Medical Association plans to develop a regional medical information reference system for supporting patients’ migration flow; patients flow from/to various types of medical facilities. Current data of patients’ migration is necessary to design such system. This article reports the results of the survey of current patients’ migration in Sapporo city. It reveals some characteristics of current patients’ migration in Sapporo city.

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 In recent years, people are raising serious concerns about the safety and reliability of medical treatment. Since it is almost impossible to prevent all the medical errors by healthcare provider’s efforts, it is expected to apply the ubiquitous communication technologies such as mobile sensors or wireless network technologies to prevent medical errors and improve the quality of medical care. Continuous monitoring of respiration is one of the crucial cares to realize reliable and safe medical treatment. In this study we developed a new wireless continuous respiration monitoring system which detects patient’s emergency situation such as cardiac arrest or asphyxia during his transfer on the stretcher in a hospital. Our monitoring system consists of non-invasive mattress measuring pressure sensors heart beats and respiration, and a wireless communication network which transmits these vital data to the alert system. We conducted experiments to measure the feasibility of this wireless system in real clinical situation and found it could detect asphyxia of the patient during his transfer on the stretcher. It is concluded that this system could contribute to achieve reliability and safety in medical practice, though several improvements such as suppression of the vibration noises are found to be necessary so as to achieve real clinical application.

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 The new inclusive payment system was introduced into acute inpatient care in main hospitals at universities to replace traditional fee-for-service payment system in 2003. The system created incentives to reduce length of stay of inpatients (LOS) and to urge early discharge to aftercare to shorten the LOS. Therefore, strong partnership with other medical facilities became more important for university hospitals. We studied the pattern of reverse referral from a university hospital to aftercare using geographic information system (GIS). We found that GIS is a useful tool to detect the spatial differences in partnership between the university hospital and other medical facilities.

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 Medical institutions which adopted DPC payment system have been required to increase its amount of earnings from medical services by improving surgical operations, ICU section, and inpatients management. As one of means which contributes to grow numbers of the operation cases, authors developed the operation progress information system, and mounted in the Tokai University new hospital. This paper describes the details of an operation progress information system, its administrative nature, a relation with a hospital information system, and also desired facilities which maximize the effect of this system. By introducing and employing this new operation progress information system in the Tokai University new hospital, authors demonstrated significant benefit of this system through the increase in the numbers of the operation cases, and enhancement of efficient use of operation rooms as a result of saving time. In an acute term hospital including an advanced treatment hospital, this operation progress information system contributes the rise in the numbers of the operation cases, and shortening time of operation by processing various operation-related services effectively.

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 We evaluated the new electronic medical record system (EMR) of Kyoto Medical Center for usefulness. Change in Gefitinib side-effect records was used as an index for evaluation. Gefitinib is used for the treatment of lung cancer, but its side effects have attracted much attention, and records of such effects provide important information which needs to be shared among medical staff to ensure drug safety. Medical records of 18 inpatients treated with Gefitinib were evaluated, and the numbers and input times of records on side effects were compared between the pre-introduction period and every 3 months after introduction of this system. A year after this system was introduced, the number of side-effect records per patient was increased from 0.25 per day to 0.97. The number of all records per patient was increased from 0.50 per day to 4.66. However, the percentage of side-effect records entered during regular working hours (8:30-17:15) decreased. In conclusion, although the EMR increases workload, it increases the number of side-effect records and is useful in improving safe medical care by ensuring proper use of medications.

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 The Japanese standard disease code master was characterized by its ability to make a new disease name through modifying the medical terms based on ICD 10. The recent advances in medical IT technology and trends to adopt DPC procedures in many Japanese hospitals have increased the importance of the Japanese standard disease code master. However, there were still some problems for their practical use. In this paper, I showed several attempts to make the new disease names in advance according to our methods, which led to resolve the present problems such as using the impossible disease name or making the great discrepancy of ICD code between the new and old disease names. In addition, our way of classification of the disease proved to have no effects on the medical statistics, which should be necessary for overcoming a big problem of the dual classification of the disease in DPC procedures.

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 At the time of the complete renewal of the hospital information system, the operating room animation live streaming distribution system was introduced. Distribution of an operating room animation is useful to monitoring of the advance situation of an operation, to education students and training doctors and to the explanation to a patient’s family and so on. By using the existing operating room video-monitor camera system and the network of an existing hospital information system, this system could realize animation distribution at comparatively low cost, and its application range as a monitor system is wide. The operation of this system in this time limits the receiving terminal to the minimum, and influences on network traffic or the performance of our order-entry system are not seen. As a result of the questionnaire, evaluation of users was good in general.

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