Busulfan (BU) is widely used in conditioning regimens before allogeneic or autologous bone marrow transplantation. BU pharmacokinetic (PK) studies have suggested that individualization of BU doses based on the area under the concentration curve (AUC) is necessary for optimal BU systemic exposure. Since standard PK measurements need multiple blood samples, various limited sampling methods (LSM) for the estimation of AUC have been proposed to reduce the number of blood samples. However, it is not clear under which conditions the estimations succeed or fail. Also, none of the existing LSMs for BU estimate the variance of AUC estimator. To solve the first problem, we introduce a systematic validation method by use of a virtual validation set generated based on the identified PK model and the distribution of its parameters. To introduce a more accurate LSM, we propose a new method for AUC estimation, in which a curve that best approximates the measured data is searched from the set of pre-generated model cases. We evaluated this estimation method and found that it has virtually no bias. For the latter variance problem, we introduce a method for calculating the distribution of an AUC estimator based on the measured distribution of within-patient errors and by the use of Monte Carlo simulation, from which we develope bootstrap 95% percentiles. This new method for the AUC estimation can also be applied to other dose-finding studies and their applications.

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 [Objectives] The purpose of the present study is to evaluate the demand of the standardized waveform information-sharing between hospitals in addition to the usefulness of the system.
 [Methods] ECG records were accumulated in an MFER repository set, and the accumulated MFER ECG records were viewed using MFER viewer equipped in over 1,500 client computers for hospital information systems in the both hospitals. And the resulting access-log in the repository was analyzed.
 [Results and Discussion] The number of access to the repository per month was about 60–70. A total number of the requests per month from cardiovascular units including cardiac care unit, ward, consulting rooms for outpatient examination in the both hospitals increased from ten per month to 30 as predicted prior to the present study. The requests from the ward and the consulting rooms for other departments were observed frequently and approximately doubled within six months, suggesting that MFER ECG records are used for treatment of patients at increased risk of cardiovascular disorders in many departments. In addition, the records are considered to be used for support of informed consent, support for clinical research, and education of medical students and residents.

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 We developed an electronic prescription interactive network system enhancing collaboration of medical staffs between a hospital and community pharmacies. The system is internet-based, and transfers medical information between a university hospital in Kagawa prefecture and community pharmacies by way of a data center. Pharmacists at the community pharmacies can see prescriptions, diagnoses, laboratory data, and physician's comments which were saved at the data center using the certification function of the Healthcare Public Key Infrastructure. Physicians and other medical staff at the hospital can see corrected prescriptions, generic names, adverse events, and pharmacist's comments which were input by pharmacists and displayed on electronic medical record terminals in the hospital. Their collaboration based on sharing of such information should provide more effective, safer, and higher quality healthcare service to patients. Results of group interviews with pharmacists showed that the widespread use of the system will need understanding and motivation on the part of relevant parties such as physicians, pharmacists, patients, and society.

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 The business continuity plan (BCP) of hospital information systems (HIS) for pandemic influenza A (H1N1) was drawn up in July 2009 at the Medical Information Center of Tokyo Medical University Hospital. Based on this experience, we found it necessary to make sure that departmental information systems have BCPs that correspond to HIS.
 We evaluated 11 departmental information systems in which the recovery time objective (RTO) is less than 1 hours, and found that RTO expected to be met in more than half of systems. To implement measures according to BCP phase, it is important to evaluate vulnerabilities. Therefore, we are introducing an evaluation sheet to address system vulnerabilities. This can also be applied to other threats such as earthquakes or terrorism incidents in departmental information systems.

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 The medical payment system based on Diagnosis Procedure Combination (DPC), which is a Japanese prospective payment system, was introduced in April 2003. By July 2010, 1,391 hospitals, which cover 18.0% of all hospitals, implemented this DPC-based payment system. The Ministry of Health, Labor and Welfare periodically conducts an impact assessment survey (hereafter referred to as a DPC survey) at those hospital to update DPC classification categories and also determine, for instance, payment weight and hospital adjustment factors. To each DPC survey, the hospitals report patients' medical data, which should be pseudonymized by certain pseudonymization methods according to the ministry's guideline.
 We surveyed DPC-based hospitals in a prefecture and conclude that 31.4% of hospitals have failed to pseudonymize personal data when reporting them to DPC surveys. We find security vulnerabilities and privacy concerns in the current DPC survey system. Moreover, we propose a way to make the survey system safer in the future.

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