IT systems are widely used at medical institutions in Japan today. As a result, medical information has been increasing and its secondary use has become a significant issue.
 Large-scale data processing is considered to be a requirement for the secondary use of medical information. The requirements for large-scale data processing are as follows: (1) collect and store data from many medical institutions, (2) build highly scalable systems that enable the use of data that increase over a long period of time, and (3) establish security for processing large amounts of data.
 Taking these requirements into consideration, we have designed and implemented a cloud system architecture which adopts a key-value datastore such as Cassandra and a distributed processing system such as Hadoop. By using Cassandra, retrieval performance showed adequate performance compared with existing RDBMS without a slowdown from increasing data. We have also achieved about 63% to 66% reduction of initial construction costs while preserving scalability in data capacity.
 We report that our implementation achieves an architecture with higher sustainability than ever before in large-scale data processing.

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 With the development of electrical medical recording technology, the function has been highly improving to fully collect a wide variety of medical information. However, medical records are still problematic because of their redundant and fragmental nature. It is anticipated to annually hold the overview of the whole medical problems of each patient orderly and compactly from the beginning of the medical practice to the current stage. This work contributes to improve the quality of medicine and communications among patients and medical staff. We contrived the standard format which included diagnoses or problems, drugs and the selected findings in standard laboratory and instrumental examinations, useful contributory medical information from the other medical offices and hospitals into a sheet of paper of A–4 size. We completed a total of 500 summaries for 2011. We affixed this summary on the first page of medical record and private medical note for patient. Family physicians consumed a lot of time and effort, but saved time to quickly grab the whole picture and could improve the quality of medical practice as well as communications. It is advisable for the physicians to make an annual summary as a routine medical work in outpatient clinic.

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 The quality of telemedicine depends on the quality of the delivered information. The authors proposed an integrated network QoS control system for telemedicine in the previous research. The system is to shape multiple data streams by dropping blocks of data, which is defined not to put each application into trouble by the reduction of data. In this research, the authors applied the JPEG 2000 image format to the QoS system for enabling telemedicine system to reduce the quality, resolution, or frame-rate of transmitted images along the target telemedicine applications. A JPEG 2000 image is denoted by a header and a container, which consists of multi-layered blocks of data. A JPEG 2000 decoder can produce a low-quality or low-resolution image, even when several blocks of data are missing from the original container. The evaluation of the prototype confirms that the proposed approach enables dynamic control of the resolution and quality of an image stream. The control of one parameter doesn't harm other parameters unexpectedly, and the control affects the required bandwidth as intended. Therefore, this paper confirmed that the combination of the proposed QoS control mechanism and the JPEG 2000 realizes flexible and dynamic QoS control for image-based communication in telemedicine.

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 Although a hospital has much medical information, even information which has been digitally entered, such as basic information of a patient, name of the disease, examination results, images, and even prescription history, is not effectively utilized. In fact, many facilities use this information simply for reports by the hospital office division, such as bed occupancy rate, average days of hospitalization, and unit price of the medical care, to prepare receipts, or to fill out DPC related information to be submitted to the Ministry of Health, Labour and Welfare. At this time, usability of IBARS (medical office work system), girasol (DPC analysis software), and D☆D (search software of standardized data), was verified. IBARS is useful in the analysis of billing items, but data abstraction is time consuming. Girasol has simple visualization of clinical indicators and can easily link to GIS, but is limited to targeting only patients who are hospitalized and not to the examination results. D☆D is reliable for indicator analysis which includes examination results, and search of drug-induced cases, but certain skills regarding search logic, are needed. Application of latent information in each hospital database can be expected.

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 The study aimed to clarify nurses' perceptions of an electronic patient record (EPR) system that partially conceals patients' personal information. Among the 515 hospitals in central Japan that have EPR systems or an order entry system, 736 nurses at 21 hospitals were surveyed anonymously. After the respondents gave a look at printed descriptions of EPR systems, they completed a self-reported questionnaire about their acceptance of partially concealing some categories of information contained in the EPR system in their daily nursing care. Among 415 nurses (58.7% response rate), 39.0% of them agreed with a partial concealment for the patient information depending on demand of the patients. As to the range of partially concealing, 59.3% agreed to each item level, and 32.7% agreed to a category level. However, 49.4% of the nurses answered they wanted to check all information at once, if necessary alternatively 41.2% of them wanted to be shown each items successively. 33.3% answered that the range of concealing should be designed based on the type of profession. Many nurses agreed with the idea of partially concealing information contained in the EPR system according to patients' requests.

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