In order to promote information sharing of electronic medical data, standardization efforts have been made intensively these years. A wide variety of entities included in medical information requires a knowledge infrastructure system of a capability of dealing with semantics of them. In order to provide such a knowledge infrastructure, we have conducted a Japanese medical ontology project and have defined diseases in terms of abnormal states together with an anatomical ontology. In this study, we have developed an abnormality ontology in a three-layer hierarchical structure which provides a flexible representation framework to guarantee consistent representation of various clinical abnormal states. Our ontology is expected to contribute to providing clinical terminologies or standardized vocabularies with a basic backbone for a better understanding of the essentials of abnormal states in diseases and sharing higher level knowledge.

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　In order to devise a method for predicting a patient's fall risk in clinical practice, we have created the technique for construction of a fall risk prediction formula (TCFP) which outlines a prediction formula based on a retrospective cohort study which analyzed data from electronic medical records (EMR), and implements script execution functions of the EMR. No additional burden was placed on patients or staff, and data regarding 10,000 patients were collected and analyzed. The sensitivity of our prediction formula was 73.6% and its specificity was 68.8%. Prediction accuracy was no lower than previous studies in Japan. Because the EMR packages of a leading vendor have a script execution function, similar implementations can be made on such EMR packages. As a result, we consider TCFP to be an applicable technique in other medical institutions.

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　The software named “J-Lacco” was developed for finding and handling JLAC10 codes described “Laboratory Test Code Master” that has been certified as a standard by Ministry of Health, Labour and Welfare. By using “J-Lacco”, JLAC10 codes, the codes and names of 5 elements (analyte code, identification code, specimen code, methodology code, and result identifying code), and units can be displayed as the results of finding. The results can be exported in CSV and text files.
　We evaluated this software with the character strings about 250 items of laboratory test and we judged whether a correct answer was included in the results. The number of correct answers was 224 of 250 (89.6%) using test character strings directly. We improved the software by the change function of different kind of character (ex. roman numeral to arabic numeral), and the correct answer rate of software was raised. The results of this test revealed that J-Lacco provide the suitable JLAC10 when we search by standardized laboratory test names. We believe that this software could promote the use of standardized coding systems, and it is useful for medical experts.

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　Magnetic resonance imaging (MRI) is an essential medical equipment for medical care nowadays, but the profitability of MRI might be influenced by the usage and performance of MRI. The main purpose of this research is to estimate cost and profit of MRIs in 2011 by hospital size and prefectures, and discussed about the difference in number of beds and regions in profitability of MRIs. MRIs with 1.5 Tesla or more could be almost profitable, but almost deficit for MRIs with less than 1.5 Tesla. The profitability of MRIs could be influenced by the cost of care, and correlate between population and number of doctors per MRI. The results of this research suggested that it is recommended for hospitals in Japan to purchase and operate more than 1.5 Tesla MRI as for the point of views of hospital management. It could be better to consider not only the clinical necessity but also profitability for purchasing MRIs.

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