Shigekoto Kaihara

Realisation of the computerised patient record; relevance and unsolved problems

Patient records are the sole source of information for all clinical activities including patient care, hospital administration, clinical education and research. For this reason, the patient data in the medical records are retrieved, transcribed, tabulated or analysed repeatedly, when need arises. However, manual processing of paper records is cumbersome and inefficient and Computerised Patient Records (CPRs) should solve the problem of inefficiency. A CPR may literally mean a medical record stored in a computer as digital data, but it implies that the data are stored with a creating structure so that they can be easily retrieved when they are needed. CPRs in the broader sense may include a system of data collection and retrieval in different clinical settings. In spite of the expectations, the full potential of CPRs has not yet been achieved. Part of it is already in daily operation in many hospitals across the world. The purpose of this paper is to review the present situation of the CPR and discuss the unsolved problems in relation to security issues. 2.

Implementation of HL7 to client-server hospital information system (HIS) in the University of Tokyo

In developing a large-scale Hospital Information System (HIS), a client-server architecture has been gaining in popularity. It is important to introduce a standard message protocol that is independent both on the database structure and on the venders proprietary platform. We introduced Health Level Seven (HL7) to our hospital information system. From our experiences, although we had to modify the original HL7 specifications in order to introduce the protocol to a client-server HIS especially in the area of order entry and record-oriented query, it was found that HL7 can be adopted in a client-server HIS.

Development and trial operation of a World Wide Web-based data entry system for the collection of statistical data on the management of the national university hospitals in Japan

A WWW-based, on-line, data-entry system for the collection of statistical data on the management of Japanese national university hospitals has been developed. Trial operation of the system showed that it can reduce the labour and budgetary costs of data collection and also demonstrated that an on-line, data-entry system is feasible in Japan. In April 1997, we began production use of the system, and we are to develop another WWW-based data-entry system that can deal with all other statistics on hospital management.

A sequential diagnostic model for medical questioning

A medical interview is a very important part of medical treatment since it is conducted when a patient is first admitted to a hospital and treatment is decided afterwards. However, these interviews are not always carried out in sufficient detail because physicians have very heavy work-loads. The development of automated medical questioning equipment which tabulates the answers to questions into a form easily understood by physicians, which enumerates data on doubtful diseases and which indicates pertinent medical examinations may come to the aid of patients and physicians. This paper presents a new diagnostic theory for the design of automated medical questioning equipment. Diagnostic theories can be classified into batch and sequential theories; the authors have investigated the sequential one, because decisions are made using minimal data. The techniques supporting this theory are multi-class recognition systems based on independently designed dual-class recognition systems and Walds Sequential Probability Ratio Test. To discuss the properties inherent in the present theory, classification of three pattern classes was made. These were normal, hypertension and myocardial infarction classes of patients. The mean error probability of classification was found to be 3.08%.

An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB

In the University of Tokyo Hospital, the improved client server HIS has been applied to clinical practice and physicians can order prescription, laboratory examination, ECG examination and radiographic examination, etc. directly by themselves and read results of these examinations, except medical signal waves, schema and image, on UNIX workstations. Recently, we designed and developed an ECG storage and retrieval system embedded in the client server HIS utilizing object-oriented database to take the first step in dealing with digitized signal, schema and image data and show waves, graphics, and images directly to physicians by the client server HIS. The system was developed based on object-oriented analysis and design, and implemented with object-oriented database management system (OODMS) and C++ programming language. In this paper, we describe the ECG data model, functions of the storage and retrieval system, features of user interface and the result of its implementation in the HIS.

Workstation network system which enables international exchange of characters and images at the University of Tokyo Hospital

The circumstances when physicians want to exchange information are analyzed and the necessary requirements for workstations are discussed. Although there are many requirements, it will not be necessary to incorporate every requirement onto a single workstation. In the international setting, the capability of handling non-alphabetic characters is also important. The requirements for image display should be classified for those physicians who make their diagnosis primarily on the basis of images and those who use images as additional diagnostic information. On the basis of these discussions, the system of the University of Tokyo Hospital, which is now being implemented, is described. The system will be a network of approximately 300 workstations with one mainframe computer.

Representation of Neuroanatomical Knowledge by PROLOG

Nach einer kurzen Diskussion des Unterschiedes von “oberflachlichem” und “tiefem” Wissen wird ein Ansatz beschrieben, das “tiefe” anatomische Wissen in eine Wissensbasis abzubilden. In drei Ebenen werden Topologie, Funktionen und Geometrie neuroanatomischer Strukturen dargestellt.Als Werkzeuge dienen PROLOG bzw. hierarchische Symbol-Binar-Koordinaten. Das Verfahren hat sich in der Praxis bewahrt.