電子カルテに関する論文・原稿




学会に発表した論文・抄録など

2002.11 電子カルテのモジュール化 (第22回医療情報学会連合大会 抄録)
-- 音声による口演内容が聞けます --
Medical treatment is very complicated, it is irrational that everyone uses the same electronic Karte, and it is not comfortable. Everyone has to be able to use it of his favorite layout or user-friendliness. However, if a part of those functions are taken by one side, there are many common portions, and there is also big futility in developing the same thing in various places. As for the software which constitutes Electronic Karte 'NOA', the database layer, the logic layer, and the user interface layer serve as rough combination. A logic layer is the server group of the settled processing, plug in, etc.It consists of parts.

1997.11 電子カルテの「ユーザごと多様な要望」への対応 (第17回医療情報学会連合大会 抄録)
The computerized medical record system will be a very complicated and diverse application. So, the methods for communicate with another system and peripherals must be standardized. On the other hand, user's working space must has no limitation. Our new system on OPENSTEP has only general purpose functions basically. But it can communicate with data base server, medical fee account server, and other servers with TCP/IP network. And user can plug-in many tools for his exclusive use very easily. With this system, many objects are separated independently, and at the same time it cooperates with network and distributed object system.

1997.05 WINE Project とマン・マシーン・インタフェース (第3回電子カルテ研究会 SeaGaia'97)
WINE Project における電子カルテ開発と運用の経験に基づき、 マン・マシーン・インタフェースについての考えを述べる。

1996.11 「電子カルテ」汎用化へのアプローチ（第２報） (第16回医療情報学会連合大会 抄録)
I made a general purpose tool for the computerized medical record. This tool was developed with object oriented programming with Objective-C and InterfaceBuilder on NEXTSTEP OS 3.3J. We can layout many cell objects on the sheet in free format, and these objects has a button and a text field. Text fields are bound various data resources, database, files, another cells, HTTPD(World Wide Web), and others. This tool makes multi purpose data sheets and applications.

1995.11 「「電子カルテ」汎用化へのアプローチ (第15回医療情報学会連合大会 抄録)
Approach of a general purpose tool for the computerized medical record

Naturally every data in our world has no order. And we keep it in order for our purpose. So, if we have a layout tool to arrange every data for our purpose, it will realize various data sheets. Now I made an object. This object can pickup data from various data source (data base, file, directory, another object, etc). And process the data in various method. Finally the object output it to varoius target (text field, file, popup-menu, etc). We can construct the computerized medical record, order sheet, and another data sheet with this object.

1995.11 「電子カルテ」標準プロトコルの試み (第15回医療情報学会連合大会 抄録)
Attempt for a common transfer format of Computerized Medical Record

We think the computerized medical record system is very usefull in our daily medical works. It must be build on a `server and client system'. And It must be developed in valious idea and valious aproach at many medical institutions. These systems must be available on any hardware and any OS, and at the same time, any systems must be communicate to each other systems. So, most important thing is the standardization of It's transport format. Our attempt is to make the `Medical Markup Language', this is like the SGML or HTML.

1994.11 「電子カルテ」における不定型情報の自由な取り扱い (第14回医療情報学会連合大会 抄録)
We store medical records with it's structure in the data base, usually. But, firmly structured records has no flexibilities to various uses. By nature, data itself has no formats, and we only make use of them with adequate formats and properties for our purpose.

So, I'll only make an adequate form sheet to my purpose, and the items on the sheet has only a pointer to it's real data. If it is network reachable, I don't mind where is the real data. So, I can handle the data as if it is in a structured record, and as if it was kept at hand.

1994.11 オブジェクト指向で開発された「電子カルテ」 (第14回医療情報学会連合大会 抄録)
I have been using ``Electronic Chart System'' for 5 and a half years.

We use this system with Local Area Network. NeXTCube, NeXTstation turbo color, Intel machine with NEXTSTEP, SPARCstation1+, SUN-3/50M, and many personal computers are connected with Ethernet and TCP/IP protocol. The structure of this system and the data are constructed as Objects, and they works with their message passing.

1993.11 電子カルテ(４年間の臨床利用より) (第13回医療情報学会連合大会 抄録)
I have been using ``Electronic Chart System'' for 4 and a half years. At the first 3 years the system was running with emacs editor and it's LISP language on SUN WorkStation.

And later, I implemented a new system on NeXT Computer with it's NeXTSTEP environment, object oriented language and Server Client model on Mach OS.

1990.10 「電子カルテ」による外来診療(運用１年を経過して) (医療情報学会誌 原著)
The ``Electronic Medical Record'' computer software system can handle many clinical tasks and is running on a networked UNIX machine. Its Basic operation is to describe clinical record much like using a Japanese word processor, and the system supports easy data input methods, while offering a flexible format for clinical charts to suit the user's requirements. The system can extract data from a clinical chart to deal with various tasks; for example, to calculate a medical charge or draw a graph based on the clinical data. Response to user instructions is quick, and a HyperText function is offered so that the user can get valuable information about any usr-specified word on the clinical chart. As an integrated work management system, non-clinical work can also be handled. Multiple users can communicate with each other via the network, which allows the same data to be shared. A different computer can also be connected, and since the current system is written in LISP, easy software maintenance, easy feature expansion and high system flexibility are available.

1989.11 「電子カルテ・システム」 (第９回医療情報学連合大会 抄録)
We are developing the computer software system, named "Electronic Medical Record", with which we can manage the miscellaneous clinical works. This system is running on the networked UNIX machine.

And its features are...

(1) Basic operation is to describe clinical record much like Japanese Word Processor. (2) Support easy data input method. (3) Offer flexible format of clinical chart to fit user's taste. (4) Parse the clinical chart to deal with various tasks, for example, calculating medical fee or drawing the graph based on clinical datum. (5) Support quick refererences to what the user want to see. (6) Offer HyperText function, that is, the user can get valuable information about user specified any word on the clinical chart. (7) Is a integrated work management system. The user can deal with non-clinical work, too. (8) Plural office/people can communicate each other based on network. (9) Plural office/people can share the same data. (10) Enable to connect a different computer machine.

Since current system is written by Lisp, easy software maintenance, easy feature expansion and high system flexibilities are available.

1985.05 UNIX による診療所統合情報システム (医療情報学会誌 原著)
この論文で「診療録のコンピュータ化」とそのプロトタイプを発表した。 当時まだ日本で電子カルテ開発に着手した施設はほとん ど無かったはずである。

7 years ago, a small stand-alone computer system with BASIC language was installed for business use. 2 years later, the system was upgraded to UCSD Pascal, and after another 2 years, UNIX operating system and C language were introduced. The host computer is Toshiba UX-300, having OS-UX(UNIX sytem III) operating system, 512 Kbytes of main memory and 30 Mbytes fixed disk drive. It can communicate to another UNIX system located in the author's home with RS-232C port and optical fiber link, and communicate to remote computer systems with a modem and standard telephone line.

An ``Electronic Chart System'' is now being developed to enable physicians and another medical staffs to simulataneously proceed with tasks without queuing. Real data in the database is stored only once, but various data handling formats are availabe for different applications to make the data easily understandable. The aim for the system is to handle all desk work from the work station.

1984.11 外来診療における UNIX システムの利用 (第4回医療情報学会連合大会 抄録)
UNIX マシーンを導入し、外来自宅間を光ケーブルで接続。どこからでも、同じ ファイルを読み書きできるようにした。窓口会計、妊婦管理、財務会計などが この上で動いており、リレーショナル・データベースのフォーマットを通して 色々なソフト間でのデータ互換をはかっている。

Since 1983 I used computer system in my clinic practically. And I desired some functions as follows to execute my task efficiently.

  1. work station.
  2. multi tasks.
  3. multi windows.
  4. local area networking.
  5. common data base system.
  6. portability of language.
  7. efficient development and execution of application software.
To realize these ideas, I decided to choice UNIX system and C-language. Now, UNIX and C realized these tasks efficiently.

医学雑誌や一般誌などに発表したもの

1999.10 「電子カルテ」はどんな点で有用なのか
山形県鶴岡地区医師会での講演より

1997.12 なぜ MML なのか (雑誌「先端医療」)

1997.07 電子カルテへのアドバイス (雑誌「新医療」)
電子カルテ実用化８年目の視点から

1995.03 「電子カルテ」は思考の道具

1992.11 電子カルテによる外来診療 (雑誌「産科と婦人科」)

update: 2001-07-25 22:40:39 +0900