Analysis of yearly variations in drug expenditure for one patient using data warehouse in a hospital.

Medical expense has grown rapidly in Japan. It could be caused by the increase of the patient number and the increase of medical expense per patient. We studied the latter factor on drug expenditure from 1996 to 2002 using the prescription data stored in the data warehouse of one hospital. We found that the drug expenditure per patient had increased 1.32 times. The mean number of prescriptions per patient increased 1.23 times and the mean expenditure of one medicine increased 1.08 times. These results demonstrated that drug expenditure for one patient had gradually increased. This was caused by both the rise in the number of medicines taken by one patient and the rise in the prices of medicines. The data warehouse in the hospital was useful for the analysis of the trends in medical expenditure for one patient.

Creation of a master table for checking indication and contraindication of medicine from a knowledge base linked with a thesaurus.

To develop a system for checking indication and contraindication of medicines in prescription order entry system, a master table consisting of the disease names corresponding to the medicines adopted in a hospital is needed. The creation of this table requires a considerable manpower. We developed a Web-based system for constructing a medicine/disease thesaurus and a knowledge base. By authority management of users, this system enables many specialists to create the thesaurus collaboratively without confusion. It supports the creation of a knowledge base using concept names by referring to the thesaurus, which is automatically converted to the check master table. When a disease name or medicine name was added to the thesaurus, the check table was automatically updated. We constructed a thesaurus and a knowledge base in the field of circulatory system disease. The knowledge base linked with the thesaurus proved to be efficient for making the check master table for indication/contraindication of medicines.

An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.