History of PACS in Asia.

First, history of PACS (picture archiving and communication system for medical use) in Japan is described in two parts: in part 1, the early stage of PACS development from 1984 to 2002, and in part 2 the matured stage from 2002 to 2010. PACS in Japan has been developed and installed by local manufacturers by their own technology and demand from domestic hospitals. Part 1 mainly focuses on quantitative growth and part 2 on qualitative change.

Workflow analysis of medical staff in surgical wards based on time-motion study data.

The aim of this study is to clarify the change over time in the elements of work (job elements) and their features, as well as the relationship between job elements and the type of job, job class, and the role of the hospital they are performed in. A time-motion study was conducted on the medical staff in the surgical wards of two hospitals. An analysis of roles bys by (a) type or class of job type, and (b) hospital function was conducted.

Development of a system which automatically acquires optimal discrete-valued attributes by dividing and grouping continuous-valued attributes to assist clinical decision making in radiotherapy.

The purposes of this study were first to develop a system which statistically tests results of radiotherapy and which automatically acquires an optimal discrete-valued attribute by dividing and grouping continuous-valued attributes, and second to find the optimal range of values such as tumor dose by taking account of the conditions and statistics in ROGAD (Radiation Oncology Greater Area Database), a multi-institutional database in Japan. Our ultimate goal is to assist clinical decision making for every patient. In this research, two algorithms for acquiring a boundary value were developed without detecting false boundaries or accidental errors of acquired boundaries.

Development of a time-oriented data warehouse based on a medical information event model.

We designed a new medical information event model and developed a time-oriented data warehouse based on the model. Here, the medical information event in a basic data unit is handled by a medical information system. The timing of decision making and treatment for a patient in the processing of his medical information is sometimes very critical.

Methodology development for quantitative optimization of security enhancement in medical information systems -Case study in a PACS and a multi-institutional radiotherapy database-.

The target of our study is to establish the methodology for analyzing level of security requirements, for searching suitable security measures and for optimizing security distribution to every portion of medical practice. Quantitative expression must be introduced to our study as possible for the purpose of easy follow up of security procedures and easy evaluation of security outcomes or results. Results of system analysis by fault tree analysis (FTA) clarified that subdivided system elements in detail contribute to much more accurate analysis.

Evaluation of video capture equipment for secondary image acquisition in the PACS.

There are many cases in which picture archiving and communication systems (PACS) are built with old-type existing modalities with no DICOM output. One of the methods for interfacing them to the PACS is to implement video capture (/ frame grabber) equipment. This equipment takes analog video signal output from medical imaging modalities, and amplitude of the video signal is A/D converted and supplied to the PACS.

[Present and future of flat panel detectors in the world].

Present status of development of flat panel detectors and their clinical application in the world have been surveyed, and future trends are also explored especially in the field of material researches and methods of manufacturing. Also the importance of role of medical physicists on user side is described because characteristic physics measurement of a detector assembly is unavoidable and essential in quality assurance in clinical routine and acceptance test in hospitals. Even though physics measurements and clinical evaluations on flat panel detectors have shown remarkable progress and advances in these several years, future problems of cost down in manufacturing and quality assurance to prevent individual differences between detector assemblies must be resolved.

PACS development in Asia.

First, history of PACS in Japan from 1982 to 2002 has been investigated. By 2002 total of 1468 PACS units have been installed. Of these, 1174 are small-size PACS with less than four image display terminals, 203 are medium-size with 5-14 terminals, and 91 are large-size with 15 up to 1300 terminals.