Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes, based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. This manuscript reviews the history of telemedicine activities in actual disasters and similar scenarios as well as ongoing telemedicine innovations that may be applicable to disaster situations. Emergency care providers must begin to plan effectively to utilize disaster-specific telemedicine applications to improve future outcomes.

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Japan experienced two major disasters in 1995: the Great Hanshin Earthquake and the Sarin Attack in the Tokyo subway system. These events inspired our society to prepare for major disasters in the future; various institutes and organizations in our country are making efforts to blush up their disaster manuals. When we make our own protocols for disaster management, we must have large amount of information and knowledge on protocol of other related institutes and organizations. We also have to keep the laws and ordinances in mind, and moreover, each information should be updated frequently. Printed documents no longer will meet such demands, and will be replaced by computer-based electronic media. In our institutes, our hospital manuals for disaster management are under the way of instituting electronic versions. Besides circulating as printed matters among hospital staffs, we write our manual as a hypertext markup language (html) file, and some of the information is launched from our internet and intra-net servers. Our manual also includes disaster protocols for other related institutes, agreements with other organizations, and disaster-related laws and ordinances. The disaster manual in a computer-based, electronic, multimedia style will be a regular form in the next century.

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