Okayama Isshindo Hospital in Okayama, Japan, has 152 beds and 200 employees. Since 1987, when 4D was first released in Japan, the hospital has been developing and updating their integrated system with 4D and manages it completely with 4D Server and 120 clients for ordering, electronic health records and reception. Via Osrix or a web browser, users can access the internal systems, including an electrocardiogram monitoring system and examination server.