The SYNAPSE ERm is a teleradiology imaging support system for emergency room. This application enables to exchange the necessary information for diagnosis/treatment in the stage of an emergency medicine not only inside the hospital but outside the hospital as well.In addition to allowing users to view the 2D study image (DICOM image) such as CT, MRI and US, it enables to rotate the 3D images to view a pathological condition in three dimensions. It has functions such as an evaluation of conscious level/neurological finding, an automatic calculation of the NIHSS score, an automated computation of the t-PA dosage amount based on weight and a reminder system in accordance with a checklist for dose calculation tool/contraindicated item.A display function in chronological order enables users to view a patient