Rapid progress in information techology enables us to retrieve relevant information from databases on the internet. Medical and health care are not exceptions: the recent advances provide a new environment to telemedicine, in which online information retrieval has been challenging problems. In this paper, a new approach to internet-based decision support from university hospital is presented. The system consists of the following four components: one is a web-based system for home doctors, which supports writing an introduction letter to the university hospital. Second one gives a diagnostic and therapeutic report on the patient who was introduced by home doctors and admitted to the university hospital. Third system gives reports on medical images and pathological examinations. Finally, the fourth one makes a decision support for neurological diseases. The integrated system has been already in use at Shimane University Hospital since 2001 and is now being evaluated by doctors inside/outside the hospital.