Server-Based Computing (SBC) is a technology for terminal administration that achieves higher security at lower expense. Use of SBC in large hospitals, however, is not widespread because methods to effectively implement the technology have not been fully established. We present a system design that uses SBC in a large-scale hospital and then discuss the implementation problems and their solutions. With the exception of network traffic estimates, the server size estimates were validated. Three results from an evaluation of an SBC implementation were: 1) security was re-enforced by applying multiple-policy adaptation to a single client terminal, 2) cost reduction was realized by having fewer PC failures and a lower power consumption, and 3) user-roaming was found to be effective in reducing the number of iterative operations performed by users.