利用云计算为中国大陆农村地区的乡村医生赋能并提升农村地区的医疗服务水平。
Empowering village doctors and enhancing rural healthcare using cloud computing in a rural area of mainland China.
机构信息
Graduate Institute of Medical Informatics, Taipei Medical University and Taipei Medical University Hospital, Taipei, Taiwan.
College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan.
出版信息
Comput Methods Programs Biomed. 2014 Feb;113(2):585-92. doi: 10.1016/j.cmpb.2013.10.005. Epub 2013 Nov 9.
BACKGROUND
China's healthcare system often struggles to meet the needs of its 900 million people living in rural areas due to major challenges in preventive medicine and management of chronic diseases. Here we address some of these challenges by equipping village doctors (ViDs) with Health Information Technology and developing an electronic health record (EHR) system which collects individual patient information electronically to aid with implementation of chronic disease management programs.
METHODS
An EHR system based on a cloud-computing architecture was developed and deployed in Xilingol county of Inner Mongolia using various computing resources (hardware and software) to deliver services over the health network using Internet when available. The system supports the work at all levels of the healthcare system, including the work of ViDs in rural areas. An analysis done on 291,087 EHRs created from November 2008 to June 2011 evaluated the impact the EHR system has on preventive medicine and chronic disease management programs in rural China.
RESULTS
From 2008 to 2011 health records were created for 291,087 (26.25%) from 1,108,951 total Xilingol residents with 10,240 cases of hypertension and 1152 cases of diabetes diagnosed and registered. Furthermore, 2945 hypertensive and 305 diabetic patients enrolled in follow-up. Implementing the EHR system revealed a high rate of cholecystectomies leading to investigations and findings of drinking water contaminated with metals. Measures were taken to inform the population and clean drinking water was supplied.
CONCLUSIONS
The cloud-based EHR approach improved the care provision for ViDs in rural China and increased the efficiency of the healthcare system to monitor the health status of the population and to manage preventive care efforts. It also helped discover contaminated water in one of the project areas revealing further benefits if the system is expanded and improved.
背景
中国的医疗体系在预防医学和慢性病管理方面面临重大挑战，因此难以满足 9 亿农村人口的需求。在这里，我们通过为乡村医生配备健康信息技术并开发电子健康记录（EHR）系统来解决其中的一些挑战，该系统通过电子方式收集个体患者信息，以帮助实施慢性病管理计划。
方法
我们在内蒙古锡林郭勒盟开发并部署了一个基于云计算架构的 EHR 系统，该系统使用各种计算资源（硬件和软件）通过互联网在卫生网络上提供服务，支持医疗体系各级别的工作，包括农村地区的乡村医生的工作。我们对 2008 年 11 月至 2011 年 6 月创建的 291087 份 EHR 进行了分析，评估了 EHR 系统对中国农村预防医学和慢性病管理计划的影响。
结果
从 2008 年到 2011 年，为锡林郭勒盟的 1108951 名居民中的 291087 人（26.25%）创建了健康记录，其中有 10240 例高血压和 1152 例糖尿病被诊断和登记。此外，有 2945 例高血压和 305 例糖尿病患者参与了随访。实施 EHR 系统后，胆囊切除术的比例很高，导致对饮用水受金属污染的调查和发现。已采取措施告知民众并提供清洁饮用水。
结论
基于云的 EHR 方法提高了中国农村地区乡村医生的护理水平，并提高了医疗体系的效率，以监测人口的健康状况并管理预防保健工作。它还帮助发现了项目区之一的受污染水，如果系统得到扩展和改进，还将带来更多好处。
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