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CN109935319A - Chronic disease systematic management system - Google Patents

Chronic disease systematic management system Download PDF

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Publication number
CN109935319A
CN109935319A CN201910197425.9A CN201910197425A CN109935319A CN 109935319 A CN109935319 A CN 109935319A CN 201910197425 A CN201910197425 A CN 201910197425A CN 109935319 A CN109935319 A CN 109935319A
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management
data
disease
chronic disease
module
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郭永安
佘昊
徐道亮
张桁忠
居益君
朱洪波
杨龙祥
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Nanjing Post and Telecommunication University
Nanjing University of Posts and Telecommunications
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Nanjing Post and Telecommunication University
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Abstract

The invention proposes a kind of chronic disease systematic management systems, including curing conjuncted management diagnosis and therapy system, individual health management system, background service system, it cures conjuncted management diagnosis and therapy system and differentiated control is carried out to mechanisms at different levels, chronic disease is subjected to Classification Management by disease, and multi-zone supervision is carried out to doctor's permission;Individual health management system relies on individual ID to establish Profile, and by the acquisition, storage, analysis of health data, realizes the prevention and screening of chronic disease;Background service system is used to support the operational management of entire platform, contains the management of database server, user account and permission and provides the decision-making function of chronic disease.The platform passes through a chronic diseases management platform, around two lines, from three layer management X kind chronic diseases, can accomplish to implement specific personal protection and diagnosis and treatment, guarantee that sufferer data acquisition system caused by community, family and hospital summarizes, to carry out close observation and treatment to slow disease.

Description

Chronic disease systematic management system
Technical field
The invention belongs to internet data processing technology fields and medical information field, and in particular to a kind of chronic disease one Change comprehensive management platform.
Background technique
Chronic diseases in China disease incidence is high, but awareness, treatment rate and control rate are lower, especially base chronic from Body health knowledge lacks, is insufficient to the harm of chronic disease and the understanding of long-term treatment importance.Therefore, carry out scientific and normal trouble Person's health education is very necessary.Base doctor is usually more close with patient contact, can use this chance to patient Health education is carried out, education patient will learn self-management chronic disease, scientifically prevent and treat chronic disease.As medical information is flourishing Development, had an electronic prescription, medical care platform, intelligent medical treatment terminal, the informationization means such as disease management program, certain journey Synthesization, the facilitation of medical information have been helped on degree.
But it is found according to the work of the inventor currently signed, it is comprehensive not enough for the System Construction of chronic disease at present, Personal health data is difficult to the storage and calling of system, incomplete to the community, hospital and family of a variety of slow disease integration linkages Covering system.Lack comprehensive, the integrated slow sick platform for sufferer individual information, thus can not also accomplish to cure it is conjuncted enter It registers one's residence in township.
Summary of the invention
Goal of the invention: in view of the deficiencies of the prior art, the present invention proposes a kind of chronic disease systematic management system, can do To specific personal protection and diagnosis and treatment is implemented, guarantee that sufferer data acquisition system caused by community, family and hospital summarizes, thus Close observation and treatment are carried out to slow disease.
Technical solution: a kind of chronic disease systematic management system, including the conjuncted management diagnosis and therapy system of doctor, individual health management System, background service system, the conjuncted management diagnosis and therapy system of the doctor and individual health management system respectively with the background service System connection, the conjuncted management diagnosis and therapy system of doctor carry out differentiated control to mechanisms at different levels, chronic disease are classified by disease Management, and multi-zone supervision is carried out to doctor's permission;The individual health management system relies on individual ID to carry out establishing Profile, And by the acquisition, storage, analysis of health data, the prevention and screening of chronic disease are realized;The background service system is for branch The operational management for supportting entire platform contains the management of database server, user account and permission and provides the auxiliary of chronic disease Help decision making function.
Further, the conjuncted management diagnosis and therapy system of doctor includes mechanism hierarchical management module, chronic disease Classification Management mould Block, doctor's multi-zone supervision module, the mechanism hierarchical management module are used to carry out medical institutions at different levels differentiated control, and integration is each The medical resource and service capability information of hospital, establish from front three-it is at county level-the classification diagnostic and therapeutic system of community, realize information fusion, Data sharing;The chronic disease Classification Management module is built for being managed to the isomeric data of multi-source by chronic disease disease The matching relationship of vertical disease and corresponding hospital and doctor;Doctor's multi-zone supervision module based on training alliance, according to Doctor authorizes different chronic disease management and diagnosis and treatment permission in the academic title of Different hospital, and the management of personal slow disease is divided into doctor Institute, community and family.
Further, the individual health management system includes health and fitness information acquisition module, data memory module, at data Reason and analysis module, the health and fitness information acquisition module are used to perceive human body indicators data, the acquisition of health and fitness information acquisition module Human body indicators data are transmitted to data memory module by way of wirelessly or non-wirelessly, and data memory module is by individual storage index Data information, and it is associated with personal essential information, establish personal health archives;The data processing and analysis module are based on referring to It enables or periodically obtains data from data memory module and handled and analyzed, identify chronic disease disease and marked.
Further, the background service system includes that database module, account management module and medical decision making support mould Block, the database module provide Account Registration, verification, log in, step on for storing various data, the account management module Out, it nullifies function and is that sufferer or doctor carry out priority assignation according to the role of user;The medical decision making supports mould Block provides the slow sick complete period Integrative Management Model based on medical big data and artificial intelligence, realizes the prevention to chronic disease and sieve It looks into.
Further, the slow sick complete period Integrative Management Model based on medical big data and artificial intelligence includes:
Slow sick integrated management strategy based on AI autonomous learning: under the premise of following objective diagnosis and treatment process, artificial intelligence is utilized Energy autonomous learning integrates medical big data, is automatically performed the processing and analysis of associated patient data in hospital information system, for doctor Business personnel provide medical decision making and support;
Full disease aid decision-making system based on artificial neural network: it utilizes slow in artificial neural network learning clinical data Patient's symptom and sign, auxiliary examination and diagnosis of disease incidence relation, based on authoritative evidence-based medicine EBM knowledge base and real world Clinical data constructs knowledge mapping, and full disease aid decision is provided in doctor's diagnosis and treatment process and is supported;
Single diseases personalized medicines DSS based on genetic algorithm: being that machine can by medical record data Content Transformation The decision tree of identification or algorithm form decision engine according to patient disease feature and provide diagnosis and treatment scheme.
The utility model has the advantages that the present invention is from the prevention of chronic disease, the screening of complication and treatment, towards a variety of not of the same race The chronic disease of class carries out the requirement of different specific aim measures, a kind of integrated management platform is proposed, to hospital, community and family Front yard carry out all standing, really realize doctor it is conjuncted enter township register one's residence.Compared with prior art, the present invention has accomplished to implement to specific individual Protection and diagnosis and treatment, guarantee sufferer data acquisition system caused by community, family and hospital summarize, thus to it is slow disease carry out it is polynary Change, for a long time, multi-level close observation and treatment.
Detailed description of the invention
Fig. 1 is the structural schematic diagram of chronic disease systematic management system of the present invention;
Fig. 2 is the structural schematic diagram of the conjuncted management diagnosis and therapy system of doctor of the invention;
Fig. 3 is the structural schematic diagram of individual health management system of the invention;
Fig. 4 is of the invention based on can the management of software definition and the communication construction schematic diagram of service system;
Fig. 5 is the structural schematic diagram of background service system of the invention;
Fig. 6 is the roll-over protective structure composition of chronic disease systematic management system of the invention;
Fig. 7 is the application schematic diagram of chronic disease systematic management system of the invention;
Fig. 8 is chronic disease systematic management system of the invention using patient as the full connection schematic diagram of core.
Specific embodiment
Technical solution of the present invention is described further with reference to the accompanying drawing.It is to be appreciated that examples provided below Merely at large and fully disclose the present invention, and sufficiently convey to person of ordinary skill in the field of the invention Technical concept, the present invention can also be implemented with many different forms, and be not limited to the embodiment described herein.For The term in illustrative embodiments being illustrated in the accompanying drawings not is limitation of the invention.
As shown in Figure 1, a kind of chronic disease systematic management system, including the conjuncted management diagnosis and therapy system of doctor, individual health pipe Reason system, background service system are cured conjuncted management diagnosis and therapy system and individual health management system and are connected respectively with background service system It connects.It cures conjuncted management diagnosis and therapy system and differentiated control is carried out to mechanisms at different levels, chronic disease is subjected to Classification Management by disease, and to each Doctor's permission of a academic title carries out multi-zone supervision.Here the conjuncted mechanisms at different levels of doctor include Grade A hospital, area/county hospital, community Hospital, community and family provide the comprehensive medical framework comprising each level from hospital's angle.Individual health management system It relies on individual ID (such as electronic health care card, Citizen Card Item, medical card, identity card) to carry out establishing Profile, and passes through healthy number According to acquisition, storage, analysis, realize the prevention and screening of chronic disease.Individual health management system is by chronic disease specific to individual Sufferer is brought convenient and collects more personal data, for analysing patient's condition to sufferer.Background service system is used to support whole The operational management of a platform, contains the management of database server, user account and permission and the auxiliary for providing chronic disease is determined Plan function.
Referring to Fig. 2, curing conjuncted management diagnosis and therapy system includes mechanism hierarchical management module, chronic disease Classification Management module, doctor Layer-management module estranged.Mechanism hierarchical management module is used to provide and be classified to the medical institutions at different levels for including community and family Management, integrates the medical resource and service capability information of each hospital, establish from front three-it is at county level-the classification diagnostic and therapeutic system of community, it is real Existing information fusion, data sharing.Chronic disease Classification Management module is for carrying out pipe by chronic disease disease to the isomeric data of multi-source Reason, including main judge index, the diagnosing and treating apparatus etc. for recording each disease, and establishes matching relationship with corresponding hospital and doctor. Doctor's multi-zone supervision module authorizes different chronic disease managements in the academic title of Different hospital based on training alliance, according to doctor With diagnosis and treatment permission, the management of personal slow disease is divided into hospital, community and family.
Fig. 3 shows the functional block diagram of individual health management system, including health and fitness information acquisition module, data store mould Block, data processing and analysis module obtain multi-source heterogeneous data by the Intellisense of various terminal equipment, and will be personal Health account, chronic disease carry out function fusion with the data such as record, medical diagnosis and treat record, the inspection of all previous coherent video are changed, and realize Individual health record is connect with the overall process of chronic disease management.Health and fitness information acquisition module is set to community or family, can be used Wearable device or other physiological detection equipment, for perceiving human blood-pressure, blood glucose, blood lipid, weight height, lung capacity, containing rouge The achievement datas such as amount, electrocardiogram.The human body indicators data of health and fitness information acquisition module acquisition pass by way of wirelessly or non-wirelessly Data memory module is transported to, data memory module stores marker data information by individual, and associated with personal essential information, builds Vertical personal health archives.Data processing and analysis module obtain data from data memory module based on instruction or periodically, first It is normalized, is compared and analyzed further according to the knowledge base prestored, tentatively identify chronic disease disease and marked. The reason of carrying out data normalization processing is that different slow sick data targets often has different dimension and unit, the situation Will have a direct impact on big data analysis as a result, in order to eliminate the influence of dimension between index, need to carry out data normalization processing, To solve the comparativity between data target.
Due to the isomerism of the portable medical terminal of the use during chronic diseases management, platform support a variety of access technologies and Networking mode forms the virtual terminal of an enhancing by assembling existing multiple portable medical terminals, and chronic diseases management platform can Some suitable health terminal equipment is automatically selected with the environment according to locating for user and accesses some wireless network, i.e., with user Centered on, towards chronic diseases management service, the health service terminal of multiple terminals collaboration is made up of the virtual terminal that multiple terminals is formed System.Multi net voting collaboration refers to the multiple functions such as access, connection, transmission, the management for coordinating a variety of heterogeneous network resources.Due to more The chronic diseases management system of terminal collaboration is transmitted using different heterogeneous networks, and uses a variety of wireless access technologys, this is just Need to break through existing a variety of healthy portable medical terminals the limitation of a certain single network, to realize chronic diseases management much sooner Service, while being also required to the suitable network of the environmental selection according to locating for slow disease patient and providing service for it.By the above-mentioned stage, The physiological data of patient could be transferred to data backstage from acquisition equipment, carry out data exchange and management, and strong in resident's electronics Kang Kanei accomplishes to timely update, and later, medical institutions and community chronic disease administrative center can just make and timely feedback.
In the specific implementation, can by construct towards multidisciplinary, multi-layer, more diseases can software definition management and clothes Business system realizes the interface function of platform multiplicity.Can management and the service system of software definition API programming abundant be provided connect Mouthful, it is easy to implement diversified management and service, accomplishes " definable " in terms of Users ' Need-oriented, and there is good expand Malleability needs to manage different diseases in chronic diseases management platform, and manages additions and deletions portable medical terminal therewith, good to open up Malleability allow can software definition management and service system in platform construction have advantage.Its thinking of development and own characteristic and society Area's chronic diseases management platform is consistent, and the network struction and function realization to platform are of great significance.
Based on can software definition management and the slow sick intelligent management and service platform of service system can be with anonymity, different Step, one-to-many or multi-to-multi mode carry out data distribution.The process is related to sensing layer, network layer and application layer in platform. First layer is sensing layer, including portable medical terminal and every attached sensors, they generate metadata and metadata is transmitted To the event agent being connected directly with them, network layer of the second layer as the basic network facilities, main includes providing network clothes The OpenFlow interchanger of business is responsible for efficiently forwarding event, and provides service to meet the qos requirement of application program;Third Layer application layer then mainly includes event agent, these event agents form a distributed post/subscription covering network, realizes base In the publish/subscribe service of chronic diseases management.Event agent receives the metadata generated from medical terminal, and metadata is packaged into Format (insertion theme) predetermined, is pushed to SDN network then to carry out network transmission.Event agent also receive from Other act on behalf of the data forwarded, then do corresponding processing.All event agents are divided into different clusters, no Event agent with cluster is also connected with each other, and forms a distributed post/subscription covering network.Event agent mainly realizes thing The publication of part such as subscribes to/unsubscribes, notifies and route at the functions, including by storing theme and strategy database, based on Calculate subscription table and the event routing modules at different levels of routing, the subscription information management module for subscribing to maintenance, for publish/subscribe The agency network topology maintenance module etc. of topology maintenance.
Fig. 4 shows the communication construction of platform, relies primarily on application layer and control layer, and application layer realizes publish/subscribe function Can, control layer then increases Internet of Things service interface as northbound interface on the controller.Its workflow is as follows:
1. parameter perception and acquisition: various relevant parameters are perceived and are acquired by sensing system, then are passed via standard agreement It is delivered to access events agency;
2. information standardization and publication: after access events agency receives data, using set in resource description model library Concept and attribute by data convert event, then event is published to publish/subscribe network via publish/subscribe interface;
3. case distribution and routing: after the event issued is received by event agent, according still further to subscription table and routing table quilt Distribute and be routed to different event agents, and sends event notice to the unit for subscribing to the event topic;
4. event subscription person is handled: after event subscription person receives event, the process flow set according to it handles the event.
On this basis, following differentiated control ability can be further provided for: 1) at using big data analysis and artificial intelligence Platform knowledge uses grading authorized point of sick management mode to the support of medical staff at different levels, with Medical Group disease that calls for specialized treatment types of alliance Management;2) implement the management changed the place of examination up and down with platform;3) carry out the hospital services of chronic disease internet;4) it is chronic to establish internet Sick MDT (Multiple Disciplinary Team) service platform;5) remote medical consultation with specialists and guidance.By internet hospital and slow disease It manages platform and carries out depth integration and cooperative development.Internet hospital is between connection patient and hospital, patient and medical staff Between bridge, be extension to conventional entity hospital services to outside institute, improve and beneficial complement.Chronic diseases management is internet Hospital realizes the splendid scene of classification diagnosis and treatment: the electronic health care that specialist and general practitioner pass through different port access citizen Management is continuously tracked to slow disease patient in card, realization.On the basis of the above, platform periodically invites each training director, deputy director doctor Teacher carries out the abnormal data consultation of doctors to internet hospital, understands patient data, after comprehensive analysis and pass through network signals patient as a result, And interacted with patient, physical space is realized in conjunction with Virtual Space, guarantees that patient treats continuity.In addition to Diagnosis-treat Model, process Optimization, improve, can also be according to being updated, reinforce to the means of services, such as slow disease cell phone managing APP can be developed.On The measure of stating will greatly enrich internet hospital in the intension and meaning of community chronic disease management, promote internet hospital and community Chronic diseases management platform depth integration.
Following multi-zone supervision ability may further be provided: 1) family doctor's team services function: front three cures conjuncted one The family doctor service team community service place point of change and and communication center;2) the virtual clinic of internet hospital services: can make It for the chronic disease diagnosis and treatment of internet hospital, manages, intervenes, the supporting point of Extension Services is nursed in health education;3) non-medical technology Health service center: including online booking, medical insurance is paid on line, and the crowds such as disability or old man see a doctor and accompany, and internet makes up a prescription; 4) service function under internet medical treatment line: the medical treatment and care of domestic medicine include blood test under line, change various conduits, Physical therapy, rehabilitation etc.;5) autonomy organizations such as Chronic Disease in Community self-education, such as diabetes ward mate's meeting, renal failure mutuality etc.;6) community Internet+precisely chronic disease health education;7) the Internet community remote medical consultation with specialists point.
Background service system provides the management of database, user account and permission and the decision-making function of chronic disease, Referring to Fig. 5, background service system includes database module, and account management module and medical decision making support module, database are used for Store various data, functions such as account management module provides the registration of user, verification, logs in, publishes, nullifying and according to using The role of person is that sufferer or doctor carry out priority assignation.Basic function such as object identity certification, medical history information acquisition storage, people Member's location tracking, individual privacy and information safety protection, the retrospect of behavior whole process trace, Workload Account analysis, bidirectionally transfering consultation etc.. And according to portable medical service procedure, residential end registration, perfect information, identity validation, submission demand for services application etc. are provided Function;Community Doctor comments situations such as its disease event, health demand by phone, video, the modes such as register one's residence comprehensively Estimate, in combination with the health and warning information of acquisition, completes preliminary treatment or worksheet processing task;Medical institutions medical staff is according to society The worksheet processing task that Qu doctor submits provides corresponding treatment and nursing service for resident.Community Doctor and O2O care new model, Service supply is expanded, efficiency of service is improved, energy Dock With Precision Position community resident diversification, multi-level health demand are formed The slow disease of all-in-one writng model in medical care " prevention and treatment health " Novel work mechanism.
Medical decision making support module is on the basis of personal health management system, it is further provided based on the big number of medical treatment According to the slow sick complete period Integrative Management Model with artificial intelligence, more precisely prevention and the screening to chronic disease is realized.Include:
Artificial intelligence autonomous learning model is constructed based on depth convolutional network, a large amount of medical datas are loaded into model includes Slow disease practice guidelines, documents and materials, professional book and medical message etc., and artificial intelligence and hospital information system (HIS) is right It connects, using slow disease patient case taking in database as training set, the slow sick clinical diagnosis and treatment process of its study is made by " training ".It utilizes Artificial Intelligence and method, it is complete by self feed back model based on authoritative evidence-based medicine EBM knowledge base and real world clinical data At adjust automatically and algorithm improvement, chronic diseases management model that is more accurate and suiting clinical thinking is constructed, finally accomplishing can be only Vertical autonomous learning new things, encountering unknown things can reasonably cope with as the mankind, be truly realized class peopleization.
During slow disease clinic diagnosis, under the premise of following objective diagnosis and treatment process, case history is automatically performed by artificial intelligence The acquisition, cutting and analysis of related data in system are converted to machine recognizable data pattern, are loaded into chronic diseases management model, It carries out disease intelligently to infer, while diagnosis different foundation, treatment plan foundation and related literatures being provided, doctor is taken Medical measure give and prompt, warn, provide decision support for medical worker's clinic diagnosis, improve medical service of hospital quality With health care level, patient's diagnosis and treatment burden is reduced.
Full disease aid decision-making system based on artificial neural network: artificial neural network learning larger scale clinical number is utilized According to middle slow disease patient symptom and sign, the incidence relation of auxiliary examination and diagnosis of disease, based on authoritative evidence-based medicine EBM knowledge base and very Real world's clinical data, building is accurate and suits the knowledge mapping of clinical thinking, and it is auxiliary that full disease is provided in doctor's diagnosis and treatment process Help decision support.
Single diseases personalized medicines DSS based on genetic algorithm: in slow disease patient individuation diagnosis and treatment process In, according to corresponding clinical guidelines and clinical expertise's scheme, analyzed in conjunction with the true medical record data of patient, by data content Machine recognizable decision tree or algorithm are converted to, decision engine is formed, according to patient disease feature, intelligence generates diagnosis and treatment side Case.
Slow self health control model of sick complete period based on big data: pass through wearable device sick patient slow to acquisition Health data simultaneously uploads to cloud database formation personal health archives, carries out data processing by AI technology, provides personalized strong Health Managed Solution.Wearable device and intelligent health terminal are relied on, continues to monitor vital sign patient, look-ahead dangerous situation simultaneously mentions Solution out.
The foundation of chronic diseases management platform also implies that increasing for healthy big data collection analysis and application, this also means that Focus on the safety of platform data.In the construction of chronic diseases management platform and operational process, it is contemplated that the slow disease of magnanimity will be generated Medical big data.These data in collection analysis, using data-privacy disclosure risk may be faced in, shared, exchange process Problem.In recent years, medical personal secrets risk case takes place frequently, and medical personal secrets there is " domestic trouble and foreign invasion ", let out by privacy Dew event makes a very bad impression, and the leak path of privacy is more hidden under big data era.Especially slow disease patient has been born Extremely heavy health and psychological burden carries out operation of making profit using its medical data if meeting with criminal, and consequence will be with The original intention for collecting slow sick big data greatly differs from each other.In the information age, big data is closely connected with cloud computing, therefore big data is general It is stored in cloud platform, and data needed for chronic diseases management are not limited in data caused by platform and terminal, it will also be with Docking hospital swaps analysis, in some instances it may even be possible to be connected to each other in future with medical management agency, therefore more to execute data safety Be rigid in checking up.
To cope with above-mentioned data safety risk, chronic diseases management platform safety frame is constructed, as shown in fig. 6, can be from three Laterally, three longitudinal directions are designed.Three lateral safe floors mainly for community chronic disease management platform general technical framework and The safety of proposition: top layer is application layer security, and middle layer is Transport Layer Security, and the bottom is sensing layer safety, is also showed that on figure The safe practice and security strategy that are related to.The security strategy that sensing layer is related to mainly has equipment certification, data encryption, peace Full coding, TPM trusted module, security protocol, access control etc..The main leaky scanning of transport layer, Initiative Defense, safety association The security strategies such as view, network filtering and empowerment management.Application layer mainly includes that security audit, intrusion detection, heat engine calamity are standby, virtual Security strategies and the means such as isolation, cloud antivirus, user right, safety management.
Security architecture and service, safety standard and security evaluation of three longitudinal safety mainly for Internet of Things entirety, tool Body implementation content includes security architecture and services, safety standard formulation, risk assessment and security evaluation, and wherein security evaluation includes Awareness apparatus safety detection service platform, Internet of things system safety detection service platform, Internet of things system risk assessment service are flat Platform etc.;Cloud platform risk assessment, Virtual Service risk platform, the integrated safety detection of cloud resource etc..
Fig. 7 shows the application schematic diagram of chronic disease systematic management system according to an embodiment of the present invention, passes through two Line is implemented prevention and control to chronic disease and is managed from three levels using 1+x chronic disease management mode, realizes that chronic disease interconnection is dry In advance." 2 " refer to two lines, indicate two kinds of chronic diseases management links, are 1) to cure conjuncted route respectively, i.e. Grade A hospital-community doctor Institute-community-family chronic disease integrated synthesis management and treatment, 2) overall process of resident Jiankang and chronic disease management connects, That is resident-handles health card (Citizen Card Item)-to establish health account-foundation human body number of package slow according to library-signing family doctor service- Sti prevention-physical examination+chronic disease disease screening-conjuncted the integrated management of doctor-community intelligent perception monitoring-data analysis-offer essence Standardization management-family doctor team provides medical services+community and provides internet medical treatment+non-medical health service of community's offer. " 3 " refer to three levels, indicate three levels of prevention and treatment of chronic diseases, 1) focus on prevention, the 2) screening and early detection of disease (including complication), 3) management and control of disease." x " refers to 1+x chronic disease management mode, towards such as hypertension, room It quivers, the x kind chronic disease such as diabetes, chronic kidney disease, cerebral apoplexy, coronary heart disease.
Fig. 8 shows the platform using patient as the full-shape color connection status figure of core.It is directed to the sufferer specific to individual, It can be connected, while associated with the health agencies such as hospital, community with healthy cloud and a variety of payment channels etc., be accomplished Information exchange, towards sufferer.The course of work is understood by several typical cases:
Case one: the patient with diabetes has found that blood glucose numerical value is abnormal recently in community's physical examination, the number at hospital Can timely update according to library, and his (she) data of physical examination equally can be in the database in county hospital.
Case two: resident handles health card (Citizen Card Item), establishes health account and human body number of package according to library, while the family that contracts Chamber doctor service, this has been switched on chronic disease prevention, by physical examination, data is uploaded in database and are analyzed, platform can provide essence Standardization management, by the non-medical health service triplicity of the internet medical treatment and community of family doctor team, community.
Case three: old old man is confined to bed, there is hypertension chronic diseases, when she visits to platform application family doctor When diagnosis and treatment, platform can arrange suitable doctor to go to according to its data.
Case four: chronic goes to the area of surrounding or county town to play, and when feeling not quite the thing, goes to medical, doctor Its available past index and allergic conditions are convenient for the case where diagnosis is with wrong medicine is reduced.
Case five: government or hospital can transfer the in-depth analysis that data therein carry out single disease, research treatment Scheme improves therapeutic efficiency, reduces misdiagnosis rate.
Case six: when encountering more complicated or multiple treatment does not have remarkable result, doctor can seek in the database The medication of other doctors is looked for treat.

Claims (5)

1. a kind of chronic disease systematic management system, which is characterized in that including curing conjuncted management diagnosis and therapy system, individual health management System, background service system, the conjuncted management diagnosis and therapy system of the doctor and individual health management system respectively with the background service System connection, the conjuncted management diagnosis and therapy system of doctor carry out differentiated control to mechanisms at different levels, chronic disease are classified by disease Management, and multi-zone supervision is carried out to doctor's permission;The individual health management system relies on individual ID to establish Profile, and leads to The prevention and screening of chronic disease are realized in the acquisition, storage, analysis for crossing health data;The background service system is used to support whole The aid decision of the operational management of a platform, the management and chronic disease that provide data storage, user account and permission supports function Energy.
2. chronic disease systematic management system according to claim 1, which is characterized in that the conjuncted management diagnosis and treatment system of doctor System includes mechanism hierarchical management module, chronic disease Classification Management module, doctor's multi-zone supervision module, the mechanism differentiated control mould Block is used to carry out differentiated control to medical institutions at different levels, integrates the medical resource and service capability information of each hospital, establishes from three First-is at county level-the classification diagnostic and therapeutic system of community, realize information fusion, data sharing;The chronic disease Classification Management module for pair The isomeric data of multi-source is managed by chronic disease disease, and establishes the matching relationship of disease with corresponding hospital and doctor;Institute Doctor's multi-zone supervision module is stated based on training alliance, authorizes different chronic disease pipes in the academic title of Different hospital according to doctor The management of personal slow disease is divided into hospital, community and family by reason and diagnosis and treatment permission.
3. chronic disease systematic management system according to claim 1, which is characterized in that the individual health management system Including health and fitness information acquisition module, data memory module, data processing and analysis module, the health and fitness information acquisition module is used for Human body indicators data are perceived, the human body indicators data of health and fitness information acquisition module acquisition are transmitted to by way of wirelessly or non-wirelessly Data memory module, data memory module store marker data information by individual, and associated with personal essential information, establish a People's health account;The data processing and analysis module obtain data based on instruction or periodically from data memory module and are returned One changes processing and comparative analysis, identifies chronic disease disease and is marked.
4. chronic disease systematic management system according to claim 1, which is characterized in that the background service system includes Database module, account management module and medical decision making support module, the database module is for storing various data;It is described Account management module is for being managed the identity of user account and carrying out priority assignation according to the role of user;The doctor Slow sick complete period Integrative Management Model of the decision support module based on medical big data and artificial intelligence is treated, is realized to chronic disease Prevention and screening.
5. chronic disease systematic management system according to claim 4, which is characterized in that it is described based on medical big data and The slow sick complete period Integrative Management Model of artificial intelligence includes:
Slow sick integrated management strategy based on AI autonomous learning: under the premise of following objective diagnosis and treatment process, certainly using artificial intelligence Primary learning integrates medical big data, is automatically performed the processing and analysis of associated patient data in hospital information system, is medical matters people Member provides medical decision making and supports;
Full disease aid decision-making system based on artificial neural network: slow sufferer in artificial neural network learning clinical data is utilized Person's symptom and sign, auxiliary examination and diagnosis of disease incidence relation, it is clinical based on authoritative evidence-based medicine EBM knowledge base and real world Data construct knowledge mapping, and full disease aid decision is provided in doctor's diagnosis and treatment process and is supported;
Single diseases personalized medicines DSS based on genetic algorithm: medical record data Content Transformation can recognize for machine Decision tree or algorithm, form decision engine and according to patient disease feature provide diagnosis and treatment scheme.
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CN110570945A (en) * 2019-11-06 2019-12-13 常州糖族部落云健康科技有限公司 AI chronic disease management method, computer storage medium and electronic device
CN110580940A (en) * 2019-08-28 2019-12-17 北京好医生云医院管理技术有限公司 Chronic disease management method and device based on big data
CN111128381A (en) * 2019-12-25 2020-05-08 武汉大学 Active 120 system based on artificial intelligence
CN111145904A (en) * 2019-12-31 2020-05-12 苏州科技城医院 Information-based integrated chronic disease management system and method
CN111243762A (en) * 2020-01-19 2020-06-05 广州天健软件有限公司 Method and system for accurately pushing medical information
CN111696633A (en) * 2020-05-13 2020-09-22 上海融达信息科技有限公司 Disease prevention and control service system and method based on community health big data
CN112164455A (en) * 2020-10-15 2021-01-01 四川大学 Interactive health management system and method for chronic diseases of old people
CN112420140A (en) * 2020-10-23 2021-02-26 江苏亚寰软件股份有限公司 Chronic disease full-period management and supervision system based on block chain and machine learning algorithm
CN112732673A (en) * 2021-01-04 2021-04-30 上海市宝山区疾病预防控制中心 System for realizing analysis and processing of chronic disease quality control data based on big data
CN112802604A (en) * 2021-02-22 2021-05-14 苏州市卫生健康委员会 Screening method and system for chronic diseases
CN113539483A (en) * 2021-08-02 2021-10-22 曜立科技(北京)有限公司 Chronic disease screening service system based on cloud computing
CN113744875A (en) * 2021-06-25 2021-12-03 韩勇 Chronic disease management method, system, electronic device and storage medium
CN114005522A (en) * 2021-10-28 2022-02-01 平安国际智慧城市科技股份有限公司 Data processing method, device, equipment and storage medium
CN114155965A (en) * 2021-12-13 2022-03-08 首都医科大学附属北京安贞医院 Intelligent hypertension and chronic disease management service system based on human-computer interaction
CN114416844A (en) * 2022-01-19 2022-04-29 平安国际智慧城市科技股份有限公司 Chronic disease management device based on medical data, electronic equipment and storage medium
CN114969379A (en) * 2022-06-17 2022-08-30 好人生(上海)健康科技有限公司 Big data-based method and device for generating single disease health management knowledge map
CN115689836A (en) * 2023-01-04 2023-02-03 山东沐华医疗科技有限公司 Home medical contract signing, basic public health and chronic disease management integrated service platform and management method
CN115798715A (en) * 2023-02-09 2023-03-14 山东沐华医疗科技有限公司 Chronic respiratory disease prevention and treatment information management system based on data analysis
CN117637089A (en) * 2023-12-06 2024-03-01 广东康合慢病防治研究中心有限公司 Medical chronic disease case storage monitoring management device and system

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Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110580940A (en) * 2019-08-28 2019-12-17 北京好医生云医院管理技术有限公司 Chronic disease management method and device based on big data
CN110570945A (en) * 2019-11-06 2019-12-13 常州糖族部落云健康科技有限公司 AI chronic disease management method, computer storage medium and electronic device
CN110570945B (en) * 2019-11-06 2020-02-14 常州糖族部落云健康科技有限公司 AI chronic disease management method, computer storage medium and electronic device
CN111128381A (en) * 2019-12-25 2020-05-08 武汉大学 Active 120 system based on artificial intelligence
CN111145904A (en) * 2019-12-31 2020-05-12 苏州科技城医院 Information-based integrated chronic disease management system and method
CN111243762A (en) * 2020-01-19 2020-06-05 广州天健软件有限公司 Method and system for accurately pushing medical information
CN111696633A (en) * 2020-05-13 2020-09-22 上海融达信息科技有限公司 Disease prevention and control service system and method based on community health big data
CN112164455A (en) * 2020-10-15 2021-01-01 四川大学 Interactive health management system and method for chronic diseases of old people
CN112420140A (en) * 2020-10-23 2021-02-26 江苏亚寰软件股份有限公司 Chronic disease full-period management and supervision system based on block chain and machine learning algorithm
CN112732673A (en) * 2021-01-04 2021-04-30 上海市宝山区疾病预防控制中心 System for realizing analysis and processing of chronic disease quality control data based on big data
CN112802604A (en) * 2021-02-22 2021-05-14 苏州市卫生健康委员会 Screening method and system for chronic diseases
CN113744875A (en) * 2021-06-25 2021-12-03 韩勇 Chronic disease management method, system, electronic device and storage medium
CN113539483A (en) * 2021-08-02 2021-10-22 曜立科技(北京)有限公司 Chronic disease screening service system based on cloud computing
CN114005522A (en) * 2021-10-28 2022-02-01 平安国际智慧城市科技股份有限公司 Data processing method, device, equipment and storage medium
CN114155965A (en) * 2021-12-13 2022-03-08 首都医科大学附属北京安贞医院 Intelligent hypertension and chronic disease management service system based on human-computer interaction
CN114416844A (en) * 2022-01-19 2022-04-29 平安国际智慧城市科技股份有限公司 Chronic disease management device based on medical data, electronic equipment and storage medium
CN114969379A (en) * 2022-06-17 2022-08-30 好人生(上海)健康科技有限公司 Big data-based method and device for generating single disease health management knowledge map
CN115689836A (en) * 2023-01-04 2023-02-03 山东沐华医疗科技有限公司 Home medical contract signing, basic public health and chronic disease management integrated service platform and management method
CN115798715A (en) * 2023-02-09 2023-03-14 山东沐华医疗科技有限公司 Chronic respiratory disease prevention and treatment information management system based on data analysis
CN115798715B (en) * 2023-02-09 2023-06-09 山东沐华医疗科技有限公司 Chronic respiratory disease prevention and treatment information management system based on data analysis
CN117637089A (en) * 2023-12-06 2024-03-01 广东康合慢病防治研究中心有限公司 Medical chronic disease case storage monitoring management device and system

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Application publication date: 20190625