关键词: 结核, 疾病管理, 集成高级信息管理系统, 结果评价(卫生保健)

Abstract:

At the beginning of 2019, Ningxia Autonomous Region has set up the “Information System for Ningxia Tuberculosis Prevention and Treatment Management”, which effectively integrated the technical work of the tuberculosis (TB) designated medical institutions, the disease prevention and control centers, the grass-roots health care institutions and other health service facilities. In this information system, with the patient’s treatment timeline as the axis, an electronic medical record, which contains more than 530 information items, is formed for each patient, including the patient’s basic personal information, disease history, previous diagnosis and treatment results and cost information, etc. Among those information items, 91 items (e.g. the patient’s basic information, physical examination and screening results and disease history, etc.) can be automatically transferred to the National New TB Monitoring System managed by the Chinese Center for Disease Control and Prevention. By the end of 2019, the Ningxia TB Prevention and Treatment Management Information System has been linked with the 19 designated TB hospitals’ information system (HIS system) in Ningxia, accounting for 95.00% (19/20) of the total number of the TB designated hospitals in the whole region; in 2019, a total of 3258 TB suspects, who were eligible, were captured by this information system, while 2445 TB patients were reported in the “infectious disease surveillance system” and 85.60% (2093/2445) of the reported patients came form the captured TB suspects. As of May 2020, 43 medical institutions have installed the artificial intelligence (AI) image system and 3639 persons with TB symptoms got screening, then 987 TB suspects were detected and 433 cases were confirmed as TB, the diagnosis rate was 43.87% (433/987). 100 chest films of the 3639 persons with TB symptoms were randomly extracted and read by the radiologists. Based on the radiologists’ reading results, the sensitivity and specificity of the AI image system were 90.91% (10/11) and 89.89% (80/89) respectively, the Kappa value was 0.61 (0.60-0.62), which effectively improved the medical service efficiency. As of May 2020, more than 2130 health staff have registered in this information system with an effective follow-up rate of 61.78% (1125/1821) to the patients under treatment; 28 patients with pulmonary TB who installed smart phone sync APP and 33 patients who did not install sync cell-phone APP were randomly selected from the information system, and the average treatment adherence rate at the first six months of treatment in the patients using sync APP was 96.93% (15396/15883), which was significantly higher than that in the patients without using sync APP (92.99% (11411/12271))](χ ²=236.17, P=0.000), the treatment adherence of the patients was significantly improved.

Key words: Tuberculosis, Disease management, Integrated advanced information management systems, Outcome assessment (health care)