Cohort study is the observational study with the highest strength of causality demonstration, which is often used to test the etiological hypothesis and determine the risk factors of diseases. However, it often takes a lot of manpower, material and financial resources to carry out a cohort study, and it is time-consuming. At the same time, due to the long follow-up time, it is difficult to maintain the compliance of the study population, which is prone to loss to follow-up bias. In recent years, driven by network technology, a new type of cohort study design, e-cohort study, has gradually emerged, which is based on the network to recruit participants, follow up and collect data. Taking advantage of the wide coverage and high flexibility of the network, it provides a new strategy for improving the recruitment speed, participant participation and compliance of cohort study. This article summarizes the development history, current status, key points of design and implementation, advantages and challenges of e-cohort study, so as to help researchers to fully understand and apply this study design to solve practical clinical problems.
ObjectiveTo summarize the experience of earthquake rescue with the help of wise information technology.MethodsThe Jiuzhaigou earthquake of magnitude 7.0 occurred at 21:19 on August 8th 2017. Three hours and 38 minutes after the earthquake, a triad model of remote consultation, mobile video consultation and mobile text consultation was established to assist the earthquake rescue based on the mobile on-line medical consultation application and telemedicine center in West China Hospital. Patients classification, primary diagnosis, psychological counseling, victims searching were done by this novel rescue model.ResultWithin 72 hours after the earthquake, there were 114 doctors taking part in the earthquake rescue, including 4 remote consultations (hospital to hospital), 7 video consultations (doctor to victim), 487 mobile text consultations (doctor to victim), and 32 cases of which were highly relative to earthquake rescue, including one case of positioning for victim-searching.ConclusionThe triad model of earhquake rescue which was first initiated by West China Hospital played an important role in assisting earthquake rescue and achieved good results.
Objective To preliminarily assess the ameliorative effect of Mom’s Good Mood (MGM) on the prevalence of antenatal depression based on a pilot study, and to provide evidence for a scale-up study. Methods This study was conducted in Ma’anshan Maternal and Child Health Center as a pilot study of an implementation study conducted in China called the Perinatal Depression Screening and Management (PDSM) program. In 2019, 1 189 participants (gestational week ≤14+6 weeks) were included in the implementation group. Females were recruited in the first trimester and followed up in the second and third trimesters. At each time point, the participants’ depression status was screened by the Edinburgh postpartum depression scale (EPDS), and those who were screened as having depression were provided the MGM intervention. In 2020, 1 708 participants who underwent screening with the EPDS in either the first, second or third trimester at Ma’anshan Maternal and Child Health Center were included in the control group. Mann‒Whitney U test, Chi-square, and multivariate logistic regression analysis were used to compare the EPDS scores and depression prevalence between the control and implementation groups to assess the ameliorative effect of MGM (screening and intervention) on antenatal depression. Results In the first trimester, there were no statistically significant differences in EPDS scores or depression prevalence between the two groups (P>0.05). In the second and third trimesters, both the EPDS scores and depression prevalence of the implementation group were lower than those of the control group (P<0.05). After adjusting for confounders, logistic regression analysis showed that the risks of depression in the implementation group in both the second and third trimesters were lower than those in the control group (ORsecond trimester=0.55, 95%CI 0.37 to 0.81, P=0.003; ORthird trimester=0.51, 95%CI 0.35 to 0.74, P<0.001). Conclusion Implementation of the MGM based on the primary care system can effectively reduce the prevalence of antenatal depression, providing evidence for further scale up.
ObjectiveTo systematically review the influencing factors of patients’ adoption intention toward online medical services. MethodsCNKI, VIP, WanFang Data, Web of Science, PubMed and EMbase databases were electronically searched to collect cross-sectional studies on the influencing factors of patients’ adoption intention toward online medical services from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies; then, meta-analysis was performed by using Stata 16.0 software. ResultsA total of 28 cross-sectional studies involving 10 200 patients were included. The results of meta-analysis showed that perceived usefulness, perceived ease of use, and performance expectations were highly positively correlated with adoption intention. Effort expectation, social influence, convenience, self-efficacy, perceived value, individual innovation and perceived behavior control were moderately positively correlated factors. Perceived health threat was a low positive correlation factor of adoption intention. Resistance to change and perception of risk were moderately negatively correlated. Technology anxiety was a low negative correlation factor of adoption intention. There was a highly positive correlation between adoption intention and use behavior. ConclusionCurrent evidence shows that there is a highly positive correlation between adoption intention and use behavior, influencing factors of patients’ adoption intention include perceived usefulness, perceived ease of use, perceived value, etc.
Lung cancer is the malignant tumor with the highest incidence and mortality rate in China. Early diagnosis and treatment are key to improving the survival rate and reducing the mortality rate for lung cancer patients. This article introduces the integrated management model for patients with pulmonary nodules/lung cancer developed by West China Hospital of Sichuan University based on “internet plus” and health service team of treatment, nursing, and care. The Integrated Care Management Center has established a multidisciplinary team, using internet platforms and artificial intelligence tools to develop a whole life cycle health service system for patients with pulmonary nodules/lung cancer, which is from the screening of high-risk population for lung cancer, the intelligent risk stratification and follow-up management of pulmonary nodules, the subsequent standardized diagnosis and treatment of lung cancer and comorbidity management, until the patient’s demise. After the implementation of this model, the malignancy rate in surgically treated patients with pulmonary nodules reached 85.08%, and the patient satisfaction score was 95.76. This model provides a new idea and reference for the innovation of chronic disease service model and the management of pulmonary nodules and lung cancer.
At present, China has entered an aging society facing the dual challenges of “growing old before becoming affluent” and “aging without adequate preparation”, leading to significant eldercare pressures. With the rapid development of smart healthcare, the elderly population’s diverse, differentiated, and personalized medical demands have become increasingly prominent, presenting new challenges for geriatric healthcare services. This article elaborates and analyzes the elderly healthcare policies and the healthcare challenges faced by the elderly under China’s national strategy for actively addressing population aging. It also introduces the practical experience of intelligent elderly medical assistance in West China Hospital of Sichuan University from the aspects of enhanced appointment coordination mechanisms, refined treatment workflow optimization, and upgraded patient-centered service provisions. The research ultimately proposes actionable management strategies to achieve intelligent continuity in geriatric care delivery.
With the increasing demand for medical and health services in China, Internet hospitals have emerged, which can provide the public with diversified health services from multiple levels and dimensions. Based on the Internet hospital policies issued, this article sorts out and summarizes the information of Internet hospitals publicly reported in China, compares and analyzes the classification characteristics and similarities and differences of the two major service models of Internet hospitals, which are the second-named entity medical institutions, and Internet hospitals independently established by medical institutions, puts forward suggestions on how to improve the service model of Internet hospitals, and reveals the challenges faced by Internet hospitals. It aims to provide a reference for the promotion and development of Internet hospitals in China in the future.
The national policy on high-quality development of hospitals proposes to strengthen information technology support and actively promote the multi-disciplinary team (MDT) model. How to use the “Internet Plus” technology and operation mode to promote MDT communication and improve the efficiency of diagnosis and treatment in the digital and intelligent information age is a direction worthy of attention and research. This paper systematically reviews the current development status of MDT informatization construction at home and abroad. Based on the current challenges and opportunities, it makes prospects for the future development of MDT informatization construction from the aspects of strengthening the digital and intelligent support of MDT operation, connecting MDT “information silos”, and deepening the construction of MDT supervision and effect evaluation system, etc.
ObjectiveUse information technology to establish an “Internet+” chronic disease management model to provide patients with a full process, seamless, and convenient services. Explore a new model of “Internet+” chronic disease management and care services in the region. Methods Patients with chronic diseases treated in Mianyang Central Hospital from May 2018 to April 2019 were selected. The patients were randomly divided into intervention group and control group according to the single and even number at the end of hospitalization number. The control group adopted the traditional chronic disease management mode, and the intervention group adopted the “Internet+” chronic disease management mode based on the patients’ needs. And select the nursing experts who provide “Internet+” online nursing services. Compared with the effective management before and after the implementation of “Internet+” chronic disease management, the number of patients with chronic diseases, clinical outcome indicators, the number of health education readings, the number of Internet nursing services, and the sense of professional benefit of nurses and other indicators, etc. Results A total of 143 patients were included, including 78 in the control group and 65 in the intervention group. A total of 28 nursing experts were investigated. The effective management rate of patients with chronic diseases was 78.7%. The WeChat public account “Slow Disease Window” has read nearly 90 000 person-times, and the Internet Hospital “Nursing Professional Online” has nearly 2 000 online nursing services. After participating in “Internet+” chronic disease management, the disease activity and functional status of chronic disease patients were significantly improved (P<0.05). Nursing professionals have a strong sense of professional benefits (P<0.05). Conclusions With the development of “Internet+” chronic disease management, a new mode of chronic disease management was explored to promote the management of chronic disease more convenient and efficient, so that the health education work can be homogenized, the clinical outcome of the patients was effectively improved. At the same time the career planning of nursing staff can be broadened.
There are more than 6 800 urban public hospitals in China, which are the main subject of our country's medical service, but the process and efficiency need to be improved because of the siphon effect of resources and the limit of service scope. The use of internet thinking and technology will solve this problem effectively. Based on the fact, Deyang People's Hospital planned "internet+" system according to the requirement of the medical and health system reform, to solve the problems such as service efficiency, doctor-patient communication, multi-spot disciple, hierarchical medical system, delicacy management, etc. Through the concrete practice of elevating the efficiency of outpatient and emergency care services, it is recognized that the application of internet thinking and technology can not only accelerate the medical and health system reform, but also subvert the traditional medical pattern, integrate the regional medical resource, and enlarge the scope of medical services. It provides a sharp weapon to push forward the reform of urban public hospitals.