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.
With the increasing burden of chronic diseases, the issue of comorbidities has become increasingly important. In practice, patients with comorbidity of chronic diseases struggle to access continuous and integrated healthcare experiences. This article introduces the construction of the referral management system for comorbidity of chronic diseases based on “internet plus” in West China Hospital of Sichuan University. By formulating a standardized and convenient referral process and using artificial intelligence to optimize the referral platform, it creates a referral system for comorbidity of chronic diseases suitable for the hospital’s clinical workflows, makes reasonable use of the resources of the return pool, and improves the referral efficiency. After the implementation of the comorbidity referral system, patient satisfaction has increased, providing new ideas and reference experience for the management of comorbidity of chronic diseases for other medical institutions.