In order to promote the openness, transparency and standardization of clinical trials, improve the scientific and reliability of results, and reserve the manpower, material, and financial resources in the process of clinical trials, this study constructed an integrated intelligent management platform for clinical trials, which could carry out various types of clinical trials such as randomized controlled trials, non-randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies simultaneously. The platform covers the whole process of scheme design, recruitment, follow-up, data analysis, and quality control. This paper mainly introduced the practical needs, design concept, basic framework and technical highlights to provide auxiliary tools for promoting the standardization and intelligence of clinical trials with energy saving and optimal efficiency.
In recent years, day surgery has developed rapidly in China. Day surgery management has shifted from extensive to refined, but there are still many problems in the service system of day surgery in Chinese hospitals. In order to further optimize the allocation of medical resources, improve the level of medical service capacity, and build a “patient-centered, safe, efficient, and orderly” day surgery service system, Northern Jiangsu People’s Hospital has integrated big data, mobile internet, and artificial intelligence since 2019, creating a smart information big data platform. This paper summarizes the experience of Northern Jiangsu People’s Hospital in promoting the high-quality development of day surgery services in the whole hospital from five aspects of top-level design, diagnostic and therapeutic process, medical quality and safety, medical supporting services, and supervision mechanism, with a view to providing reference for the implementation of overall management of day surgery in the hospital.
As a science which focuses on evidence, the decision making process of evidence medicine encounters an opportunity for development in the big data era. The starting point is shifting forward from evidence to data. The big data technology is playing an active role in evidence's collection, process and utilization. Evidence is more objective, righteous, authentic, transparent and easier to collect. Thus, to initiate evidence-based medicine research in the big data era and to structure an evidence-based medicine intelligent service platform, a full-scaled strategy should be developed in order to improve the quality of evidence. To promote the complete publicity of clinical research data, structuralized clinical data standard should be constructed. To provide a pathway to patients' follow-up data, portable and wearable monitoring devices should be popularized. To avoid risks from utilization of clinical research big data, regulations of clinical data usage should be implemented.
ObjectiveExplore the impact of a digital-intelligence-based quality control platform for thyroid cancer on the effectiveness of clinical diagnosis and treatment quality management. MethodsThe digital-intelligence-based quality control platform for thyroid cancer at Zhejiang Provincial People’s Hospital was launched at the end of July 2022. In its initial phase, six quality control indicators related to the standardized diagnosis and treatment of thyroid cancer were deployed. This study analyzed the changes in these six quality control indicators between January 2022 and November 2023, comparing data before and after the platform’s implementation. ResultsCompared with the period from January to July 2022 (prior to the platform’s launch), the rates of preoperative cytopathological examination (t=–8.490, P<0.001) and postoperative pTNM staging for thyroid cancer patients (t=–3.027, P=0.013) increased from July to November 2023 (one year post-launch). However, the proportion of minimally invasive surgeries among thyroid cancer patients (t=4.085, P=0.002) decreased. The linear regression model results indicated that, following the platform’s launch, there was a gradual increase over time in both the preoperative cytopathological examination rate for thyroid cancer (P=0.001) and the postoperative pTNM staging rate (P=0.049). ConclusionPreliminary results of this study suggest that the thyroid cancer digital-intelligence-based quality control platform developed by our team can effectively enhance the standardized quality control of clinical diagnosis and treatment for thyroid cancer.
With the continuous advancement of internet technology and the improvement of internet literacy among the general population, the concept of online-offline integration in internet hospitals has gradually gained acceptance and has been applied and developed both domestically and internationally. In thoracic surgery, the applicability of this model lies in enhancing efficiency and delivering comprehensive, diversified, and personalized medical services to address complex and severe conditions. However, challenges such as hardware limitations and diagnostic/treatment risks persist during the implementation of internet hospitals. Through future in-depth and localized research, the online-offline integration of internet hospitals is expected to undergo further development and refinement. This progress will facilitate its integration into clinical practice in thoracic surgery, ultimately providing patients with improved medical care services.
Platform daytime chemotherapy means that the hospital sets up a fixed area for daytime chemotherapy, and all patients with daytime chemotherapy are treated in the same area. The platform daytime chemotherapy center has the advantages of further optimizing the limited hospital resources, reducing the consumption of medical resources, and improving the efficiency of bed use and patient satisfaction. Its construction is the further sublimation of tumor treatment concept, harmonious relationship between doctors and patients, and humanistic care. This article shares the construction experience of the platform daytime chemotherapy center from the definition, orientation, operation mechanism, ward configuration, drug access, patient access and management mode, and puts forward suggestions that the promotion of the platform daytime chemotherapy center should be carried out from the aspects of policy support, hospital vigorously promoting and self-management breakthrough.
ObjectiveTo explore the function of information system platform in the management of outpatient registration source.
MethodsOn the basis of registration appointment system, we surveyed again on outpatients traffic between February 6th and 10th in 2012 to find out find out the disadvantages of outpatient service procedures. Certain measures were taken for improvement, especially the management of registration source.
ResultsAfter improvement by certain measures, queuing phenomenon and the degree of congestion in the waiting area were improved. To some extent, the satisfaction of patients and doctors was raised from 91% to 93%.
ConclusionStandardizing outpatient administration and behavior of patients by information system platform has a good effect and is worth promoting.
ObjectiveTo investigate the effectiveness of rotating-platform prosthesis for valgus knee deformity in total knee arthroplasty (TKA).
MethodsA retrospective analysis was made on the clinical date of 25 cases (28 knees) of valgus deformity undergoing primary TKA by using Gemini MK II rotating-platform prosthesis. There were 6 males (7 knees) and 19 females (21 knees), aged from 47 to 82 years, with an average age of 64.8 years. The unilateral knee was involved in 22 cases and the bilateral knees in 3 cases. The causes included osteoarthritis in 20 cases (22 knees), rheumatoid arthritis in 4 cases (5 knees), and traumatic arthritis in 1 case (1 knee). The disease duration was 2-22 years (mean, 10.4 years). The main clinical symptoms were arthralgia combined with limited movement. According to the Keblish grade, there were 13 knees of mild deformity, 11 knees of moderate deformity, and 4 knees of severe deformity.
ResultsAll incisions healed by first intension. No complications of infection, cutaneous necrosis, deep venous thrombosis, and pulmonary embolism occurred. The postoperative follow-up duration was 12-60 months (mean, 25.4 months). Medial instability and palsies of nervus peroneus communis occurred in 1 and 2 cases respectively, and all were cured after symptomatic treatment. No patellar and polysthylene insert dislocation, prosthetic loosening or infection was observed. The Hospital for Special Surgery (HSS) score, femoral tibial angle, maximun flexion and extension angles, knee range of motion, and patellar score were significantly improved at last follow-up when compared with preoperative ones (P<0.01).
ConclusionThe rotating-platform prosthesis for valgus deformity can obtain satisfactory effectiveness, but it requires precise soft tissue balancing technology, and the long-term effectiveness remains further observation.
According to system reform of the current medical insurance diagnosis related groups, quality control of rehabilitation medicine and requirements of information management, this paper constructs a rehabilitation information system by using the theoretical framework and core sets of International Classification of Functioning, Disability and Health (ICF). Then, the constructed system is embedded into the work of rehabilitation medicine team. By the four processes of ICF items evaluation, rehabilitation goal setting, team cooperation scheme formulation and reevaluation, the operation process of rehabilitation information management based on ICF is formed, which strengthens comprehensively the rehabilitation diagnosis and treatment standards and improves the efficiency of quality control management. The big data mining and multi-dimensional analysis in this platform can provide support of medical insurance payment, achieve exchanging and sharing rehabilitation medical quality control data among hospitals at different levels in different regions, assist tertiary referral and remote rehabilitation, improve the rehabilitation medical service system, and enhance the level of rehabilitation medical care. This paper will summarize the application experience of constructing ICF rehabilitation information management system.
The full-cycle rehabilitation management for orthopedic patients can solve the problems of standardization, systematization, and whole process of orthopaedic rehabilitation management, and prevent short-term and long-term complications. The First Affiliated Hospital of Sun Yat-sen University has constructed a full-cycle rehabilitation management platform for orthopedic patients based on multi-source data since 2023, including six modules: multi-source data collection and integration module, intelligent individualized rehabilitation program setting module, and visual rehabilitation training module, and has explored a digitally-driven full-cycle rehabilitation management mode for orthopedic patients. This article elaborates on the platform’s functional design and implementation, full-cycle rehabilitation management mode, and application effectiveness, in order to provide a reference for promoting the integration of mobile health and orthopedic patient rehabilitation practice.
