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目的设计开发医院慢性病网络上报系统,实现医院慢性病监测信息化管理,并与浙江省疾病预防控制中心进行实时数据交换。方法系统中慢性病上报端和保健部的管理客户端,均采用Microsoft Visual C#开发(基于Microsoft.NET Framework 4.0),采用Microsoft SQL Server 2008 R2建立数据库。系统在传统的3层架构(表现层、业务逻辑层、数据访问层)中加入了Windows通信接口(WCF)技术作为数据通信,Web Form和Win Form调用同一个WCF服务,业务逻辑和数据访问均在WCF服务端完成。医院内部采用专用的服务器和防火墙,保健部将数据实时发送到慢性病上报系统前置机(省专用网络上),将数据转成XML格式,然后调用浙江省疾病预防控制中心的Web Service接口完成数据上报。结果慢性病网络上报系统分为系统管理、上报查询、数据查询、新增、卡口设置及病人监测6大模块。该系统自2013年7月成功运行至2015年12月20日,已成功上报传输肿瘤卡片12 013张,心脑血管疾病卡片2 458张,糖尿病12 310张。对90张肿瘤、糖尿病和心脑血管疾病卡片的测试结果显示,手工填写所用时间均明显多于电子报卡(P<0.01)。慢性病网络上报系统有自动抓取功能,所需信息通过电子病历可从医院的信息系统(HIS)和实验室系统(LIS)等系统集成获取自动生成,提高了报告卡信息的完整性和准确性且能够自动根据条件匹配设限防止漏报。该系统运行后,浙江大学医学院附属第一医院的慢性病报告率为100.00%。该系统还具有可扩展性,可通过灵活设置满足慢性病监测管理的需求。结论慢性病网络上报系统实现了慢性病网络化报告和监测,具有时效性、完整性、低漏报率及灵活性。
Objective To design and develop a network reporting system for chronic diseases in hospitals and realize information management of chronic diseases monitoring in hospitals and to exchange real-time data with Zhejiang Provincial Center for Disease Control and Prevention. Methods The chronic health reporting client and management client of the health department were both developed by Microsoft Visual C # (based on Microsoft.NET Framework 4.0) and used Microsoft SQL Server 2008 R2 to establish the database. The system adds Windows Communication Interface (WCF) technology as data communication to the traditional 3-tier architecture (presentation layer, business logic layer, data access layer), Web Forms and Win Form invoking the same WCF service, business logic and data access Completed in the WCF server. The hospital uses a dedicated server and firewall, the Ministry of Health real-time data sent to the chronic disease reporting system front-end (province-specific network), the data into XML format, and then call the Center for Disease Control and Prevention in Zhejiang Province Web Service interface to complete the data Reported. Results The chronic diseases network reporting system was divided into 6 modules: system management, reporting query, data inquiry, adding, bayonet setting and patient monitoring. The system was successfully operated from July 2013 to December 20, 2015. It has successfully reported 12,133 oncology cards, 2 458 cardio-cerebrovascular diseases cards and 12 310 diabetics. Tests on 90 cancer, diabetes and cardio-cerebrovascular disease cards showed significantly more time spent on manual filling than on electronic cards (P <0.01). Chronic disease network reporting system with automatic capture function, the required information through the electronic medical records from the hospital’s information system (HIS) and laboratory systems (LIS) and other system integration to obtain automatically generated to improve the integrity of the report card information and accuracy And can automatically match the conditions to prevent underreporting. After the system is running, the first hospital affiliated to Zhejiang University School of Medicine reported a chronic disease rate of 100.00%. The system is also scalable and flexible enough to meet the needs of chronic disease surveillance and management. Conclusion The chronic disease network reporting system has realized the network reporting and monitoring of chronic diseases, with timeliness, completeness, low false negative rate and flexibility.