基层医院院内静脉血栓栓塞症智能防治系统的构建与实践

Construction and practice of an intelligent prevention and treatment system for venous thromboembolism in grassroots hospitals

  • 摘要: 目的 探讨基层医院院内静脉血栓栓塞症(VTE)智能防治系统的构建和实践情况。方法 依据VTE防治相关指南、专家共识,查阅国内外文献,由医院VTE防治临床专家、医疗护理质量管理专家和信息工程师组成的研发团队至周边基层医院考察调研,通过循证、调研整理出基层医院相关业务需求、用户需求和功能需求,最后拟定详细的系统设计方案。系统主程序使用Java编写,通过Webservice和视图的接口方式从院内数据平台获取数据。为防止后期服务器使用扩展应用时多应用定时任务对同一患者进行评估易导致重复数据提取的问题,采用XXL-JOB分布式任务调度平台来处理医护人员对患者的VTE评估工作。结果 VTE智能防治系统应用于临床后,出血风险评估率由系统上线初(2023年1月)的26.20%提升至2023年年底的83.04%; 2023年1月, VTE中高危患者机械预防实施率、药物预防实施率、联合预防实施率分别为21.39%、16.39%、5.26%; 2023年12月,分别提升至51.75%、25.50%、25.65%。结论 基层医院研发的VTE防治软件系统提高了研发效率,增强了系统的临床实用性,减轻了医护人员的工作负担,促进了VTE防治的规范化、标准化,强化了VTE单病种医疗质量的闭环管理,并有效提升了院内VTE防治能力和水平。

     

    Abstract: Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism (VTE) in grassroots hospitals. Methods Based on relevant guidelines and expert consensuses on VTE prevention and treatment, domestic and foreign literature was reviewed. A research and development team composed of clinical experts in VTE prevention and treatment, medical and nursing quality management experts, and information engineers conducted investigations and research in surrounding grassroots hospitals. Through evidence-based research and surveys, the team identified relevant business needs, user needs, and functional requirements of grassroots hospitals, and finally formulated a detailed design plan. The main program of system was written in Java. The interface obtained data from the hospital's data platform through Webservice and view interfaces. To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion, the XXL-JOB distributed task scheduling platform was adopted to handle VTE assessments by medical staff. Results After the clinical application of the intelligent VTE prevention and treatment system, the bleeding risk assessment rate increased from 26.20% at the initial system launch in January 2023 to 83.04% by the end of 2023. In January 2023, the implementation rates of mechanical prevention, pharmacological prevention, and combined prevention for medium-to-high-risk VTE patients were 21.39%, 16.39%, and 5.26%, respectively, which increased to 51.75%, 25.50%, and 25.65% in December 2023. Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve development efficiency, enhance the clinical practicality of the system, reduce the workload of medical staff, promote standardization and normalization in VTE prevention and treatment, strengthen closed-loop management of medical quality for VTE as a single disease, and effectively improve the prevention and treatment capabilities and levels of VTE within hospitals.

     

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