Research On The Construction And Application Of Remote Follow-up System For Early Gastric Cancer Treated With Endoscopic Submucosal Dissection

[Objectives]Based on mobile Internet technology,building a special disease database and cloud follow-up platform for early gastric cancer to form the remote follow-up system for early gastric cancer patients treated with endoscopic submucosal dissection.So as to break time and space limitation and then improve the accessibility of follow-up,realize the precision and efficiency of follow-up to offer reference for exploring remote follow-up for early gastric cancer patients treated with endoscopic submucosal dissection.[ Methods]1.Current situation researchBased on the usability engineering theory and the health belief model,we investigated and analyzed the endoscopic reexamination follow-up compliance for early gastric cancer patients treated with endoscopic submucosal dissection and the effect of follow-up via We Chat platform to understand patients’ acceptance of online follow-up and the factors of follow-up effect.On the basis of current investigation,literature research was conducted to gather the development and application status of remote follow-up in various fields and then learn from each other to provide the basis for the construction of high quality remote follow-up system.2.Construction of remote follow-up systemEstablish research objectives and system design ideas,set up a multidisciplinary team,define the responsibilities of the team and then build the organizational structure of remote follow-up system,develop the system operation and warning mechanism,and finally complete the platform construction of the system and put it into operation online with continue optimization.3.Positive ResearchEffect of the remote follow-up system after endoscopic submucosal dissection for early gastric cancer patients was evaluated by empirical analysis.The main evaluation indexes included endoscopic reexamination rate,Hp-positive eradication rate,follow-up workload,and doctor-patient satisfaction.[Results]1.Current situation research63.51% of patients with early gastric cancer treated with endoscopic submucosal dissection had low compliance with endoscopic reexamination,and their medical insurance,intraoperative Hp infection status,postoperative complications and family history of digestive tract cancer were the main factors for compliance with endoscopic reexamination.The online follow-up was acceptable for doctors and patients,and the consultation frequency of postoperative patients on pathological results(25%),re-examination registration(24%),diet(17%),medication(15%),and the response to discomfort(14%)was high.Online follow-up via We Chat could improve the endoscopic reexamination rate by 13.8%(3rd month after surgery),10.58%(6th month after surgery),and the Hp positive eradication rate by 23.33%.Literature studies showed that remote follow-up is mainly used for out-of-hospital management of patients with chronic diseases,and its functions mainly included remote consultation and education.There is no specific remote follow-up system in the field of postoperative management of early gastric cancer.2.Construction of remote follow-up systemThe remote follow-up system for early gastric cancer patients treated with endoscopic submucosal dissection is composed of early gastric cancer database and cloud follow-up platform.The early gastric cancer database could structure information related to diagnosis,treatment and follow-up of early gastric cancer patients and realize automatic enrolment in follow-up by real-time data transmission between the database and cloud follow-up platform.The main functions of remote follow-up included remote consultation,remote monitoring,remote education and remote guidance.Through the personalized binding of follow-up rules,follow-up management form and health education content,accurate follow-up can be implemented and the intellectualization of follow up can be improved.3.Positive ReasearchRemote follow-up system for early gastric cancer treated with endoscopic submucosal dissection can significantly improve the first endoscopic review rate,Hp positive eradication rate,doctor-patient follow-up satisfaction and reduce follow-up workload(P<0.05).[Conclusions]The status of early gastric cancer postoperative follow-up and study of remote follow-up field was researched by current situation research.And then establish the objective of system,build a multidisciplinary team to construct the organizational structure of remote follow-up system,design system operation and warning mechanism,research and running the early gastric cancer database and cloud follow-up platform to achieve accurate and efficient follow-up,thus improving the quality of follow-up management after endoscopic submucosal dissection for early gastric cancer patients,and providing theoretical basis and model reference for the management of early gastric cancer patients treated with endoscopic submucosal dissection.