Exploration And Practice On Colorectal Cancer Of Chinese Medicine Chronic Disease Management Model In Community Based On The Information Collaboration Platform

Background:With the aging of our population, diet changes and economic conditions continued to improve, the imperfect monitoring and management of colorectal cancer, prevention and control system of colorectal cancer is relatively weak, morbidity and mortality of colorectal cancer showed a rapid upward trend in recent years. In the case of colorectal cancer treatment has not been a breakthrough, three prevention is an important means to reduce colorectal cancer morbidity and mortality. It is a research focus how to create network on prevention and treatment of colorectal cancer based on colorectal cancer screening, early diagnosis and early treatment to reducing the morbidity and mortality of colorectal cancer. This study comes from Capital’s Medical Science and Technology Development Fund of Beijing (No.:SF-2007-Ⅰ-05).This portion is system about colorectal cancer of Chinese medicine chronic disease management in community based on the information collaboration platform,a part Study of Tertiary prevention and control system of the colorectal cancer based on information collaboration platform. In this management program, we join the content about healthcare and diet therapy of TCM, intervention of colorectal cancer in high-risk groups and colorectal cancer patients by traditional Chinese medicine rehabilitation therapy. With the help of IT and database management techniques,we realize the community population health education for cancer prevention, screening for colorectal cancer, intervention of high-risk groups, Colonoscopy appointments, referral and community physicians’ technical training in this information platform. In order to improve efficiency of colorectal cancer prevention and control, reduce the working strength of the medical personnel. To explore and research model On the community of colorectal cancer TCM chronic disease management, strengthening management ability of colorectal cancer in community.This paper consists of four parts.Part I include two review. A review of Regional Health Information is mainly described the status and trends of regional health information in domestic and international,as well as informatization policies in regional health our country.The other one introduces epidemiology of colorectal cancer and methods of colorectal cancer screening,in order to select suitable program for information system on colorectal cancer’s TCM chronic disease management in community.Part II Investigation on the Cancer Prevention and treatment knowledge level of of residents and the feasibility study of establishment tumor’s tertiary prevention and control network.Objective:By way of questionnaire survey for community residents, to know the current awareness of cancer prevention knowledge, the status of TCM in cancer prevention and therapy, hospital’s choosing of residents in cancer therapy behavior, looking for effective way to anti-cancer health education.Methods:Conducting structured questionnaires survey for990case community residents in Haidian District of Beijing, with SPSS13.0software for statistical analysis.Results:Population who choose the inadequate In popular science propaganda promotion of tumor accounted for88.9%. Analysis showed that only21.4percent said they know of precancerous lesions,32%of people know the early symptoms of the tumor,38.9%of people know the concept of tumor high risk population,74.4%of respondents believe that TCM have a positive effect on cancer prevention. About93.4%of people considered three prevention network of tumor was feasible in the investigation, and87.3%of those surveyed indicated that they would participate.93%of people think that there is a need for community cancer screening,97.6%said they would participate in screening. In tumor detection and diagnosis of hospital category, more than80%select the three general hospitals and Cancer Hospital patients.83.7%of patients in the548cancer patients have received or are receiving TCM treatment.73.3%of cancer patients go to see a doctor for diagnosis and treatment because of physical discomfort, only19.0%of patients are found and diagnose in health examination t.Conclusion:Community residents have a strong awareness of preventing cancer generally, but they lack of proper cancer prevention knowledge. Traditional Chinese medicine has a good mass base in healthcare, prevention and control of cancer. Traditional prevention monitoring network of tumor is inefficiency. It is the urgent requirements of tumor prevention currently that expanding publicity about cancer prevention knowledge by means of media and Internet,to establish a novel prevention and control system of tumor. Part III City community screening for colorectal cancer and follow-up results analysis of high risk populationObjective:by analyzing results of colorectal cancer screening in different type community of city, to explore the model of colorectal cancer screening for city community of our country, providing basis for the design of system demand and medical program of colorectal cancer TCM chronic disease management information system.Methods:Accord to "The Chinese cancer screening in the early diagnosis and early treatment technology program (Trial)",we make colorectal cancer screening from June to September,2010, in two community of Haidian District for the age of40-74, community residents, there are1414community residents participating in the screening; screening results were analyzed statistically by SPSS13.0software.Results:There are1414cases who completed the questionnaireIn3002cases target population,1105cases completed FOBT check. Questionnaire compliance was47.1%, FOBT compliance was36.8%. Comparing compliance of two communities for colorectal cancer screening, the difference was statistically significant (P<0.05).366high-risk groups was screened in1414Community population, positive rate was25.9percent. Comparing the questionnaire and FOBT positive rate of the two communities, Shuangyushu community’s screening positive rate was significantly higher than that the communities of the Central University for Nationalities.A total of65cases of participants in rescreening of colonoscopy In366cases high-risk groups, colonoscopy compliance was17.8%. The total detection rate of colonoscopy for early cancer and precancerous lesions is32.3%. The community of Minzu University of China was significantly higher than the Shuangyushu community In the respect of colonoscopy compliance. The detection rate of colorectal cancer and precancerous lesion was not statistically significant.258cases high risk population of colorectal cancer was intervented by telephone follow-up and community health lecture. A total of21cases of high-risk groups received colonoscopy, Comparison of colonoscopy compliance before and after intervention was statistically significant, P<0.05.Conclusion:It is very important to raise community residents’public awareness of colorectal cancer screening. The higher the degree of understanding of screening-related knowledge, higher screening compliance. It can improve colorectal cancer chronic illness management efficiency and level of the community to explore more convenient and efficient screening methods, optimizing the screening program, simplified screening process, to strengthen the community medical personnel training.Part IV Design and construction of community colorectal cancer TCM chronic disease management model based on the information collaboration platform community programObjective:Constructing network of cancer prevention and rehabilitation by way of establishing suitable community colorectal cancer TCM chronic disease management information system. Play the role of Chinese medicine in prevention and treatment of colorectal cancer. Promoting the implementation of the classification of medical and two-way referral system, to achieve the interoperability of information in tertiary hospitals, to implement continuous tracking management of the service object’s long-term. Improving the medical service quality and efficiency of medical institutions, to improve the level of overall colorectal cancer prevention by raising efficiency and management capabilities.Methods:This part incolude the design for TCM intervention programs of colorectal cancer and Construction of information system mainly. We designed TCM intervention program of colorectal cancer in community according to the colorectal cancer TCM treatment program of Xiyuan Hospital’s oncology Department, we join the content about healthcare and diet therapy of TCM, intervention of high-risk groups in colorectal cancer and colorectal cancer patients by traditional Chinese medicine rehabilitation therapy. With the help of IT and database management techniques, we realize the community population health education for cancer prevention, screening for colorectal cancer, intervention of high-risk groups, Colonoscopy appointments, referral and community physicians’ technical training in this information platform. Based on the former two study, Beijing Kang Tu Shang bang health Technology Co., Ltd. is responsible for the construction of the information system for TCM chronic disease management of colorectal cancer.Conclusion:Community colorectal cancer Chinese medicine chronic disease management information system with B/S model design, is easy to install and maintain. Information collaboration platform may share medical data center, eliminating the traditional model of medical information silos. Community population of anti-cancer information resources are effectively shared. It also ensure that anti-cancer information is authoritative, accurate and continuous. Community medical staff were trained In the working process. It resolved the problem of community medical staff lack of the cancer prevention and treatment knowledge. This system also realizes the function of two-way referral medical appointment.the utilization of medical resources is maximized, rational distributed. At the same time the community colorectal cancer TCM for chronic disease management information system link with the medical management departments, medical insurance agencies, cancer registration agency, to provide data support for diagnosis and treatment performance analysis, the rational allocation of medical resources.