The Chronic Disease Management Model Study Based On The Military Electronic Health Records

With the development of social economy, the army’s chronic non-communicable diseases have become increasingly prominent. It has been shown that the prevalence rate is increasing and the patients are becoming younger, which has become an outstanding problem that threatens the soldiers’ health. In the new era, the development of military revolution has changed the landscape of military medical demand, and the expansion of military missions has changed the radius of medical service, which not only calls for higher and more comprehensive requirements of the soldiers’ health, but also poses grim challenge to the traditional pattern of medical service. Therefore, the application of information technology in managing soldiers’ chronic disease has become a major issue to promote the development of army’s health service.Under the guidance of the modern concept of military health, this study endorses the general idea of giving top priority to humans and prevention, as well as orienting towards the grass roots level. A variety of analytical approaches were employed, including literature research, empirical analysis, logic analysis, expert consultation, analytic hierarchy process, and grey relational grade evaluation. Based on a summary of the domestic and foreign experience in the management of chronic diseases, a new soldiers’ chronic disease control mode was built around the military electronic health record platform, resulting in an overall strategy and informed advice for strengthening health management. We hope this work would improve the solders’ health condition and service’ efficiency, and supply a reference for the exploration of modern solders’ all-dimension and all-life-span health management.This research covers the following five parts. The first part is a comprehensive analysis of the present situation of chronic disease’s epidemicity and management, both in and outside of China or Chinese military. It has been confirmed that chronic disease is a threat to the combat effectiveness of the army, and a series of problems in the management of chronic disease are found such as insufficient attention, outmoded idea, imperfect mechanism and absence of unified management rules. Therefore it is imperative to innovate the mode of military chronic disease management, with prevention taking precedence over treatment according to the classification principle. The second part is the research on military chronic disease’s management based on soldiers’ electronic record. We analyzed and classified related concepts. Based on the methods of system theory, we analyzed three key elements of chronic disease management: daily life management, clinical management as well as psychological management. We summarized the characteristics and requirements of the military chronic disease management, and discussed the importance of applying electronic records. The third part is the case analysis of the chronic disease in our troops. Taking hypertension as an example, we designed data structure and data sets, described and standardized the electronic records’ workflow of hypertension. To evaluate the effect of the electronic record assisted system on the control of hypertension, we applied retrospective survey and cross-section statistics to judge control rate of hypertension, service and clinical satisfaction. The fourth part is a systemic study on the current mode of Chinese military chronic disease management. We carried out a general strategy to improve chronic disease management and offered 20 pieces of advice on organization, improvement of rules, optimization of service, information availability and other supporting measures. The fifth part is the evaluation of the suggestions and advice provided herein. We carried out a professional survey on the 20 suggestions and advice mentioned above, constructed a system of 3 first-step goals and 9 two-step goals, and made a generalized assessment of those suggestions and advice. A well-defined and standardized system for military chronic disease management is yet to be worked out. Basically the management mode is dominated by injury treatment and specialized medical institutions. This study makes a departure from traditional concept, viewing military medical and medical logistical management from the prospective of the military and adapting to the three tasks of modern medical support: injury treatment, health maintenance and capability building. The study introduces the new health concept characterized by military administration, professional guidance, and participation by all soldiers. Finally a new chronic disease management mode based on modern means of information and basic units’ prevention is built. The main innovations in this thesis are: We sorted out the characteristics of military chronic disease management in the basic theory study part, including the three key points on soldiers’ chronic disease control, summarized the features of soldiers’ chronic disease control, carried out the development requirements adapting to the new situation, analyzed the demand and workflow of chronic disease’s centered soldiers’ electronic health record. The second is that we experimentally contrasted a chronic disease management mode based on soldiers’ electronic health record. We completed the data design, standardized management, and operation workflow for high blood pressure. Thirdly, we developed a general strategy for and identified the focus of soldiers’ chronic disease and health management, and constructed an evaluation system for health management.