The Assessment Of Integrated Information System Management For Early Diagnosis And Treatment Of Brucellosis,with Internet Based Cloud-Platform

Objective:1.To conduct assessment of the integrated information system management for early diagnosis and treatment of brucellosis,with internet based cloud-platform(it is referred to information system for diagnosis and treatment of brucellosis and as below).2.To understand the application prospects and design deficiency of the information system for diagnosis and treatment of brucellosis in case identification,standardized diagnosis and treatment management,so as to provide suggestions for further strengthening the information system for diagnosis and treatment of brucellosis.Methods:1.Through the expert consultation method,this paper analyzes the information system for diagnosis and treatment of brucellosis,so as to lay a foundation for the systematic evaluation.2.By referring to the framework and indicators of evaluation of US CDC and WHO infectious disease surveillance system,the information system of the brucellosis diagnosis and treatment was evaluated.2.1 Collecting the blood samples of suspected brucellosis patients who visited Ulanchap Endemic Disease Prevention and Control Center from March 18 to December 18 of 2019.By using the tube agglutination gold standard assay to determine the specimen positive or negative and then by using the GICA to test and evaluate the assay's sensitivity,specificity,total coincidence rate and Kappa consistency coefficient of GICA,etc.2.2 Collecting the patient's individual medical file from the information system of the brucellosis diagnosis and treatment from March 18 to December 18,2019,developing evaluation database and analyzing the completeness and accuracy of the system.2.3 Collecting the patient's individual medical file information through the National Notifiable Disease Report System(NNDRS)from Ulanchap Endemic Disease Prevention and Control Center,Tongliao Endemic Disease Prevention and Control Center and Ulanqab central hospital,and to analyze its timeliness of reporting.2.4 Assessing the simplicity,acceptability,stability and satisfaction of the system through a development of centralized questionnaire surveying all medical staffs who ever used the system in the Ulanchap Endemic Disease Prevention and Control Center.Results:1.The contents and functions of three subsystems of registration management,diagnosis and treatment management and follow-up management of the information system for diagnosis and treatment of brucellosis were improved,and realizes the interconnection and information sharing between the hospital information system(HIS system)and the laboratory management information system(LIS system).2.Total 580 positive serums,424 positive whole blood and 80 negative homologous serums and whole blood were tested by applying GICA assay.The serums detection sensitivity,specificity,total coincidence rate and Kappa value were 98.97%,95.00%,98.48%and 0.94 respectively.The whole blood detection sensitivity,specificity,total coincidence rate and Kappa value were 99.06%,95.00%,98.41%,and 0.94 respectively.The consistency rate of homologous serum and whole blood was 99.01%,and the Kappa value was 0.96.3.Questionnaire survey were conducted among 20 local medical personnel engaged in the diagnosis and treatment of brucellosis diseases,among which 70.00%believed the system easily used,60.00%thought it could be skilled for clinical using within 30min to 1.0h training,65.00%thought the system was stable.50.00%of the medical staff had encountered system operational malfunctions more than 5 times during the project implementation.65.00%of the medical staffs needed 10-30min system restoration before normal use.Overall,75.00%thought the system was acceptable.65.00%of the medical staffs were satisfied with the system.4.The completeness rate and accuracy rate of the information listed in NNDRS information system for diagnosis and treatment of brucellosis were 100%and 98.29%respectively.The completeness rate of the information listed in the national brucellosis surveillance protocol information system for diagnosis and treatment of brucellosis was only 33.90%.The accuracy rate of completed information was 99.56%.The maximum,median and minimum values for interval timing between diagnosis and report were 7.42h,1.15h and 0.29h,respectively,which were reduced by 83.36%,50.00%and 63.29%compared with the same period of 2016 to 2018.The median time interval between diagnosis and report of brucellosis in Ulanchap Endemic Disease Prevention and Control Center was significantly lower than that in Ulanchap center hospital and Tongliao Endemic Disease Prevention and Control Center.Conclusion:1.As a detection method of the management information system for the diagnosis and treatment of brucellosis,GICA can completely guarantee the accuracy of the system in case detection and diagnosis.2.The information system for the diagnosis and treatment of brucellosis contains all the information listed by China's NNDRS and the national brucellosis surveillance protocol,that makes up for the deficiency of the notifiable diseases reporting system for infectious diseases that with only basic data such as the morbidity and mortality of patients,meanwhile it also makes up the delay in data reporting from the surveillance points and all these provide important supports for the local brucellosis surveillance and prevention operations.3.The diagnosis and treatment information system is simple,flexible and doctor-friendly manner the listed NNDRS reporting information were fully-completed and high accurate,the overall medical staffs are satisfied with the system.The implementation of the project has significantly improved the timeliness of brucellosis report.However,the information completeness of the national brucellosis monitoring protocol is low,and the system's stability are also needs to be further improved.