健康医疗大数据下疾病监测报告模式的变革——宜昌市健康管理大数据分析中心建设的启示
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摘要
目的探讨疾病监测报告模式的变革发展方向。方法通过分析我国现行疾病监测系统的发展,结合宜昌市健康管理大数据建设及在疾病监测报告领域的应用情况,获得今后疾病监测报告模式变革的启示。结果我国疾病监测信息系统取得了较快发展,但仍然存在数据共享利用不充分,病例漏报、错报等问题;基于医院信息化的疾病监测信息管理取得了一些进展,但在数据互联共享和综合利用上有难度;宜昌市通过依托健康管理大数据分析中心建设,开展了疾病智能监测报告系统的建设与应用,并取得了一些成效。结论健康医疗大数据的背景下,疾病监测报告模式与管理将会出现信息系统向基层下沉、转向主动智能监测、危险因素监测、早期预警等一系列变革与发展。
Objective To discuss the change trend and development of the disease surveillance reporting model in China.Methods Trough analysis on the development of the current disease surveillance system in China,along with the construction of big data for health management and its application in the field of disease surveillance reporting in Yichang,some inspirations of future changes in disease surveillance reporting model were obtained.Results Disease surveillance information system in China has achieved a rapid development.However,there are still problems such as insufficient data sharing,underreporting and misreporting.Some progress has been achieved in the management of disease surveillance information based on hospital information system,but data sharing and comprehensive application are still difficult.Based on the big data analysis center for health management,an intelligence disease surveillance system construction and application has been conducted in Yiuchang,and improvement have been made.Conclusion Under the background of health big data,a series of changes and developments in the disease surveillance reporting model and management would emerge,such as the establishment of information system at grassroots level,active intelligence surveillance,risk factor surveillance and early warning.
Objective To discuss the change trend and development of the disease surveillance reporting model in China.Methods Trough analysis on the development of the current disease surveillance system in China,along with the construction of big data for health management and its application in the field of disease surveillance reporting in Yichang,some inspirations of future changes in disease surveillance reporting model were obtained.Results Disease surveillance information system in China has achieved a rapid development.However,there are still problems such as insufficient data sharing,underreporting and misreporting.Some progress has been achieved in the management of disease surveillance information based on hospital information system,but data sharing and comprehensive application are still difficult.Based on the big data analysis center for health management,an intelligence disease surveillance system construction and application has been conducted in Yiuchang,and improvement have been made.Conclusion Under the background of health big data,a series of changes and developments in the disease surveillance reporting model and management would emerge,such as the establishment of information system at grassroots level,active intelligence surveillance,risk factor surveillance and early warning.
引文
[1]Palmer S.Surveillance of diseases[M]//Armitage P,Colton T.Encyclopedia of biostatistics.Chichester:John Wiley&Sons,Ltd.,2005.
[2]洪荣涛,吴生根,李群,等.中国大陆传染病监测与展望[J].疾病监测,2015,30(12):994-1001.DOI:10.3784/j.issn.1003-9961.2015.12.004.Hong RT,Wu SG,Li Q,et al.Current status and outlook of communicable disease surveillance in the mainland of China[J].Dis Surveill,2015,30(12):994-1001.DOI:10.3784/j.issn.1003-9961.2015.12.004.
[3]王佐卿,王树山,邱洪斌,等.新医改模式下区域卫生信息化建设的探讨[J].中国医院管理,2010,30(11):47-48.DOI:10.3969/j.issn.1001-5329.2010.11.022.Wang ZQ,Wang SS,Qiu HB,et al.Discussion on regional health information construction under the new medical reform model[J].Chin Hosp Manag,2010,30(11):47-48.DOI:10.3969/j.issn.1001-5329.2010.11.022.
[4]于颖洁,罗小飞.疾病预防控制信息系统的发展[J].中国药物与临床,2015,15(9):1361-1362.DOI:10.11655/zgywylc2015.09.061.Yu YJ,Luo XF.Development of disease prevention and control information system[J].Chin Remed Clin,2015,15(9):1361-1362.DOI:10.11655/zgywylc2015.09.061.
[5]施雯慧,陈伟.2005-2011年网络直报系统和结核病专报系统报告肺结核患者比较分析[J].疾病监测,2012,27(10):824-827.DOI:10.3784/j.issn.1003-9961.2012.10.020.Shi WH,Chen W.Comparison of pulmonary tuberculosis reporting between web-based infectious disease reporting system and tuberculosis management information system,2005-2011[J].Dis Surveill,2012,27(10):824-827.DOI:10.3784/j.issn.1003-9961.2012.10.020.
[6]陈红缨,蔡晶,洪希成,等.湖北省疾病控制机构公共卫生信息资源调查[J].医学与社会,2015(6):54-56.DOI:10.13723/j.yxysh.2015.06.018.Chen HY,Cai J,Hong XC,et al.Investigation of the public health information resources of Hubei center for disease control and prevention[J].Med Soc,2015(6):54-56.DOI:10.13723/j.yxysh.2015.06.018.
[7]裴迎新,刘慧慧.对中国传染病监测发展方向的思考[J].疾病监测,2014,29(4):327-330.DOI:10.3784/j.issn.1003-9961.2014.04.018.Pei YX,Liu HH.Discussion on future development of communicable disease surveillance in China[J].Dis Surveill,2014,29(4):327-330.DOI:10.3784/j.issn.1003-9961.2014.04.018.
[8]王晓风,郭青,张春曦,等.法定传染病网络报告系统质量评价指标体系评价[J].疾病监测,2016,31(3):240-245.DOI:10.3784/j.issn.1003-9961.2016.03.014.Wang XF,Guo Q,Zhang CX,et al.Evaluation on quality index system for notifiable communicable diseases network reporting[J].Dis Surveill,2016,31(3):240-245.DOI:10.3784/j.issn.1003-9961.2016.03.014.
[9]郭岩,张业武,蔡玥,等.全国疾病预防控制机构信息基础设施建设现状分析[J].中国数字医学,2012,7(3):19-22.DOI:10.3969/j.issn.1673-7571.2012.03.006.Guo Y,Zhang YW,Cai Y,et al.The current status of information infrastructure in the Chinese centers for disease prevention and control at three levels[J].Chin Digit Med,2012,7(3):19-22.DOI:10.3969/j.issn.1673-7571.2012.03.006.
[10]王才有,汤学军,董方杰,等.全国三级医院信息化情况调查研究[J].中国卫生信息管理杂志,2016,13(4):342-347.DOI:10.3969/j.issn.1672-5166.2016.04.03.Wang CY,Tang XJ,Dong FJ,et al.Investigation and research on informatization of the tertiary hospital in China[J].Chin Health Inf Manag J,2016,13(4):342-347.DOI:10.3969/j.issn.1672-5166.2016.04.03.
[11]夏寒,吴凡,夏天.智能插件在公共卫生领域的应用研究[J].中国卫生信息管理杂志,2016,13(4):410-413.DOI:10.3969/j.issn.1672-5166.2016.04.016.Xia H,Wu F,Xia T.Study on application of intelligent plug-in in public health field[J].Chin Health Inf Manag J,2016,13(4):410-413.DOI:10.3969/j.issn.1672-5166.2016.04.016.
[12]黄素丹,张德仁,张秀英,等.基于医院信息化系统的医院防保信息一体化管理[J].预防医学情报杂志,2007,23(4):444-447.DOI:10.3969/j.issn.1006-4028.2007.04.020.Huang SD,Zhang DR,Zhang XY,et al.Integrative administration system of preventive and health care information in hospital based on HIS[J].J Prev Med Inf,2007,23(4):444-447.DOI:10.3969/j.issn.1006-4028.2007.04.020.
[13]丁正荣.医院信息系统的慢性病报告与网络直报一体化管理[J].浙江预防医学,2010,22(5):84-86.DOI:10.3969/j.issn.1007-0931.2010.05.045.Ding ZR.Integrated management of chronic disease reporting and web direct reporting in hospital information system[J].Zhejiang Prev Med,2010,22(5):84-86.DOI:10.3969/j.issn.1007-0931.2010.05.045.
[14]杨吉星,黄忆,汤显,等.构建医院基于HIS的传染病报告监测系统的尝试[J].疾病监测与控制,2016,10(5):360-361,359.Yang JX,Huang Y,Tang X,et al.Trial of building the reporting and surveillance system for infectious disease in hospital based on HIS[J].J Dis Monitor Control,2016,10(5):360-361,359.
[15]丁芸,樊迪.医院慢性病监测系统的开发与应用[J].预防医学,2016,28(8):810-812.DOI:10.19485/j.cnki.issn.1007-0931.2016.08.014.Ding Y,Fan D.Development and application of a hospital chronic disease surveillance system[J].Prev Med,2016,28(8):810-812.DOI:10.19485/j.cnki.issn.1007-0931.2016.08.014.
[16]张良,董红军,陈奕,等.宁波市传染病智能平台直报模式实践[J].中国公共卫生管理,2017,33(2):205-207.DOI:10.19568/j.cnki.23-1318.2017.02.017.Zhang L,Dong HJ,Chen Y,et al.Practice of intelligence platform of pattern for infectious diseases,Ningbo[J].Chin J Public Health Manag,2017,33(2):205-207.DOI:10.19568/j.cnki.23-1318.2017.02.017.
[17]张良,纪威,李辉,等.慢性病智能平台直报模式探索与实践[J].中国卫生信息管理杂志,2017,14(2):179-183.DOI:10.3969/j.issn.1672-5166.2017.02.015.Zhang L,Ji W,Li H,et al.Ningbo intelligent practice mode of platform direct reporting of infectious diseases[J].Chin Health Inf Manag J,2017,14(2):179-183.DOI:10.3969/j.issn.1672-5166.2017.02.015.
[18]中华人民共和国国家卫生和计划生育委员会,中医药管理局.关于加快推进人口健康信息化建设的指导意见[EB/OL].(2013-12-09)[2018-04-10].http://www.nhc.gov.cn/guihuaxxs/s10742/201312/2519dea9a4b14318a0736881116275ee.shtml.The National Health and Family Planning Commission of the People's Republic of China,Administration of Traditional Chinese Medicine.Guiding opinions on accelerating the construction of informatization of population health[EB/OL].(2013-12-09)[2018-04-10].http://www.nhc.gov.cn/guihuaxxs/s10742/201312/2519dea9a4b14318a0736881116275ee.shtml.
[19]曹若明,耿兴义,刘翀,等.济南市“数字疾控、智慧公卫”信息平台建设实践和体会[J].中华预防医学杂志,2016,50(1):94-96.DOI:10.3760/cma.j.issn.0253-9624.2016.01.017.Cao RM,Geng XY,Liu C,et al.Practice and experience:establishment of digital CDC and intelligent public health informationization platform in Jinan[J].Chin J Prev Med,2016,50(1):94-96.DOI:10.3760/cma.j.issn.0253-9624.2016.01.017.
[20]蔡智强,李丽萍,白雲屏.公共卫生监测的过去、现在和未来:(三)未来[J].疾病监测,2015,30(11):897-903.DOI:10.3784/j.issn.1003-9961.2015.11.004.Cai ZQ,Li LP,Bai XP.Past,present,and future of public health surveillance:the future(Ⅲ)[J].Dis Surveill,2015,30(11):897-903.DOI:10.3784/j.issn.1003-9961.2015.11.004.
[21]Ginsberg J,Mohebbi MH,Patel RS,et al.Detecting influenza epidemics using search engine query data[J].Nature,2009,457(7232):1012-1014.DOI:10.1038/nature07634.
[2]洪荣涛,吴生根,李群,等.中国大陆传染病监测与展望[J].疾病监测,2015,30(12):994-1001.DOI:10.3784/j.issn.1003-9961.2015.12.004.Hong RT,Wu SG,Li Q,et al.Current status and outlook of communicable disease surveillance in the mainland of China[J].Dis Surveill,2015,30(12):994-1001.DOI:10.3784/j.issn.1003-9961.2015.12.004.
[3]王佐卿,王树山,邱洪斌,等.新医改模式下区域卫生信息化建设的探讨[J].中国医院管理,2010,30(11):47-48.DOI:10.3969/j.issn.1001-5329.2010.11.022.Wang ZQ,Wang SS,Qiu HB,et al.Discussion on regional health information construction under the new medical reform model[J].Chin Hosp Manag,2010,30(11):47-48.DOI:10.3969/j.issn.1001-5329.2010.11.022.
[4]于颖洁,罗小飞.疾病预防控制信息系统的发展[J].中国药物与临床,2015,15(9):1361-1362.DOI:10.11655/zgywylc2015.09.061.Yu YJ,Luo XF.Development of disease prevention and control information system[J].Chin Remed Clin,2015,15(9):1361-1362.DOI:10.11655/zgywylc2015.09.061.
[5]施雯慧,陈伟.2005-2011年网络直报系统和结核病专报系统报告肺结核患者比较分析[J].疾病监测,2012,27(10):824-827.DOI:10.3784/j.issn.1003-9961.2012.10.020.Shi WH,Chen W.Comparison of pulmonary tuberculosis reporting between web-based infectious disease reporting system and tuberculosis management information system,2005-2011[J].Dis Surveill,2012,27(10):824-827.DOI:10.3784/j.issn.1003-9961.2012.10.020.
[6]陈红缨,蔡晶,洪希成,等.湖北省疾病控制机构公共卫生信息资源调查[J].医学与社会,2015(6):54-56.DOI:10.13723/j.yxysh.2015.06.018.Chen HY,Cai J,Hong XC,et al.Investigation of the public health information resources of Hubei center for disease control and prevention[J].Med Soc,2015(6):54-56.DOI:10.13723/j.yxysh.2015.06.018.
[7]裴迎新,刘慧慧.对中国传染病监测发展方向的思考[J].疾病监测,2014,29(4):327-330.DOI:10.3784/j.issn.1003-9961.2014.04.018.Pei YX,Liu HH.Discussion on future development of communicable disease surveillance in China[J].Dis Surveill,2014,29(4):327-330.DOI:10.3784/j.issn.1003-9961.2014.04.018.
[8]王晓风,郭青,张春曦,等.法定传染病网络报告系统质量评价指标体系评价[J].疾病监测,2016,31(3):240-245.DOI:10.3784/j.issn.1003-9961.2016.03.014.Wang XF,Guo Q,Zhang CX,et al.Evaluation on quality index system for notifiable communicable diseases network reporting[J].Dis Surveill,2016,31(3):240-245.DOI:10.3784/j.issn.1003-9961.2016.03.014.
[9]郭岩,张业武,蔡玥,等.全国疾病预防控制机构信息基础设施建设现状分析[J].中国数字医学,2012,7(3):19-22.DOI:10.3969/j.issn.1673-7571.2012.03.006.Guo Y,Zhang YW,Cai Y,et al.The current status of information infrastructure in the Chinese centers for disease prevention and control at three levels[J].Chin Digit Med,2012,7(3):19-22.DOI:10.3969/j.issn.1673-7571.2012.03.006.
[10]王才有,汤学军,董方杰,等.全国三级医院信息化情况调查研究[J].中国卫生信息管理杂志,2016,13(4):342-347.DOI:10.3969/j.issn.1672-5166.2016.04.03.Wang CY,Tang XJ,Dong FJ,et al.Investigation and research on informatization of the tertiary hospital in China[J].Chin Health Inf Manag J,2016,13(4):342-347.DOI:10.3969/j.issn.1672-5166.2016.04.03.
[11]夏寒,吴凡,夏天.智能插件在公共卫生领域的应用研究[J].中国卫生信息管理杂志,2016,13(4):410-413.DOI:10.3969/j.issn.1672-5166.2016.04.016.Xia H,Wu F,Xia T.Study on application of intelligent plug-in in public health field[J].Chin Health Inf Manag J,2016,13(4):410-413.DOI:10.3969/j.issn.1672-5166.2016.04.016.
[12]黄素丹,张德仁,张秀英,等.基于医院信息化系统的医院防保信息一体化管理[J].预防医学情报杂志,2007,23(4):444-447.DOI:10.3969/j.issn.1006-4028.2007.04.020.Huang SD,Zhang DR,Zhang XY,et al.Integrative administration system of preventive and health care information in hospital based on HIS[J].J Prev Med Inf,2007,23(4):444-447.DOI:10.3969/j.issn.1006-4028.2007.04.020.
[13]丁正荣.医院信息系统的慢性病报告与网络直报一体化管理[J].浙江预防医学,2010,22(5):84-86.DOI:10.3969/j.issn.1007-0931.2010.05.045.Ding ZR.Integrated management of chronic disease reporting and web direct reporting in hospital information system[J].Zhejiang Prev Med,2010,22(5):84-86.DOI:10.3969/j.issn.1007-0931.2010.05.045.
[14]杨吉星,黄忆,汤显,等.构建医院基于HIS的传染病报告监测系统的尝试[J].疾病监测与控制,2016,10(5):360-361,359.Yang JX,Huang Y,Tang X,et al.Trial of building the reporting and surveillance system for infectious disease in hospital based on HIS[J].J Dis Monitor Control,2016,10(5):360-361,359.
[15]丁芸,樊迪.医院慢性病监测系统的开发与应用[J].预防医学,2016,28(8):810-812.DOI:10.19485/j.cnki.issn.1007-0931.2016.08.014.Ding Y,Fan D.Development and application of a hospital chronic disease surveillance system[J].Prev Med,2016,28(8):810-812.DOI:10.19485/j.cnki.issn.1007-0931.2016.08.014.
[16]张良,董红军,陈奕,等.宁波市传染病智能平台直报模式实践[J].中国公共卫生管理,2017,33(2):205-207.DOI:10.19568/j.cnki.23-1318.2017.02.017.Zhang L,Dong HJ,Chen Y,et al.Practice of intelligence platform of pattern for infectious diseases,Ningbo[J].Chin J Public Health Manag,2017,33(2):205-207.DOI:10.19568/j.cnki.23-1318.2017.02.017.
[17]张良,纪威,李辉,等.慢性病智能平台直报模式探索与实践[J].中国卫生信息管理杂志,2017,14(2):179-183.DOI:10.3969/j.issn.1672-5166.2017.02.015.Zhang L,Ji W,Li H,et al.Ningbo intelligent practice mode of platform direct reporting of infectious diseases[J].Chin Health Inf Manag J,2017,14(2):179-183.DOI:10.3969/j.issn.1672-5166.2017.02.015.
[18]中华人民共和国国家卫生和计划生育委员会,中医药管理局.关于加快推进人口健康信息化建设的指导意见[EB/OL].(2013-12-09)[2018-04-10].http://www.nhc.gov.cn/guihuaxxs/s10742/201312/2519dea9a4b14318a0736881116275ee.shtml.The National Health and Family Planning Commission of the People's Republic of China,Administration of Traditional Chinese Medicine.Guiding opinions on accelerating the construction of informatization of population health[EB/OL].(2013-12-09)[2018-04-10].http://www.nhc.gov.cn/guihuaxxs/s10742/201312/2519dea9a4b14318a0736881116275ee.shtml.
[19]曹若明,耿兴义,刘翀,等.济南市“数字疾控、智慧公卫”信息平台建设实践和体会[J].中华预防医学杂志,2016,50(1):94-96.DOI:10.3760/cma.j.issn.0253-9624.2016.01.017.Cao RM,Geng XY,Liu C,et al.Practice and experience:establishment of digital CDC and intelligent public health informationization platform in Jinan[J].Chin J Prev Med,2016,50(1):94-96.DOI:10.3760/cma.j.issn.0253-9624.2016.01.017.
[20]蔡智强,李丽萍,白雲屏.公共卫生监测的过去、现在和未来:(三)未来[J].疾病监测,2015,30(11):897-903.DOI:10.3784/j.issn.1003-9961.2015.11.004.Cai ZQ,Li LP,Bai XP.Past,present,and future of public health surveillance:the future(Ⅲ)[J].Dis Surveill,2015,30(11):897-903.DOI:10.3784/j.issn.1003-9961.2015.11.004.
[21]Ginsberg J,Mohebbi MH,Patel RS,et al.Detecting influenza epidemics using search engine query data[J].Nature,2009,457(7232):1012-1014.DOI:10.1038/nature07634.