通讯作者: 丁贤彬, 784702780@qq.com

DOI：10.12201/bmr.202506.00071

The Construction and Practical Application of Regional Chronic Disease Surveillance Management Information Platform Based on Medical Big Data

• 摘要：目的/意义 利用多源慢性病医疗数据建设区域慢性病管理信息平台，构建慢性病患者全景数据视图并进行全过程管理，全面提升区域慢性病监测质效和高效防控。方法/过程 从各级医疗机构、公共卫生机构、行政部门等多机构自动采集慢性病相关的医疗数据、公共卫生数据和健康数据等多源数据，经过清洗和计算形成中间库。利用大数据分析技术构建患者全景数据视图、预警监测分析模型和分级诊疗规则，实现医防协同智能监测、慢性病病例报告、慢性病筛查干预、患者全景数据视图构建及全程管理、动态监测评价等平台功能。结果/结论 应用实践表明，患者全景数据驱动慢病管理从“群体化标准照护”升级为“个性化精准防控”；分析区域就诊数据、疾病分布，优化防控资源分配；识别高危患者，推动分级诊疗落地。该平台提高了慢性病监测和管理的效率和准确性，为区域慢性病防控和科学研究提供了有力支撑。

  关键词： 医疗大数据; 慢性病管理; 信息平台; 智能监测; 

   

  Abstract: Purpose/Significance Leveraging multi-source chronic disease medical data to build a regional chronic disease management information platform, constructing a comprehensive data view of chronic disease patients and enabling whole-process management, thereby fully enhancing the quality and efficiency of regional chronic disease monitoring and enabling high-efficacy prevention and control. Method/Process The platform automatically collects multi-source data related to chronic diseases—including medical data, public health data, and health records-from various institutions such as healthcare facilities at all levels, public health agencies, and administrative departments. After cleaning and processing, the data is stored in an intermediate database.Using big data analytic, the platform constructs a comprehensive patient data view, early-warning and monitoring models, and hierarchical diagnosis and treatment rules. Key functionalities include:Intelligent healthcare-public health collaborative monitoring、Chronic disease case reporting、Screening and intervention for chronic diseases、Comprehensive patient data profiling and whole-process management、Dynamic monitoring and evaluation.Result/Conclusion Practical applications demonstrate that the patient-centered panoramic data approach upgrades chronic disease management from standardized population-based care to personalized precision prevention and control. By analyzing regional medical visit data and disease distribution patterns, the platform optimizes healthcare resource allocation and identifies high-risk patients requiring referrals, thereby facilitating the implementation of hierarchical diagnosis and treatment.This platform significantly improves the efficiency and accuracy of chronic disease monitoring and management, providing robust support for regional chronic disease prevention and control as well as scientific research.

  Key words: Medical Big Data; Chronic Disease Management; Information Platform; Intelligent Surveillance; 。

  提交时间：2025-06-24

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-03-16	bmr.202506.00071V1	下载

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