新型冠状病毒肺炎疫情防控期间眼科远程专属医生平台的构建和应用价值

Development of a remote dedicated doctor platform of ophthalmology and its application efficiency during epidemic of COVID-19

目的针对新型冠状病毒肺炎(COVID-19)疫情防控期间各方面人员需居家隔离、眼科医院无法正常开诊的情况,探索利用互联网+技术构建眼科远程专属医生平台进行在线就诊、问询、取药及会诊的应用效果,助力该平台下一步开发和应用。方法于2018年联合开发和研制眼科远程专属医生平台系统,并依据国家医疗政策、医保政策的制定和2019年末COVID-19疫情的暴发进行修改和完善,在COVID-19疫情防控期间进行全面的应用验证。该平台采用B/S架构对接微信公众号,在服务器端采用J2EE的Struts2,Spring和Hibernate三大框架的集成开发,以Oracle作为数据库,移动客户端采用React-Native和Redux配合开发,并在业务逻辑层采用Restful WebAPI的微服务架构。采用终端数据信息对平台为眼科患者提供远程诊疗、在线处方、物流送药和健康宣教等功能服务结果进行总结,对疫情防控期间服务的各类数据进行统计,验证平台各项功能的运管能力。结果眼科远程专属医生平台系统在COVID-19疫情防控期间每月问诊次数由2019年9月1~30日的1063人次提高到2020年2月1日至2月28日的3002人次,该平台诊疗人次占诊疗总人次比例由19.1%(203/1063)增加到92.3%(277/3002),即可有效避免人员接触感染风险,又满足了患者的就诊需求。患者非常满意比例为95.8%。结论眼科远程专属医生平台在疫情期间所建立的医患沟通渠道,是有效解决患者就诊取药需求的重要途径。

Objective Due to the circumstances where people being required to home quarantine and eye hospitals being unable to receive patient normally,The application of internet plus technology is explored to build Remote Dedicated Doctor Platform of Ophthalmology(RDDPO)for online consultation,accessing to medication,medical services and advises orderly,and to help to further develop and apply the platform.Methods In 2018,RDDPO was jointly developed.It has been modified and improved to the formulation of national medical policy and medical insurance policy and the outbreak of COVID-19 at the end of 2019,and it has been carried out comprehensive application verification during the prevention and control of COVID-19 epidemic.With a B/S structure,platform docks the official accounts of Wechat platform.On the server side,three J2EE frameworks of the integrated development,including Struts2,Spring and Hibernate are adopted;on the mobile client side,a combination of development tools including React-Native and Redux is used.Meanwhile,a micro-services Architecture(msA)of RESTful WebAPI is chosen at the business logic layer.The terminal data information is used to summarize the results of the platform's functional services for ophthalmic patients,such as remote diagnosis and treatment,online prescription,medicine delivery and health education,etc.,and to make statistics on all kinds of data during the epidemic prevention and control period,so as to verify the operations management capabilities of the platform's functions.Results During the period of COVID-19 epidemic prevention and control,the number of monthly visits of RDDPO increased from 1063 person times from September 1,2019 to the end of September to 30002 person times from February 1,2020 to February 28,2020.The proportion of diagnosis and treatment person times of this platform in the total number of diagnosis and treatment person times increased from 19.1%(203/1063)to 92.3%(277/3002),which can effectively avoid the risk of personal contact infection and meet the patients'medical needs.95.8%of the patients were very satisfied.95.8%of the patients were very satisfied.Conclusions The RDDPO establishes a channel for doctor-patient communication during the epidemic,which can be considered as an important way to effectively address the needs of patients for medical treatment.