关键词: 互联网+, 医养结合, 老年人, 慢性病, 对策

Abstract: In China，the aggravated population aging has boosted the demands of the elderly for health，medical and nursing services，and the popularization of the internet and smart tech products is increasing.To promote the development of elderly and medical care industries to satisfy the health needs of older people，integrating the internet technologies into integrated medical and nursing care and community-based care，is a good way yet a big problem that needs to be discussed and solved urgently.In this paper，we discussed the implementation of internet-based integrated medical and nursing for health management of community-dwelling elderly people with chronic diseases，and analyzed the opportunities and challenges during the implementation.Moreover，corresponding countermeasures were put forward as follows：further increasing the government support，improving the offline service capabilities and realizing a closed loop management with the integrated medical and nursing care，training high-quality professional care providers，strengthening the supporting role of information technology，building an age-friendly society，integrating resources by attracting more companies engaged in elderly care industry and more investments into the industry，and developing an internet-based elderly care pattern suitable for domestic conditions with joint efforts of multidisciplinary teams. In addition，in an explorative way，we developed a comprehensive health management system of internet-based integrated medical and nursing，which includes the basic database subsystem，end-user subsystem，service subsystem，and supervision and evaluation subsystem.

Key words: Internet+, Combination of medical care and pension, Aged, Chronic disease, Countermeasure