信息技术在国外全科医学实践中的应用：系统综述

doi:10.12114/j.issn.1007-9572.2021.00.269

摘要/Abstract

摘要： 背景　“互联网+医疗健康”在我国蓬勃发展，各类新兴的信息技术在全科医学实践中也得到了不同程度的应用。但国内关于“互联网+全科医学”的研究并不多，远远落后于专科医疗实践。目的　整理信息技术在国外全科医学实践中的典型应用与研究主题，揭示全科医学信息技术相关的研究热点及未来趋势，以期为我国全科医学的研究与实践提供参考。方法　以2020年JCR SCI Primary Health Care子类影响因子排名前10位的期刊为文献来源，通过“Information Technology、Information and Communication Technology、Internet、Web 2.0、Social Media、Online Health Community、Online Support Group”共7个关键词检索并收集文献，应用归纳法及比较法总结信息技术在国外全科医学实践中的典型应用及研究热点。结果　信息技术在国外全科医学实践中的典型应用包括：统一的电子病历系统建设与数据深度利用、全科医生辅助决策系统、在线视频等非面对面虚拟问诊、全科医学团队内外部协作、院外数据采集、全科医学服务团队宣传与展示等。研究主题包括：典型信息技术应用的有用性分析、全科医学服务团队及患者的技术接纳与持续使用、基于信息技术的患者健康宣教与全科医学教育、基于机器学习算法的患者数据深度利用、信息技术在全科医学中应用的伦理问题等。结论　建议借助国家支持全科医学发展及电子病历建设的契机，积极利用新兴的信息技术布局全科医学服务生态系统的建设。利用5G等加强远程医疗实践及社区基层医疗卫生机构的服务能力，打造医联体服务建设，落实分级诊疗体系，完善全科医生“守门人”角色。以评促建，各医院对标卫生健康委员会电子病历系统应用水平9级评级标准，逐步建立统一的电子病历数据库；加强患者数据的连续性及完整性建设，积极利用机器学习等大数据算法提高全科医学的诊疗决策等服务。鼓励全科医生服务团队与信息管理与信息系统等学科领域的科研人员开展交叉学科研究，全面促进我国全科医学实践及研究的发展。

关键词: 信息技术, 互联网+, 全科医学, 系统综述

Abstract: Background　Along with the vigorous development of "Internet plus healthcare"，various information technologies（ITs） have been applied to general practices to varying degrees in China. However，studies on domestic "Internet plus general practices" are still very limited compared to those on "Internet plus specialty practices". Objective　To review the typical applications of ITs in general practices abroad and relevant research topics to reveal the research hot topics and future trend in this field，providing insights into general medicine research and practices in China. Methods　We searched the electronic version of top 10 SCI-indexed primary healthcare journals ranked by the JCR in terms of the value of impact factors in 2020 for articles about ITs used in general practices abroad using seven search terms：Information Technology，Information and Communication Technology，Internet，Web 2.0，Social Media，Online Health Community，and Online Support Group. Inductive and comparative analyses of the typical applications and research hotspots were performed. Results　The typical IT applications in general practices abroad include developing national electronic medical record systems，intensive application of data，decision support systems for general practitioners，video consultation and other alternative virtual consultations，intra- or inter-team collaboration of general practice teams，data collection outside hospitals，and publicity and demonstration of general practice teams. Research topics include the usefulness of IT applications in general practices，technology adoption and continuous use by general practice teams and patients，IT-enabled patient education and general practice education，intensive application of electronic medical records，and ethical issues related to IT use in general practices. Conclusion　This review recommends the following measures to be taken to promote domestic application of ITs in general practices against the backdrop of developing general practice and electronic medical record system backed by the Chinese government：Proactively using new and emerging ITs to build an IT-enabled general practice service ecosystem. For example，using the 5G technology to improve remote medical services，the service capacity of community healthcare settings，the services delivered by a regional medical consortium，the development of a tiered healthcare system and the services by the general practitioner as a gatekeeper. Using the informationization level of electronic medical record system as an evaluation criterion for hospitals，for example，hospitals should use grade 9 electronic medical record system to report data to the National Health Commission of the People's Republic of China，thereby promoting the building of a national electronic medical record system. Strengthening the construction of integrity and continuity of patient data management system using ITs，and improving the accuracy of diagnosis and treatment decisions made by general practitioners using machine-learning and other big data algorithms. Encouraging the implementation of interdisciplinary studies by general practice teams in collaboration with researchers in the field of information management and system，to promote domestic development of general medicine practice and research comprehensively.

Key words: Information technology, Internet plus, General practice, Systematic review

周军杰,余若暄,史威力,等. 信息技术在国外全科医学实践中的应用：系统综述[J]. 中国全科医学, 2021, 24(25): 3154-3160. DOI: 10.12114/j.issn.1007-9572.2021.00.269.
ZHOU Junjie,YU Ruoxuan,SHI Weili, et al. Information Technologies Used in General Practices Abroad：a Systematic Review　[J]. Chinese General Practice, 2021, 24(25): 3154-3160. DOI: 10.12114/j.issn.1007-9572.2021.00.269.

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