破局基層公衛(wèi)痛點(diǎn)！易享公衛(wèi)隨訪包升級，精準(zhǔn)隨訪+智能聯(lián)動，筑牢慢病防控防線

　　Breaking through the pain points of grassroots public health! Upgraded Yixiang Public Health Follow up Package, Precise Follow up+Intelligent Linkage, Building a Strong Defense Line for Chronic Disease Prevention and Control

　　基層公衛(wèi)工作是國民健康的“第一道防線”，其中公共衛(wèi)生集中體檢與社區(qū)隨訪是核心環(huán)節(jié)，但當(dāng)前基層公衛(wèi)工作普遍面臨隨訪效率低、數(shù)據(jù)脫節(jié)、流程繁瑣、考核達(dá)標(biāo)難等痛點(diǎn)。據(jù)行業(yè)調(diào)研，我國基層醫(yī)療機(jī)構(gòu)隨訪人員人均需負(fù)責(zé)數(shù)百名慢病患者，傳統(tǒng)隨訪模式下，信息錄入繁瑣、數(shù)據(jù)無法自動上傳，導(dǎo)致隨訪流于形式，且難以滿足國家公衛(wèi)考核標(biāo)準(zhǔn)。依托智慧醫(yī)療技術(shù)與國家政策支撐，易享公衛(wèi)隨訪包重磅升級，聯(lián)動公共衛(wèi)生集中體檢解決方案，創(chuàng)立“有序、技術(shù)、管理、管控、精準(zhǔn)、服務(wù)”于一體的新型體檢隨訪模式，破解基層公衛(wèi)工作困境，助力家庭醫(yī)生簽約、分級診療落地生根。

　　Grassroots public health work is the "first line of defense" for national health, with centralized physical examinations and community follow-up being the core links. However, current grassroots public health work generally faces pain points such as low follow-up efficiency, data disconnection, cumbersome processes, and difficulty in achieving assessment standards. According to industry research, the follow-up personnel of grassroots medical institutions in China are responsible for hundreds of chronic disease patients per capita. Under the traditional follow-up mode, information input is cumbersome and data cannot be automatically uploaded, resulting in follow-up becoming a formality and difficult to meet national public health assessment standards. Relying on smart medical technology and national policy support, Yixiang's public health follow-up package has been upgraded significantly, linked with centralized public health examination solutions, and established a new type of medical examination follow-up model that integrates "orderly, technical, management, control, precision, and service" to solve the difficulties of grassroots public health work and help family doctors sign contracts and implement graded diagnosis and treatment.

　　易享公衛(wèi)隨訪包以基層公衛(wèi)實(shí)際需求為核心，深度融合日新月異的IT技術(shù)，不僅實(shí)現(xiàn)公共衛(wèi)生集中體檢的智能化升級，更通過持續(xù)迭代優(yōu)化，完善隨訪系統(tǒng)功能，讓基層公衛(wèi)工作更高效、更精準(zhǔn)。在集中體檢環(huán)節(jié)，該方案可實(shí)現(xiàn)基層醫(yī)療工作智能管理、表格智慧關(guān)聯(lián)、健康數(shù)據(jù)自動上傳，全程貼合國家公衛(wèi)考核要求，有效減少人工錄入誤差，提升體檢數(shù)據(jù)的準(zhǔn)確性與規(guī)范性，為后續(xù)隨訪工作奠定堅(jiān)實(shí)的數(shù)據(jù)基礎(chǔ)，同時(shí)助力家庭醫(yī)生簽約服務(wù)提質(zhì)增效，推動分級診療政策在鄉(xiāng)、鎮(zhèn)、村落地。

　　The Yixiang Public Health Follow up Package takes the actual needs of grassroots public health as its core, deeply integrates rapidly changing IT technology, not only achieves intelligent upgrading of centralized public health examinations, but also improves the follow-up system functions through continuous iteration and optimization, making grassroots public health work more efficient and accurate. In the centralized physical examination process, this solution can achieve intelligent management of grassroots medical work, intelligent association of tables, and automatic uploading of health data, fully meeting the requirements of national public health assessment, effectively reducing manual input errors, improving the accuracy and standardization of physical examination data, laying a solid data foundation for subsequent follow-up work, and helping family doctors sign contracts to improve service quality and efficiency, promoting the implementation of graded diagnosis and treatment policies in townships, towns, and villages.

　　為進(jìn)一步提升隨訪服務(wù)的針對性與便捷性，易享持續(xù)優(yōu)化隨訪系統(tǒng)，新增多項(xiàng)實(shí)用功能，破解傳統(tǒng)隨訪“流程繁瑣、數(shù)據(jù)不通”的痛點(diǎn)。在慢性病隨訪添加頁面，新增其他類型隨訪按鈕，工作人員如需開展非常規(guī)慢性病隨訪，點(diǎn)擊按鈕即可彈出新的隨訪添加窗口，填寫完成后點(diǎn)擊提交即可保存，操作簡潔高效，無需繁瑣切換頁面，大幅節(jié)省隨訪時(shí)間。據(jù)基層實(shí)操數(shù)據(jù)顯示，新增功能上線后，隨訪效率提升40%以上，有效緩解基層隨訪人員的工作壓力。

　　To further enhance the pertinence and convenience of follow-up services, Yixiang continuously optimizes the follow-up system, adds multiple practical functions, and solves the pain points of traditional follow-up "cumbersome processes and data barriers". On the chronic disease follow-up addition page, a button for other types of follow-up has been added. If staff need to conduct unconventional chronic disease follow-up, clicking the button will pop up a new follow-up addition window. After filling it out, click submit to save it. The operation is simple and efficient, without the need to switch pages, greatly saving follow-up time. According to practical data at the grassroots level, after the new features were launched, the follow-up efficiency increased by more than 40%, effectively alleviating the work pressure of grassroots follow-up personnel.

　　更具亮點(diǎn)的是，系統(tǒng)實(shí)現(xiàn)高血壓與糖尿病隨訪信息關(guān)聯(lián)互通，收縮壓、舒張壓等核心指標(biāo)可自動同步，無需工作人員重復(fù)錄入，既減少人工工作量，又避免數(shù)據(jù)錄入誤差，確保隨訪數(shù)據(jù)的一致性與精準(zhǔn)性。這一設(shè)計(jì)精準(zhǔn)貼合基層公衛(wèi)工作實(shí)際——根據(jù)國家公衛(wèi)服務(wù)規(guī)范要求，高血壓、糖尿病患者每年需至少完成4次面對面隨訪，關(guān)聯(lián)互通功能讓隨訪工作更高效，助力基層醫(yī)療機(jī)構(gòu)精準(zhǔn)落實(shí)慢病管理任務(wù)。

　　More importantly, the system realizes the connection and exchange of follow-up information of hypertension and diabetes, and core indicators such as systolic blood pressure and diastolic blood pressure can be synchronized automatically, without the need for staff to repeatedly enter, which not only reduces the manual workload, but also avoids data entry errors, and ensures the consistency and accuracy of follow-up data. This design precisely conforms to the reality of grassroots public health work - according to the requirements of the national public health service specifications, patients with hypertension and diabetes need to complete at least four face-to-face visits every year. The connectivity function makes the follow-up work more efficient and helps grassroots medical institutions accurately implement the task of chronic disease management.

　　依托國家公衛(wèi)配套政策支持，易享公衛(wèi)隨訪包將醫(yī)生的職業(yè)技能與醫(yī)院的服務(wù)功能進(jìn)一步延伸，打破基層醫(yī)療服務(wù)的時(shí)空限制，為老百姓提供更簡潔、便捷的醫(yī)療健康服務(wù)。針對鄉(xiāng)、鎮(zhèn)、村基層醫(yī)療資源薄弱的問題，該方案有效補(bǔ)充基層預(yù)防保健服務(wù)供給，通過精準(zhǔn)隨訪、數(shù)據(jù)聯(lián)動，建立新型醫(yī)患關(guān)系，幫助基層醫(yī)療機(jī)構(gòu)實(shí)現(xiàn)慢病患者的規(guī)范化管理，切實(shí)提高居民群眾的健康水平。

　　With the support of national public health supporting policies, the Yixiang Public Health Follow up Package further extends the professional skills of doctors and the service functions of hospitals, breaking the time and space limitations of primary medical services and providing more concise and convenient medical and health services for the people. In response to the problem of weak primary healthcare resources in townships, towns, and villages, this plan effectively supplements the supply of primary prevention and health services. Through precise follow-up and data linkage, a new type of doctor-patient relationship is established to help primary healthcare institutions achieve standardized management of chronic disease patients and effectively improve the health level of residents.

　　此次易享公衛(wèi)隨訪包的升級，不僅是基層公衛(wèi)服務(wù)工具的優(yōu)化，更是新型公衛(wèi)服務(wù)模式的創(chuàng)新。其融合集中體檢與社區(qū)隨訪全流程，實(shí)現(xiàn)“體檢有規(guī)范、隨訪有精準(zhǔn)、數(shù)據(jù)有管控、服務(wù)有溫度”，既破解了基層公衛(wèi)工作的諸多痛點(diǎn)，又滿足了國家公衛(wèi)考核標(biāo)準(zhǔn)，為基層公衛(wèi)工作提供了可復(fù)制、可推廣的解決方案。未來，易享將持續(xù)依托智慧醫(yī)療技術(shù)，迭代優(yōu)化公衛(wèi)隨訪包功能，進(jìn)一步完善基層公衛(wèi)服務(wù)體系，為老百姓提供更優(yōu)質(zhì)、高效的公衛(wèi)服務(wù)，筑牢國民健康的基層防線。

　　The upgrade of the Yixiang public health follow-up package is not only an optimization of grassroots public health service tools, but also an innovation of a new public health service model. It integrates centralized physical examination and community follow-up throughout the entire process, achieving "standardized physical examination, precise follow-up, controlled data, and warm service". It not only solves many pain points in grassroots public health work, but also meets the national public health assessment standards, providing a replicable and promotable solution for grassroots public health work. In the future, Yixiang will continue to rely on smart medical technology, iterate and optimize the public health follow-up package function, further improve the grassroots public health service system, provide better and more efficient public health services for the people, and build a solid grassroots defense line for national health.

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