Abstract
Background: An electronic health record (e-HR) system has been developed in Minhang District of Shanghai, China, since 2005, making it convenient for local health institutions to provide integrative and comprehensive health care and management for major diseases.Methods: In 2008, an e-HR-based cancer prevention program was initiated to screen multiple cancers, including colorectal, gastric, liver, lung, cervical, and breast cancers, and provide subsequent health education and health management to cancer patients and high-risk individuals. This study was designed in prospective analysis, based on the constructive analysis of key information, observation of cancer screening and healthcare processes and organizations, and stages of cancers detected by the e-HR-based programs.Results: From 2008 to 2016, health education was conducted for over 5 million attendances, and more than 3 million screening tests were performed for eligible residents over 40 years old. A total of 2,948 cancer cases were detected, accounting for 13.3% of all newly diagnosed cancers in the district during the 9-year period. Thirty point seven percent detected cancer cases were at the early stage, significantly higher than the 22.9% in cases identified by e-HR-based follow-up and 13.8% in cases diagnosed due to signs or symptoms. More than 136,000 residents were identified as individuals at high risk of cancer and subject to sustainable clinical follow-up and health management.Conclusions: The successful application of e-HR system in cancer prevention and control in Minhang district of Shanghai, China, implies that the system may act as an extendable and sustainable infrastructure for comprehensive health care and services for a broad spectrum of diseases and health events.
Highlights
In China, a vertical networking system for non-communicable disease prevention and control has been well-established, in which national, provincial, municipal, and local Health Commissions; the Centers for Disease Control and Prevention (CDC); offices for specific disease control; hospitals; and Community Healthcare Service Centers (CHSC) are supposed to work together to fight against non-communicable diseases [1]
We introduced the 9-year experience of the eHR-based cancer screening and health management for detected cancer cases and individuals at high risk and provide recommendations for seamless service delivery in the real world
All residents over 40 years in Minhang district were eligible for colorectal cancer and gastric cancer screening programs
Summary
In China, a vertical networking system for non-communicable disease prevention and control has been well-established, in which national, provincial, municipal, and local Health Commissions; the Centers for Disease Control and Prevention (CDC); offices for specific disease control; hospitals; and Community Healthcare Service Centers (CHSC) are supposed to work together to fight against non-communicable diseases [1]. In limited areas where the cancer registry system is well-established will medical centers report newly diagnosed cancer cases to a local cancer registry system, from which the local CDC and CHSCs can be alerted of occurrence of the disease and provide standardized health care to the patients [3]. This happens in the absence of detailed feedbacks and technical supports from medical centers for specific and individualized patient care. An electronic health record (e-HR) system has been developed in Minhang District of Shanghai, China, since 2005, making it convenient for local health institutions to provide integrative and comprehensive health care and management for major diseases
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