Dalian Jinshitan Hospital

Resident health records

Health archives are the standard records in the process of medical and health services provided by medical and health institutions for urban and rural residents. They are systematic records with residents' personal health as the core, running through the whole life process and covering various health-related factors. They are important information resources to meet residents' own needs and health management.
Residents' health records include: personal health records, family health records, and community health records.
Only by establishing complete and authentic health records can community health service workers understand residents' needs for community health services, so as to provide high-quality, comprehensive and continuous community health services, improve the health level of community residents and improve the community health conditions.
For individual residents, health records are indispensable medical information for self-care, which records the occurrence, development, treatment and outcome of diseases of each of us. By comparing the data and data examined over a period of time, community residents can find the changes in their health status, disease development trend, treatment effect and other conditions, which is conducive to residents to take targeted health care measures. At the same time, residents who have established health records can also get convenient, timely and free public health services at community health service institutions in their jurisdictions. In addition, the establishment of electronic health records after going to the hospital to see a doctor, to the doctor diagnosis and treatment of diseases also brings great convenience, the doctor saw some examination has been done recently, can avoid repeated examination.
For community health service institutions, can through the establishment of individual, family and community health records, to be able to understand and master the health status and disease of community residents, community residents major health problems and health problems, and for the screening of high-risk groups, disease management and laying a foundation for targeted prevention measures; It is also convenient for community responsible doctors to provide timely prevention and health guidance to the elderly, women, children, hypertension, diabetes and other key groups with chronic diseases.
The effect of electronic health files on the management of patients with hypertension and diabetes
Hypertension and diabetes are chronic and high incidence affected by many factors. Only by comprehensive treatment in many aspects can we effectively reduce blood pressure, control blood sugar and keep blood pressure and blood sugar stable. Only by establishing electronic health records for patients with hypertension and diabetes can community doctors do primary prevention work more effectively and reasonably and reduce the medical expenses of ordinary people.
With the development of medical career and the change of disease spectrum, community diseases in China have gradually changed from infectious diseases to chronic non-communicable diseases, such as coronary heart disease, hypertension, diabetes, chronic bronchitis and so on. And chronic diseases are the main diseases that lead to physical and mental weakness, disability, death and medical expenses of urban residents. The national strategy for chronic diseases also moves forward from back-end treatment to systematic management of integrated prevention and treatment.
It is an important content of community health management to establish health records of residents and carry out prevention and treatment of chronic diseases. Hypertension and diabetes are important risk factors of cardiovascular and cerebrovascular diseases. Blood pressure and blood sugar are the most basic factors that determine the complications of hypertension and diabetes. The benefit of hypertension treatment mainly comes from lowering blood pressure, while the benefit of diabetes treatment mainly comes from effective control of blood sugar. Therefore, improving the control rate of blood pressure and blood sugar primary prevention is the key measure to reduce the burden of cardiovascular and cerebrovascular diseases. Electronic health records can make primary prevention effective and standard.
Community doctors can conduct regular home visits, measure blood pressure and blood sugar for patients, make detailed inquiries and record their conditions, and timely adjust individual treatment plans for patients. Its advantages lie in continuity, systematicness, timeliness and initiative. Doctors can comprehensively observe the changes in patients' symptoms, signs, risk factors, lifestyle and other aspects, and timely adjust the treatment plan. Patients and doctors have good interaction and high treatment compliance.
Some residents with hypertension and diabetes in the community do not understand, do not cooperate, do not file, the ultimate impact is their own health, is irresponsible for their own.

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