以“智慧医疗”为核心的糖尿病管理团队智慧服务创新与实践  

Innovation and Practice of Smart Service of Diabetes Management Team with"Smart Medicine"as the Core

作　　者：赵峰英[1,2] 罗江 王燕[1,2] 李丽群 黄晓婷[1,2] ZHAO Feng-ying;LUO Jiang;WANG Yan;LI Li-qun;HUANG Xiao-ting(Department of Endocrinology,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China;Fujian Institute of Diabetes Prevention and Treatment,Fuzhou,Fujian Province,350005 China)

机构地区：[1]福建医科大学附属第一医院内分泌科,福建福州350005 [2]福建省糖尿病防治研究院,福建福州350005

出　　处：《糖尿病新世界》2021年第2期188-191,195,共5页Diabetes New World Magazine

基　　金：中央财政引导地方发展专项-福建省糖尿病及并发症创新联合实验室(2018L3007)。

摘　　要：有效的糖尿病自我管理教育与支持是糖尿病良好控制的基础。该文详细介绍了以糖尿病专科护士为主导、借助糖尿病智慧管理平台开展的信息“互联、互通、共享”的“互联网+”糖尿病智慧一体化健康管理模式创新与实践,阐述了有效的糖尿病自我管理教育支持闭环的形成、延伸和随访,介绍了实现闭环管理的各临床、护理服务智慧创新实践要点,以实现规范化、信息化、系统化的糖尿病自我管理。Effective diabetes self-management education and support is the basis for good diabetes control.This article introduces in detail the innovation and practice of the“Internet+”diabetes intelligent integrated health management model led by diabetes specialist nurses and using the diabetes intelligent management platform to carry out information"interconnection,intercommunication,sharing",and elaborates the effective diabetes self-management education support closed loop formation,extension and follow-up of the clinic,introduces the key points of clinical and nursing service innovation practice to realize closed-loop management,so as to realize standardized,information-based and systematic diabetes self-management.

关 键 词：糖尿病智慧管理 自我管理教育与支持 闭环管理 个体化糖尿病自我管理处方 

分 类 号：R587.1[医药卫生—内分泌]