With the advancement of high-quality development in the healthcare system, the quality of the home page of medical records has become increasingly prominent, as an important data source for hospital management, performance evaluation, and medical insurance payment. In 2022, a grade-A tertiary hospital took improving the quality of the main diagnosis and surgical operations related data on the home page of medical records as the core goal, and constructed a quality control system for the home page of inpatient medical records based on the national medical security disease diagnosis-related groups (CHS-DRG). This system included two parts: the CHS-DRG grouper and early warning rules for high-risk medical records, which could issue warnings for abnormal data in the grouping results. Then, based on this system, a human-machine collaborative quality control mechanism for the home page of medical records, namely " system warning-coder review-communication between coders and clinical doctors", was established and applied since January 2022, realizing closed-loop management of quality control for the home page of medical records. Compared with 2020-2021, the accuracy rates of main diagnosis filling, main surgeries filling, and main diagnosis coding in 2022-2023 increased by 16.31, 12.45, and 1.70 percentage points respectively ( P<0.05); the number of diagnosis items increased by 0.91 ( P<0.05), and the coding time consumption decreased by 4.59 d ( P<0.05). Meanwhile, after the application, the quality improvement effect on the non-DRG payment group was higher than that on the DRG payment group ( P<0.05). The application of this system not only helps to improve the information-based means of medical record quality control and enrich the method system of medical record quality control, but also comprehensively improves the quality and work efficiency of the home page of medical records under different payment methods, which can provide reference for other hospitals to continuously improve the quality control work of the home page of medical records.

With the advancement of high-quality development in the healthcare system, the quality of the home page of medical records has become increasingly prominent, as an important data source for hospital management, performance evaluation, and medical insurance payment. In 2022, a grade-A tertiary hospital took improving the quality of the main diagnosis and surgical operations related data on the home page of medical records as the core goal, and constructed a quality control system for the home page of inpatient medical records based on the national medical security disease diagnosis-related groups (CHS-DRG). This system included two parts: the CHS-DRG grouper and early warning rules for high-risk medical records, which could issue warnings for abnormal data in the grouping results. Then, based on this system, a human-machine collaborative quality control mechanism for the home page of medical records, namely " system warning-coder review-communication between coders and clinical doctors", was established and applied since January 2022, realizing closed-loop management of quality control for the home page of medical records. Compared with 2020-2021, the accuracy rates of main diagnosis filling, main surgeries filling, and main diagnosis coding in 2022-2023 increased by 16.31, 12.45, and 1.70 percentage points respectively ( P<0.05); the number of diagnosis items increased by 0.91 ( P<0.05), and the coding time consumption decreased by 4.59 d ( P<0.05). Meanwhile, after the application, the quality improvement effect on the non-DRG payment group was higher than that on the DRG payment group ( P<0.05). The application of this system not only helps to improve the information-based means of medical record quality control and enrich the method system of medical record quality control, but also comprehensively improves the quality and work efficiency of the home page of medical records under different payment methods, which can provide reference for other hospitals to continuously improve the quality control work of the home page of medical records.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

December 2019 witnessed the outbreak of COVID-19 in Wuhan city and its rapid spread to other parts of China, and overseas as well. Tongji Hospital, as a designated hospital for treatment of critically ill patients, shoulders the diagnosis and treatment tasks of numerous critically ill patients of such a disease. For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital puts in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients’ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.