Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for circular superficial esophageal cancer.Methods:A retrospective analysis was conducted on 74 consecutive cases of circular superficial esophageal squamous cell carcinoma treated with ESD at Nanjing Drum Tower Hospital from January 2015 to December 2019. The success rate of ESD, curative resection rate, incidence of complications, and additional treatment were mainly observed.Results:One case was transferred to surgery, and the remaining 73 cases successfully completed ESD treatment. The success rate of ESD was 98.6%. Postoperative pathology of ESD revealed that 39 cases achieved curative resection, with a curative resection rate of 53.4% (39/73). Intraoperative muscle layer injury occurred in 15 cases (20.5%), and intraoperative perforation occurred in 1 case (1.4%). Two cases (2.7%) experienced delayed bleeding, and one case (1.4%) experienced delayed perforation. Eleven cases were lost to follow-up, and the remaining 62 cases received follow-up for 36.4±19.0 months. Among the follow-up cases, 12 underwent additional surgery and 5 cases additional chemotherapy and radiotherapy. Among the 57 patients with follow-up data who did not underwent surgery, 49 developed esophageal stenosis after ESD, with an incidence rate of 86.0%.Conclusion:ESD for circular superficial esophageal cancer is generally safe, but it is prone to muscle layer injury during the operation, with a low curative resection rate, a high incidence of postoperative esophageal stenosis, and a high proportion of additional surgical procedures.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

To review the clinical data of 13 patients with benign stenosis in deep small intestine treated by balloon-assisted enteroscopy from September 2017 to December 2019, and to evaluate the stenosis characteristics, endoscopic treatment effects and its safety in different lesions. The results showed that there were 6 cases of Crohn disease (CD), 4 cases of cryptogenic multifocal ulcerative stenosing enteritis (CMUSE) and 3 cases of small bowel stenosis with unknown etiology. A total of 38 stenoses were found after 17 enteroscopic treatments, including 35 web-like stenoses and 3 columnar stenoses. Thirteen stenoses were found in 6 patients with CD, including 4 single stenosis, 1 case of 3 stenoses and 1 case of 6 stenoses. Twenty-one stenoses were found in 4 patients with CMUSE and they were all web-like stenosis. A total of 18 times of balloon dilatation and 10 times of IT knife incision were performed. The technical success rate was 88.2% (15/17), and the clinical effective rate was 76.9% (10/13). The follow-up time was 3-28 months, and one patient underwent surgical treatment. There was 1 case of delayed hemorrhage and 3 cases of delayed perforation after operation. They were all improved by medical treatment. These results indicated that treatment of benign stenosis in deep small intestine by enteroscopy is technically feasible and can improve the symptoms of patients in a short time.