中国消化内镜图文系统应用现状分析及功能指标探索

Analysis of the current application status of digestive endoscopy graphic and textual reporting systems in China and exploration of their functional indicators

摘要:

目的 调查消化内镜图文系统在我国医疗机构的应用现状，明确适合我国医院消化内镜中心的图文系统基本功能指标。方法 依据国内外相关技术文献初步拟定消化内镜图文系统的功能标准，基于2020年11月至2021年11月国家消化内镜专业质量控制中心开展的第二次全国消化内镜普查中对全国医疗机构消化内镜图文系统的调查结果，筛选主要内镜图文系统，通过调查图文系统的功能及在各地域、各等级医疗机构的分布情况，分析我国内镜图文系统的应用现状，同时通过德尔菲法征求专家意见，建立功能指标体系。结果 我国主流消化内镜图文系统共26种，功能差异显著，在满足基本内镜诊疗需求的同时，在内镜质控相关的兼容国际疾病分类标准编码（international classification of diseases， ICD）10/11编码、病理结果回输、洗消记录追溯等功能方面存在欠缺。总体来看，高等级医疗机构、东南沿海地区医疗机构使用的内镜图文系统功能较其他医疗机构更为丰富。通过德尔菲法确定功能指标包括：①基本功能：患者信息记录与档案管理，内镜检查图片与视频的获取、存储与导出，多路同步采图，结构化报告，支持ICD10/11编码，兼容医疗卫生信息传输协议；②辅助功能：病理结果回输，工作量统计与分析，洗消记录追溯；③消化内镜质量管理功能：质量控制指标自主计算与传报。结论 我国消化内镜图文系统种类繁多，功能异质性大，需对消化内镜图文系统的基本功能指标加以界定，以适应消化内镜诊疗不断提升的需求。

Abstract:

Objective To investigate the current application status of digestive endoscopy graphic and textual systems in Chinese medical facilities and clarify their basic functional indicators. Methods Preliminary functional standards of digestive endoscopy graphic and textual systems were defined based on literature review home and abroad. Using data from the Second National Digestive Endoscopy Survey (November 2020–November 2021), the main systems in use were identified, and further investigation was conducted into their functional features and application status across various regions and levels of medical facilities in China. A Delphi questionnaire survey was subsequently conducted to obtain expert consensus and finalize the functional standards. Results A total of 26 mainstream systems were analyzed. These systems exhibited marked functional heterogeneity; most met basic requirements for endoscopic diagnosis and treatment but lacked essential quality control capabilities, including international classification of diseases (ICD) 10/11 compatibility, pathological feedback integration, and disinfection traceability. Overall, high-level medical facilities and those in the southeastern coastal regions utilized more comprehensive systems compared with others. Delphi consensus identified the following core functions: ①Basic functions: patient information record and file management, the acquisition, storage and export of endoscopic image and video, multi-channel synchronization, structured reports, ICD10/11 compatibility, healthcare information transmission protocol support. ②Auxiliary functions: pathological feedback, workload analysis, and disinfection tracing. ③Quality management: automated calculation and reporting of key performance indicators. Conclusion Numerous types of digestive endoscopy graphic and textual systems are currently in use across China with significant functional heterogeneity. It is necessary to define the standardized core functional indicators to meet the growing demands of digestive endoscopy diagnosis and treatment.