Research on the Management of Chronic Diseases in Functional Communities Based on Informatization

As a significant enterprise responsible for power supply assurance, power functional communities have health needs that align with other functional communities but also exhibit unique disease characteristics. Chronic disease management in electric power functional communities combines both online and offline strategies, establishing a community-centric chronic disease management model led by functional community health services and facilitated through information systems. With the assistance of professional technical tools and expertise, the initiative seeks to not only strengthen the management of key chronic disease risk factors but also enhance chronic disease management among patients. Such measures aim to reduce the onset of chronic diseases and control their progression, thereby minimizing mortality and morbidity rates. Leveraging information technology, this paper proposes a chronic disease management model tailored for functional communities: one driven by big data analytics for overall chronic disease management, management of high-risk populations, and an effectiveness and process evaluation system. The model emphasizes proactive intervention, reminders, and follow-ups to boost self-management compliance, thus ensuring effective management outcomes. Through these efforts, the objective is to bolster the health status and quality of life for chronic disease patients, reduce chronic disease risks, curb the progression and onset of chronic diseases, and consequently provide a sustainable health framework supporting enterprise growth.