Objective: Study and design an AI-based automatic risk management and management effect evaluation system for chronic diseases. Construct a high-risk management system based on the knowledge base of chronic diseases, to realize automatic screening and manual confirmation of high-risk automatic manual combined screening system. Early detection of high-risk chronic disease factors, early follow-up intervention. Methods: According to the electronic medical records of patients with chronic diseases, and other information such as personal information, they are summarized into personal health records, and the artificial intelligence is used to evaluate the health status and conduct personalized intervention management. Results: Achieved the dynamic update of the health records during the illness, improved the awareness of risk factors in patients with chronic diseases, and promoted the changes in healthy behaviors. Conclusion: The system can effectively improve the management efficiency and effect of chronic diseases, reduce the mortality of chronic diseases, and save a lot of medical insurance funds.
chronic disease management