Follow-up visit management system for tumor patients in comprehensive hospitals

Abstract

The invention provides a follow-up visit management system for tumor patients in a comprehensive hospital. The follow-up visit management system comprises a follow-up visit object management module, a personalized follow-up visit module and a follow-up visit result statistical analysis module, wherein the personalized follow-up visit module comprises a follow-up visit material editing sub-module, a follow-up visit scheme creating sub-module and a follow-up visit task management sub-module; the follow-up material editing sub-module is used for a follow-up visitor to edit follow-up materials in a user-defined manner; the follow-up scheme creation sub-module is used for creating different follow-up schemes according to different follow-up objects; the follow-up task management sub-module is used for managing and following up the execution progress of the follow-up task in the follow-up scheme; the system has the following beneficial effects that the follow-up visit experience and the follow-up visit rate of the patient are improved through a plurality of channel information input modes and a reasonable follow-up visit strategy; according to the invention, customized management and personalized follow-up visit schemes are realized, professional follow-up visit services can be provided for patients with different illness states at proper time, and the pertinence and effectiveness of follow-up visit are improved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical informatization, and particularly to a follow-up management system for tumor patients in general hospitals. Background Art

[0002] Data released by the National Cancer Center in 2022 showed that more than 4.8 million new cases of malignant tumors occurred in China, with more than 2.5 million deaths, and the disease burden has been on the rise. The "Implementation Plan for the Action to Prevent and Control Cancer in the Healthy China Initiative (2023-2030)" proposed that the overall 5-year survival rate of cancer should reach 46.6% by 2030. To achieve this goal, 12 departments including the Shanghai Municipal Health Commission jointly formulated the "Implementation Plan for the Action to Prevent and Control Cancer in the Healthy Shanghai Initiative (2023-2030)", which mentioned many times that the follow-up work of tumor patients needs to be standardized, and emphasized that "indicators such as the quality of tumor registration reports, patient follow-up management, and survival quality assessment should be included in the evaluation and assessment of medical institution grades". Follow-up is of crucial significance to both tumor patients and doctors. As a chronic non-communicable disease, for patients, only by regular reexaminations can the recurrence and metastasis be detected in time, and symptomatic treatment can be carried out for the adverse reactions during the treatment process; for doctors, only through follow-up can information such as overall survival, disease remission, and five-year survival cycle be obtained, and then the severity of the disease and the treatment effect can be evaluated in reverse.

[0003] However, the current situation of the follow-up work of tumor patients in China is not ideal. Currently, it is only carried out in a few tumor specialized hospitals. For example, the Cancer Hospital of Fudan University has regularly followed up malignant tumor patients hospitalized since 2008, and has formed a special disease cohort of about 300,000 people so far; the five-year total effective follow-up rate of tumor patients in Peking University Cancer Hospital has remained above 90% for 10 years. However, in the actual follow-up process, there are many problems. For patients, the same patient may frequently receive different follow-up calls, disrupting the normal life rhythm, thus reducing the willingness to cooperate with the investigation; for doctors, a large amount of time needs to be taken out of the busy clinical work to collect and query the diagnosis, treatment, and survival information of patients inside and outside the hospital, consuming a lot of time and energy. Especially in general hospitals, the problems are more complex. The patients admitted to general hospitals have diverse disease types, which puts forward higher requirements for the informatization level of extracting tumor-related information from numerous information; in addition, there are also problems such as insufficient standardization of tumor medical record writing and lack of refined management level. Therefore, how to explore an efficient operation and development model for the follow-up management of tumor patients in general hospitals and develop tools that meet the application scenarios of general hospitals has become an important topic of common concern to all parties in society. Summary of the Invention

[0004] In view of the above-mentioned disadvantages of the prior art, the purpose of the present invention is to provide a follow-up management system for cancer patients in general hospitals, which is used to solve the problem that in general hospitals, the problem is more complex, the types of diseases of the patients admitted to general hospitals are diverse, and it is not convenient to carry out the follow-up work of cancer patients.

[0005] To achieve the above object and other related objects, the present invention provides the following technical solutions:

[0006] A follow-up management system for cancer patients in general hospitals includes a follow-up object management module, a personalized follow-up module, and a follow-up result statistical analysis module; the follow-up object management module is used to manage the information of follow-up objects collected through various channels, and the information of the collected follow-up objects can help the follow-up staff quickly form a disease-specific cohort through customized screening rules; the personalized follow-up module is used to formulate different follow-up plans in a customized manner, and different follow-up plans will be formulated according to different follow-up objects and the research needs of doctors; the follow-up result statistical analysis module is used to statistically summarize the received follow-up reply data, so as to form relevant charts and report contents, which can intuitively reflect the follow-up results and prognosis of each cancer type.

[0007] Among them, the personalized follow-up module includes a follow-up material editing sub-module, a follow-up plan creation sub-module, and a follow-up task management sub-module; the follow-up material editing sub-module is used for the follow-up staff to customize and edit follow-up materials, and the follow-up materials will be pushed to the follow-up objects for filling in the future; the follow-up plan creation sub-module is used to create different follow-up plans according to different follow-up objects, and the follow-up plan includes the target follow-up object, the follow-up materials corresponding to the target follow-up object, the follow-up time, and the execution method, and the follow-up time includes the start time, the expiration date, and the usage frequency of the follow-up materials; the follow-up task management sub-module is used to manage and track the execution progress of the follow-up tasks in the follow-up plan.

[0008] In an embodiment of the present invention, the follow-up object management module includes a follow-up object collection sub-module and a follow-up research cohort establishment sub-module; the follow-up object collection sub-module is used to collect the information of follow-up objects through various channels and generate a follow-up object resource library according to the collected information of the follow-up objects; the follow-up research cohort establishment sub-module is established for the follow-up object research cohort group and is used to follow up and study the follow-up object research cohort group.

[0009] In an embodiment of the present invention, collecting information of follow-up objects through multiple channels and generating a follow-up object resource library based on the collected information of follow-up objects includes: collecting information of follow-up objects through multiple channels and integrating the collected information; then classifying the integrated information, and dividing the information into different categories according to different research requirements and research purposes; then cleaning the classified information to obtain a follow-up object resource library.

[0010] In an embodiment of the present invention, the establishment process of the follow-up research cohort in the follow-up research cohort establishment sub-module includes: creating a custom screening rule according to actual needs, where the custom screening rule is based on various index data and other relevant information of follow-up objects; screening out research objects that meet the research requirements from the follow-up object resource library according to the custom screening rule, and creating a follow-up object research cohort group according to the research objects; and simultaneously establishing a follow-up research cohort and a team corresponding to the follow-up object research cohort group.

[0011] In an embodiment of the present invention, each follow-up staff can apply for their own account, and there are "My Follow-up Objects" and "Team Follow-up Objects" in the follow-up staff's account; "My Follow-up Objects" are the follow-up objects bound to the current account, which can be displayed in three dimensions: cohort, plan, and label, and the plan can be allocated to the follow-up objects as needed to implement the task distribution and operation of the plan; "Team Follow-up Objects" are the follow-up objects bound to the teams "I manage" and "I join" under the current account.

[0012] In an embodiment of the present invention, the creation process of the follow-up plan in the follow-up plan creation sub-module is as follows: the follow-up staff can click "New Follow-up Plan", select target follow-up objects according to the actual usage scenario of tumor follow-up, add the already formulated follow-up materials, and set the start time, expiration date, usage frequency, and execution method of the follow-up materials, where the execution method includes WeChat, SMS, and phone.

[0013] In an embodiment of the present invention, managing and following up the execution progress of the follow-up tasks in the follow-up plan includes: the follow-up staff can create "Follow-up Task Points" according to the existing follow-up schedule of the research, which are used to manage the push time of each follow-up material and the follow-up objects, where the follow-up task points can be single or periodic; after the follow-up plan is started, the follow-up materials will be automatically pushed according to the preset parameters; and the follow-up tasks include follow-up scheduled tasks and follow-up temporary tasks. The follow-up scheduled tasks are to send follow-up tasks to follow-up objects regularly according to the set start time, and the follow-up temporary tasks are to send additional follow-up after the scheduled tasks start.

[0014] In one embodiment of the present invention, the received follow-up reply data is statistically summarized to form relevant charts and report contents, including: statistically summarizing the received follow-up reply data from multiple dimensions, calculating key data such as the follow-up situation of the follow-up objects at each time node, thereby forming relevant charts and report contents, clearly showing the evolution path of the survival status of the follow-up objects of different cancer types over time, and intuitively reflecting the follow-up results and prognosis of each cancer type.

[0015] As described above, a follow-up management system for oncology patients in a general hospital according to the present invention has the following beneficial effects:

[0016] 1. The present invention effectively solves the problems of frequent disturbance to patients, low cooperation degree, and time-consuming and laborious information collection by doctors in the existing follow-up of oncology patients. Through various channels of information entry methods and reasonable follow-up strategies, it improves the patient follow-up experience and follow-up rate; 2. The present invention realizes customized management and personalized follow-up plans, can provide professional follow-up services for patients with different conditions at the appropriate time, and improves the pertinence and effectiveness of follow-up; 3. The team management mode breaks the follow-up information barrier between departments, realizes the whole life cycle management of tumors, is conducive to doctors comprehensively mastering the patient's condition, and improves the treatment effect; 4. Multi-disease management: The present invention realizes the comprehensive coverage of various disease types. Whether it is common diseases or rare diseases, it can formulate adapted follow-up plans according to their respective pathological characteristics, treatment processes, and rehabilitation needs, breaking the limitation of single-disease follow-up, and providing accurate and efficient follow-up services for various patients in all aspects. Brief Description of the Drawings

[0017] Figure 1 It shows the overall structural schematic diagram of the follow-up management system for oncology patients in a general hospital disclosed in the embodiment of the present invention;

[0018] Figure 2 It shows the overall management process schematic diagram of the follow-up management system for oncology patients in a general hospital disclosed in the embodiment of the present invention;

[0019] Figure 3 It shows the process schematic diagram of collecting follow-up object information in the follow-up management system for oncology patients in a general hospital disclosed in the embodiment of the present invention;

[0020] Figure 4 It shows the process schematic diagram of establishing a follow-up research cohort in the follow-up management system for oncology patients in a general hospital disclosed in the embodiment of the present invention;

[0021] Figure 5 It shows the process schematic diagram of creating and executing a follow-up plan in the follow-up management system for oncology patients in a general hospital disclosed in the embodiment of the present invention. Detailed Embodiments

[0022] The following specific examples illustrate the implementation manners of the present invention. Those skilled in the art can easily understand other advantages and effects of the present invention from the content disclosed in this specification. It should be noted that, without conflict, the following embodiments and the features in the embodiments can be combined with each other.

[0023] The present invention relates to a follow-up management system for tumor patients in a comprehensive hospital. Please refer to Figure 1 and Figure 2 , which includes a follow-up object management module, a personalized follow-up module, and a follow-up result statistical analysis module.

[0024] The follow-up object management module is used to manage the information of follow-up objects collected through various channels. The information of the collected follow-up objects can help the follow-up staff quickly form a disease-specific cohort through customized screening rules. It is also used to implement a patient network management mode through various clinical application scenarios, which can ensure that every tumor patient who has visited the hospital can be included in the follow-up management system. The follow-up object management module allows doctors to screen patients according to various conditions through the "advanced search" function, helping doctors quickly form a disease-specific cohort. In addition, the follow-up object management in the follow-up object management module realizes the integration and sharing of patient condition and survival information; among them, the follow-up object management module includes a follow-up object collection sub-module and a follow-up research cohort establishment sub-module; the follow-up object collection sub-module is used to collect the information of follow-up objects through various channels and generate a follow-up object resource library according to the collected information of the follow-up objects; the follow-up research cohort establishment sub-module is established for the follow-up object research cohort group and is used to follow up and study the follow-up object research cohort group;

[0025] Specifically, the collection process of follow-up objects is as follows: mainly through various channels, including scanning codes on small programs, manual import on browser terminals, custom push of the hospital HIS, etc.; the diversity of these information sources ensures the comprehensiveness and accuracy of the information; first, the collected information is integrated, and the information from different sources is unified into a dataset; then, the information is classified, and according to different research needs and purposes, the information is divided into different categories; finally, the information is cleaned to remove duplicate, incorrect, and incomplete information to ensure the quality and usability of the information; through this series of steps, a standardized and high-quality dataset, that is, the follow-up object resource library, is finally formed, laying a solid foundation for subsequent research work. Please refer to Figure 3; The process of establishing the follow-up study cohort is as follows: mainly guided by actual needs, custom screening rules are created. Among them, the custom screening rules are based on various index data and other relevant information of the follow-up objects, such as age, gender, historical medical visits, medical history records, health monitoring, etc.; through the custom screening rules, eligible research objects can be screened out from a large dataset, that is, the follow-up object resource library, to construct a research cohort group; at the same time, a follow-up study cohort and team are created to ensure that subsequent follow-up objects can automatically enter the cohort / team through the screening rules; this automated screening and updating mechanism enables the research cohort to self-update, forming a sustainable research object group, which not only improves research efficiency but also ensures the stability and representativeness of the research objects. For details, please refer to Figure 4 ;

[0026] More specifically, the follow-up object resource library is all the follow-up patients collected by the system, and these patients join through 4 channels: scanning the code to join, batch import, hospital HIS push, and patients' active joining; each follow-up staff can apply for their own account. In this embodiment, the follow-up staff are medical staff. The "follow-up object resource library" is all the follow-up objects visible according to the current account role permissions; the follow-up objects can be allocated to the follow-up staff as needed, and a follow-up object can be allocated multiple times; "My Follow-up Objects" are the follow-up objects bound to the current account, which can be displayed in three dimensions: cohort, plan, and label, and the plan can be allocated to the follow-up objects as needed to implement the task issuance and operation of the plan; "Team Follow-up Objects" are the follow-up objects bound to the teams "I manage" and "I joined" under the current account, and the functions are the same as those of "My Follow-up Objects".

[0027] The personalized follow-up module is used to formulate different follow-up plans in a customized manner. Among them, different follow-up plans will be formulated according to different follow-up objects and the research needs of doctors. Formulating the follow-up plan in a customized manner can not only reduce the workload of doctors and avoid disturbing patients but also monitor the changes in the disease diagnosis of patients in real time to ensure that doctors can track the patient's condition in a timely manner. Additionally, the personalized follow-up module can create and share follow-up plans; the personalized follow-up module includes a follow-up material editing sub-module, a follow-up plan creation sub-module, and a follow-up task management sub-module; the follow-up material editing sub-module is used for the follow-up staff to customize and edit follow-up materials, and the follow-up materials will be pushed to the follow-up objects for filling in the future; the follow-up plan creation sub-module is used to create different follow-up plans according to different follow-up objects. The follow-up plan includes the target follow-up objects, the follow-up materials corresponding to the target follow-up objects, the follow-up time, and the execution method. The follow-up time includes the start time, expiration date, and usage frequency of the follow-up materials; the follow-up task management sub-module is used to manage and follow up the execution progress of the follow-up tasks in the follow-up plan;

[0028] Specifically, the follow-up material editing submodule: the follow-up material editing submodule can customize the follow-up materials, including assessment questionnaires, patient education knowledge (articles / videos), health monitoring and other contents, and push them to the follow-up subjects for filling in; the follow-up plan creation submodule: in this follow-up plan creation submodule, you can check the scope of use of the plan (individual / team) according to the actual usage scenario of tumor follow-up, add follow-up materials (such as questionnaires or scales), set the start time, validity period, frequency of use, execution method (SMS, WeChat, phone), etc. of the follow-up materials; the follow-up task management submodule: the follow-up plan includes several follow-up tasks, and the follow-up task module is divided into a follow-up scheduled task submodule and a follow-up temporary task submodule; the follow-up scheduled task submodule is used to manage and follow up the execution progress of the follow-up tasks in the follow-up plan, centrally manage whether the patient completes the follow-up tasks accurately and on time, and use telephone follow-up and other related methods to assist the patient in completing the follow-up according to the situation; in the temporary task submodule, the doctor can send follow-up tasks in a targeted manner according to the patient's follow-up situation, medical treatment situation, and medical history, so as to meet the patient's follow-up needs to the greatest extent;

[0029] More specifically, the steps for creating a follow-up plan and managing follow-up tasks are as follows: the operator, that is, the follow-up person, can click "Create a new follow-up plan", input the formulated questionnaire or scale, and select the available personnel, start time, validity period, etc. of the questionnaire or scale; the operator can create "follow-up task points" according to the existing follow-up schedule of the study (for example, follow-up once a week or a month), which are used to manage the push time and objects of each questionnaire or scale, among which these follow-up task points can be single or periodic; after the follow-up plan is started, these questionnaires or scales will automatically push tasks according to pre-set parameters (frequency, time, etc.); Execute follow-up tasks: the operator can execute tasks through WeChat, SMS and phone calls. Follow-up tasks can be divided into scheduled tasks and temporary tasks. That is, after the scheduled task starts, a follow-up can also be reissued through a temporary task to improve the accuracy, timeliness and completeness of the research data.

[0030] The follow-up result statistical analysis module is used to summarize the received follow-up response data, so as to form relevant charts and report contents, which can intuitively reflect the follow-up results and prognosis of various cancer types. Specifically, the follow-up result statistical analysis module mainly focuses on the survival status and status update time of the follow-up subjects, and conducts statistics from the dimensions of tumor location, pathological type, international disease code (ICD10), and tumor type of single disease quality control, calculates key data such as the follow-up status of the follow-up subjects at each time point, and realizes T+1 update, clearly showing the evolution path of the survival status of the follow-up subjects of different cancer types over time, and intuitively reflecting the follow-up results and prognosis of various cancer types;

[0031] More specifically, summarize the follow-up results: mainly conduct the induction and summary of user feedback data, combine the content of passive follow-up, and obtain effective follow-up data information, which includes patients' feedback, treatment effects, rehabilitation conditions, etc.; through these follow-up data information, the needs and problems of patients can be deeply understood, providing important references for subsequent research work, and forming relevant charts and reports according to custom rules, providing data support and factual basis for relevant theoretical research; the content of these charts and reports visually displays the research data, which can help doctors / teams better understand the research results and formulate better treatment plans.

[0032] In practical applications, manage the follow-up objects: 1. Scan the code and enter: Post the platform QR code in prominent positions such as the hospital outpatient department and inpatient department. After the patient scans it with the mobile phone, fill in basic information (such as name, ID card, etc.) and informed consent on the pop-up page to complete registration, and the platform associates the patient information with the information in the hospital registration system; 2. Data import: Doctors or multidisciplinary teams organize the scientific research data into the format specified by the platform (such as XLS file format, including necessary fields such as patient name, visit number / hospitalization number, etc.) locally, select the file and upload it through the import interface of the platform, and the system checks the format and data integrity of the uploaded file. If errors are found, prompt for modification, and if there are no errors, import them into the database; 3. Hospital HIS push: The system monitors the update of patients' disease diagnoses in HIS in real time. When the new diagnosis meets the preset push conditions (such as the diagnosis of a specific tumor type), push the patient to the follow-up system platform account of the relevant doctor.

[0033] Personalized follow-up plan: For patients who have undergone radical surgery for early gastric cancer, a multidisciplinary team formulates a follow-up plan. The follow-up content can add personalized questionnaires or scales, such as pain scores, weight changes, etc., and select to share them so that all doctors under the team can view them. Set the questionnaire to be pushed periodically with a validity period of one week, that is, if there is no response to the questionnaire or scale within one week after the patient receives the follow-up information, it will expire. The frequency is once every six months after surgery until three years after surgery, and once a year after three years until five years after surgery; Follow-up task execution: At the beginning of each month (or other set time), the follow-up assignment method in the follow-up task management sub-module interacts with the hospital registration system and the diagnosis and treatment system to obtain the patient's medical records in the past period (such as within one month), and temporarily exclude these patients from the current follow-up list. For the remaining patients, the message reminder follow-up task management sub-module first sends a follow-up reminder message to the patient through the WeChat mini-program. The message contains clear follow-up guidance and operation instructions. If the patient does not respond to the message within 24 hours, the system automatically reminds again by text message. The text message content concisely informs the patient of the importance of follow-up and the operation method. If there is still no feedback from the patient after another 48 hours, the work order generation sub-module automatically generates a telephone follow-up work order, assigns it to the follow-up staff, and records the work order generation information in the platform at the same time.

[0034] Follow-up result statistics: For general doctors, they can view all patient information under their personal accounts, and can also check the gender, age, TNM stage distribution, survival and death status of the follow-up subjects in the teams they have joined, as well as the completion status of different follow-up methods, etc.; department managers can understand the disease type distribution of the oncology patients admitted to their departments, and then evaluate the treatment efficacy of their departments; when researchers need to export data for research, they fill out an application form in the data export application sub-module, including the research project name, research purpose, required data scope (such as patient group, data time span, data type, etc.), and submit the application. For details, please refer to Figure 5 .

[0035] In summary, the present invention is committed to a follow-up service system of "establishing a doctor-patient interaction channel, actively reaching out for follow-up, and providing coherent disease management for patients", including multiple modules such as follow-up subject management, personalized follow-up, and follow-up result statistical analysis; the present invention adopts an advanced microservice architecture, splitting the application into independent service units for deployment, expansion, and maintenance; using WEB-side development technology to design the user interface, enhancing compatibility and accessibility; relying on the WeChat mini-program platform and adopting mobile application development technology to enable the application to be accessed and used by users anytime and anywhere, improving the convenience and practicality of the application.

[0036] The above embodiments are only illustrative of the principles and effects of the present invention, and are not intended to limit the present invention. All equivalent modifications or changes completed by those with ordinary knowledge in the technical field without departing from the spirit and technical ideas disclosed by the present invention shall still be covered by the claims of the present invention.

Claims

1. A follow-up management system for tumor patients in a comprehensive hospital, characterized by: It includes follow-up object management module, personalized follow-up module and follow-up result statistical analysis module; The follow-up object management module is used to manage the information of the follow-up objects collected through various channels, and the collected information of the follow-up objects can help the follow-up staff to quickly form a disease-specific queue through custom screening rules; The personalized follow-up module is used to formulate different follow-up plans in a customized manner, wherein different follow-up plans are formulated according to different follow-up subjects and doctors' research needs; The follow-up result statistical analysis module is used to statistically summarize the received follow-up response data, thereby forming relevant charts and report contents, which can intuitively reflect the follow-up results and prognosis of various cancer types; Among them, the personalized follow-up module includes a follow-up material editing submodule, a follow-up plan creation submodule and a follow-up task management submodule; the follow-up material editing submodule is used for the follow-up staff to customize the follow-up materials, and the follow-up materials will be pushed to the follow-up objects for filling in later; the follow-up plan creation submodule is used to create different follow-up plans according to different follow-up objects, and the follow-up plan includes the target follow-up object, the follow-up material corresponding to the target follow-up object, the follow-up time and the execution method, and the follow-up time includes the start time, validity period and frequency of use of the follow-up material; the follow-up task management submodule is used to manage and follow up the execution progress of the follow-up tasks in the follow-up plan.

2. A follow-up management system for tumor patients in a comprehensive hospital according to claim 1, characterized in that: The follow-up object management module includes a follow-up object collection submodule and a follow-up study cohort establishment submodule; the follow-up object collection submodule is used to collect information on follow-up objects through multiple channels, and generate a follow-up object resource library based on the collected information on follow-up objects; the follow-up study cohort establishment submodule is established corresponding to the follow-up object study cohort group, and is used to follow up and study the follow-up object study cohort group.

3. A follow-up management system for tumor patients in a comprehensive hospital according to claim 2, characterized in that: The collecting of the information of the follow-up objects through multiple channels and generating a follow-up object resource library according to the collected information of the follow-up objects include: Information on the follow-up subjects is collected through various channels, and the collected information is integrated; the integrated information is then classified, and the information is divided into different categories according to different research needs and research purposes; the classified information is then cleaned to obtain a follow-up subject resource library.

4. A follow-up management system for tumor patients in a comprehensive hospital according to claim 3, characterized in that: The process of establishing the follow-up study cohort in the follow-up study cohort establishment submodule includes: Create custom screening rules according to actual needs, wherein the custom screening rules are based on various indicator data and other relevant information of the follow-up objects; screen out research objects that meet the research requirements in the follow-up object resource library according to the custom screening rules, and create a follow-up object research cohort group based on the research objects; and simultaneously establish a follow-up research cohort and team corresponding to the follow-up object research cohort group.

5. A follow-up management system for tumor patients in a comprehensive hospital according to claim 4, characterized in that: Each follow-up officer can apply for his / her own account. In the account of the follow-up officer, there are "My follow-up objects" and "Team follow-up objects"; "My follow-up objects" are the follow-up objects bound to the current account, which can be displayed in three dimensions: queue, plan, and label. Plans can be assigned to follow-up objects as needed to implement the task issuance and operation of the plan; "Team follow-up objects" are the follow-up objects under the teams "I manage" and "I join" bound to the current account.

6. The follow-up management system for tumor patients in a comprehensive hospital according to claim 1, characterized in that: The creation process of the follow-up plan in the follow-up plan creation submodule is as follows: The follow-up staff can click "Create a new follow-up plan", check the target follow-up object according to the actual usage scenario of tumor follow-up, add the prepared follow-up materials, and set the start time, validity period, frequency of use and execution method of the follow-up materials, among which the execution methods include WeChat, SMS and phone.

7. A follow-up management system for tumor patients in a comprehensive hospital according to claim 6, characterized in that: The management and follow-up of the execution progress of the follow-up tasks in the follow-up plan include: The follow-up staff can create "follow-up task points" based on the existing follow-up schedule for research, which are used to manage the push time and follow-up objects of each follow-up material, wherein the follow-up task points can be single or periodic; after the follow-up plan is started, the follow-up material will automatically push the task according to the pre-set parameters; and the follow-up tasks include follow-up scheduled tasks and follow-up temporary tasks, wherein the follow-up scheduled tasks are to send follow-up tasks to the follow-up objects at regular intervals according to the set start time, and the follow-up temporary tasks are to reissue the follow-up through temporary tasks even after the scheduled tasks start.

8. The follow-up management system for tumor patients in a comprehensive hospital according to claim 1, characterized in that: The received follow-up response data is statistically summarized to form relevant charts and report contents, including: The received follow-up response data are statistically summarized from multiple dimensions, and key data such as the follow-up status of the follow-up subjects at each time point are calculated to form relevant charts and report contents, which clearly show the evolution path of the survival status of the follow-up subjects of different cancer types over time, and intuitively reflect the follow-up results and prognosis of each cancer type.

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