TEDxAustin
Joel Selanikio: The big-data revolution in health care
约尔·塞拉尼科: 令人惊讶的医疗保健大数据革新开端
Filmed:
Readability: 4.1
745,046 views
收集关于全球健康的数据本是一个不完美的过程：工作人员徒步穿过村庄去挨家挨户敲门问问题，在纸质表格上写下答案，然后输入数据——然后从这满是漏洞的信息中，各个国家做出重大的决策。数据极客约尔·塞拉尼科谈论了在过去几十年来关于收集医疗健康数据的质的改变——从掌上电脑到Hotmail，现在又转移到云端。（影片拍摄于TEDx奥斯丁）
Joel Selanikio - Health and technology activist
Dr. Joel Selanikio combines technology and data to help solve global health challenges. Full bio
Dr. Joel Selanikio combines technology and data to help solve global health challenges. Full bio
Double-click the English transcript below to play the video.
00:12
There's an old joke about a cop who's walking his beat
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有一个很古老的笑话，
00:15
in the middle of the night,
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一个警察在深夜里巡逻时
00:16
and he comes across a guy under a street lamp
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在路灯下遇到了一个男人
00:18
who's looking at the ground and moving from side to side,
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他一边盯着地面看一边来回走
00:21
and the cop asks him what he's doing.
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警察问他在做什么
00:23
The guys says he's looking for his keys.
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那个男人说他正在找他的钥匙
00:25
So the cop takes his time and looks over
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所以警察也花了时间仔细查看
00:27
and kind of makes a little matrix and looks
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并且做下一些小记号之类的，
00:29
for about two, three minutes. No keys.
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经过两三分钟。找不到钥匙。
00:32
The cop says, "Are you sure? Hey buddy,
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警察说：“你确定吗？嘿， 朋友，
00:35
are you sure you lost your keys here?"
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你确定你在这里丢了你的钥匙吗？”
00:37
And the guy says, "No, no, actually I lost them
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然后那个男人说：“不不，实际上我丢了他们
00:38
down at the other end of the street,
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在街的那一边，
00:40
but the light is better here."
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但是这里的灯光更亮。”
00:46
There's a concept that people talk about nowadays
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现今，有一个人们谈论的概念
00:47
called big data, and what they're talking about
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叫做大数据，他们谈论的
00:50
is all of the information that we're generating
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是我们产生的所有信息
00:52
through our interaction with and over the Internet,
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在我们通过网络交流的时候
00:55
everything from Facebook and Twitter
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所有东西，从“脸书”和“推特”
00:56
to music downloads, movies, streaming, all this kind of stuff,
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到下载音乐，电影，流媒体，所有这种东西，
01:01
the live streaming of TED.
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TED的直播
01:02
And the folks who work with big data, for them,
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对于这些负责处理大数据的人来说
01:05
they talk about that their biggest problem is
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他们最大的问题是
01:07
we have so much information,
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我们有这么多的信息，
01:09
the biggest problem is, how do we organize all that information?
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我们该怎样组织这所有的信息？
01:12
I can tell you that working in global health,
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我可以告诉你，在全球健康组织工作时，
01:15
that is not our biggest problem.
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这不是我们最大的问题。
01:18
Because for us, even though the light
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因为对于我们来说，
01:19
is better on the Internet,
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即使灯在网络上比较亮
01:22
the data that would help us solve the problems
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即使网上数据会帮助我们解决一些问题
01:25
we're trying to solve is not actually present on the Internet.
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但我们正在努力解决的实际上并不会呈现在网络上
01:28
So we don't know, for example, how many people
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所以我们不知，比如说，有多少人
01:30
right now are being affected by disasters
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现在正在被疾病困扰着
01:32
or by conflict situations.
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或者是正处于战争中
01:35
We don't know for really basically any of the clinics
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我们不知道现实中一个发展中国家的诊所里
01:39
in the developing world, which ones have medicines
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哪些有药物
01:41
and which ones don't.
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哪些没有
01:42
We have no idea of what the supply chain is for those clinics.
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我们完全不知道这些诊所的供应链是怎样的
01:45
We don't know -- and this is really amazing to me --
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我们不知道——这真的让我很惊讶——
01:48
we don't know how many children were born,
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我们不知道有多少孩子出生，
01:51
or how many children there are in Bolivia
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或者是有多少孩子，在玻利维亚
01:54
or Botswana or Bhutan.
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或者博茨瓦纳，或者不丹
01:57
We don't know how many kids died last week
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我们不知道上周有多少小孩夭折
01:59
in any of those countries.
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在这些国家里的任一个。
02:01
We don't know the needs of the elderly, the mentally ill.
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我们不知道老年病人和精神病人的需求。
02:04
For all of these different critically important problems
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对于所有这些种种非常重要的问题
02:07
or critically important areas that we want to solve problems in,
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或者是我们想解决问题的非常重要的地区
02:10
we basically know nothing at all.
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我们基本上一无所知。
02:15
And part of the reason why we don't know anything at all
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我们一无所知的部分原因
02:18
is that the information technology systems
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是由于当我们在全球健康组织
02:20
that we use in global health to find the data
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用来寻找数据、解决问题
02:24
to solve these problems is what you see here.
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所用的信息技术系统是你们所见的这个。
02:27
And this is about a 5,000-year-old technology.
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这是一个大约有5000年历史的技术。
02:29
Some of you may have used it before.
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你们当中的一些可能以前用过。
02:30
It's kind of on its way out now, but we still use it
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它现在已经快过时了，可是我们仍在用它
02:32
for 99 percent of our stuff.
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百分之九十九的员工都在用。
02:34
This is a paper form, and what you're looking at
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这是一张纸质表格，你看到的
02:38
is a paper form in the hand of a Ministry of Health nurse
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是健康部护士手中的一张纸质表格
02:42
in Indonesia who is tramping out across the countryside
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她正徒步穿行在印度尼西亚的乡下
02:45
in Indonesia on, I'm sure, a very hot and humid day,
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在印尼，我相信，那是个热而潮湿的一天，
02:49
and she is going to be knocking on thousands of doors
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并且她要去敲上千家的门
02:51
over a period of weeks or months,
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在几周或几个月之中，
02:53
knocking on the doors and saying, "Excuse me,
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敲开门并且说：“打扰一下，
02:56
we'd like to ask you some questions.
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我们想问你一些问题。
02:58
Do you have any children? Were your children vaccinated?"
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你有孩子吗？你的孩子打疫苗了吗？”
03:02
Because the only way we can actually find out
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因为实际上这是我们唯一的方法，为了知道
03:03
how many children were vaccinated in the country of Indonesia,
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在印尼乡下有多少孩子注射过疫苗，
03:06
what percentage were vaccinated, is actually not
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注射过疫苗的百分比，实际上
03:09
on the Internet but by going out and knocking on doors,
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不在网络上，而是通过去挨家挨户地敲门，
03:12
sometimes tens of thousands of doors.
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有时候是成千上万的门。
03:15
Sometimes it takes months to even years
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有时候这要花去数月甚至几年时间
03:17
to do something like this.
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为了做一些这样的事情
03:19
You know, a census of Indonesia
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你知道吗？在印尼的一次人口普查
03:21
would probably take two years to accomplish.
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很可能要两年时间才能完成。
03:23
And the problem, of course, with all of this is that
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当然，这其中的问题
03:25
with all those paper forms — and I'm telling you
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在于所有这些纸质表格——而且我想告诉你们
03:27
we have paper forms for every possible thing.
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什么事情都有纸质表格。
03:29
We have paper forms for vaccination surveys.
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注射疫苗统计有纸质表格。
03:32
We have paper forms to track people who come into clinics.
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调查去医院的人计有纸质表格。
03:36
We have paper forms to track drug supplies,
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调查药物和血液供应有纸质表格。
03:38
blood supplies, all these different paper forms
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所有这些不同的纸质表格
03:41
for many different topics,
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关于很多不同主题的，
03:43
they all have a single common endpoint,
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他们都有一个共同的终结点，
03:45
and the common endpoint looks something like this.
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那个终结点看起来就像这样。
03:48
And what we're looking at here is a truckful o' data.
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我们现在看到的是一卡车的数据
03:52
This is the data from a single vaccination coverage survey
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这仅仅是一个疫苗注射覆盖范围的调查数据
03:57
in a single district in the country of Zambia
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仅仅是赞比亚乡下的一个地区
03:59
from a few years ago that I participated in.
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（数据）来自于前几年我参与的一次调查。
04:01
The only thing anyone was trying to find out
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我们唯一想知道的事
04:04
is what percentage of Zambian children are vaccinated,
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只是有多少百分比的赞比亚儿童注射过疫苗，
04:07
and this is the data, collected on paper over weeks
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这就是在几周里收集到纸上的数据，
04:10
from a single district, which is something like a county
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仅仅是一个地区，有点像是我们在美国所说的
04:13
in the United States.
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一个县。
04:14
You can imagine that, for the entire country of Zambia,
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你可以想象一下，对于赞比亚整个国家，
04:16
answering just that single question
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只是回答那一个问题
04:20
looks something like this.
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看起来就像这样。
04:22
Truck after truck after truck
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一车一车又一车
04:24
filled with stack after stack after stack of data.
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装满着一叠一叠又一叠的数据。
04:28
And what makes it even worse is that
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并且更糟糕的是
04:29
that's just the beginning,
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这只是开始，
04:31
because once you've collected all that data,
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因为一旦当你收集了所有那些数据
04:33
of course someone's going to have to --
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当然必须有一些人要去——
04:35
some unfortunate person is going to have to type that into a computer.
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要有一些不幸的人不得不去把他们输入到计算机里。
04:38
When I was a graduate student, I actually was
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当我是研究生的时候，有时候我实际上就是
04:40
that unfortunate person sometimes.
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那个不幸的人。
04:42
I can tell you, I often wasn't really paying attention.
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我可以告诉你，我那时经常分心。
04:45
I probably made a lot of mistakes when I did it
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很可能在输入时犯了很多错误
04:47
that no one ever discovered, so data quality goes down.
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没有人会发现，所以数据质量会下降。
04:50
But eventually that data hopefully gets typed into a computer,
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但是最终但愿那些数据被输入进了计算机里，
04:53
and someone can begin to analyze it,
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然后一些人可以开始分析它们，
04:55
and once they have an analysis and a report,
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一旦他们做出了一份分析和报告，
04:57
hopefully then you can take the results of that data collection
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但愿你能拿着这些数据采集的结果
05:01
and use it to vaccinate children better.
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并且用它们能更好地给孩子们接种疫苗。
05:03
Because if there's anything worse
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因为如果在全球公共健康的范畴，
05:06
in the field of global public health,
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有任何东西错了，
05:08
I don't know what's worse than allowing children on this planet
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我不知道这世上还有什么比让孩子们
05:11
to die of vaccine-preventable diseases,
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死于原本疫苗可预防的疾病更糟糕的事，
05:14
diseases for which the vaccine costs a dollar.
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那些疾病的疫苗只价值一美元。
05:17
And millions of children die of these diseases every year.
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但是每年有数以百万计的儿童死于这些疾病。
05:20
And the fact is, millions is a gross estimate because
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并且事实是，几百万只是一个粗略的估计因为
05:24
we don't really know how many kids die each year of this.
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我们并不真的知道每年有多少小孩死于这些（疾病）。
05:27
What makes it even more frustrating is that
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更加令人沮丧的是，
05:29
the data entry part, the part that I used to do as a grad student,
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数据输入的环节，也就是我作为研究生时曾做过的工作，
05:32
can take sometimes six months.
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有时候会长达六个月之久。
05:34
Sometimes it can take two years to type that information
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有的时候可能需要两年时间把那些信息输入
05:37
into a computer, and sometimes, actually not infrequently,
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到计算机里，而且有的时候，实际上这是常事，
05:40
it actually never happens.
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就是（那些数据）根本就没有被输入。
05:42
Now try and wrap your head around that for a second.
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现在试着考虑一下这一点。
05:44
You just had teams of hundreds of people.
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你只有一个几百人的团队。
05:47
They went out into the field to answer a particular question.
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他们要去实地回答一个特定的问题。
05:49
You probably spent hundreds of thousands of dollars
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你很可能花掉了成百上千美元
05:51
on fuel and photocopying and per diem,
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在汽油、复印和每日生活上，
05:55
and then for some reason, momentum is lost
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但是之后由于某些原因，没了劲头儿，
05:58
or there's no money left,
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或者是没钱了，
05:59
and all of that comes to nothing
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然后所有那些全部就全都白费了
06:01
because no one actually types it into the computer at all.
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因为实际上根本没有人把数据输入电脑里。
06:04
The process just stops. Happens all the time.
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进程就中断了。这常常发生。
06:07
This is what we base our decisions on in global health:
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在全球健康组织，我们的决策所基于的就是：
06:10
little data, old data, no data.
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少数据，旧数据，没数据。
06:15
So back in 1995, I began to think about ways
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所以，回到1995年，我开始思考
06:18
in which we could improve this process.
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我们能够改善这种过程的方法。
06:20
Now 1995, obviously that was quite a long time ago.
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现在说起1995年，很显然已经是很长时间以前了。
06:23
It kind of frightens me to think of how long ago that was.
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想想那是多久以前真的有点吓到我了。
06:25
The top movie of the year was
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那年最火的电影是
06:27
"Die Hard with a Vengeance."
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“龙胆虎威3”。
06:28
As you can see, Bruce Willis had a lot more hair back then.
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正如你所看到的，布鲁斯·威利斯那时候还有很多头发。
06:31
I was working in the Centers for Disease Control,
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我那时候正在疾病控制中心工作，
06:34
and I had a lot more hair back then as well.
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我那时候也有很多头发。
06:37
But to me, the most significant thing that I saw in 1995
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但是对于我来说，在1995年我看到的最有意义的事
06:40
was this.
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是这个。
06:41
Hard for us to imagine, but in 1995,
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我们很难想象，但是在1995年，
06:44
this was the ultimate elite mobile device.
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那时候这是当时最高端的移动装置。
06:48
Right? It wasn't an iPhone. It wasn't a Galaxy phone.
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对吧？那不是个iPhone，也不是三星Galaxy手机。
06:50
It was a Palm Pilot.
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它是个掌上电脑。
06:52
And when I saw the Palm Pilot for the first time, I thought,
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当我第一次看到掌上电脑的时候，我想：
06:55
why can't we put the forms on these Palm Pilots
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我们为什么不能把那些表格放到这些掌上电脑里？
06:58
and go out into the field just carrying one Palm Pilot,
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然后去实地调查时就只带着一个掌上电脑，
07:00
which can hold the capacity of tens of thousands
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它可以容载成千上万的
07:04
of paper forms? Why don't we try to do that?
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纸质表格。我们为什么不试着那么做做看？
07:06
Because if we can do that, if we can actually just
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因为如果我们能那么做，如果我们真的可以
07:09
collect the data electronically, digitally,
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电子化、数字化地收集数据，
07:11
from the very beginning,
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从最最开始，
07:13
we can just put a shortcut right through that whole process
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我们就在整个过程中走了一个捷径，减省了
07:16
of typing,
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输入（数据的过程），
07:19
of having somebody type that stuff into the computer.
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或是让某些人去把那些东西输入电脑。
07:21
We can skip straight to the analysis
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我们可以直接跳到分析的过程
07:23
and then straight to the use of the data to actually save lives.
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然后直接用这些数据去真真正正地挽救生命。
07:26
So that's actually what I began to do.
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所以那就是我开始做的事。
07:29
Working at CDC, I began to travel to different programs
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在疾病防控中心工作时，我开始去到全世界不同的部门
07:32
around the world and to train them in using Palm Pilots
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并且训练他们用掌上电脑
07:36
to do data collection instead of using paper.
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收集数据，而不是用纸。
07:39
And it actually worked great.
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事实上一切都很顺利。
07:41
It worked exactly as well as anybody would have predicted.
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它就像每个人所预计的那么好。
07:43
What do you know? Digital data collection
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你知道吗？电子数据收集
07:46
is actually more efficient than collecting on paper.
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实际上比用纸收集高效得多。
07:48
While I was doing it, my business partner, Rose,
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当我在做这件事的时候，我的生意伙伴，罗斯，
07:50
who's here with her husband, Matthew, here in the audience,
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她和他的丈夫，马太，就在观众席里，
07:53
Rose was out doing similar stuff for the American Red Cross.
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罗斯也去美国红十字会做了同样的事。
07:56
The problem was, after a few years of doing that,
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问题是，在那几年之后，
07:58
I realized I had done -- I had been to maybe
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我意识到我已经办到的——我可能已经去了
08:01
six or seven programs, and I thought,
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六、七个组织，然后我想，
08:04
you know, if I keep this up at this pace,
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你知道，如果我持续进度的话，
08:06
over my whole career, maybe I'm going to go
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在我的整个工作生涯中，我可能会去
08:08
to maybe 20 or 30 programs.
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大概20到30个组织。
08:10
But the problem is, 20 or 30 programs,
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但是问题是，20到30个组织，
08:13
like, training 20 or 30 programs to use this technology,
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好比说，训练20到30个组织用这种技术，
08:16
that is a tiny drop in the bucket.
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那仍然是杯水车薪。
08:18
The demand for this, the need for data to run better programs,
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这种要让数据更好地运作的需求，
08:22
just within health, not to mention all of the other fields
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仅仅是在健康方面，先暂不提其他领域
08:25
in developing countries, is enormous.
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在发展中国家，是巨大的。
08:27
There are millions and millions and millions of programs,
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有成千上万无以计数的组织，
08:31
millions of clinics that need to track drugs,
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数以百万的医院需要跟踪药物情况，
08:34
millions of vaccine programs.
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数以百万的疫苗组织。
08:35
There are schools that need to track attendance.
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有很多学校需要记录出勤率。
08:37
There are all these different things
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有各种各样这样不同的事情
08:39
for us to get the data that we need to do.
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要我们取得我们所需要的数据
08:41
And I realized, if I kept up the way that I was doing,
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并且我意识到，如果我继续我以前的方式，
08:46
I was basically hardly going to make any impact
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我基本上很难做出什么影响
08:49
by the end of my career.
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在我的职业生涯结束前。
08:51
And so I began to wrack my brain
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之后我开始开动脑筋
08:53
trying to think about, you know,
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努力思考，像你知道的那样，
08:54
what was the process that I was doing,
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我之前做是什么样的过程，
08:56
how was I training folks, and what were the bottlenecks
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我如何训练那些人，遇到的瓶颈是什么
08:59
and what were the obstacles to doing it faster
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以及是什么妨碍了让这些做到更快
09:01
and to doing it more efficiently?
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做到更高效？
09:03
And unfortunately, after thinking about this for some time,
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但是不幸的是，在考虑了这些一段时间后，
09:06
I realized -- I identified the main obstacle.
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我意识到——我找到了最大的障碍。
09:10
And the main obstacle, it turned out,
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这个主要的障碍，它出现了，
09:12
and this is a sad realization,
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并且这是一个令人沮丧的认识，
09:13
the main obstacle was me.
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这主要的障碍就是我自己。
09:16
So what do I mean by that?
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那么我是什么意思呢？
09:18
I had developed a process whereby
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我已经开发了这个过程
09:20
I was the center of the universe of this technology.
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我是这项技术的集结点。
09:25
If you wanted to use this technology, you had to get in touch with me.
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如果你想用这项技术，你必须要和我取得联系。
09:28
That means you had to know I existed.
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这意味着你必须知道有我在，
09:30
Then you had to find the money to pay for me
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然后你必须要有钱来付给我
09:32
to fly out to your country
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为了飞到你的国家去
09:33
and the money to pay for my hotel
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然后钱用来让我住旅馆
09:35
and my per diem and my daily rate.
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和我的每日支出和日常开销
09:38
So you could be talking about 10,000 or 20,000 or 30,000 dollars
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所以你可以说是10,000或20,000或是30,000美元
09:41
if I actually had the time or it fit my schedule
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如果我真的有时间或者是能把这件事提上日程
09:43
and I wasn't on vacation.
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并且我没有在度假。
09:45
The point is that anything, any system that depends
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问题是不论任何东西，任何系统，只要是依赖于
09:48
on a single human being or two or three or five human beings,
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一两个或三五个人，
09:51
it just doesn't scale.
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它就不会成规模。
09:53
And this is a problem for which we need to scale
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问题就是我们需要传播
09:55
this technology and we need to scale it now.
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这个技术并且我们现在就需要扩大它的规模。
09:58
And so I began to think of ways in which I could basically
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所以我开始想能让我
10:00
take myself out of the picture.
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把自己脱离出来的方法。
10:02
And, you know, I was thinking,
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并且，如你所知，我在想，
10:07
how could I take myself out of the picture
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怎样能把我自己脱离出来呢？
10:09
for quite some time.
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想了相当长的一段时间。
10:11
You know, I'd been trained that the way that
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如你所知，我已经有了经验，
10:13
you distribute technology within international development
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你在国际发展中传播科技
10:16
is always consultant-based.
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常常是基于咨询顾问的。
10:18
It's always guys that look pretty much like me
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常常是有些像我一样的家伙，
10:21
flying from countries that look pretty much like this
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从一些像这里的国家飞到
10:23
to other countries with people with darker skin.
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有着黑皮肤人民的国家。
10:26
And you go out there, and you spend money on airfare
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并且你去到那儿，你要花机票钱
10:29
and you spend time and you spend per diem
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还要花时间，花钱在你的日常生活上，
10:32
and you spend [on a] hotel and you spend all that stuff.
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花钱在住旅馆等等这些东西上。
10:34
As far as I knew, that was the only way
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据我所知，那是唯一的方法
10:36
you could distribute technology, and I couldn't figure out a way around it.
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你可以传播科技，并且我没法找到可以避开它的方法。
10:39
But the miracle that happened,
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但是奇迹发生了，
10:42
I'm going to call it Hotmail for short.
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为了简约，我把他叫做Hotmail。
10:45
Now you may not think of Hotmail as being miraculous,
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2181
现在你可能不把Hotmail看做一个奇迹，
10:47
but for me it was miraculous, because I noticed,
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2913
但是对我来说那是个奇迹，因为我注意到，
10:50
just as I was wrestling with this problem,
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2566
就当我努力解决这个问题的时候，
10:52
I was working in sub-Saharan Africa mostly at the time.
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3414
那时候我大概正在非洲撒哈拉南部工作，
10:56
I noticed that every sub-Saharan African health worker
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我注意到每一个和我一起工作的非洲撒哈拉南部的工作人员
10:58
that I was working with had a Hotmail account.
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都有Hotmail账户。
11:02
And I thought, it struck me,
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2144
于是我想，它给了我灵感，
11:05
wait a minute, I know that the Hotmail people
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等一下，我知道Hotmail公司的人
11:07
surely didn't fly to the Ministry of Health of Kenya
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2716
肯定不需要飞到肯尼亚健康部去
11:10
to train people in how to use Hotmail.
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2711
教人们怎么用Hotmail。
11:13
So these guys are distributing technology.
255
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2487
所以这些人正在传播技术
11:15
They're getting software capacity out there
256
663612
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他们让软件技术传播到那里，
11:17
but they're not actually flying around the world.
257
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2009
但是他们没有真的在世界到处飞。
11:19
I need to think about this some more.
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我需要在多多考虑一下这个。
11:21
While I was thinking about it, people started using
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2173
当我正在想这个的时候，人们开始使用
11:23
even more things just like this, just as we were.
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甚至更多的这种东西，就像我们也在用。
11:26
They started using LinkedIn and Flickr
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1210
他们开始用Linkedln和Flickr
11:27
and Gmail and Google Maps, all these things.
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2761
谷歌邮箱和谷歌地图，所有的这些东西。
11:30
Of course, all of these things are cloud-based
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2726
当然，所有的这些东西都是基于云端技术
11:33
and don't require any training.
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2206
并且不需要任何训练。
11:35
They don't require any programmers.
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1600
他们不需要任何程序员。
11:37
They don't require any consultants, because
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他们不需要任何咨询师，因为
11:38
the business model for all these businesses
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所有这些公司的商业模式
11:41
requires that something be so simple we can use it ourselves
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需要的东西简单到我们可以自己使用它
11:44
with little or no training.
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1185
几乎不需要训练。
11:45
You just have to hear about it and go to the website.
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2614
你只需要听说它然后登陆网站。
11:47
And so I thought, what would happen if we built software
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4365
因此我想，如果我们开发软件来做我做咨询的事
11:52
to do what I'd been consulting in?
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2011
会发生什么呢？
11:54
Instead of training people how
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1434
而不是训练人们如何
11:55
to put forms onto mobile devices,
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2850
把表格植入移动设备，
11:58
let's create software that lets them do it themselves
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2284
让我们发明一些软件来让人们自己做这件事
12:00
with no training and without me being involved?
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1890
不需要训练，也不需要我的参与
12:02
And that's exactly what we did.
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1804
那就是我们所做的
12:04
So we created software called Magpi,
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所以我们发明了一种叫Magpi的软件，
12:08
which has an online form creator.
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1877
它有一个网上表格生成器。
12:10
No one has to speak to me.
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1151
不需要有人来和我说话了。
12:11
You just have to hear about it and go to the website.
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2694
你只需要听说它然后登陆那个网站。
12:14
You can create forms, and once you've created the forms,
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你可以生成表格，并且一旦你生成了表格，
12:16
you push them to a variety of common mobile phones.
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2340
你可以把它推送到许多普通的手机。
12:19
Obviously nowadays, we've moved past Palm Pilots
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2475
当然了，现在我们已经把过去的掌上电脑换成了
12:21
to mobile phones.
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1328
手机。
12:22
And it doesn't have to be a smartphone.
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1132
而且不需要是智能手机。
12:24
It can be a basic phone like the phone on the right there,
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2707
他可以是一个非智能手机，像右边的这个手机一样，
12:26
you know, the basic kind of Symbian phone
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1336
你知道，这种非智能的塞班手机
12:28
that's very common in developing countries.
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在发展中国家是非常普遍的。
12:30
And the great part about this is, it's just like Hotmail.
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3999
并且它最棒的部分是它就像Hotmail一样。
12:34
It's cloud-based, and it doesn't require any training,
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2334
它基于云端技术，并且不需要任何训练，
12:36
programming, consultants.
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2040
编程，顾问咨询。
12:38
But there are some additional benefits as well.
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1936
而且还有一些更大的益处。
12:40
Now we knew, when we built this system,
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1955
现在我们知道，当我们建立了这个系统，
12:42
the whole point of it, just like with the Palm Pilots,
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2293
就像用掌上电脑的时候，最重要的一点
12:45
was that you'd have to, you'd be able to
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2604
是你不得不并且必须能够
12:47
collect the data and immediately upload the data and get your data set.
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3191
采集数据并且立即上传数据以获得你的数据库。
12:50
But what we found, of course, since it's already on a computer,
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2437
但是我们发现，当然了，因为数据已经在计算机中了，
12:53
we can deliver instant maps and analysis and graphing.
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3188
我们可以产生即时图像并且分析画图。
12:56
We can take a process that took two years
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2251
我们可以把一个需要花两年时间的过程
12:58
and compress that down to the space of five minutes.
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3222
压缩到只要五分钟的时间。
13:01
Unbelievable improvements in efficiency.
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2506
难以置信的效率提升。
13:04
Cloud-based, no training, no consultants, no me.
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4766
基于云端的，不需要训练，不需要咨询，不需要我。
13:09
And I told you that in the first few years
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2323
并且我告诉过你们，在刚开始的几年
13:11
of trying to do this the old-fashioned way,
305
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1827
用老方法做这个的时候，
13:13
going out to each country,
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1292
到每个国家去，
13:14
we reached about, I don't know,
307
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3054
我们达到了大约，我不确定，
13:17
probably trained about 1,000 people.
308
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2118
可能是训练了1000人左右。
13:19
What happened after we did this?
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1803
我们在做了这些之后发生了什么呢？
13:21
In the second three years, we had 14,000 people
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2506
在第二个三年中，我们有14000个人
13:24
find the website, sign up, and start using it to collect data,
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3193
找到了网站，注册，并且开始用它收集数据，
13:27
data for disaster response,
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1502
疾病反馈的数据，
13:28
Canadian pig farmers tracking pig disease and pig herds,
313
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4748
加拿大的养猪户用来跟踪记录猪的疾病和猪饲料，
13:33
people tracking drug supplies.
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2415
人们跟踪记录药品供应。
13:36
One of my favorite examples, the IRC,
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1942
我最喜欢的例子之一，是IRC
13:37
International Rescue Committee,
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1629
国际救援委员会，
13:39
they have a program where semi-literate midwives
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807609
3237
他们的程序，能让半文盲的产婆们
13:42
using $10 mobile phones
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2427
用10美元的手机
13:45
send a text message using our software
319
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2209
通过我们的软件每周发送一次短信息
13:47
once a week with the number of births
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2209
出生的数量
13:49
and the number of deaths, which gives IRC
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2313
死亡的数量，
13:52
something that no one in global health has ever had:
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2599
这是在全球健康组织都不曾有过的东西：
13:54
a near real-time system of counting babies,
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3637
一个近乎实时的记录新生儿的系统，
13:58
of knowing how many kids are born,
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1492
能知道有多少婴儿出生了，
13:59
of knowing how many children there are
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1676
能知道儿童的数量是多少
14:01
in Sierra Leone, which is the country where this is happening,
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2782
在塞拉利昂，人们就正在使用它，
14:04
and knowing how many children die.
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3204
并且知道有多少孩子死去。
14:07
Physicians for Human Rights --
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1597
人权团体的内科医生
14:08
this is moving a little bit outside the health field —
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2479
现在我们说的有点超出了健康的领域—
14:11
they are gathering, they're basically training people
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2865
他们正聚集在一起，在刚果训练人们
14:14
to do rape exams in Congo, where this is an epidemic,
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3364
做关于强奸的测验，在刚果这是一种盛行，
14:17
a horrible epidemic,
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1748
一个非常可怕的盛行，
14:19
and they're using our software to document
333
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2171
并且他们正在用我们的软件记录
14:21
the evidence they find, including photographically,
334
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2972
他们找到的证据，包括图像上的，
14:24
so that they can bring the perpetrators to justice.
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4152
这样他们能够致以罪犯法律制裁。
14:28
Camfed, another charity based out of the U.K.,
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3683
Camfed，在英国的另一个慈善机构，
14:32
Camfed pays girls' families to keep them in school.
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Camfed付给女孩子们家里钱好让她们能上学。
14:36
They understand this is the most significant intervention
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他们明白这是他们能做的最有意义的干预。
14:38
they can make. They used to track the dispersements,
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他们过去在纸上跟踪支出，
14:41
the attendance, the grades, on paper.
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出勤，成绩。
14:43
The turnaround time between a teacher
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这是一个转折点，从一个老师
14:44
writing down grades or attendance
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写下成绩或出勤率
14:46
and getting that into a report was about two to three years.
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然后在大约两三年后得出报告。
14:49
Now it's real time, and because this is such
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现在这是一个实时系统，并且因为这是如此
14:51
a low-cost system and based in the cloud, it costs,
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一个低花费的系统，基于云端，它的花费
14:54
for the entire five countries that Camfed runs this in
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对于Camfed资助的五个国家
14:57
with tens of thousands of girls,
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千千万万的女孩子们，
14:59
the whole cost combined is 10,000 dollars a year.
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所有花费每年只要10000美元。
15:03
That's less than I used to get
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那比我原来
15:04
just traveling out for two weeks to do a consultation.
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出去两周做一次咨询
15:10
So I told you before that
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所以我之前告诉过你
15:12
when we were doing it the old-fashioned way, I realized
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当我们用老式方法做这些的时候，我意识到
15:14
all of our work was really adding up to just a drop in the bucket --
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所有这些工作加起来也不过是滴水之于长河
15:17
10, 20, 30 different programs.
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10个，20个，30个不同的程序。
15:19
We've made a lot of progress, but I recognize
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我们已经做出了很多进展，但是我意识到
15:21
that right now, even the work that we've done
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现在，虽然我们所的工作
15:23
with 14,000 people using this,
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有14000的人在用它，
15:26
is still a drop in the bucket. But something's changed.
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这仍然是滴水之于长河。但是已经发生了一些改变。
15:29
And I think it should be obvious.
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并且我觉得它应该很明显。
15:30
What's changed now is,
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现在所发生的改变是，
15:32
instead of having a program in which we're scaling at such a slow rate
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我们过去用的低效率的方式已经被取代
15:36
that we can never reach all the people who need us,
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我们可以再也不用到需要我们的人那里去，
15:39
we've made it unnecessary for people to get reached by us.
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我们已经做到不需要有人来找我们。
15:43
We've created a tool that lets programs
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我们已经发明了一个工具，可以让组织部门
15:46
keep kids in school, track the number of babies
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记录在学校的孩子，跟踪新生儿的数量
15:49
that are born and the number of babies that die,
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和婴儿的死亡数量，
15:52
to catch criminals and successfully prosecute them,
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用来逮捕罪犯并且成功诉讼他们，
15:55
to do all these different things to learn more
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来做所有这些不同的事情从而知道的更多
15:58
about what's going on, to understand more, to see more,
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关于正在发生什么，以便能理解的更多，看得更多，
16:03
and to save lives and improve lives.
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来挽救生命并改善生活。
16:07
Thank you.
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谢谢大家。
16:09
(Applause)
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（掌声）
ABOUT THE SPEAKER
Joel Selanikio - Health and technology activistDr. Joel Selanikio combines technology and data to help solve global health challenges.
Why you should listen
A practicing pediatrician, former Wall Street computer consultant, and former epidemiologist at the Centers for Disease Control, Dr. Joel Selanikio is the CEO of DataDyne, a social business working in fields such as international development and global health.
Selanikio started to experiment with electronic data capture back when the Palm Pilot was cutting edge technology. In the years since then, he has helped to experiment with the growing potential and availability of technology--and the growing ubiquity of the cloud. Combining the two has led to systems such as Magpi mobile data collection software. Previously known as "EpiSurveyor," the service now has over 20,000 users in more than 170 countries.
Selanikio holds a bachelor's degree from Haverford College, a medical degree from Brown University, and he is a graduate of the Epidemic Intelligence Service fellowship of the CDC. He continues to practice clinical pediatrics as an Assistant Professor at Georgetown University and on the Emergency Response Team of the International Rescue Committee.
Joel Selanikio | Speaker | TED.com