ABOUT THE SPEAKER
Eric Dishman - Social scientist
Eric Dishman does health care research for Intel -- studying how new technology can solve big problems in the system for the sick, the aging and, well, all of us.

Why you should listen

Eric Dishman is an Intel Fellow and general manager of Intel's Health Strategy & Solutions Group. He founded the product research and innovation team responsible for driving Intel’s worldwide healthcare research, new product innovation, strategic planning, and health policy and standards activities.

Dishman is recognized globally for driving healthcare reform through home and community-based technologies and services, with a focus on enabling independent living for seniors. His work has been featured in The New York Times, Washington Post and Businessweek, and The Wall Street Journal named him one of “12 People Who Are Changing Your Retirement.” He has delivered keynotes on independent living for events such as the annual Consumer Electronics Show, the IAHSA International Conference and the National Governors Association. He has published numerous articles on independent living technologies and co-authored government reports on health information technologies and health reform.

He has co-founded organizations devoted to advancing independent living, including the Technology Research for Independent Living Centre, the Center for Aging Services Technologies, the Everyday Technologies for Alzheimer’s Care program, and the Oregon Center for Aging & Technology.

More profile about the speaker
Eric Dishman | Speaker | TED.com
TED@Intel

Eric Dishman: Health care should be a team sport

艾瑞克迪旭曼 (Eric Dishman): 健康照護應該是團隊運動

Filmed:
1,053,887 views

艾瑞克迪旭曼 (Eric Dishman) 念大學時,醫生說他只能再活 2 到 3 年-那已是好久以前的事了。艾瑞克後來經歷了不同的診斷及器官移植,他結合個人經驗及尖端醫學技術,提出了大膽的創新思維,改以病人為治療團隊核心,以重塑健康照護系統。(攝於TED@Intel)
- Social scientist
Eric Dishman does health care research for Intel -- studying how new technology can solve big problems in the system for the sick, the aging and, well, all of us. Full bio

Double-click the English transcript below to play the video.

00:13
I want to share分享 some personal個人 friends朋友 and stories故事 with you
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我要分享一些我的朋友和故事
00:17
that I've actually其實 never talked about in public上市 before
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我從來沒有公開談過
00:19
to help illustrate說明 the idea理念
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我的目的是要說明一種想法、
00:21
and the need and the hope希望
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一種需求、一種希望
00:23
for us to reinvent重塑 our health健康 care關心 system系統 around the world世界.
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以重塑全球的醫療照護系統
00:26
Twenty-four二十四 years年份 ago, I had -- a sophomore二年級 in college學院,
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24年前,我還是個大二學生
00:30
I had a series系列 of fainting昏暈 spells法術. No alcohol was involved參與.
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我昏迷了好幾次,不是因為酒醉
00:33
And I ended結束 up in student學生 health健康,
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我被送到學生健康中心
00:35
and they ran some labworklabwork and came來了 back right away,
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做了一些檢驗後,立刻得知
00:38
and said, "Kidney problems問題."
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是腎臟問題
00:40
And before I knew知道 it, I was involved參與 and thrown拋出 into
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我還沒搞清楚狀況,就開始了
00:43
this six months個月 of tests測試 and trials試驗 and tribulations磨難
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六個月的檢驗、考驗和折磨
00:46
with six doctors醫生 across橫過 two hospitals醫院
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由2家醫院的6位醫生診治
00:49
in this clash衝突 of medical titans巨頭
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這些醫界權威互相爭執
00:52
to figure數字 out which哪一個 one of them was right
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想釐清誰才正確
00:54
about what was wrong錯誤 with me.
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診斷出我的病情
00:56
And I'm sitting坐在 in a waiting等候 room房間 some time later後來 for an ultrasound超聲,
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做完超音波後,我坐在候診室
01:00
and all six of these doctors醫生 actually其實 show顯示 up in the room房間 at once一旦,
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6位醫生同時出現
01:02
and I'm like, "Uh oh, this is bad news新聞."
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我想:「糟了,一定是壞消息!」
01:07
And their diagnosis診斷 was this:
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醫生診斷說:
01:08
They said, "You have two rare罕見 kidney diseases疾病
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「你得了兩種罕見的腎臟疾病,
01:10
that are going to actually其實 destroy破壞 your kidneys腎臟 eventually終於,
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最終會讓你的腎臟壞死,
01:13
you have cancer-like癌樣 cells細胞 in your immune免疫的 system系統
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你的免疫系統中有類似癌症細胞,
01:15
that we need to start開始 treatment治療 right away,
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必須立即治療。
01:17
and you'll你會 never be eligible合格 for a kidney transplant移植,
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你永遠不可能符合換腎資格,
01:20
and you're not likely容易 to live生活 more than two or three years年份."
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最多還能活2到3年。」
01:23
Now, with the gravity重力 of this doomsday末日 diagnosis診斷,
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這項診斷好像世界末日
01:26
it just sucked me in immediately立即,
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讓我立刻認定
01:29
as if I began開始 preparing準備 myself as a patient患者
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自己就是病人
01:31
to die according根據 to the schedule時間表 that they had just given特定 to me,
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將在醫生宣判的日期死亡
01:35
until直到 I met會見 a patient患者 named命名 Verna貝爾納 in a waiting等候 room房間,
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我在候診室遇到另一位病人薇娜
(Verna)
01:38
who became成為 a dear friend朋友, and she grabbed抓起 me one day
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她成了我的好友,有天她拉著我
01:40
and took me off to the medical library圖書館
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帶我到醫學圖書館
01:42
and did a bunch of research研究 on these diagnoses診斷 and these diseases疾病,
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仔細研究我的疾病和診斷
01:45
and said, "Eric埃里克, these people who get this
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然後說:「得到這些疾病的人,
01:48
are normally一般 in their '70s and '80s.
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通常都是七、八十歲,
01:49
They don't know anything about you. Wake喚醒 up.
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他們根本不了解你,醒醒吧,
01:53
Take control控制 of your health健康 and get on with your life."
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掌握自己的健康、好好的生活!」
01:56
And I did.
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我真的這麼做了
01:57
Now, these people making製造 these proclamations宣言 to me
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宣告我病症的人
02:00
were not bad people.
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都不是壞人
02:01
In fact事實, these professionals專業人士 were miracle奇蹟 workers工人,
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他們都是仁心仁術的專科醫師
02:03
but they're working加工 in a flawed有缺陷, expensive昂貴 system系統 that's set up the wrong錯誤 way.
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但他們在有缺陷、昂貴、錯誤
的系統下工作
02:08
It's dependent依賴的 on hospitals醫院 and clinics診所 for our every一切 care關心 need.
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所有的照護都依賴醫院與診所
02:11
It's dependent依賴的 on specialists專家 who just look at parts部分 of us.
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依賴只看我們部分身體的專科醫師
02:14
It's dependent依賴的 on guesswork猜測 of diagnoses診斷 and drug藥物 cocktails雞尾酒,
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依賴基於猜測的診斷
以及亂槍打鳥的用藥
02:18
and so something either works作品 or you die.
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他不成功,你就成仁
02:21
And it's dependent依賴的 on passive被動 patients耐心
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這系統也依賴消極的病人
02:25
who just take it and don't ask any questions問題.
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默默承受、不問問題
02:29
Now the problem問題 with this model模型
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以上這種模式是有問題的
02:31
is that it's unsustainable不可持續的 globally全球.
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以全球來說,是無法永續的
02:33
It's unaffordable負擔不起 globally全球.
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也是無法負擔的
02:35
We need to invent發明 what I call a personal個人 health健康 system系統.
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我們要發展「個人化健康系統」
02:38
So what does this personal個人 health健康 system系統 look like,
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個人化健康系統是什麼?
02:41
and what new technologies技術 and roles角色 is it going to entail意味著?
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有哪些新技術、新角色?
02:46
Now, I'm going to start開始 by actually其實 sharing分享 with you
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我現在要與各位分享
02:48
a new friend朋友 of mine, Libby利比,
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我的新朋友「利比」(Libby)
02:50
somebody I've become成為 quite相當 attached to over the last six months個月.
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過去半年我們關係密切
02:53
This is Libby利比, or actually其實, this is an ultrasound超聲 image圖片 of Libby利比.
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這就是利比
也可說是利比的超音波影像
02:56
This is the kidney transplant移植 I was never supposed應該 to have.
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是我本來永遠等不到的移植腎臟
02:59
Now, this is an image圖片 that we shot射擊 a couple一對 of weeks ago for today今天,
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這是幾週前照的影像
03:03
and you'll你會 notice注意, on the edge邊緣 of this image圖片,
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請注意角落
03:05
there's some dark黑暗 spots斑點 there, which哪一個 was really concerning關於 to me.
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那裡有些陰影,我很擔心
03:08
So we're going to actually其實 do a live生活 exam考試
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我要在現場進行檢驗
03:11
to sort分類 of see how Libby's利比的 doing.
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看看利比的狀況好不好
03:12
This is not a wardrobe衣櫃 malfunction故障. I have to take my belt off here.
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不是衣服有問題,我要脫掉皮帶
03:15
Don't you in the front面前 row worry擔心 or anything.
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前排的請不要擔心
03:17
(Laughter笑聲)
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(笑聲)
03:18
I'm going to use a device設備 from a company公司 called MobisanteMobisante.
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我要開始使用行動檢測公司
(Mobisante) 所開發的儀器
03:22
This is a portable手提 ultrasound超聲.
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叫做行動超音波
03:23
It can plug插頭 into a smartphone手機. It can plug插頭 into a tablet片劑.
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可連接手機或平板電腦
03:26
MobisanteMobisante is up in Redmond雷德蒙, Washington華盛頓,
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行動檢測公司在華盛頓州雷德蒙市
03:28
and they kindly和藹 trained熟練 me to actually其實 do this on myself.
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他們好心訓練我自助使用
03:32
They're not approved批准 to do this. Patients耐心 are not approved批准 to do this.
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他們沒有獲准這麼做
病人也沒獲准這麼用
03:34
This is a concept概念 demo演示, so I want to make that clear明確.
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先講清楚,這只是概念的展示
03:37
All right, I gotta總得 gel凝膠 up.
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塗上凝膠
03:38
Now the people in the front面前 row are very nervous緊張. (Laughter笑聲)
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現在前排觀眾很緊張了
(笑聲)
03:42
And I want to actually其實 introduce介紹 you to Dr博士. BatiukBatiuk,
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我要介紹貝謝克醫師
(Dr. Thomas Batiuk)
03:46
who's誰是 another另一個 friend朋友 of mine.
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他是我的另一位朋友
03:48
He's up in Legacy遺產 Good Samaritan撒瑪利亞 Hospital醫院 in Portland波特蘭, Oregon俄勒岡.
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在奧勒岡州波特蘭市的撒馬利亞
慈善醫院 (Legacy Good Samaritan)
03:52
So let me just make sure. Hey, Dr博士. BatiukBatiuk. Can you hear me okay?
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先確認一下,貝醫生,聽得到嗎?
03:55
And actually其實, can you see Libby利比?
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還有,你看得到「利比」嗎?
03:57
Thomas托馬斯 BatuikBatuik: Hi你好 there, Eric埃里克.
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貝醫師:嗨!艾瑞克,你好
(即演講者 Eric Dishman)
03:58
You look busy. How are you?
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你看起來好忙啊!你好!
04:00
Eric埃里克 Dishman迪氏曼: I'm good. I'm just taking服用 my clothes衣服 off
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艾瑞克:我很好,我剛脫了衣服
04:02
in front面前 of a few少數 hundred people. It's wonderful精彩.
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有幾百位觀眾在看,感覺真好!
04:05
So I just wanted to see, is this the image圖片 you need to get?
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我想知道這是不是你要看的影像?
04:10
And I know you want to look and see if those spots斑點 are still there.
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請幫我檢查那些陰影還在不在?
04:13
TBTB: Okay. Well let's scan掃描 around a little bit here,
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貝醫師:請往周圍掃描一下
04:16
give me a lay鋪設 of the land土地.
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我先看一下整體狀況
04:17
EDED: All right.TBTB: Okay. Turn it a little bit inside,
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艾瑞克:好的
貝醫師:往裡面一點
04:21
a little bit toward the middle中間 for me.
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往中間一點點
04:23
Okay, that's good. How about up a little bit?
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好,很好,往上一點點
04:28
Okay, freeze凍結 that image圖片. That's a good one for me.
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停,這個影像正是我要的
04:31
EDED: All right. Now last week, when I did this,
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艾瑞克:上週停住時
04:34
you had me measure測量 that spot to the right.
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你要我量陰影的大小
04:37
Should I do that again?
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現在要做嗎?
04:38
TBTB: Yeah, let's do that.
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貝醫師:沒錯,量一下
04:39
EDED: All right. This is kind of hard to do
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艾瑞克:這有點難
04:43
with one hand on your belly肚皮 and one hand on measuring測量,
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一手在腹部,另一手還要操作
04:45
but I've got it, I think,
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我想我作到了
04:46
and I'll save保存 that image圖片 and send發送 it to you.
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我把影像存檔,再寄給你
04:49
So tell me a little bit about what this dark黑暗 spot means手段.
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請告訴我那個陰影是什麼
04:51
It's not something I was very happy快樂 about.
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我不太安心
04:53
TBTB: Many許多 people after a kidney transplant移植
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貝醫師:很多人在腎臟移植後
04:55
will develop發展 a little fluid流體 collection採集 around the kidney.
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腎臟周圍會積水
04:58
Most of the time it doesn't create創建 any kind of mischief惡作劇,
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大部分不會造成傷害
05:02
but it does warrant保證 looking at,
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但是需要注意
05:04
so I'm happy快樂 we've我們已經 got an opportunity機會 to look at it today今天,
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很高興今天有機會檢查
05:07
make sure that it's not growing生長, it's not creating創建 any problems問題.
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確認沒有變大、不會造成問題
05:10
Based基於 on the other images圖片 we have,
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與先前影像比較
05:12
I'm really happy快樂 how it looks容貌 today今天.
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我很滿意今天的狀況
05:15
EDED: All right. Well, I guess猜測 we'll double check it when I come in.
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艾瑞克:我去看診時請再檢查一次
05:17
I've got my six month biopsy活檢 in a couple一對 of weeks,
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再幾週就要做6個月的切片檢查
05:20
and I'm going to let you do that in the clinic診所,
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我會請你幫忙
05:21
because I don't think I can do that one on myself.
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因為我沒辦法自己作切片
05:24
TBTB: Good choice選擇.EDED: All right, thanks謝謝, Dr博士. BatiukBatiuk.
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貝醫師:沒錯
艾瑞克:謝謝你,貝醫師
05:26
All right. So what you're sort分類 of seeing眼看 here
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好的,各位剛才看到的
05:28
is an example of disruptive破壞性 technologies技術,
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是革命性的創新技術
05:31
of mobile移動, social社會 and analytic解析 technologies技術.
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包括行動裝置、社群、分析技術
05:34
These are the foundations基金會 of what's going to make personal個人 health健康 possible可能.
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是未來個人化健康照護的基礎
05:37
Now there's really three pillars支柱
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有三大支柱支撐著…
05:39
of this personal個人 health健康 I want to talk to you about now,
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接下來要談的個人化健康照護
05:41
and it's care關心 anywhere隨地, care關心 networking聯網 and care關心 customization定制.
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就是照護行動化、網路化、客製化
05:45
And you just saw a little bit of the first two
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剛才只匆匆一瞥前兩項
05:47
with my interaction相互作用 with Dr博士. BatiukBatiuk.
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看到我和貝醫生的互動
05:48
So let's start開始 with care關心 anywhere隨地.
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現在從第一點開始,照護行動化
05:51
Humans人類 invented發明 the idea理念 of hospitals醫院 and clinics診所
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建立醫院和診所的構想,起源自
05:54
in the 1780s. It is time to update更新 our thinking思維.
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1780年,現在該重新思考了
05:58
We have got to untetheruntether clinicians臨床醫生 and patients耐心
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我們該將醫生和病人
06:01
from the notion概念 of traveling旅行 to a special特別
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都要走到一棟專用
06:04
bricks-and-mortar磚頭和水泥 place地點 for all of our care關心,
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建築物進行醫療的做法中
釋放出來
06:06
because these places地方 are often經常 the wrong錯誤 tool工具,
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對醫療目的而言,這往往是錯誤的
06:09
and the most expensive昂貴 tool工具, for the job工作.
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而且昂貴的
06:11
And these are sometimes有時 unsafe不安全 places地方 to send發送 our sickest最病 patients耐心,
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對重病患者有時並不安全
06:15
especially特別 in an era時代 of superbugs超級細菌
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尤其是這個超級細菌、
06:17
and hospital-acquired醫院獲得 infections感染.
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及院內感染橫行的時代
06:19
And many許多 countries國家 are going to go bricklessbrickless from the start開始
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許多國家想直接跳過實體醫院
06:22
because they're never going to be able能夠 to afford給予
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因為太貴了,永遠負擔不起…
06:24
the mega-medicalplexes大型medicalplexes that a lot of the rest休息 of the world世界 has built內置.
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已開發國家的這種大型醫學中心
06:28
Now I personally親自 learned學到了 that hospitals醫院
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我個人的經驗是,醫院
06:31
can be a very dangerous危險 place地點 at a young年輕 age年齡.
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對小孩來說,是個很危險的地方
06:34
This was me in third第三 grade年級.
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這是小學三年級的我
06:35
I broke打破 my elbow彎頭 very seriously認真地, had to have surgery手術,
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手肘嚴重骨折,需要動手術
06:38
worried擔心 that they were going to actually其實 lose失去 the arm.
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我很怕會失去整隻手臂
06:40
Recovering恢復 from the surgery手術 in the hospital醫院, I get bedsores褥瘡.
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手術後的住院期間,我得了褥瘡
06:43
Those bedsores褥瘡 become成為 infected感染,
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褥瘡受到感染
06:45
and they give me an antibiotic抗生素 which哪一個 I end結束 up being存在 allergic過敏的 to,
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抗生素治療造成嚴重過敏
06:48
and now my whole整個 body身體 breaks休息 out,
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最後全身爆發…
06:50
and now all of those become成為 infected感染.
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全面性的感染
06:53
The longer I stayed in the hospital醫院, the sicker病情加重 I became成為,
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住院越久,我病得越重
06:55
and the more expensive昂貴 it became成為,
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醫藥費也越高
06:57
and this happens發生 to millions百萬 of people around the world世界 every一切 year.
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全球每年數百萬人都是相同情形
07:00
The future未來 of personal個人 health健康 that I'm talking about
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我講的未來個人化健康照護
07:03
says care關心 must必須 occur發生 at home as the default默認 model模型,
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是以居家照護為優先
07:07
not in a hospital醫院 or clinic診所.
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不是目前的醫院或診所
07:09
You have to earn your way into those places地方
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你想進醫院或診所
07:10
by being存在 sick生病 enough足夠 to use that tool工具 for the job工作.
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要病到有必要的程度才行
07:14
Now the smartphones智能手機 that we're already已經 carrying攜帶
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現在我們用的智慧型手機
07:16
can clearly明確地 have diagnostic診斷 devices設備 like ultrasounds超聲 plugged into them,
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已可外接各種診斷裝置,如超音波
07:19
and a whole整個 array排列 of others其他, today今天,
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及其他許多裝置
07:22
and as sensing傳感 is built內置 into these,
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智慧型手機還內建多種感測器
07:23
we'll be able能夠 to do vital重要 signs跡象 monitor監控
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可進行生命跡像監測
07:25
and behavioral行為的 monitoring監控 like we've我們已經 never had before.
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及過去沒聽過的行為監測
07:28
Many許多 of us will have implantables可植入物 that will actually其實 look
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未來我們之中許多人可能會植入
07:31
real-time即時的 at what's going on with our blood血液 chemistry化學
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即時監控血液中化學物質
07:33
and in our proteins蛋白質 right now.
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及蛋白質的裝置
07:36
Now the software軟件 is also getting得到 smarter聰明, right?
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軟體越來越聰明,對吧?
07:38
Think about a coach教練, an agent代理人 online線上,
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就像是線上的教練或經紀人
07:41
that's going to help me do safe安全 self-care自我護理.
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可幫我們安全的自我照顧
07:43
That same相同 interaction相互作用 that we just did with the ultrasound超聲
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像我剛才展示超音波的互動
07:46
will likely容易 have real-time即時的 image圖片 processing處理,
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未來可能會有即時影像處理
07:48
and the device設備 will say, "Up, down, left, right,
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機器會指揮我上下左右
07:50
ah, Eric埃里克, that's the perfect完善 spot to send發送 that image圖片
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說:「就是這個位置,影像存檔,
07:53
off to your doctor醫生."
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傳給你的醫生吧!」
07:55
Now, if we've我們已經 got all these networked聯網 devices設備
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如果我們有了這些網路裝置
07:57
that are helping幫助 us to do care關心 anywhere隨地,
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照護行動化就可以達成
07:59
it stands站立 to reason原因 that we also need a team球隊
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當然,我們需要一個團隊
08:01
to be able能夠 to interact相互作用 with all of that stuff東東,
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來進行相關互動
08:03
and that leads引線 to the second第二 pillar支柱 I want to talk about,
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這就需要我說的第二根支柱
08:06
care關心 networking聯網.
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照護網路化
08:07
We have got to go beyond this paradigm範例
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我們要突破傳統模式
08:10
of isolated孤立 specialists專家 doing parts部分 care關心
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也就是獨立專科醫師
分別進行部分照護
08:14
to multidisciplinary多學科 teams球隊 doing person care關心.
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進而由多科別團隊進行個人化照護
08:18
Uncoordinated不協調 care關心 today今天 is expensive昂貴 at best最好,
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今日缺乏協調的照護,不僅昂貴
08:22
and it is deadly致命 at worst最差.
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還可能致命
08:24
Eighty八十 percent百分 of medical errors錯誤 are actually其實 caused造成
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80%的醫療錯誤是因為
08:26
by communication通訊 and coordination協調 problems問題
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溝通協調問題
08:28
amongst其中包括 medical team球隊 members會員.
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存在醫療團隊成員間
08:30
I had my own擁有 heart scare years年份 ago in graduate畢業 school學校,
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在念研究所時我有心驚膽顫的經驗
08:33
when we're under treatment治療 for the kidney,
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那時在治療腎臟
08:35
and suddenly突然, they're like, "Oh, we think you have a heart problem問題."
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突然有人說:「你得了心臟病!」
08:37
And I have these palpitations心悸 that are showing展示 up.
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接著我出現了心悸
08:39
They put me through通過 five weeks of tests測試 --
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進行了5個星期檢驗
08:42
very expensive昂貴, very scary害怕 -- before the nurse護士 finally最後 notices通告
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又貴又可怕-
最後有位護士注意到
08:45
the piece of the paper, my meds吃藥 list名單
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一張紙,我的藥單
08:47
that I've been carrying攜帶 to every一切 single appointment約定,
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我每次約診都帶的單子
08:49
and says, "Oh my gosh天哪."
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他說:「天哪!」
08:51
Three different不同 specialists專家 had prescribed規定
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有三位專科醫師開了
08:53
three different不同 versions版本 of the same相同 drug藥物 to me.
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相同的處方藥
08:55
I did not have a heart problem問題. I had an overdose過量 problem問題.
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我心臟沒病,是用藥過量
08:59
I had a care關心 coordination協調 problem問題.
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是照護缺乏協調的問題
09:02
And this happens發生 to millions百萬 of people every一切 year.
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這每年發生在數百萬人身上
09:05
I want to use technology技術 that we're all working加工 on and making製造 happen發生
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我想用現有的科技
09:09
to make health健康 care關心 a coordinated協調 team球隊 sport運動.
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使健康照護成為合作的團隊運動
09:12
Now this is the most frightening可怕的 thing to me.
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才能解決這件讓我最害怕的事
09:15
Out of all the care關心 I've had in hospitals醫院 and clinics診所 around the world世界,
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我曾在世界各地的醫院及診所診治
09:19
the first time I've ever had a true真正 team-based以團隊為基礎 care關心 experience經驗
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我第一次感受到
真正的醫療團隊照護
09:22
was at Legacy遺產 Good Sam山姆 these last six months個月
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就是過去半年在撒馬利亞慈善醫院
(Legacy Good Samaritan)
09:25
for me to go get this.
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讓我有此感受
09:26
And this is a picture圖片 of my graduation畢業 team球隊 from Legacy遺產.
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這是我在醫院的畢業團隊照片
09:29
There's a couple一對 of the folks鄉親 here. You'll你會 recognize認識 Dr博士. BatiukBatiuk.
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有好幾位,這位是貝醫師
09:32
We just talked to him. Here's這裡的 Jenny珍妮, one of the nurses護士,
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剛和他通電話
這是珍妮,其中一位護士
09:34
Allison佳佳, who helped幫助 manage管理 the transplant移植 list名單,
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這是艾利森,他幫忙處理移植清單
09:36
and a dozen other people who aren't pictured合照,
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還有十幾位不在相片中
09:39
a pharmacist藥劑師, a psychologist心理學家, a nutritionist營養師,
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有藥師、心理醫師、營養師
09:41
even a financial金融 counselor顧問, Lisa麗莎,
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甚至還有財務顧問,麗莎
09:43
who helped幫助 us deal合同 with all the insurance保險 hassles麻煩.
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她幫我們處理所有保險事務
09:46
I wept哭泣 the day I graduated畢業.
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我畢業那天哭了
09:49
I should have been happy快樂, because I was so well
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我應該要高興,因為病已好到
09:50
that I could go back to my normal正常 doctors醫生,
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可以回去看一般的醫師了
09:52
but I wept哭泣 because I was so actually其實 connected連接的 to this team球隊.
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我哭是因為和團隊感情深厚
09:55
And here's這裡的 the most important重要 part部分.
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這才是最重要的部份
09:57
The other people in this picture圖片 are me and my wife妻子, Ashley阿什利.
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照片上還有我,以及我太太艾希莉
10:00
Legacy遺產 trained熟練 us on how to do care關心 for me at home
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醫院訓練我們在家自行照護
10:04
so that they could offload卸載 the hospitals醫院 and clinics診所.
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醫院和診所就不必那麼忙碌
10:07
That's the only way that the model模型 works作品.
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這是這種模式成功的唯一方式
10:09
My team球隊 is actually其實 working加工 in China中國
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我的團隊其實在中國工作
10:11
on one of these self-care自我護理 models楷模
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從事自助照護模式
10:13
for a project項目 we called Age-Friendly關愛老人 Cities城市.
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稱為「年齡友善城市」計畫
10:15
We're trying to help build建立 a social社會 network網絡
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我們嘗試建立社群網路
10:17
that can help track跟踪 and train培養 the care關心 of seniors老年人
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以幫助追蹤並且訓練年長者
10:19
caring愛心 for themselves他們自己
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能自已照顧自己
10:21
as well as the care關心 provided提供 by their family家庭 members會員
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以及由家人提供照護
10:23
or volunteer志願者 community社區 health健康 workers工人,
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還有社區的健康照護志工
10:26
as well as have an exchange交換 network網絡 online線上,
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另外還有線上照護交換網站
10:28
where, for example, I can donate three hours小時 of care關心 a day to your mom媽媽,
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例如我每天照顧你媽三小時
10:31
if somebody else其他 can help me with transportation運輸 to meals,
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而有人可以幫我送餐點
10:34
and we exchange交換 all of that online線上.
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大家在網路上交換工作
10:37
The most important重要 point I want to make to you about this
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我要強調的重點是
10:39
is the sacred神聖 and somewhat有些 over-romanticized過浪漫
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可怕而又太理想化的
10:43
doctor-patient醫患 one-on-one一對一
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一對一醫病關係
10:45
is a relic遺跡 of the past過去.
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已成為過去式
10:48
The future未來 of health健康 care關心 is smart聰明 teams球隊,
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健康照護的未來是智慧團隊
10:50
and you'd better be on that team球隊 for yourself你自己.
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而你自己最好就是團隊的一員
10:54
Now, the last thing that I want to talk to you about
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我要談的最後一件事是
10:56
is care關心 customization定制,
246
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照護客製化
10:57
because if you've got care關心 anywhere隨地 and you've got care關心 networking聯網,
247
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因為照護行動化與照護網路化
11:00
those are going to go a long way towards improving提高 our health健康 care關心 system系統,
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要改善醫療系統,並非一蹴可幾
11:03
but there's still too much guesswork猜測.
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但現有醫療存在太多猜測
11:06
Randomized隨機 clinical臨床 trials試驗 were actually其實 invented發明 in 1948
250
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隨機臨床實驗是在1948年發明的
11:10
to help invent發明 the drugs毒品 that cured治愈 tuberculosis結核,
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用來發明治療結核病的藥
11:13
and those are important重要 things, don't get me wrong錯誤.
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那是很重要的事,別誤會
11:16
These population人口 studies學習 that we've我們已經 doneDONE have created創建
253
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這些全民研究幫忙創造了
11:17
tons of miracle奇蹟 drugs毒品 that have saved保存 millions百萬 of lives生活,
254
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許多新藥,救治了數百萬的生命
11:20
but the problem問題 is that health健康 care關心
255
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問題是,這種醫療照護
11:22
is treating治療 us as averages均線, not unique獨特 individuals個人,
256
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把我們當成平均數
而不是獨立的個人
11:27
because at the end結束 of the day,
257
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終究來說
11:28
the patient患者 is not the same相同 thing as the population人口
258
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病人和研究的平均數並不相同
11:31
who are studied研究. That's what's leading領導 to the guesswork猜測.
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所以必須要用猜的
11:35
The technologies技術 that are coming未來,
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新科技已經來臨
11:36
high-performance高性能 computing計算, analytics分析,
261
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電腦的高速運算、分析
11:39
big data數據 that everyone's大家的 talking about,
262
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大家都在講的大資料運算
(big data)
11:40
will allow允許 us to build建立 predictive預測 models楷模 for each of us
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可針對每個人建立預測模型
11:43
as individual個人 patients耐心.
264
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把每個人當作個別病人
11:45
And the magic魔法 here is, experiment實驗 on my avatar頭像
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更神奇的是可拿我的電腦分身實驗
11:50
in software軟件, not my body身體 in suffering痛苦.
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不必讓我身體受苦
11:55
Now, I've had two examples例子 I want to quickly很快 share分享 with you
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我有兩個案例很快和各位分享
11:57
of this kind of care關心 customization定制 on my own擁有 journey旅程.
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關於我親身經歷的照護客製化
12:00
The first was quite相當 simple簡單. I finally最後 realized實現 some years年份 ago
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第一個很簡單,我幾年前才瞭解
12:03
that all my medical teams球隊 were optimizing優化 my treatment治療 for longevity長壽.
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我的整個醫療團隊都在為
延長我的壽命而精進治療
12:07
It's like a badge徽章 of honor榮譽 to see how long they can get the patient患者 to live生活.
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能讓病人活得更久
他們就像得到榮譽徽章一樣
12:09
I was optimizing優化 my life for quality質量 of life,
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那時我想改善生活品質
12:13
and quality質量 of life for me means手段 time in snow.
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對我來說,生活品質就是
在雪地的時光
12:17
So on my chart圖表, I forced被迫 them to put, "Patient患者 goal目標:
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我強迫他們在病歷上寫:
「病人的目標為,
12:20
low doses劑量 of drugs毒品 over longer periods of time,
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長時間低劑量的用藥,
12:24
side effects效果 friendly友善 to skiing滑雪."
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副作用不影響滑雪。」
12:27
And I think that's why I achieved實現 longevity長壽.
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我想這就是我活得較久的原因
12:29
I think that time-in-snow時間在雪 therapy治療 was as important重要
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「雪地的時光」這項治療很重要
12:32
as the pharmaceuticals藥品 that I had.
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跟其他藥品一樣重要
12:34
Now the second第二 example of customization定制 -- and by the way,
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第二個客製化案例是…順道一提
12:36
you can't customize定制 care關心 if you don't know your own擁有 goals目標,
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如果你沒有目標,是無法客製化的
12:38
so health健康 care關心 can't know those until直到 you know your own擁有 health健康 care關心 goals目標.
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你要先有目標,醫療小組才會知道
12:41
But the second第二 example I want to give you is,
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但我要說的第二個案例
12:43
I happened發生 to be an early guinea幾內亞 pig,
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我剛好是個早期的白老鼠
12:45
and I got very lucky幸運 to have my whole整個 genome基因組 sequenced測序.
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我很幸運擁有完整的基因體定序
12:48
Now it took about two weeks of processing處理
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目前大約要花兩星期
12:51
on Intel's英特爾公司 highest-end最高端的 servers服務器 to make this happen發生,
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用英特爾最高速的伺服器定序
12:53
and another另一個 six months個月 of human人的 and computing計算 labor勞動
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再加上6個月的人工與電腦運算
12:56
to make sense of all of that data數據.
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以解讀所有資料
12:59
And at the end結束 of all of that, they said, "Yes,
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最後他們說:「成功了,
13:02
those diagnoses診斷 of that clash衝突 of medical titans巨頭
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醫界權威爭執多年的診斷
13:04
all of those years年份 ago were wrong錯誤,
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全都錯了,
13:06
and we have a better path路徑 forward前鋒."
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現在有更好的方向可以邁進。」
13:09
The future未來 that Intel's英特爾公司 working加工 on now is to figure數字 out
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英特爾正努力,希望能找出方法
13:11
how to make that computing計算 for personalized個性化 medicine醫學
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讓個人化醫療的運算
13:13
go from months個月 and weeks to even hours小時,
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由幾個月縮短到幾週,甚至幾小時
13:17
and make this kind of tool工具 available可得到,
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讓更多人可使用
13:19
not just in the mainframes大型機 of tier-one一線 research研究 hospitals醫院 around the world世界,
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不僅限於全球一流的教學醫院
13:22
but in the mainstream主流 -- every一切 patient患者, every一切 clinic診所
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而能成為主流-
讓每個病人、每間診所都可使用
13:25
with access訪問 to whole整個 genome基因組 sequencing測序.
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這種完整的基因體定序
13:27
And I tell you, this kind of care關心 customization定制
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這種照護客製化
13:30
for everything from your goals目標 to your genetics遺傳學
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從個人目標到基因體定序
13:33
will be the most game-changing改變遊戲規則 transformation轉型
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將是改變遊戲規則的大革命
13:34
that we witness見證 in health健康 care關心 during our lifetime一生.
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我們有生之年就可見證到
13:38
So these three pillars支柱 of personal個人 health健康,
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健康照護的三大支柱
13:41
care關心 anywhere隨地, care關心 networking聯網, care關心 customization定制,
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照護行動化、網路化、客製化
13:44
are happening事件 in pieces now,
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正逐步發生
13:45
but this vision視力 will completely全然 fail失敗 if we don't step up
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但這個願景可能完全失敗,如果
13:49
as caregivers護理人員 and as patients耐心 to take on new roles角色.
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醫護人員和患者不願扮演新的角色
13:53
It's what my friend朋友 Verna貝爾納 said:
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我朋友凡恩說得好:
13:54
Wake喚醒 up and take control控制 of your health健康.
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醒醒吧!你要主導自己的健康,
13:57
Because at the end結束 of the day these technologies技術
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有了這些科技
13:58
are simply只是 about people caring愛心 for other people
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最後還是「人」在照顧別人與自己
14:02
and ourselves我們自己 in some powerful強大 new ways方法.
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只是運用更好更新的方法
14:05
And it's in that spirit精神 that I want to introduce介紹 you
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這正是接下來我要很快介紹的
14:07
to one last friend朋友, very quickly很快.
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最後一位朋友的精神
14:10
Tracey特蕾西 GamleyGamley stepped加強 up to give me the impossible不可能 kidney
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翠西甘姆利(Tracey Gamley)
挺身而出,她捐出了
14:13
that I was never supposed應該 to have.
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我本來不可能得到的腎臟
14:18
(Applause掌聲)
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(掌聲)
14:34
So Tracey特蕾西, just tell us a little bit quickly很快 about what the donor捐贈者 experience經驗 was like with you.
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翠西,請很快分享一下
作為捐贈者的經驗
14:39
Tracey特蕾西 GamleyGamley: For me, it was really easy簡單.
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翠西:對我來說,真的很簡單
14:41
I only had one night in the hospital醫院.
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我只在醫院住了一夜
14:43
The surgery手術 was doneDONE laparoscopically腹腔鏡,
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手術是以腹腔鏡進行的
14:44
so I have just five very small scars傷疤 on my abdomen腹部,
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我的腹部只留下5個很小的疤痕
14:48
and I had four weeks away from work
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我有4個星期不能工作
14:50
and went back to doing everything I'd doneDONE before
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之後就完全回復到我原來的生活
14:52
without any changes變化.
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沒有任何改變
14:53
EDED: Well, I probably大概 will never get a chance機會 to say this to you
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艾瑞克:我可能再也沒有機會
14:56
in such這樣 a large audience聽眾 ever again.
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在這麼多人面前對妳說…
14:58
So "thank you" feel likes喜歡 a really trite平凡的 word,
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「謝謝你!」
感覺上好像老掉牙了
15:01
but thank you from the bottom底部 of my heart for saving保存 my life.
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但我打從心底感謝妳救了我一命
15:04
(Applause掌聲)
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(掌聲)
15:10
This TEDTED stage階段 and all of the TEDTED stages階段
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在 TED 講台上
15:12
are often經常 about celebrating慶祝 innovation革新
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大多都是讚揚創新發明
15:15
and celebrating慶祝 new technologies技術,
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以及新科技
15:16
and I've doneDONE that here today今天,
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這正是我剛才所做的
15:18
and I've seen看到 amazing驚人 things coming未來 from TEDTED speakers音箱,
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我也目睹了其他演講者的驚人成就
15:21
I mean, my gosh天哪, artificial人造 kidneys腎臟, even printable可印刷 kidneys腎臟, that are coming未來.
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天啊!人工腎臟、列印腎臟
可能都不再是夢想
15:25
But until直到 such這樣 time that these amazing驚人 technologies技術
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但在那些驚人科技實現
15:28
are available可得到 to all of us, and even when they are,
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還有普及之前,甚至於之後
15:31
it's up to us to care關心 for, and even save保存, one another另一個.
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都要靠我們彼此關愛,互相救助
15:35
I hope希望 you will go out and make personal個人 health健康 happen發生
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希望各位今後能夠讓
個人化健康照護實現
15:38
for yourselves你自己 and for everyone大家. Thanks謝謝 so much.
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為了你,也為了每個人
非常感謝
15:42
(Applause掌聲)
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(掌聲)
Translated by Maria Liu
Reviewed by Allen Li

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ABOUT THE SPEAKER
Eric Dishman - Social scientist
Eric Dishman does health care research for Intel -- studying how new technology can solve big problems in the system for the sick, the aging and, well, all of us.

Why you should listen

Eric Dishman is an Intel Fellow and general manager of Intel's Health Strategy & Solutions Group. He founded the product research and innovation team responsible for driving Intel’s worldwide healthcare research, new product innovation, strategic planning, and health policy and standards activities.

Dishman is recognized globally for driving healthcare reform through home and community-based technologies and services, with a focus on enabling independent living for seniors. His work has been featured in The New York Times, Washington Post and Businessweek, and The Wall Street Journal named him one of “12 People Who Are Changing Your Retirement.” He has delivered keynotes on independent living for events such as the annual Consumer Electronics Show, the IAHSA International Conference and the National Governors Association. He has published numerous articles on independent living technologies and co-authored government reports on health information technologies and health reform.

He has co-founded organizations devoted to advancing independent living, including the Technology Research for Independent Living Centre, the Center for Aging Services Technologies, the Everyday Technologies for Alzheimer’s Care program, and the Oregon Center for Aging & Technology.

More profile about the speaker
Eric Dishman | Speaker | TED.com

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