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EricDishman_2009P-_让医保脱离主体_
If you think about the phone -- and Intel has tested a lot of the things I'm going to show you, over the last 10 years, in about 600 elderly households -- 300 in Ireland, and 300 in Portland -- trying to understand: How do we measure and monitor behavior in a medically meaningful way? 如果你想想电话- 正如英特尔（intel）已经测试过的 我将向你展示 最近10年间的很多东西 在大约600个老年家庭中- 其中300个在爱尔兰,300个在波兰 正在尝试理解我们如何用一种 和观察行为 并以一种医学上有意义的方式？
Intel:n.美国英特尔公司(财富500强公司之一,以生产CPU芯片著称); elderly:adj.上了年纪的;过了中年的;稍老的; households:n.家庭;拆迁户;家户(household的复数); medically:adv.医学上地;医药上地; meaningful:adj.严肃的;重要的;重大的;意味深长的;
And if you think about the phone, right, it's something that we can use for some incredible ways to help people actually take the right medication at the right time . 如果你考虑一下电话,好 我们可以用一些不可思议的方式使用它 （比如）帮助人们在正确的时间服用正确的药物
incredible:adj.难以置信的,惊人的; medication:n.药;药物; at the right time:在适当时候;
We're testing these kinds of simple sensor-network technologies in the home so that any phone that a senior is already comfortable with can help them deal with their medications . 我们正在测试这些简单的 在家里使用的传感网络技术 任何与传感器适应良好的电话 都可以帮助他们处理药物
technologies:n.技术;科技(technology的复数); senior:adj.大;级别(或地位)高的;成人的;高级水平的;n.上级;上司;较…年长的人; medications:n.药;药物;(medication的复数)
And a lot of what they do is they pick up the phone, and it's our system whispering to them which pill they need to take, and they fake like they're having a conversation with a friend. 很多情况下他们做的就是拿起电话 然后我们的系统就会轻声对他们说,他们该吃那些药了 让他们觉得就像在跟朋友聊天
pill:n.[医]药丸;药品; fake:n.假货;骗子;假动作;v.捏造;假装…的样子;adj.伪造的;
And they're not embarrassed by a meds caddy that's ugly , that sits on their kitchen table and says, "I'm old. I'm frail ." 而不用对着一个厨房的桌子上的丑陋的药箱子 为难地说: 我老了,我很脆弱。”
embarrassed:adj.尴尬的;窘迫的;v.使...局促不安;(embarrass的过去分词和过去式) meds:n.药物: caddy:卡迪拉克(Cadillac); ugly:adj.丑陋的;邪恶的;令人厌恶的; frail:adj.脆弱的;虚弱的;n.灯心草篓;少妇;少女;
It's surreptitious technology that's helping them do a simple task of taking the right pill at the right time. 这项技术具有保密性 帮助他们完成一项简单的任务 即按时服药
surreptitious:adj.秘密的;鬼鬼祟祟的;暗中的; technology:n.技术;工艺;术语;
Now, we also do some pretty amazing things with these phones. 目前,我们还在电话上做了一些非常惊人事情
Because that moment when you answer the phone is a cognitive test every time that you do it. 因为当你在接电话的时候 每次做的都是一个认知的测试
cognitive:adj.认知的,认识的;
Think about it, all right? I'm going to answer the phone three different times. 想一下,好吗？我正在要接这三个不同的电话
'"Hello? Hey." “喂？是你啊。”
All right? That's the first time. 行吧？这是第一次
'"Hello? Uh, hey." “喂？噢,是你啊”
'"Hello? Uh, who? “喂？哦,谁？”
Oh, hey." “哦,是你啊”
All right? Very big differences between the way I answered the phone the three times. 对吧？非常大的差别 在我三次接电话中
And as we monitor phone usage by seniors over a long period of time, down to the tenths of a microsecond , that recognition moment of whether they can figure out that person on the other end 由于我们观测电话的使用 通过传感器,已经有很长时间了 （甚至观测细致到）数十微秒的程度 还有认出的时刻 他们是否能认出电话那头的对方是谁
usage:n.使用;利用;利用率;惯用法; seniors:n.年长者,老年人;资历较深的人(senior的复数形式); tenths:n.十分位(tenth的复数形式); microsecond:n.微秒;[计量]一百万分之一秒; recognition:n.识别;认识;承认;认可;
is a friend and we start talking to them immediately, or they do a lot of what's called trouble talk, where they're like, "Wait, who is this? Oh." Right? 是朋友的话,他们就立刻开始跟他们聊天 或者（没认出来）,他们就会做很多被称作麻烦对话的问话 都像这个样子,“等等,是谁呀？哦。”
Waiting for that recognition moment may be the best early indicator of the onset of dementia than anything that shows up clinically today. 今天临床显示, 等待认知时刻或许是最好的老年痴呆症发病早期显示器, 比什么都好。
indicator:n.指示器;[试剂]指示剂;[计]指示符;压力计; onset:n.开始,着手;发作;攻击,进攻; dementia:n.[内科]痴呆; clinically:adv.临床地;门诊部地;不偏不倚;通过临床诊断;
We call these behavioral markers . 我们称这些是行为的记录者。
behavioral:adj.行为的; markers:n.(表示方位的)标记,记号;标识;表示;记号笔;(marker的复数)
There's lots of others. Is the person going to the phone as quickly, when it rings, as they used to? 还有很多其它的方式。这个人是否跟原先一样, 电话一响就接了呢？
Is it a hearing problem or is it a physicality problem? 是听觉上的问题还是行动不便？
physicality:n.肉体性;
Has their voice gotten more quiet? We're doing a lot of work with people with Alzheimer's and particularly with Parkinson's, where that quiet voice that sometimes shows up with Parkinson's patients may be the best early indicator of Parkinson's five to 10 years before it shows up clinically. 还是声音变的轻了呢？我们研究了很多 患有阿尔茨海默氏症,特别是帕金森症的病人, 轻声可能是最好的 发现前期帕金森症的征兆, 比临床显现的要早5年到10年。
particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地; patients:n.接受治疗者,病人;(patient的复数)
But those subtle changes in your voice over a long period of time are hard for you or your spouse to notice until it becomes so extreme and your voice has become so quiet. 但是你声音的那些长时间的微妙改变 对于你和你的配偶来说是很难发现的,直到它恶化, 你的声音变得完全轻微的时候。
subtle:adj.微妙的;精细的;敏感的;狡猾的;稀薄的; spouse:n.配偶;vt.和…结婚; extreme:adj.极端的;极度的;偏激的;尽头的;n.极端;末端;最大程度;极端的事物;
So, sensors are looking at that kind of voice. 所以说,传感器就监视这种声音。
sensors:n.[自]传感器,感应器;感测器(sensor的复数);
When you pick up the phone, how much tremor are you having, and what is that like, and what is that trend like over a period of time? 当你接电话的时候, 你的声带震动了多少, 那是怎么样的,你以前又是什么状况的？
tremor:n.[医]震颤;颤动; trend:n.趋势;动向;趋向;动态;v.走向;趋向;
Are you having more trouble dialing the phone than you used to? 你打电话时是否感到比以前费劲儿？
Is it a dexterity problem? Is it the onset of arthritis ? 是灵活性的问题？还是关节炎的问题？
dexterity:n.灵巧;敏捷;机敏; arthritis:n.[外科]关节炎;
Are you using the phone? Are you socializing less than you used to? 你在打电话么？你是否比以前联系朋友的次数少了？
socializing:v.交往,交际;使适应社会;使社会主义化;(socialize的现在分词)
And looking at that pattern. And what does that decline in social health mean, as a kind of a vital sign of the future? 看那个模型。社交健康降低意味着什么呢, 是否算是一种来自未来的至关重要的信号呢？
decline:v.下降;衰退;减少;谢绝;n.下降; vital sign:n.生命体征(如呼吸、体温、心搏等);
And then wow, what a radical idea, we -- except in the United States -- might be able to use this newfangled technology to actually interact with a nurse or a doctor on the other end of the line. 哇,这是什么先进的想法, 我们,除了在美国, 可能能够使用这种新奇的科技 来与另一端的护士或医生们交流。
radical:n.自由基;激进分子;游离基;adj.根本的;彻底的;完全的;全新的; United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) newfangled:adj.新奇的;新流行的;最新式的;v.使流行(newfangle的过去式及过去分词); interact:v.互相影响;互相作用;n.幕间剧;幕间休息;
Wow, what a great day that will be once we're allowed to actually do those kinds of things. 当我们真的能这么做的时候, 该是多么美好的一天呀。
So, these are what I would call behavioral markers. 这就是我们所说的行为记录者。
And it's the whole field that we've been trying to work on for the last 10 years at Intel. 这是我们过去十年 在Intel公司所努力的。
How do you put simple disruptive technologies, and the first of five phrases that I'm going to talk about in this talk? 你如何将简单的全新技术用一句话讲出来, 我这次总共才打算说五句话？
disruptive:adj.破坏的;分裂性的;制造混乱的;
Behavioral markers matter. 行为记录者很重要。
How do we change behavior? 我们怎样才能改变行为呢？
How do we measure changes in behavior in a meaningful way that's going to help us with prevention of disease , early onset of disease , and tracking the progression of disease over a long period of time? 当它能帮助我们预防疾病, 早期疾病的爆发,记录疾病的长期进展, 我们怎样量化这样的行为 所带来的重大意义上的改变呢？
prevention:n.预防;阻止;妨碍; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; tracking:n.追踪,跟踪;v.跟踪;(track的现在分词) progression:n.前进;连续;
Now, why would Intel let me spend a lot of time and money, over the last 10 years, trying to understand the needs of seniors and start thinking about these kinds of behavioral markers? 现在,为什么Intel公司 让我花费无数的实践和金钱,数十年来, 试图了解老人的需要, 并试图了解这些行为记录者呢？
This is some of the field work that we've done. 这是我们已经了解的一些领域。
We have now lived with 1,000 elderly households in 20 countries over the last 10 years. 过去十年中,我们同20个国家的 1000多户老人生活在一起。
We study people in Rochester , New York. 我们研究纽约州罗切斯特市的人们。
Rochester:n.罗契斯特市(美国明尼苏达州一城市);
We go live with them in the winter because what they do in the winter, and their access to healthcare , and how much they socialize , is very different than in the summer. 我们一冬天都跟他们生活在一起, 因为他们在冬天的所作所为, 他们的医保,他们的社交 都跟他们在夏天的完全不一样。
healthcare:n.医疗保健;健康护理,健康服务;卫生保健; socialize:v.使社会化;使社会主义化;交际;参与社交; different than:不同于;
If they have a hip fracture we go with them and we study their entire discharge experience. 如果他们髋部骨折了,我们会跟随着他们, 研究他们的整个过程。
hip:n.臀部;蔷薇果;忧郁;adj.熟悉内情的;非常时尚的; fracture:n.(指事实)骨折;(指状态)断裂;破裂;v.(使)断裂;破裂;(使)分裂; discharge:v.履行;释放;排出;流出;n.出院;执行;退伍;排出(物);
If they have a family member who is a key part of their care network, we fly and study them as well. 如果他们有家庭成员是他们医保网络的重要部分, 我们就飞过去,研究他们。
So, we study the holistic health experience of 1,000 seniors over the last 10 years in 20 different countries. 所以说,在过去的10年中, 20多个不同的国家, 我们进行了1000多个传感器的整体健康试验。
holistic:adj.整体的;全盘的;
Why is Intel willing to fund that? 为什么Intel公司愿意资助我们呢？
fund:n.基金;资金;存款;v.投资;资助;
It's because of the second slogan that I want to talk about. 原因也正是我要讲到的第二个口号。
slogan:n.口号;标语;
Ten years ago, when I started trying to convince Intel to let me go start looking at disruptive technologies that could help with independent living, this is what I called it: "Y2K + 10." 10年前,当我刚刚开始向Intel公司游说 让我实施这个 能够帮助单独个体家庭的新奇的技术时, 我使用了“Y2K+10”这个口号。
convince:v.使确信;使相信;说服,劝说; independent:adj.独立的; n.无党派议员(或候选人等);
You know, back in 2000, we were all so obsessed with paying attention to the aging of our computers, and whether or not they were going to survive the tick of the clock from 1999 to 2000, that we missed a moment that only demographers were paying attention to. 你知道,在2000年的时候, 我们都着迷于 计算机的千年虫问题, 看他们是否能够 随着时钟从1999到2000的滴答声中幸存下来, 但我们却错过了人口学家所关注的时刻。
obsessed:v.使痴迷;使迷恋;使着迷;(obsess的过去式和过去分词) whether or not:是否…; demographers:n.[统计]人口统计学家,人口学家;
It was right around New Years. 那就在新年夜前后。
And that switchover , when we had the larger number of older people on the planet, for the first time than younger people. 那是个大转变, 这个星球上第一次 老年人比年轻人多。
switchover:n.转换;替换;
For the first time in human history -- and barring aliens landing or some major other pandemic , that's the expectation from demographers, going forward. 也是人类历史上的第一次,禁止外国人登陆 或者其他一些主要瘟疫, 那就是人口统计学的期望,又向前了一步。
pandemic:adj.(疾病等)全国流行的;普遍的;n.流行性疾病; expectation:n.预料;预期;期待;希望;指望;
And 10 years ago it seemed like I had a lot of time to convince Intel to work on this. Right? 10年前,看起来好像我有很多时间 劝说Intel公司研究这个。对吧？
Y2K + 10 was coming, the baby boomers starting to retire. Y2K+10正来临, 婴儿潮也正开始退却。
baby boomers:婴儿潮出生的一代人(babyboomer的名词复数);
Well folks, it's like we know these demographics here. 大伙看看,这就好像我们知道这些人口统计学似的。
demographics:n.人口统计资料;
This is a map of the entire world. 这是张世界地图。
It's like the lights are on, but nobody's home on this demographic 这就像灯是亮着的, 却没有人思考着人口统计学的
Y2K + 10 problem. Right? Y2K+10问题。对吧？
I mean we sort of get it here, but we don't get it here, and we're not doing anything about it. 我的意思是,我们好像是了解了,但是我们却没有真正了解。 我们没解决任何问题。
The health reform bill is largely ignoring the realities of the age wave that's coming, and the implications for what we need to do to change not only how we pay for care, but deliver care in some radically different ways. 医保改革大体上忽视了 正来临的老龄化 和我们需要做些什么来改变 不仅仅是我们如何支付医疗保健, 更是用一些完全不同的方式来实施医疗保健的影响。
reform:v.改革;改进;改良;(使)悔改;n.改革;改良;改善; largely:adv.主要地;大部分;大量地; ignoring:v.忽略,忽视;(ignore的现在分词); implications:n.蕴涵式;暗指,暗示;含蓄,含意;卷入(implication的复数); radically:adv.根本上;彻底地;以激进的方式;
And in fact, it's upon us. 实际上,这取决于我们。
I mean you probably saw these headlines. This is Catherine Casey who is the first boomer to actually get Social Security . 我的意思是,你可能读到过这些头条新闻。这是凯瑟琳凯西, 她是第一位实际上得到社会保障的婴儿潮出生的孩子。
Social Security:n.社会保障金(政府定期向贫穷、失业、患病等人发放);
That actually occurred this year. She took early retirement . 其实是今年发生的事。她选择提前退休。
occurred:v.发生;出现;存在于;出现在;(occur的过去分词和过去式) retirement:n.退休;退职;退休年龄;退休生活;
She was born one second after midnight in 1946. 她在1946年的午夜1秒钟后出生的。
A retired school teacher, there she is with a Social Security administrator . 她是一位退休的学校老师。 这是她同她的社保人员在一起,
administrator:n.管理人;行政官;
The first boomer actually, we didn't even wait till 2011, next year. 第一位婴儿潮出生的人,我们还没等到2011年,也就是明年。
We're already starting to see early retirement occur this year. 我们已经看到了今年提前退休的人们。
All right, so it's here. This Y2K + 10 problem is at our door. 好,现在。这个Y2K+10问题就在我们家门口。
This is 50 tsunamis scheduled on the calendar , but somehow we can't sort of marshal our government and innovative forces to sort of get out in front of it and do something about it. We'll wait until it's more of a catastrophe , and react , as opposed to prepare for it. 日历上记录着50个海啸。 但是不知何故,我们没能够鼓舞我们的政府, 没能够激发出力量 来做点什么。我们只是等待着, 直到发生更多的灾难后才有反应, 而不是提前准备好。
tsunamis:n.海啸;津波(tsunami的复数); calendar:n.日历;挂历;v.把…记入日程表中; somehow:adv.以某种方法;莫名其妙地; marshal:n.元帅;司仪;执行官;v.收集;安排;控制人群; innovative:adj.革新的,创新的; catastrophe:n.大灾难;大祸;惨败; react:v.起反应;回应;(对食物等)有不良反应,过敏;起化学反应; opposed:adj.强烈反对; v.反对(计划、政策等); (oppose的过去分词和过去式)
So, one of the reasons it's so challenging to prepare for this Y2K problem is, I want to argue, we have what I would call mainframe poisoning. 所以说,备战Y2K问题很富有挑战性的 众多原因之一是, 我想争辩一下,我们有我称之为 主体中毒的东西。
mainframe:n.[计]主机;大型机;
Andy Grove , about six or seven years ago, he doesn't even know or remember this, in a Fortune Magazine article he used the phrase "mainframe healthcare," 安迪 格鲁夫,大约在六到七年前, 他甚至都不知道或不记得这个了,在一期财富杂志的文章中 他用到了“主体医保”的词语,
Grove:n.小树林;果园; Fortune:n.财富;命运;运气;v.给予财富,偶然发生
and I've been extending and expanding this. 我就一直在扩展这个词语。
extending:v.使伸长;扩大;扩展;延长;(extend的现在分词) expanding:v.扩大,增加,增强细谈;详述;(expand的现在分词)
He saw it written down somewhere. He's like, "Eric that's a really cool concept." 他看到这个词语出现在一些地方。 他说了类似这样的话“埃里克,那个点子真棒。”
I was like, "Actually it was your idea. You said it in a Fortune Magazine article. 我就说了类似这样的话“实际上那是你的点子。是你在一期财富杂志的文章中说过的。
I just extended it." 而我只是将它扩展了。”
extended:adj.延长了的;扩展了的;v.使伸长;扩大;扩展;(extend的过去式和过去分词)
You know, this is the mainframe. 你知道,这也是个主体。
This mentality of traveling to and timesharing large, expensive healthcare systems actually began in 1787. 旅游和 分期巨额的医保系统的想法 实际开始于1787年。
mentality:n.心态;[心理]智力;精神力;头脑作用; timesharing:n.分时;v.时间划分(timeshare的ing形式);
This is the first general hospital in Vienna. 第一个普通医院建立在维也纳。
And actually the second general hospital in Vienna, in about 1850, was where we started to build out an entire curriculum for teaching med students specialties . 实际上维也纳的第二个普通议员 是在大约1850年,也是在我们准备扩建 医药学生的整个课程的地方。
curriculum:n.课程;总课程; specialties:n.特别;专长;特性(specialty的复数);
And it's a place in which we started developing architecture that literally divided the body, and divided care into departments and compartments . 我们开始发展 人体构造建筑学的地方, 将保健分散到不同的部门和机构中。
architecture:n.建筑学;建筑风格;建筑式样;架构; literally:adv.按字面:字面上:确实地: compartments:n.隔间;分隔间,隔层;(compartment的复数)
And it was reflected in our architecture, it was reflected in the way that we taught students, and this mainframe mentality persists today. 我们的建筑学也受其影响。 我们教学生的方式也受其影响。 这个主体在精神上持续到今天。
reflected:adj.反射的;得自他人的;v.反射;思考;(reflect的过去式和过去分词) in the way:妨碍;挡道; persists:vi.存留,坚持;持续,固执;vt.坚持说,反复说;
Now, I'm not anti-hospital. 我并不是反对医院。
With my own healthcare problems, I've taken drug therapies , 我使用药物疗法的医保问题是,
therapies:n.治疗方法(therapy复数形式);
I've traveled to this hospital and others, many, many times. 我的从一个医院到另一个医院,许多许多次。
But we worship the high hospital on a hill. Right? 但是我们把医院放在一个很高的位置上。对吧？
worship:n.崇拜;崇敬;爱慕;阁下;v.崇拜(上帝或神);做礼拜;热爱;崇拜;
And this is mainframe healthcare. 这个就是主体的医保。
And just as 30 years ago we couldn't conceive that we would have the power of a mainframe computer that took up a room this size in our purses and on our belts , 就在30年前, 我们还不能够想象到我们能够有一台 具有主体计算机的能力,却只有 我们的钱包和皮带大小,
conceive:v.想出;想象;构想;设想;怀孕; purses:n.钱包;资金;财源;v.抽紧;把…放进钱袋;(purse的第三人称单数和复数) belts:n.皮带(belt的复数);带子;v.用皮带等围绕;用带扎牢(belt的三单形式);
that we're carrying around in our cell phone today, and suddenly, computing , that used to be an expert driven system, it was a personal system that we all owned as part of our daily lives -- that shift from mainframe to personal computing is what we have to do for healthcare. 我们今天可以随时随地用手机带着它。 突然间,计算机化, 原先只是个专家驱动系统, 是一个个人系统,我们把它作为我们日常生活的一部分。 那个从主体到个人化的转变 是我们需要在医保改革中做的。
computing:n.计算;计算机技术;信息处理技术;v.计算;求出;(compute的现在分词) personal:adj.个人的;身体的;亲自的;n.人事消息栏;人称代名词; shift:n.移动;变化;手段;轮班;v.移动;转变;转换;
We have to shift from this mainframe mentality of healthcare to a personal model of healthcare. 我们需要从这个主体医保的想法转变到 以个人为模型的医保。
We are obsessed with this way of thinking. 我们对这个想法着迷。
When Intel does surveys all around the world and we say, "Quick response : healthcare." 当Intel公司对全世界做调研时,我们说, “快速回复,医保。”
surveys:n.调查(survey的复数); response:n.响应;反应;回答;
The first word that comes up is "doctor." 出现的第一个词就是医生。
The second that comes up is "hospital." And the third is "illness" or "sickness." Right? 出现的第二个词就是医院。第三个是疾病。对吧？
We are wired, in our imagination , to think about healthcare and healthcare innovation as something that goes into that place. 我们被束缚着,在我们的想象中,生了病联想到到医保 和医保创新,就好像是件 理所应当的事。
imagination:n.想象;想象力;创造力;想象的事物; innovation:n.创新,革新;新方法;
Our entire health reform discussion right now, health I.T., when we talk with policy makers, equals "How are we going to get doctors using electronic medical records in the mainframe?" 我们现在的整个医疗改革争论, 健康I.T.,当我们同制度的制定者谈话时 等于我们如何要医生使用 主体电子医药记录？
policy:n.政策,方针;保险单; electronic:adj.电子的;电子器件的;电子设备的;
We're not thinking about how do we shift from the mainframe to the home. 我们没有想过 如果将主体转变到家庭。
And the problem with this is the way we conceive healthcare. Right? 这个的问题是 我们想到医保的方式。对吧？
This is a very reactive , crisis-driven system. 这是个多反应,危机驱动的系统。
reactive:adj.反应的;电抗的;反动的;
We're doing 15-minute exams with patients. 我们对患者做了15分钟的试验。
It's population-based . 基于人口。
population-based:基于人群的;
We collect a bunch of biological information in this artificial setting, and we fix them up, like Humpty-Dumpty all over again, and send them home, and hope -- we might hand them a brochure , maybe an interactive website -- that they do as asked and don't come back into the mainframe. 我们集合了一些生物学的信息。 将它们整合,就像玩Humpty-Dumpty一样, 然后送他们回家, 再希望,我们给他们一本小册子,或许还有一个交互式的网站, 通过网站,他们按照所要求的行动,不再回到主体中来。
a bunch of:一群;一束;一堆; biological:adj.生物学的;生物的;与生命过程有关的;加酶的;n.[药]生物制品; artificial:adj.人造的;仿造的;虚伪的;非原产地的;武断的; Humpty-Dumpty:adj.矮胖的;粗短的; brochure:n.手册,小册子; interactive:adj.合作的;相互影响的;互相配合的;交互式的;n.交互式视频设备;
And the problem is we can't afford it today, folks. 问题是,大伙们,我们今天还无法担负这个系统。
afford:v.给予,提供;买得起;
We can't afford mainframe healthcare today to include the uninsured . 我们担负不起要求现在的主体医保包括那些没有保险的。
uninsured:adj.未保过险的;
And now we want to do a double-double of the age wave coming through? 现在我们希望能有双重保险 在老龄化来的时候？
Business as usual in healthcare is broken and we've got to do something different. 做医保生意同以往一样不景气,我们需要做些不同的事情。
Business as usual:na.照常营业;
We've got to focus on the home. 我们需要关注家庭。
We've got to focus on a personal healthcare paradigm that moves care to the home. How do we be more proactive , prevention-driven? 我们需要关注个人医保例子 那些将保健带到家的例子。我们如何变得更积极主动, 更加保护驱动呢？
paradigm:n.范例;词形变化表; proactive:adj.前摄的(前一活动中的因素对后一活动造成影响的);
How do we collect vital signs and other kinds of information 24 by 7? 我们如何24小时一周7天的不间断地收集重要信号和其他的信息呢？
How do we get a personal baseline about what's going to work for you? 我们如何知晓如何为你工作的个人底线呢？
baseline:n.基线;底线;
How do we collect not just biological data but behavioral data, psychological data, relational data, in and on and around the home? 我们如何收集不仅仅是生物学数据 还有行为数据,心理学数据, 人际关系数据,跟整个家庭相关的方方面面的数据呢？
psychological:adj.心理的;心理学的;精神上的; relational:adj.相关的;亲属的;
And how do we drive compliance to be a customized care plan that uses all this great technology that's around us to change our behavior? 我们如何驱动个人化的保健方案 来改变我们的行为, 这个保健方案使用了我们周围的伟大科技？
compliance:n.顺从,服从;承诺; customized:v.订制,订做,改制;(customize的过去分词和过去式)
That's what we need to do for our personal health model. 这就是我们自身的医保模式所需要的。
I want to give you a couple of examples. This is Mimi from one of our studies -- in her 90s, had to move out of her home because her family was worried about falls. 我来给你们一些例子。这是咪咪- 我们研究对象之一- 她90岁的时候,离开了家 因为她的家人担心她会摔倒。
Raise your hand if you had a serious fall in your household, or any of your loved ones, your parents or so forth. Right? 如果在你家,有过严重的摔倒, 不论是你,还是你的爱人, 你的父母还是其他人,请举起你的手。对吧？
Classic . Hip fracture often leads to institutionalization of a senior. 太经典了。髋部骨折通常导致老年人的日常生活。
Classic:n.名著;优秀的典范;adj.最优秀的;第一流的;有代表性的;典型的; institutionalization:n.制度化;体制化;
This is what was happening to Mimi; the family was worried about it, moved her out of her own home into an assisted living facility . 这就是发生在咪咪身上的事情,她全家都很担心, 所以将她搬了出来,搬到一所养老院。
facility:n.设施;设备;特别装置;特色;场所;天资;
She tripped over her oxygen tank. 她的氧气罐绊倒了她。
tripped:v.绊;绊倒;将…绊倒;使跌倒;脚步轻快地走;(trip的过去分词和过去式)
Many people in this generation won't press the button, even if they have an alert call system, because they don't want to bother anybody, even though they've been paying 30 dollars a month. 这代人中的大多数人都不会按下按钮, 即便他们有报警系统,因为他们不想麻烦别人, 即便他们每月支付30美金。
alert:n.警报; adj.警觉的; v.向…报警; bother:v.烦扰,打扰;使…不安;操心,麻烦;n.麻烦;烦恼;
Boomers will press the button. Trust me. 婴儿潮出生的人会按下按钮。相信我。
They're going to be pressing that button non-stop . Right? 他们会不停的按下按钮的。对吧?
non-stop:adj.直达的;中途不停的;adv.不停地;
Mimi broke her pelvis , lay all night, all morning, finally somebody came in and found her, sent her to the hospital. 咪咪的骨盆骨折了,她就那样躺了一整天,一整夜, 终于有人进来发现了她, 将她送进了医院。
pelvis:n.骨盆; finally:adv.终于;最终;(用于列举)最后;彻底地;
They fixed her back up. She was never going to be able to move back into the assisted living. They put her into the nursing home unit. 他们固定住了她的背部。她永远也不能够搬回 养老院了。他们将她送进了护理之家。
nursing home:养老院;
First night in the nursing home unit where she had been in the same assisted living facility, moved her from one bed to another, kind of threw her, rebroke her pelvis, 在护理之家的第一个夜晚, 也是她原先呆过的养老院,他们将她从一张床移到另一张床, 动作大了点,结果造成她的骨盆再次骨折。
home unit:用法,发音,音标,搭配,同义词,反义词和例句等在线英语服务。
sent her back to the hospital that she had just come from, no one read the chart, put her on Tylenol , which she is allergic to, broke out, got bedsores , basically , had heart problems, and died from the fall and the complications and the errors that were there. 她又被送到她刚刚出院的那家医院, 没有人看过病历,就给她泰诺, 可是她对泰诺过敏,过敏症爆发后,她得了褥疮, 基本上,还有心脏的问题,最后她在摔倒后和并发症以及种种错误下 去世了。
Tylenol:n.泰勒诺,泰诺(药品扑热息痛的一种品牌); allergic:adj.对…过敏的;对…极讨厌的; bedsores:n.褥疮; basically:adv.主要地,基本上;
Now, the most frightening thing about this is this is my wife's grandmother. 现在,这个最可怕的是, 这是我妻子的祖母。
frightening:adj.可怕的;骇人的;引起恐惧的;v.使惊吓;使惊恐(frighten的现在分词)
Now, I'm Eric Dishman. I speak English, 我是埃里克迪什曼。我讲英语。
I work for Intel, I make a good salary, 我为Intel公司工作。我挣的钱不少。
I'm smart about falls and fall-related injuries -- it's an area of research that I work on. 对于跟摔倒相关的损伤我很注意。 这是我工作的研究领域。
injuries:n.伤害,损伤;挫伤;(injury的复数)
I have access to senators and CEOs. 我能接触到参议员和CEO。
senators:n.参议员(senator的复数);
I can't stop this from happening. 我不能够阻止这样的事情继续发生。
What happens if you don't have money, you don't speak English or don't have the kind of access to deal with these kinds of problems that inevitably occur? 如果你没有钱,也不会英语, 或者也没有什么人能接触 来解决这样不可避免发生的问题,又会发生些什么呢？
inevitably:adv.不可避免地;必然地;
How do we actually prevent the vast majority of falls from ever occurring in the first place ? 我们实际上如何首先阻止 绝大多数摔倒的发生？
majority:n.大部分:大多数:多数票:成年人: occurring:n.事件;事故;事变; in the first place:首先;起初;
Let me give you a quick example of work that we're doing to try to do exactly that. 让我给你们一个简短的例子,来展示给你们 我们正在从事的工作。
I've been wearing a little technology that we call Shimmer . 一种我们成为Shimmer的科技。
Shimmer:n.微光;闪光;vi.闪烁;发闪烁的微光;vt.使闪烁;
It's a research platform . 它是一个研究平台。
platform:n.平台; v.把…放在台上[放在高处;
It has accelerometry. You can plug in a three-lead ECG. 它有个加速器。你能插入一个3导联心电图。
plug:n.插头;塞子;栓;v.塞住;用插头将与电源接通;
There is all kinds of sort of plug-and-play kind of Legos that you can do to capture , in the wild, in the real world, things like tremor, gait , stride length and those kinds of things. 那里有所有种类的即插即用的 像乐高一样的装置,你可以捕获,野生的, 现实世界的, 像震颤,步态, 步幅,以及那类的信息。
plug-and-play:n.一种不必经由用户复杂安装即可使用的软件,即插即用; Legos:n.乐高玩具(德国一个积木玩具品牌); capture:v.俘虏;捕获;攻占;夺得;刻画,描述;n.(被)捕获;(被)俘获 gait:n.步法,步态;v.训练步法; stride:n.大步;步幅;进展;v.跨过;大踏步走过;跨坐在…;
The problem is, our understanding of falls today, like Mimi, is get a survey in the mail three months after you fell, from the State, saying, "What were you doing when you fell?" 问题是,我们对摔倒的理解,在今天, 像咪咪,就是在你摔到三个月后收到一封调查邮件, 它来自于州政府,上面写着“你跌倒的时候在干什么？”
That's sort of the state of the art . 这也算是一种州政府的艺术。
state of the art:adj.最先进的;已经发展的;达到最高水准的;
But with something like Shimmer, or we have something called the Magic Carpet , embedded sensors in carpet, or camera-based systems that we borrowed from sports medicine, 但是,当有了像Shimmer一类,或者我们称之为神奇地谈的帮助, 将监控器放入地毯中,或者一个从运动医学借鉴来的 基于摄像头的系统,
Magic Carpet:n.(可载人飞行的)魔毯; embedded:adj.嵌入式的;植入的;内含的;v.嵌入(embed的过去式和过去分词形式);
we're starting for the first time in those 600 elderly households to collect actual kinematic motion data to understand: What are the subtle changes that are occurring that can show us that mom has become risk at falls? 我们第一次向600个老年住户 收集实际的运动学移动数据 来了解正在发生的微妙变化是什么 这也向我们显示了妈妈也存在摔倒的风险。
kinematic:adj.[力]运动学上的,[力]运动学的; motion:n.动作;移动;手势;请求;意向;议案;v.运动;打手势;
And most often we can do two interventions , fix the meds mix. 最多的,我们能做两种干预, 修复医药合剂。
interventions:n.[法]干预,干涉;处置(intervention的复数);
I'm a qualitative researcher, but when I look at these data streams coming in from these homes, I can look at the data and tell you the day that some doctor prescribed them something that nobody else knew that they were on, because we see the changes in their patterns in the household. Right? 我是一名定性的研究人员,但是当我看到这些来自于 这些家庭的数据时,我能够通过这些数据告诉你有一天 医生会给他们开处方, 没有人能够察觉。因为我们看到的改变 就发生在他们的家中。对吧?
qualitative:adj.定性的;质的,性质上的; prescribed:v.给…开(药); (prescribe的过去式和过去分词)
These discoveries of behavioral markers, and behavioral changes are game changing, and like the discovery of the microscope because of our collecting data streams that we've actually never done before. 这些行为记录者的发明, 和行为的改变 改变了游戏规则,就像显微镜的发明一样 因为我们收集数据的方法是我们从来没有使用过的。
microscope:n.显微镜;
This is an example in our TRIL Clinic in Ireland of -- actually what you're seeing is she's looking at data, in this picture, from the Magic Carpet. 这是一个发生在爱尔兰的Trill诊所的例子 是关于...你们自己看吧, 她在读取 照片里的数据,来自于神奇地毯。
So, we have a little carpet that you can look at your amount of postural sway , and look at the changes in your postural sway over many months. 所以,一块小地毯你可以看到你自己的状态, 还能看到数月中你自己状态的改变。
postural:adj.姿势的,位置的;心态的; sway:n.影响;摇摆;摆动;统治;v.摇动;说服;使相信;使动摇;
Here's what some of this data might look like. 这里是一些数据可能出现的样子。
This is actually sensor firings . 这个实际上是传感器
firings:n.开火;烧制;解雇;生火;v.开火;烧制;解雇(fire的ing形式);点燃;激励;
These are two different subjects in our study. 我们的研究有两个不同的主题。
It's about a year's worth of data. 大约是一年的数据。
The color represents different rooms they are in the house. 颜色代表了房屋中不同的房间。
represents:v.代表;维护…的利益;相当于;(represent的第三人称单数)
This person on the left is living in their own home. 左边的这个人住在他们自己的屋子里。
This person on the right is actually living in an assisted living facility. 右边的这个人实际上住在养老院。
I know this because look at how punctuated meal time is when they are no longer in their particular rooms here. Right? 我知道这些是因为当他们不住在自己的屋子时, 他们的吃饭时间都很准。对吧？
punctuated:vt.不时打断;强调;加标点于;vi.加标点;
Now, this doesn't mean that much to you. 现在,这些对你并不重要。
But when we look at these cycles of data over a longer period of time -- and we're looking at everything from motion around different rooms in the house, to sort of micro-motions that Shimmer picks up, 但是,当你看到长时间的 整体数据时,我们能从 房屋中不同房间的动态看出任何信息, 像Shimmer收集的微观动态,
about gait and stride length -- these streams of data are starting to tell us things about behavioral patterns that we've never understood before. 关于步态和步幅,这些数据 告诉我们行为模式, 一些我们从来不知道的模式。
You can go to ORCATech.org -- it has nothing to do with whales, it's the Oregon Center for Aging and Technology -- to see more about that. 你可以查看ORCATech.org- 这跟鲸鱼没有关系,这是俄勒冈州的老龄化技术中心- 得知更多的信息。
Oregon:n.俄勒冈州(美国州名);
The problem is, Intel is still one of the largest funders in the world of independent living technology research. 问题是,Intel公司仍然是 世界上独立生活技术研发的 最大的资助者之一。
I'm not bragging about how much we fund; it's how little anyone else actually pays attention to aging and funds innovation on aging, chronic disease management and independent living in the home. 我没有吹牛我们有多少资金, 其他人实际注意到的 老龄化和用于老龄化的资金很少, 慢性疾病管理,独立生活在家。
bragging:v.吹嘘;自吹自擂;(brag的现在分词) funds:n.[会计]资金,现金(fund的复数);基金;v.资助(fund的三单形式);提供资金; chronic:adj.慢性的;长期的;习惯性的; management:n.管理;管理人员;管理部门;操纵;经营手段;
So, my mantra here, my fourth slogan is: 10,000 households or bust . 所以,我的咒语,我第四个口号是: 要么是10,000户家人或者是一无所有。
mantra:n.咒语(尤指四吠陀经典内作为咒文或祷告唱念的);颂歌; bust:n.(石或金属的)半身像; v.打破; adj.破碎;
We need to drive a national, if not international, Framingham-type heart study of independent living technologies, where we have 10,000 elderly connected households with broadband , full medical characterization , and a platform by which we can start to experiment and turn these from 20-household anecdotal studies that the universities fund, to large clinical trials that prove out the value of these technologies. 我们需要驱使 整个国家,即使不是国际间的,像弗雷明汉式心脏研究一样的 做对独立生活技术的研究, 这样10000连在一起的老年住户 有着宽带,全套的医疗设施, 一个我们可以开始试验的平台 将大学基金资助的 20位住户研究, 变成大型的临床试验来证明这些科技的价值。
broadband:n.宽频;宽波段;adj.宽频带的;宽波段的;宽频通讯的; characterization:n.描述;特性描述; anecdotal:adj.轶事的;轶事一样的;多轶事的;
So, 10,000 households or bust. 所以说,要么是10000住户,要么是一无所有。
These are just some of the households that we've done in the Intel studies. 这只是我们在Intel研究中所研究的一些住户。
My fifth and final phrase: 我的第五个,也是最后一个口号是:
I have tried for two years, and there were moments when we were quite close, to make this healthcare reform bill be about reform from something and to something, from a mainframe model to a personal health model, or to mean something more than just a debate about the public option and how we're going to finance . 我试了两年, 有过几次我们离 改革医保非常近了 就是将一些事改革成另一些事。 从主体模型 到个人健康模型, 或者不仅仅是一场关于 公众选择和我们将如果投资的辩论。
debate:n.辩论;争论;考虑;v.辩论;争论;考虑; option:n.选择;可选择的东西; finance:n.财政,财政学;金融;v.负担经费,供给…经费;
It doesn't matter how we finance healthcare. 我们如何投资医保其实并不重要。
We're going to figure something out for the next 10 years, and try it. 我们只是想把事情弄明白 在接下来的10年内,然后试验。
No matter who pays for it, we better start doing care in a fundamentally different way and treating the home and the patient and the family member and the caregivers as part of these coordinated care teams 谁来支付这个并不重要, 我们最好以一种根本不同的方式开始关心 和对待家庭和病人 以及家庭成员,和护理人员 把他们当作互相协调的团队
fundamentally:adv.从根本上;基础地;重要地 treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) caregivers:n.照顾者;看护人(caregiver的复数); coordinated:v.使协调;使相配合;搭配,协调;(coordinate的过去分词和过去式)
and using disruptive technologies that are already here to do care in some pretty fundamental different ways. 用这里已经有的全新技术 以完全不同的方式来护理。
The president needs to stand up and say, at the end of a healthcare reform debate, "Our goal as a country is to move 50 percent of care out of institutions , clinics , hospitals and nursing homes, to the home, in 10 years." 领导人应该站起来说, 这是医保改革争论的结尾, “我们作为一个国家的目标是将百分之五十的保健 从机构,诊所,医院和护理之家分离, 移到家庭,在未来的10年内。”
institutions:n.机构;慈善机构;风俗习惯,制度;(institution的复数) clinics:n.诊所(clinic的复数形式);
It's achievable . We should do it economically , we should do it morally , and we should do it for quality of life. 我们可以做到的。我们要从经济上这么做。 我们要从道义上这么做。 从生活品质上这么做。
achievable:adj.可完成的;可有成就的;做得成的; economically:adv.经济地;在经济上;节俭地; morally:adv.道德上;有道德地;确实地;
But there is no goal within this health reform. 但是,这项医保改革是没有目标的。
It's just a mess today. 今天只是一团乱。
mess:n.混乱;餐厅;杂乱;肮脏;v.使不整洁;弄脏;弄乱;随地便溺;
So, you know, that's my last message to you. 你知道,这是我给你们的最后的讲话。
How do we set a going-to-the-moon goal of dealing with the Y2K +10 problem that's coming? 我们要如何完成这个像去月球一样的 解决即将来临的Y2K+10的问题的目标？
It's not that innovation and technology is going to be the magic pill that cures all, but it's going to be part of the solution . 创新和技术不会成为 万灵药,但是却是解决方法的一部分。
solution:n.解决方案;溶液;溶解;解答;
And if we don't create a personal health movement, something that we're all aiming towards in reform, then we're going to move nowhere . 如果我们不创造出一个个人健康运动, 一个我们改革的方向, 我们将无所去处。
nowhere:v.无处; n.无处; adj.不存在的;
So, I hope you'll turn this conference into that kind of movement forward. 所以,我希望你把这场会议看成一种运动。
conference:n.会议;研讨会;商讨会;体育协会(或联合会)
Thanks very much. 谢谢大家
(Applause) （鼓掌）