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NielsvanNamen_2018S-_为什么未来的医院在你自己家中_
Probably not a surprise to you, but I don't like to be in a hospital or go to a hospital. 也许你不会惊讶, 我不喜欢呆在医院, 或去医院看病。
Do you? 你喜欢吗？
I'm sure many of you feel the same way, right? 我相信你们很多人 有同样的感受,对吗？
But why? Why is it that we hate hospitals so much? 但为什么？为什么我们如此厌恶医院？
Or is it just a fact of life we have to live with? 这不是生活中不可避免的一个事实吗？
Is it the crappy food? 是难吃的病号饭？
crappy:adj.蹩脚的;糟糕的;没价值的;
Is it the expensive parking? 是昂贵的停车费？
Is it the intense smell? 是强烈的药水气味？
intense:adj.强烈的;紧张的;非常的;热情的;
Or is it the fear of the unknown? 或者是对未知的恐惧？
Well, it's all of that, and it's more. 全部都有,而且不止这些。
Patients often have to travel long distances to get to their nearest hospital, and access to hospital care is becoming more and more an issue in rural areas, in the US, but also in sparsely populated countries like Sweden. 病人常常需要赶很长一段路 才能到最近的医院, 而且在美国的乡村地区 要获得医院护理 越来越成问题, 在瑞典这样人口稀少的国家也是如此。
Patients:n.接受治疗者,病人;(patient的复数) issue:n.重要议题;争论的问题;v.宣布;公布;发出;发行; rural:adj.农村的,乡下的;田园的,有乡村风味的; sparsely:adv.稀疏地;贫乏地; populated:v.生活于;
And even when hospitals are more abundant , typically the poor and the elderly have trouble getting care because they lack transportation that is convenient and affordable to them. 即便当医院资源更加充裕时, 特别是穷人和老人也通常 因为缺乏便利,廉价的交通 而无法获得医疗服务。
abundant:adj.丰富的;充裕的;盛产; typically:adv.代表性地;作为特色地; elderly:adj.上了年纪的;过了中年的;稍老的; transportation:n.运输;运输系统;运输工具;流放; convenient:adj.实用的;便利的;方便的; affordable:adj.负担得起的;
And many people are avoiding hospital care altogether, and they miss getting proper treatment due to cost. 许多人甚至完全避开医疗治疗, 为了节省开销而错过了 合适的治疗。
treatment:n.治疗;疗法;对待;处理;讨论;
We see that 64 percent of Americans are avoiding care due to cost. 我们可以看到,有64%的美国人 因为费用问题而避免医疗服务。
And even when you do get treatment, hospitals often make us sicker. 即便你接受了治疗, 医院也常常会让我们病情加重。
Medical errors are reported to be the third cause of death in the US, just behind cancer and heart disease , the third cause of death. 据报道,医疗事故是 美国的第三大致死因素, 仅次于癌症和心脏疾病, 第三大死因。
cancer:n.癌症;恶性肿瘤; disease:n.病,[医]疾病;弊病;vt.传染;使…有病;
I'm in health care for over 20 years now, and I witness every day how broken and how obsolete our hospital system is. 我从事医疗行业已经20多年了, 每天我都见证着我们的医院系统 是如此的破败和落后。
health care:n.卫生保健; witness:n.证人;目击者;证据;v.目击;证明;为…作证; obsolete:adj.废弃的;老式的;n.废词;陈腐的人;vt.淘汰;废弃;
Let me give you two examples. 让我给你们两个例子。
Four in 10 Japanese medical doctors and five in 10 American medical doctors are burnt out. 10个日本医生中有4个, 10个美国医生中有5个 已经在超负荷工作了。
In my home country, the Netherlands, only 17 million people live there. 在我的祖国,荷兰, 只有1700万人口。
We are short 125,000 nurses over the coming years. 在未来几年,我们会缺少12.5万名护士。
But how did we even end up here, in this idea of placing all kinds of sick people together in one big building? 但我们是怎么走到这一步的, 把所有病人都集中到 一幢大楼里的？
Well, we have to go back to the Ancient Greeks. 这就要追溯到古希腊时期。
In 400 BC, temples for cure were erected where people could go to get their diagnosis , their treatment and their healing . 公元前400年,人们建造了治病的庙宇, 病人在那里可以得到诊断, 治疗和恢复。
erected:adj.直立的;正立的;v.建立;竖立(erect的过去分词); diagnosis:n.诊断; healing:n.康复; adj.痊愈中的; v.(使)康复,复原; (heal的现在分词)
And then really for about 2,000 years, we've seen religious care centers all the way up to the Industrial Revolution , where we've seen hospitals being set up as assembly lines 在之后的2000年间, 我们看到了教会的护理中心, 直到进入工业革命时期, 我们看到医院基于工业革命的原则,
religious:adj.宗教的;虔诚的;严谨的;修道的;n.修道士;尼姑; Industrial Revolution:n.工业革命; assembly:n.装配;集会,集合;
based on the principles of the Industrial Revolution, to produce efficiently and get the products, the patients in this case, out of the hospital as soon as possible. 像流水线那样尽快产出产品, 提升了生产效率, 在医院的案例中,产品变成了病人, 以让他们尽快走出医院。
principles:n.原则;主义;本质;政策;(principle的复数) efficiently:adv.有效地;效率高地(efficient的副词形式); as soon as:一…就;
Over the last century, we've seen lots of interesting innovations . 在过去一个世纪中, 我们看到了很多有趣的创新。
innovations:n.创新(innovation的复数);改革;
We figured out how to make insulin . 我们找到了制造胰岛素的方法。
insulin:n.[生化][药]胰岛素;
We invented pacemakers and X-ray, and we even came into this wonderful new era of cell and gene therapies . 我们发明了起搏器和X光, 我们甚至进入了细胞和 基因治疗的奇妙新时代。
pacemakers:[基医]起搏器; gene:n.基因;遗传基因;遗传因子; therapies:n.治疗方法(therapy复数形式);
But the biggest change to fix our hospital system altogether is still ahead of us. 但修复我们医疗系统的最大变革 仍然没有到来。
And I believe it's time now, we have the opportunity, to revolutionize the system altogether and forget about our current hospital system. 我相信现在是时候了,我们有机会 去彻底改革整个系统, 完全忘掉我们现有的医院系统。
revolutionize:vt.发动革命;彻底改革;宣传革命;vi.革命化;从事革命;
I believe it's time to create a new system that revolves around health care at home. 我相信是时候创造新的, 以家庭护理为中心的系统了。
revolves:vi.旋转;循环出现;反复考虑;n.旋转;循环;旋转舞台;
Recent research has shown that 46 percent of hospital care can move to the patient's home. 最近的研究发现, 46%的医院治疗 可以转移到患者家中进行。
That's a lot. 这个数量相当庞大。
And that's mainly for those patients who suffer from chronic diseases . 这主要是针对那些患有慢性疾病的病人。
mainly:adv.大多;大部分;主要地;首要地; chronic:adj.慢性的;长期的;习惯性的; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
With that, hospitals can and should reduce to smaller, agile and mobile care centers focused on acute care. 对此,医院可以,而且应该 精简到专注于急症治疗的 更加小型,灵活和移动的 医疗中心。
agile:adj.敏捷的;机敏的;活泼的; mobile:n.手机;汽车;移动电话;adj.活跃的;可动的; acute:adj.严重的,[医]急性的;敏锐的;激烈的;尖声的;
So things like neonatology , intensive care , surgery and imaging will still remain at the hospitals, at least I believe for the foreseeable future. 比如新生儿,重症监护,手术和成像, 这些可以仍然保留在医院, 至少在可预见的未来是这样。
neonatology:新生儿科学;新生儿学;新生儿医师; intensive care:n.(医院里的)特别护理病房;重症监护; surgery:n.外科;外科手术;手术室;诊疗室; imaging:n.[物]成像;造像;v.反映;想像;作…的像;象征;(image的现在分词形式) foreseeable:adj.可预知的;能预测的;
A few weeks ago, I met a colleague whose mom was diagnosed with incurable cancer, and she said, "Niels, it's hard. 几周前,我遇到一个同事, 她妈妈被诊断患了癌症,时日无多。 她说:“尼尔斯,真的很艰难。
colleague:n.同事,同僚; diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) incurable:adj.不能治愈的;无可救药的;n.患不治之症者,不能治愈的人;
It's so hard when we know that she's got only months to live. 当知道她只有几个月生命时, 一切都变得如此艰难。
Instead of playing with the grandchildren, she now has to travel three times a week two hours up and down to Amsterdam just to get her treatment and tests." 她无法再和孙子们玩耍了, 现在她每周需要外出三次, 经历两个小时的颠簸到阿姆斯特丹, 就为了进行治疗和检查。”
Amsterdam:n.阿姆斯特丹(荷兰首都);阿姆斯特丹(美国纽约东部城市);
And that really breaks my heart, because we all know that a professional nurse could draw her blood at home as well, right? 这让我感到很伤心, 因为我们都知道,一个专业的护士 在家就可以进行抽血操作,对吧？
professional:adj.专业的;职业的;职业性的;n.专业人员;职业运动员;
And if she could get her tests and treatment at home as well, she could do the things that are really important to her in her last months. 如果她也能在家接受治疗和检查, 就可以利用她生命的 最后几个月做一些 真正对她重要的事情。
My own mom, 82 years old now -- God bless her -- she's avoiding to go to the hospital because she finds it difficult to plan and manage the journey . 我的母亲,现在82岁了 ——老天保佑她—— 她不想去医院, 因为她发现很难规划和管理她的行程。
journey:n.旅行;行程;vi.旅行;
So my sisters and I, we help her out. 于是我和妹妹会帮她搞定。
But there's many elderly people who are avoiding care and are waiting that long that it becomes life-threatening , and it's straight to the costly , intensive care. 但有很多不去医院的老年人, 拖的时间过长,到了危及生命的程度, 不得不直接进入昂贵的重症监护环节。
life-threatening:adj.威胁生命的; costly:adj.昂贵的;代价高的;
Dr. Covinsky, a clinical researcher at the University of California, he concludes that a third of patients over 70 and more than half of patients over 85, leave the hospital more disabled than when they came in. 科文斯基博士,加州大学的临床研究员 得出结论,1/3年龄超过70岁的人 和超过一半年龄超过85岁的人, 离开医院时比他们进来的时候更糟糕。
clinical:adj.临床的;诊所的; concludes:v.结束; (conclude的第三人称单数)
And a very practical problem that many patients face when they have to go to a hospital is: 很多病人去医院 不得不面临的一个实际问题是:
practical:adj.实际的;真实的;客观存在的;n.实习课;实践课;
Where do I go with my main companion in life, where do I go with my dog? 我和我的主要生活伴侣要去哪里, 我和我的狗要去哪里？
companion:n.同伴;伴侣;陪伴;手册;v.(与…)同行;(跟…)搭伴儿去;
That's our dog, by the way . Isn't she cute? 这是我的狗,她是不是很可爱？
by the way:顺便说一下;
(Laughter) （笑声）
But it's not only about convenience . 但这并不只跟便利有关。
convenience:n.方便;便利;适宜;便利的事物(或设施);
It's also about unnecessary health care stays and costs. 它还涉及到不必要的医疗住宿和费用。
A friend of mine, Art, he recently needed to be hospitalized for just a minor surgery, and he had to stay in the hospital for over two weeks, just because he needed a specific kind of IV antibiotics . 我的一个朋友,阿特, 他最近需要住院接受一个小手术, 他不得不在医院呆两个星期, 只是因为他需要 一种特殊的静脉抗生素。
recently:adv.最近;新近; hospitalized:vt.住院;入院就医;(hospitalize的过去分词); minor:adj.未成年的; n.未成年人; vi.副修; specific:adj.特殊的,特定的;明确的;详细的;[药]具有特效的;n.特性;细节;特效药; antibiotics:n.抗菌素;抗生素(如青霉素);(antibiotic的复数)
So he occupied a bed for two weeks that cost over a thousand euros a day. 于是他占用了一张病床两周, 每天需要花费超过1千欧。
occupied:adj.被占领的; v.占用; (occupy的过去分词和过去式) euros:n.欧元;欧洛斯风;带雨东南暴风(euro复数);
It's just ridiculous . 这真是荒谬。
ridiculous:adj.可笑的;荒谬的;
And these costs are really at the heart of the issue. 这些费用正是问题的核心。
So we've seen over many of our global economies , health care expense grow as a percentage of GDP over the last years. 我们看到了很多全球经济中, 医疗支出在GDP中的 占比在过去这些年 一直在增长。
global:adj.全球的;总体的;球形的; economies:n.经济;经济结构;节约;(economy的复数) expense:n.费用;开支;花费;开销; percentage:n.百分比;百分率;利润的分成;提成;
So here we see that over the last 50 years, health care expense has grown from about five percent in Germany to about 11 percent now. 在过去50年间, 医疗费用占比在德国从5% 上升到现在的11%。
In the US, we've seen growth from six percent to over 17 percent now. 在美国,这个比例从6%上升到17%。
And a large portion of these costs are driven by investments in large, shiny hospital buildings. 这些花费中很大部分来于 对宏伟,熠熠生辉的医院建筑的投资。
portion:n.部分;(食物的)一份;分担的责任;v.把…分成若干份(或部分); investments:n.[经]投资,投资的财产;投资学;(investment的复数) shiny:adj.闪亮的;光亮的;反光的;有光泽的;
And these buildings are not flexible , and they maintain a system where hospital beds need to be filled for a hospital to run efficiently. 这些大楼并不灵活, 还维持着一个需要 让医院的床位被占满, 以保持医院效率的体系。
flexible:adj.灵活的;柔韧的;易弯曲的; maintain:v.维持;保持;维修;保养;坚持(意见);
There's no incentive for a hospital to run with less beds. 于是医院就没有动力减少床位。
incentive:n.动机;刺激;adj.激励的;刺激的;
Just the thought of that makes you sick, right? 一想到这个你就恶心,是吧？
And here's the thing: the cost for treating my buddy Art at home can be up to 10 times cheaper than hospital care. 事实上:我的朋友阿特在家治疗的费用 要比医在院的花费便宜10倍。
treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) buddy:n.伙伴,好朋友;密友;小男孩;v.做好朋友,交朋友;
And that is where we're headed. 那就是我们前进的方向。
The hospital bed of the future will be in our own homes. 医院未来的床位在我们自己的家中。
And it's already starting. 而且这种趋势已经开始了。
Global home care is growing 10 percent year over year. 全球家庭护理正在以 每年10%的速度增长。
And from my own experience, I see that logistics and technology are making these home health care solutions work. 从我个人的经验来看,物流和技术 让家庭医疗护理变得可行。
logistics:n.[军]后勤;后勤学;物流; technology:n.技术;工艺;术语;
Technology is already allowing us to do things that were once exclusive to hospitals. 技术让我们可以做过去 只有医院才能做的事情。
exclusive:adj.独有的;排外的;专一的;n.独家新闻;独家经营的项目;排外者;
Diagnosis tests like blood, glucose tests, urine tests, can now be taken in the comfort of our homes. 如血液, 葡萄糖和尿液检测那样的诊断测试, 现在可以在舒适的家中进行。
glucose:n.葡萄糖;葡糖(等于dextrose); urine:n.尿;
And more and more connected devices we see like pacemakers and insulin pumps that will proactively signal if help is needed soon. 越来越多的联网设备, 如心脏起搏器和胰岛素泵, 在紧急情况下会发出预警信号。
devices:n.[机][计]设备;[机]装置;[电子]器件(device的复数); pumps:n.[机]泵; v.用泵送; proactively:adv.前摄地;主动地;
And all that technology is coming together in much more insights into the patients' health, and that insight and all of the information leads to better control and to less medical errors -- remember, the third cause of death in the US. 所有这些技术组合在一起 可以更加深入地理解病人的健康, 这样的剖析和所有这些信息 可以带来更好的控制, 并减少医疗事故—— 记住,这可是美国第三大 死因。
insights:n.洞察力;眼力;深刻见解(insight的复数);
And I see it every day at work. 我每天都在工作中见证这些。
I work in logistics and for me, home health care works. 我工作在物流领域, 对我而言,家庭医护的确可行。
So we see a delivery driver deliver the medicine to the patient's home. 我们看到送货司机运输药物 到患者家中。
delivery:n.[贸易]交付;分娩;递送;
A nurse joins him and actually administers the drug at the patient's home. 护士与他一道,在患者家中 进行管理药物。
administers:v.管理;治理(国家);施行;执行;提供;(administer的第三人称单数)
It's that simple. 就是这么简单。
Remember my buddy, Art? 还记得我的朋友,阿特？
He can now get the IV antibiotics in the comfort of his home: no hospital pajamas , no crappy food and no risk of these antibiotic-resistant superbugs that only bite you in these hospitals. 他现在可以在舒适的家中 获得静脉注射抗生素: 不需要穿病号服,吃难吃的病号餐, 也不会面临被只存在于 医院中的那些耐抗生素的 超级病菌叮咬的风险。
pajamas:n.睡衣;宽长裤; antibiotic-resistant:adj.耐抗生素的; superbugs:n.超级病菌;
And it goes further. 好处还不止于此。
So now the elderly people can get the treatment that they need in the comfort of their own home while with their best companion in life. 现在老年人也可以在他们舒适的家中 获得所需要的治疗, 同时有生活中最佳伴侣陪同。
And there's no need anymore to drive hours and hours just to get your treatment and tests. 也不再需要开车几个小时, 只是为了获得医疗和检查。
In the Netherlands and in Denmark, we've seen very good successes in cancer clinics organizing chemotherapies at the patient's homes, sometimes even together with fellow patients. 在荷兰和丹麦, 我们在癌症诊所看到了 在病人家中组织化疗的非常成功的例子, 有时候甚至几个病友一起。
clinics:n.诊所(clinic的复数形式); organizing:v.组织;安排;处理;分配;管理;(organize的现在分词) chemotherapies:n.[医]化学疗法;(chemotherapies是chemotherapy的复数);
The best improvements for these patients have been improvements in reduction in stress, anxiety disorders and depression . 对于这些病人而言, 最大的改善在于压力、 焦虑障碍和抑郁的减轻。
improvements:n.改善;改进;改善的事物;(improvement的复数) reduction:n.减少;缩小;降低;减价;折扣;缩图; anxiety:n.焦虑;渴望;挂念;令人焦虑的事; disorders:n.无秩序,混乱; v.[电子]扰乱(disorder的单三形式); depression:n.沮丧;洼地;不景气;忧愁;
Home health care also helped them to get back a sense of normality and freedom in their lives, and they've actually helped them to forget about their disease. 家庭医护也帮助他们找回了生活中的 正常和自由的感觉, 这其实也帮助他们忘记了病痛。
normality:n.常态;[化学]当量浓度;[化学]规定浓度;
But home health care, Niels -- what if I don't even have a home, when I'm homeless, or when I do have a home but there's no one to take care of me or even open up the door? 但关于家庭医护,尼尔斯—— 如果我没有家,当我无家可归时, 或者当我有家,但没人可以照看我, 或者连开窗户都没人帮忙时怎么办？
what if:如果…怎么办?
Well, in comes our sharing economy , or, as I like to call it, the Airbnb for home care. 这个时候我们的共享经济就发挥作用了。 或者,我喜欢称之为,家庭医护爱彼迎。
economy:n.经济;节约;理财; Airbnb:寻找奇居;爱本卜(一个网站);
In the Netherlands, we see churches and care organizations match people in need of care and company with people who actually have a home for them and can provide care and company to them. 在荷兰,我们看到教堂和护理机构 会将需要护理和陪伴的人们, 与有家并能提供医护 和陪伴的人们进行匹配。
organizations:n.组织,构造,有机体(organization的复数);组织机构;
Home health care is cheaper, it's easier to facilitate , and it's quick to set up -- in these rural areas we talked about, but also in humanitarian crisis situations where it's often safer, quicker and cheaper to set things up at home. 家庭医护更便宜, 它易于安置,可以快速投入使用—— 在这些我们谈到的农村地区, 也在人道主义危机的情况下, 把医疗设施放在家里通常 要更加安全,快速和廉价。
facilitate:vt.促进;帮助;使容易; humanitarian:adj.人道主义的;博爱的;基督凡人论的;n.人道主义者;基督凡人论者; crisis:n.危机;危险期;决定性时刻;adj.危机的;用于处理危机的;
Home health care is very applicable in prosperous areas but also very much in underserved communities . 家庭医护非常适用于繁荣地区, 但在服务水平低下的社区也是如此。
applicable:adj.可适用的;可应用的;合适的; prosperous:adj.繁荣的;兴旺的; underserved:adj.服务不周到的;服务水平低下的; communities:n.社区;社会;团体;共有(community的复数)
Home health care works in developed countries as well as in developing countries. 家庭护理对发达国家有效, 对发展中国家也是如此。
as well as:也;和…一样;不但…而且;
So I'm passionate to help facilitate improvements in patients' lives due to home health care. 因此,我非常热衷于通过家庭医护服务 帮助改善病人的生活。
passionate:adj.热情的;热烈的,激昂的;易怒的;
I'm passionate to help facilitate that the elderly people get the treatment that they need in the comfort of their own homes, together with their best companion in life. 我热衷于帮助 那些老年人在自己舒适的家中 获得所需要的治疗, 有他们生活中最佳伴侣的陪伴。
I'm passionate to make the change and help ensure that patients, and not their disease, are in control of their lives. 我热衷于推动改变, 帮助确保是病人,而不是他们的疾病 在掌控他们的生活。
ensure:vt.保证,确保;使安全;
To me, that is health care delivered at home. 对我而言,这就是医疗护理上门服务。
Thank you. 谢谢。
(Applause) （鼓掌）