A temporary tattoo that brings hospital care to the home | Todd Coleman

翻译人员: Junyi Sha 校对人员: Xiang Li

Please meet Jane.

这是简。

She has a high-risk pregnancy.

她属于高风险怀孕人群。

Within 24 weeks,

在长达24周的时间里，

she's on bed rest at the hospital,

她都要躺在医院的病床上，

being monitored for her preterm contractions.

时刻被监视，以免发生早产。

She doesn't look the happiest.

她看起来并不开心。

That's in part because it requires technicians and experts

一部分是因为她需要 携带这些笨重的检测带，

to apply these clunky belts on her to monitor her uterine contractions.

以便技术人员与专家 监测她子宫的收缩情况。

Another reason Jane is not so happy is because she's worried.

简不高兴的另一个原因是她很担心。

In particular, she's worried about what happens

具体来说，她担心的

after her 10-day stay on bed rest at the hospital.

是在医院病床上躺了十天之后的情况。

What happens when she's home?

她回家的话会发生什么呢？

If she were to give birth this early it would be devastating.

如果选择提前生产， 结果将是难以承受的。

As an African-American woman,

作为一个非裔美国妇女，

she's twice as likely to have a premature birth

出现早产或是死胎的几率

or to have a stillbirth.

是一般人的两倍。

So Jane basically has one of two options:

所以简基本只能二选一：

stay at the hospital on bed rest,

继续呆在医院的病床上，

a prisoner to the technology until she gives birth,

成为科技的奴隶， 直到她生产为止，

and then spend the rest of her life paying for the bill;

并用余生去偿还账单；

or head home after her 10-day stay and hope for the best.

或是在10天后选择回家，祈求天助。

Neither of these two options seems appealing.

这两种选择听起来都不怎么样。

As I began to think about stories like this

当我听说这些故事，

and hear about stories like this,

尝试去思考它们，

I began to ask myself and imagine:

我就开始质问自己：

Is there an alternative?

难道没有第三种选择吗？

Is there a way we could have the benefits of high-fidelity monitoring

有没有一种办法让人们 既能从医院中值得信任的人手上

that we get with our trusted partners in the hospital

拿到高可信度的监测结果，

while someone is at home living their daily life?

又能在家中正常生活呢？

With that in mind,

带着这种想法，

I encouraged people in my research group

我鼓励我研发团队中的成员

to partner with some clever material scientists,

去与一些聪明的材料学家合作，

and all of us came together and brainstormed.

我们聚在一起，集思广益。

And after a long process,

很长一段时间过去之后，

we came up with a vision, an idea,

我们提出了一种设想， 一个点子，

of a wearable system that perhaps you could wear like a piece of jewelry

那就是一种便携式的系统，

or you could apply to yourself like a Band-Aid.

就像佩戴珠宝或是 贴块儿膏药一样容易操作。

And after many trials and tribulations and years of endeavors,

在经过许多次失败的尝试和 多年的努力之后，

we were able to come up with this flexible electronic patch

我们终于做出了这款柔性电子贴膜。

that was manufactured using the same processes

它的制作过程与

that they use to build computer chips,

生产电脑芯片的过程大同小异，

except the electronics are transferred from a semiconductor wafer

除了电子元件从半导体晶片

转移到了能与人类皮肤 相贴合的柔性材料上。

onto a flexible material that can interface with the human body.

These systems are about the thickness of a human hair.

这套产品的厚度只相当于 人类的头发直径。

它们能检测我们需要的信息，

They can measure the types of information that we want,

things such as:

比如：

bodily movement,

人体的运动，

bodily temperature,

体温，

electrical rhythms of the body

人体电信号节律，

and so forth.

等等其他信息。

We can also engineer these systems,

我们还可以改造这套系统，

so they can integrate energy sources,

使它们可以整合能源，

and can have wireless transmission capabilities.

或者拥有无线电传输功能。

So as we began to build these types of systems,

因此，当我们开始创建这套系统，

we began to test them on ourselves in our research group.

我们就把自身当作实验对象。

But in addition, we began to reach out to some of our clinical partners

另外，我们也联系了在圣地亚哥的

in San Diego,

合作诊所，

and test these on different patients in different clinical conditions,

在不同的病患身上 依据不同临床状况做测试，

including moms-to-be like Jane.

也包括一些像简一样 即将作母亲的人。

Here is a picture of a pregnant woman in labor at our university hospital

这是一位正在我们大学医院

being monitored for her uterine contractions with the conventional belt.

接受传统腰带法 检测子宫收缩情况的孕妇。

In addition,

同时，

our flexible electronic patches are there.

她也使用了我们的柔性电子贴片。

This picture demonstrates waveforms pertaining to the fetal heart rate,

这张图演示了 胎儿心率的波形图。

where the red corresponds to what was acquired

其中，红色对应传统腰带的

with the conventional belts,

采集结果，

and the blue corresponds to our estimates

蓝色对应我们用柔性电子检测贴片

using our flexible electronic systems and our algorithms.

以及我们的算法做出的预估值。

At this moment,

这个结果，

we gave ourselves a big mental high five.

给予了我们莫大的精神鼓舞。

Some of the things we had imagined were beginning to come to fruition,

我们所梦想的这一切 已经开始取得初步成果，

and we were actually seeing this in a clinical context.

我们也能在真正的 临床背景下目睹进展。

But there was still a problem.

但仍然存在一个问题。

The problem was, the way we manufactured these systems

我们生产这种系统的

was very inefficient,

能效不足，

had low yield

产率低下，

而且出错率高。

and was very error-prone.

In addition,

另外，

as we talked to some of the nurses in the hospital,

当我们与医院中的护士们交流时，

they encouraged us to make sure

她们希望我们能确保

that our electronics worked with typical medical adhesives

医院里常用的医用胶布

也能作为我们系统的载体。

that are used in a hospital.

We had an epiphany and said, "Wait a minute.

我们茅塞顿开，回答道：“等一下，

Rather than just making them work with adhesives,

与其只是让系统和胶布绑定，

let's integrate them into adhesives,

不如干脆把系统直接内置在胶布上

and that could solve our manufacturing problem."

这也会同时解决 批量生产上的问题。”

This picture that you see here

你们现在看到的这张图，

is our ability to embed these censors inside of a piece of Scotch tape

展现了我们通过 简单晶片表层剥离技术，

by simply peeling it off of a wafer.

使将检测系统整合入 透明胶带中的能力。

Ongoing work in our research group allows us to, in addition,

我们实验小组的持续研究还让我们

embed integrated circuits into the flexible adhesives

能够将集成电路做进柔性胶带中，

to do things like amplifying signals and digitizing them,

实现信号放大，数字化，

processing them

加工处理，

and encoding for wireless transmission.

以及无线电传输的编码工作。

All of this integrated into the same medical adhesives

这一切都被整合进入

这同一款医用胶布当中。

that are used in the hospital.

So when we reached this point,

当我们达到这个目标时，

we had some other challenges,

我们又面临了来自工程，

from both an engineering as well as a usability perspective,

来自实用领域的新挑战，

to make sure that we could make it used practically.

我们需要确保它简单易用。

In many digital health discussions,

在许多数字化健康讨论当中，

people believe in and embrace the idea that we can simply digitize the data,

人们坚信一个观点， 那就是我们可以将数据轻松数字化，

wirelessly transmit it,

将其无线传输，

send it to the cloud,

发送到云端，

and in the cloud,

并在云端当中

提取有价值的信息进行分析。

we can extract meaningful information for interpretation.

And indeed, you can do all of that,

确实，这些都能实现，

if you're not worried about some of the energy challenges.

前提是系统不存在能耗问题。

Think about Jane for a moment.

想一下简。

She doesn't live in Palo Alto,

她并不居住在帕洛阿尔托，

nor does she live in Beverly Hills.

也不住在贝弗利山庄。

What that means is,

这意味着什么呢？

we have to be mindful about her data plan and how much it would cost

我们必须充分考虑她的数据流量， 发出持续的信号流

for her to be sending out a continuous stream of data.

是否会导致高昂的开销。

There's another challenge

还有另一个挑战，

that not everyone in the medical profession is comfortable talking about.

这并不是每一个医疗领域的 从业者都愿提及的。

And that is, that Jane does not have the most trust

那就是，简对待医疗机构

in the medical establishment.

没有充分的信任。

She, people like her, her ancestors, have not had the best experiences

她，还有和她一样的人们， 他们的前辈们都曾经

at the hands of doctors and the hospital

对医生，医院，或是保险公司留下过

or insurance companies.

不好的印象。

That means that we have to be mindful of questions of privacy.

这表明我们必须注意 个人隐私的问题。

Jane might not feel that happy

简可能会为

about all that data being processed into the cloud.

数据全部传送至云端而感到担忧。

And Jane cannot be fooled;

通过读新闻，

she reads the news.

简是不会轻易被骗的。

She knows that if the federal government can be hacked,

她知道如果 联邦政府系统都可以被黑，

if the Fortune 500 can be hacked,

如果“财富”500强企业 都可以被黑，

so can her doctor.

她医生的系统也可能被黑。

And so with that in mind,

想到这一点，

we had an epiphany.

我们不由得灵机一动：

We cannot outsmart all the hackers in the world,

既然不能做到比世界上 所有的黑客都更加聪明，

but perhaps we can present them a smaller target.

不如我们把自己变小， 淡出他们的目标。

What if we could actually,

如果说我们可以

rather than have those algorithms that do data interpretation

将原本在云端当中进行的

run in the cloud,

数据算法过程

what if we have those algorithms run on those small integrated circuits

转移到一个内嵌于贴片的小型

embedded into those adhesives?

集成电路当中呢？

And so when we integrate these things together,

这样我们就能做到彻底的整合，

what this means is that now we can think about the future

借此来想像一下未来，

where someone like Jane can still go about living her normal daily life,

像简一样的人们 可以过着正常人的生活，

she can be monitored,

同时被监控着，

it can be done in a way where she doesn't have to get another job

她也不需要找第二份工作

to pay her data plan,

来支付数据流量，

and we can also address some of her concerns about privacy.

我们也能缓解 她的部分疑虑和担忧。

So at this point,

基于这种情况，

we're feeling very good about ourselves.

我们对自己的表现很满意。

We've accomplished this,

我们做到了，

we've begun to address some of these questions about privacy

我们成功解决了 关于个人隐私的问题，

and we feel like, pretty much the chapter is closed now.

我们觉得这件事基本告一段落了。

Everyone lived happily ever after, right?

所有人从此过上幸福的生活， 是这样吗？

Well, not so fast.

不，还没这么快。

(Laughter)

（笑声）

One of the things we have to remember, as I mentioned earlier,

就像我之前提到的， 还有一件我们需要记住的事情，

is that Jane does not have the most trust in the medical establishment.

那就是简对于医疗机构 没有充分的信任。

我们必须要意识到

We have to remember

that there are increasing and widening health disparities,

健康服务的两极分化在不断扩大，

and there's inequity in terms of proper care management.

在适当护理管理方面 仍存在不公平的现象。

And so what that means is that this simple picture

也就是说，

简和她的数据的简单构图——

of Jane and her data --

even with her being comfortable being wirelessly transmitted to the cloud,

当她已经能舒适的 将数据传送至云端,

letting a doctor intervene if necessary --

在必要时才让医生来干预——

is not the whole story.

这还并非故事的全部。

So what we're beginning to do

所以我们下一步的目标，

is to think about ways to have trusted parties serve as intermediaries

是去思考如何让值得 被信任的机构成为

between people like Jane and her health care providers.

像简这样的病患 和医生之间的中间人。

For example, we've begun to partner with churches

举个例子， 我们已经开始和教会合作，

and to think about nurses that are church members,

我们考虑那些是 教会成员的护士们,

that come from that trusted community,

她们是被信赖的群体，

as patient advocates and health coaches to people like Jane.

让她们成为像简 一样的人们的健康私教。

Another thing we have going for us

随之而来的还有一件事，

is that insurance companies, increasingly,

许多保险公司也陆续的

are attracted to some of these ideas.

开始关注我们的这些想法。

They're increasingly realizing

他们逐渐意识到

that perhaps it's better to pay one dollar now

可能花费一点儿钱

for a wearable device and a health coach,

去支付便携式设备 和健康教练，

rather than paying 10 dollars later,

要比之后因孩子早产

when that baby is born prematurely

而要常住新生儿ICU，

and ends up in the neonatal intensive care unit --

医院中最贵的部门之一，

one of the most expensive parts of a hospital.

从而产生的大比花销要稍微好点儿。

This has been a long learning process for us.

我们经历了漫长的学习过程。

This iterative process of breaking through and attacking one problem

这个反复的过程—— 每当突破一个问题，

and not feeling totally comfortable,

并不感到满足，

and identifying the next problem,

而是接着提出下一个问题，

has helped us go along this path

这帮助我们 遵循这样一条道路，

of actually trying to not only innovate with this technology

就是不仅为了科技创新，

but make sure it can be used for people who perhaps need it the most.

而且为了造福真正需要他们的人。

Another learning lesson we've taken from this process

我们学会的另一件事，

that is very humbling,

一件非常谦卑的事，

is that as technology progresses and advances at an accelerating rate,

是伴随着科技的迅速发展，

we have to remember that human beings are using this technology,

我们必须铭记使用 这些科技的是人类，

and we have to be mindful

我们必须铭记

that these human beings -- they have a face,

这些人—— 他们有血有肉，

they have a name

他们有自己的名字，

and a life.

他们有自己的生活。

And in the case of Jane,

在简的例子中是这样，

hopefully, two.

还有她即将出生的孩子。

Thank you.

谢谢。

(Applause)

（鼓掌）