Why the hospital of the future will be your own home | Niels van Namen
81,681 views ・ 2018-10-10
请双击下面的英文字幕来播放视频。
翻译人员: jacks peng
校对人员: Lipeng Chen
00:13
Probably not a surprise to you,
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也许你不会惊讶,
00:16
but I don't like to be in a hospital
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我不喜欢呆在医院,
00:18
or go to a hospital.
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或去医院看病。
00:20
Do you?
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你喜欢吗?
00:21
I'm sure many of you
feel the same way, right?
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我相信你们很多人
有同样的感受,对吗?
00:24
But why? Why is it
that we hate hospitals so much?
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但为什么?为什么我们如此厌恶医院?
00:28
Or is it just a fact of life
we have to live with?
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这不是生活中不可避免的一个事实吗?
00:31
Is it the crappy food?
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是难吃的病号饭?
00:34
Is it the expensive parking?
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是昂贵的停车费?
00:36
Is it the intense smell?
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是强烈的药水气味?
00:38
Or is it the fear of the unknown?
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或者是对未知的恐惧?
00:41
Well, it's all of that, and it's more.
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全部都有,而且不止这些。
00:45
Patients often have
to travel long distances
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病人常常需要赶很长一段路
00:47
to get to their nearest hospital,
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才能到最近的医院,
00:50
and access to hospital care
is becoming more and more an issue
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而且在美国的乡村地区
00:54
in rural areas,
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要获得医院护理
00:55
in the US,
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越来越成问题,
00:57
but also in sparsely populated
countries like Sweden.
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在瑞典这样人口稀少的国家也是如此。
01:01
And even when hospitals are more abundant,
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即便当医院资源更加充裕时,
01:05
typically the poor and the elderly
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特别是穷人和老人也通常
01:07
have trouble getting care
because they lack transportation
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因为缺乏便利,廉价的交通
01:10
that is convenient and affordable to them.
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而无法获得医疗服务。
01:13
And many people are avoiding
hospital care altogether,
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许多人甚至完全避开医疗治疗,
01:18
and they miss getting proper treatment
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为了节省开销而错过了
01:20
due to cost.
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合适的治疗。
01:22
We see that 64 percent of Americans
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我们可以看到,有64%的美国人
01:26
are avoiding care due to cost.
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因为费用问题而避免医疗服务。
01:30
And even when you do get treatment,
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即便你接受了治疗,
01:33
hospitals often make us sicker.
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医院也常常会让我们病情加重。
01:37
Medical errors are reported to be
the third cause of death in the US,
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据报道,医疗事故是
美国的第三大致死因素,
01:43
just behind cancer and heart disease,
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仅次于癌症和心脏疾病,
01:46
the third cause of death.
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第三大死因。
01:49
I'm in health care for over 20 years now,
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我从事医疗行业已经20多年了,
01:51
and I witness every day how broken
and how obsolete our hospital system is.
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每天我都见证着我们的医院系统
是如此的破败和落后。
01:58
Let me give you two examples.
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让我给你们两个例子。
02:00
Four in 10 Japanese medical doctors
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10个日本医生中有4个,
02:03
and five in 10 American medical doctors
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10个美国医生中有5个
02:06
are burnt out.
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已经在超负荷工作了。
02:08
In my home country, the Netherlands,
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在我的祖国,荷兰,
02:11
only 17 million people live there.
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只有1700万人口。
02:13
We are short 125,000 nurses
over the coming years.
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在未来几年,我们会缺少12.5万名护士。
02:19
But how did we even end up here,
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但我们是怎么走到这一步的,
02:21
in this idea of placing
all kinds of sick people
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把所有病人都集中到
02:24
together in one big building?
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一幢大楼里的?
02:27
Well, we have to go back
to the Ancient Greeks.
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这就要追溯到古希腊时期。
02:31
In 400 BC, temples for cure were erected
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公元前400年,人们建造了治病的庙宇,
02:34
where people could go
to get their diagnosis,
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病人在那里可以得到诊断,
02:36
their treatment and their healing.
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治疗和恢复。
02:39
And then really for about 2,000 years,
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在之后的2000年间,
02:42
we've seen religious care centers
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我们看到了教会的护理中心,
02:45
all the way up
to the Industrial Revolution,
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直到进入工业革命时期,
02:48
where we've seen hospitals
being set up as assembly lines
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我们看到医院基于工业革命的原则,
02:56
based on the principles
of the Industrial Revolution,
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像流水线那样尽快产出产品,
02:58
to produce efficiently
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提升了生产效率,
03:00
and get the products,
the patients in this case,
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在医院的案例中,产品变成了病人,
03:02
out of the hospital as soon as possible.
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以让他们尽快走出医院。
03:06
Over the last century, we've seen
lots of interesting innovations.
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在过去一个世纪中,
我们看到了很多有趣的创新。
03:10
We figured out how to make insulin.
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我们找到了制造胰岛素的方法。
03:13
We invented pacemakers and X-ray,
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我们发明了起搏器和X光,
03:16
and we even came into this wonderful
new era of cell and gene therapies.
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我们甚至进入了细胞和
基因治疗的奇妙新时代。
03:21
But the biggest change
to fix our hospital system altogether
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但修复我们医疗系统的最大变革
03:26
is still ahead of us.
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仍然没有到来。
03:28
And I believe it's time now,
we have the opportunity,
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我相信现在是时候了,我们有机会
03:31
to revolutionize the system altogether
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去彻底改革整个系统,
03:34
and forget about
our current hospital system.
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完全忘掉我们现有的医院系统。
03:37
I believe it's time to create a new system
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我相信是时候创造新的,
03:39
that revolves around health care at home.
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以家庭护理为中心的系统了。
03:43
Recent research has shown
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最近的研究发现,
03:46
that 46 percent of hospital care
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46%的医院治疗
03:49
can move to the patient's home.
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可以转移到患者家中进行。
03:52
That's a lot.
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这个数量相当庞大。
03:54
And that's mainly for those patients
who suffer from chronic diseases.
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这主要是针对那些患有慢性疾病的病人。
03:58
With that, hospitals can and should
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对此,医院可以,而且应该
04:01
reduce to smaller,
agile and mobile care centers
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精简到专注于急症治疗的
更加小型,灵活和移动的
04:05
focused on acute care.
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医疗中心。
04:07
So things like neonatology,
intensive care, surgery and imaging
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比如新生儿,重症监护,手术和成像,
04:13
will still remain at the hospitals,
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这些可以仍然保留在医院,
04:16
at least I believe
for the foreseeable future.
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至少在可预见的未来是这样。
04:20
A few weeks ago, I met a colleague
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几周前,我遇到一个同事,
04:22
whose mom was diagnosed
with incurable cancer,
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她妈妈被诊断患了癌症,时日无多。
04:25
and she said, "Niels, it's hard.
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她说:“尼尔斯,真的很艰难。
04:27
It's so hard when we know
that she's got only months to live.
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当知道她只有几个月生命时,
一切都变得如此艰难。
04:32
Instead of playing with the grandchildren,
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她无法再和孙子们玩耍了,
04:34
she now has to travel three times a week
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现在她每周需要外出三次,
04:38
two hours up and down to Amsterdam
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经历两个小时的颠簸到阿姆斯特丹,
04:40
just to get her treatment and tests."
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就为了进行治疗和检查。”
04:43
And that really breaks my heart,
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这让我感到很伤心,
04:45
because we all know
that a professional nurse
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因为我们都知道,一个专业的护士
04:49
could draw her blood
at home as well, right?
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在家就可以进行抽血操作,对吧?
04:51
And if she could get her tests
and treatment at home as well,
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如果她也能在家接受治疗和检查,
04:55
she could do the things
that are really important to her
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就可以利用她生命的
最后几个月做一些
04:58
in her last months.
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真正对她重要的事情。
05:01
My own mom, 82 years old now --
God bless her --
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我的母亲,现在82岁了
——老天保佑她——
05:06
she's avoiding to go to the hospital
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她不想去医院,
05:08
because she finds it difficult
to plan and manage the journey.
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因为她发现很难规划和管理她的行程。
05:12
So my sisters and I, we help her out.
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于是我和妹妹会帮她搞定。
05:15
But there's many elderly people
who are avoiding care
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但有很多不去医院的老年人,
05:18
and are waiting that long
that it becomes life-threatening,
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拖的时间过长,到了危及生命的程度,
05:22
and it's straight
to the costly, intensive care.
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不得不直接进入昂贵的重症监护环节。
05:26
Dr. Covinsky, a clinical researcher
at the University of California,
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科文斯基博士,加州大学的临床研究员
05:30
he concludes that a third
of patients over 70
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得出结论,1/3年龄超过70岁的人
05:33
and more than half of patients over 85,
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和超过一半年龄超过85岁的人,
05:36
leave the hospital more disabled
than when they came in.
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离开医院时比他们进来的时候更糟糕。
05:41
And a very practical problem
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很多病人去医院
05:44
that many patients face
when they have to go to a hospital is:
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不得不面临的一个实际问题是:
05:48
Where do I go with my main
companion in life,
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我和我的主要生活伴侣要去哪里,
05:52
where do I go with my dog?
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我和我的狗要去哪里?
05:57
That's our dog, by the way.
Isn't she cute?
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这是我的狗,她是不是很可爱?
05:59
(Laughter)
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(笑声)
06:02
But it's not only about convenience.
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但这并不只跟便利有关。
06:04
It's also about unnecessary
health care stays and costs.
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它还涉及到不必要的医疗住宿和费用。
06:09
A friend of mine, Art,
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我的一个朋友,阿特,
06:11
he recently needed to be hospitalized
for just a minor surgery,
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他最近需要住院接受一个小手术,
06:15
and he had to stay in the hospital
for over two weeks,
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他不得不在医院呆两个星期,
06:17
just because he needed
a specific kind of IV antibiotics.
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只是因为他需要
一种特殊的静脉抗生素。
06:21
So he occupied a bed for two weeks
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于是他占用了一张病床两周,
06:25
that cost over a thousand euros a day.
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每天需要花费超过1千欧。
06:27
It's just ridiculous.
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这真是荒谬。
06:29
And these costs are really
at the heart of the issue.
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这些费用正是问题的核心。
06:32
So we've seen over many
of our global economies,
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我们看到了很多全球经济中,
06:35
health care expense grow
as a percentage of GDP
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医疗支出在GDP中的
占比在过去这些年
06:38
over the last years.
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一直在增长。
06:40
So here we see
that over the last 50 years,
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在过去50年间,
06:43
health care expense has grown
from about five percent in Germany
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医疗费用占比在德国从5%
06:47
to about 11 percent now.
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上升到现在的11%。
06:50
In the US, we've seen growth
from six percent to over 17 percent now.
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在美国,这个比例从6%上升到17%。
06:56
And a large portion of these costs
are driven by investments
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这些花费中很大部分来于
07:00
in large, shiny hospital buildings.
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对宏伟,熠熠生辉的医院建筑的投资。
07:03
And these buildings are not flexible,
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这些大楼并不灵活,
07:05
and they maintain a system
where hospital beds need to be filled
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还维持着一个需要
让医院的床位被占满,
07:08
for a hospital to run efficiently.
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以保持医院效率的体系。
07:11
There's no incentive
for a hospital to run with less beds.
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于是医院就没有动力减少床位。
07:15
Just the thought of that
makes you sick, right?
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一想到这个你就恶心,是吧?
07:18
And here's the thing: the cost
for treating my buddy Art at home
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事实上:我的朋友阿特在家治疗的费用
07:22
can be up to 10 times cheaper
than hospital care.
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要比医在院的花费便宜10倍。
07:27
And that is where we're headed.
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那就是我们前进的方向。
07:29
The hospital bed of the future
will be in our own homes.
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医院未来的床位在我们自己的家中。
07:34
And it's already starting.
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而且这种趋势已经开始了。
07:35
Global home care is growing
10 percent year over year.
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全球家庭护理正在以
每年10%的速度增长。
07:39
And from my own experience,
I see that logistics and technology
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从我个人的经验来看,物流和技术
07:44
are making these home
health care solutions work.
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让家庭医疗护理变得可行。
07:48
Technology is already
allowing us to do things
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技术让我们可以做过去
07:50
that were once exclusive to hospitals.
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只有医院才能做的事情。
07:53
Diagnosis tests like blood,
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如血液,
07:56
glucose tests, urine tests, can now
be taken in the comfort of our homes.
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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。
08:01
And more and more connected devices
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越来越多的联网设备,
08:05
we see like pacemakers and insulin pumps
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如心脏起搏器和胰岛素泵,
08:08
that will proactively signal
if help is needed soon.
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在紧急情况下会发出预警信号。
08:12
And all that technology is coming together
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所有这些技术组合在一起
08:14
in much more insights
into the patients' health,
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可以更加深入地理解病人的健康,
08:18
and that insight and all of
the information leads to better control
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这样的剖析和所有这些信息
可以带来更好的控制,
08:22
and to less medical errors --
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并减少医疗事故——
08:24
remember, the third cause of death
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记住,这可是美国第三大
08:27
in the US.
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死因。
08:29
And I see it every day at work.
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我每天都在工作中见证这些。
08:31
I work in logistics
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我工作在物流领域,
08:33
and for me, home health care works.
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对我而言,家庭医护的确可行。
08:38
So we see a delivery driver
deliver the medicine
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我们看到送货司机运输药物
08:42
to the patient's home.
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到患者家中。
08:44
A nurse joins him
and actually administers the drug
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护士与他一道,在患者家中
08:47
at the patient's home.
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进行管理药物。
08:50
It's that simple.
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就是这么简单。
08:52
Remember my buddy, Art?
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还记得我的朋友,阿特?
08:54
He can now get the IV antibiotics
in the comfort of his home:
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他现在可以在舒适的家中
获得静脉注射抗生素:
08:57
no hospital pajamas, no crappy food
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不需要穿病号服,吃难吃的病号餐,
09:01
and no risk of these
antibiotic-resistant superbugs
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也不会面临被只存在于
医院中的那些耐抗生素的
09:06
that only bite you in these hospitals.
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超级病菌叮咬的风险。
09:08
And it goes further.
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好处还不止于此。
09:10
So now the elderly people
can get the treatment that they need
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现在老年人也可以在他们舒适的家中
09:14
in the comfort of their own home
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获得所需要的治疗,
09:16
while with their best companion in life.
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同时有生活中最佳伴侣陪同。
09:19
And there's no need anymore
to drive hours and hours
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也不再需要开车几个小时,
09:22
just to get your treatment and tests.
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只是为了获得医疗和检查。
09:25
In the Netherlands and in Denmark,
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在荷兰和丹麦,
09:27
we've seen very good successes
in cancer clinics
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我们在癌症诊所看到了
09:29
organizing chemotherapies
at the patient's homes,
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在病人家中组织化疗的非常成功的例子,
09:34
sometimes even together
with fellow patients.
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有时候甚至几个病友一起。
09:38
The best improvements for these patients
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对于这些病人而言,
09:40
have been improvements
in reduction in stress,
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最大的改善在于压力、
09:44
anxiety disorders and depression.
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焦虑障碍和抑郁的减轻。
09:47
Home health care also helped them
to get back a sense of normality
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家庭医护也帮助他们找回了生活中的
09:51
and freedom in their lives,
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正常和自由的感觉,
09:53
and they've actually helped them
to forget about their disease.
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这其实也帮助他们忘记了病痛。
09:59
But home health care, Niels --
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但关于家庭医护,尼尔斯——
10:02
what if I don't even have a home,
when I'm homeless,
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如果我没有家,当我无家可归时,
10:06
or when I do have a home
but there's no one to take care of me
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或者当我有家,但没人可以照看我,
10:09
or even open up the door?
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或者连开窗户都没人帮忙时怎么办?
10:12
Well, in comes our sharing economy,
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这个时候我们的共享经济就发挥作用了。
10:15
or, as I like to call it,
the Airbnb for home care.
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或者,我喜欢称之为,家庭医护爱彼迎。
10:19
In the Netherlands,
we see churches and care organizations
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在荷兰,我们看到教堂和护理机构
10:22
match people in need of care and company
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会将需要护理和陪伴的人们,
10:25
with people who actually
have a home for them
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与有家并能提供医护
10:27
and can provide care and company to them.
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和陪伴的人们进行匹配。
10:30
Home health care is cheaper,
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家庭医护更便宜,
10:32
it's easier to facilitate,
and it's quick to set up --
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它易于安置,可以快速投入使用——
10:36
in these rural areas we talked about,
but also in humanitarian crisis situations
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在这些我们谈到的农村地区,
也在人道主义危机的情况下,
10:40
where it's often safer, quicker
and cheaper to set things up at home.
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把医疗设施放在家里通常
要更加安全,快速和廉价。
10:48
Home health care is very applicable
in prosperous areas
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家庭医护非常适用于繁荣地区,
10:52
but also very much
in underserved communities.
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但在服务水平低下的社区也是如此。
10:55
Home health care
works in developed countries
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家庭护理对发达国家有效,
10:58
as well as in developing countries.
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对发展中国家也是如此。
11:00
So I'm passionate to help facilitate
improvements in patients' lives
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因此,我非常热衷于通过家庭医护服务
11:06
due to home health care.
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帮助改善病人的生活。
11:08
I'm passionate to help facilitate
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我热衷于帮助
11:11
that the elderly people
get the treatment that they need
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那些老年人在自己舒适的家中
11:13
in the comfort of their own homes,
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获得所需要的治疗,
11:15
together with their
best companion in life.
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有他们生活中最佳伴侣的陪伴。
11:18
I'm passionate to make the change
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我热衷于推动改变,
11:21
and help ensure that patients,
and not their disease,
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帮助确保是病人,而不是他们的疾病
11:24
are in control of their lives.
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在掌控他们的生活。
11:27
To me, that is health care
delivered at home.
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对我而言,这就是医疗护理上门服务。
11:30
Thank you.
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谢谢。
11:31
(Applause)
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(鼓掌)
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