Eric Topol: The wireless future of medicine

50,330 views ・ 2010-02-23

TED


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譯者: Sunshine Wang 審譯者: Ching-Yi Wu
00:15
Does anybody know when the stethoscope was invented?
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有人知道聽診器是什麼時候發明的嗎?
00:20
Any guesses? 1816.
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猜猜看? 答案是1816年。
00:23
And what I can say is, in 2016,
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我預測到2016年,
00:26
doctors aren't going to be walking around with stethoscopes.
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醫生就不會再帶聽診器了。
00:28
There's a whole lot better technology coming,
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未來科技將更加精良,
00:30
and that's part of the change in medicine.
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醫療科技的變革亦然。
00:33
What has changed our society
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在過去,無線設備
00:36
has been wireless devices.
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改變了我們的社會,
00:38
But the future are digital medical wireless devices, OK?
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而未來,數位醫療無線設備是必然趨勢。
00:43
So, let me give you some examples of this
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我可以用一些例子
00:45
to kind of make this much more concrete.
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來具體說明。
00:48
This is the first one. This is an electrocardiogram.
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首先,這是一張心電圖。
00:51
And, as a cardiologist, to think that you could see in real time
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身為一位心臟專科醫師,試想不論在世上任何地方,
00:54
a patient, an individual, anywhere in the world
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你都能在第一時間,用智慧型手機,
00:57
on your smartphone,
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判讀病患的心電圖,
00:59
watching your rhythm -- that's incredible,
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這是多麼不可思議,
01:01
and it's with us today.
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今天我們辦到了,
01:03
But that's just the beginning.
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但這只是個開始。
01:06
You check your email while you're sitting here.
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坐在這裡的同時你也在檢查電子郵件,
01:09
In the future you're going to be checking all your vital signs,
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未來你可以檢查你的生命徵象,
01:13
all your vital signs: your heart rhythm,
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所有生命徵象,包括心跳、
01:15
your blood pressure, your oxygen, your temperature, etc.
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血壓、血氧量及體溫等等。
01:19
This is already available today.
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這些數據現在垂手可得。
01:21
This is AirStrip Technologies.
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這是遠端醫療監測服務(AirStrip Technologies公司提供)。
01:23
It's now wired -- or I should say, wireless --
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目前是有線的,如果從彙集醫院,
01:27
by taking the aggregate of these signals
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加護病房裡的訊號,
01:29
in the hospital, in the intensive care unit,
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再匯入醫生的智慧型手機這一點來看,
01:31
and putting it on a smartphone for physicians.
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那我應該說它是無線的。
01:34
If you're an expectant parent,
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如果你即將為人父母,
01:36
what about the ability to monitor, continuously,
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要是能夠持續觀察監測
01:39
fetal heart rate, or intrauterine contractions,
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胎兒的心跳或子宮收縮,
01:42
and not having to worry so much that things are
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不用太過擔心懷孕的過程,
01:45
fine as the pregnancy,
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一直到生產的那天,
01:47
and moving over into the time of delivery?
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那會如何呢?
01:50
And then as we go further,
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我們再來看看,
01:53
today we have continuous glucose sensors.
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現有的連續式血糖感應器,
01:55
Right now, they are under the skin,
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目前是植入在皮膚底下的。
01:57
but in the future, they won't have to be implanted.
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但是未來不再需要植入體內了。
02:01
And of course, the desired range -- trying to keep glucose
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理想的狀況是把血糖值控制在
02:03
between 75 and less than 200,
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75 到 200 之間,
02:07
checking it every five minutes in a continuous glucose sensor --
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每五分鐘檢查一次血糖感應器。
02:10
you'll see how that can impact diabetes.
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可以想見這對糖尿病患影響有多大。
02:12
And what about sleep?
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那麼在睡眠方面呢?
02:14
We're going to zoom in on that a little bit.
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現在來稍微深入看看睡眠。
02:16
We're supposed to spend a third of our life in sleep.
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我們一生中有三分之一都在睡覺,
02:18
What if, on your phone,
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要是接下來的幾個禮拜
02:20
which will be available in the next few weeks,
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你每分鐘的睡眠狀況
02:22
you had every minute of your sleep displayed?
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都可以顯示在手機上呢?
02:25
And this is, of course, as you can see, the awake is the orange.
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如您所見,橘色代表清醒狀態。
02:28
The REM sleep, rapid eye movement,
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綠色是REM,快速動眼期,
02:30
dream state, is in light green;
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也就是夢發生的時期。
02:32
and light is gray, light sleep;
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灰色是淺眠期。
02:34
and deep sleep, the best restorative sleep,
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還有,最有助於恢復精神的深眠期
02:36
is that dark green.
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是深綠色。
02:38
How about counting every calorie?
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那麼,計算卡路里呢?
02:40
And this is ability, in real time, to actually take
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藉由類似OK蹦的東西就可以
02:43
measurements of caloric intake
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即時測量所攝取
02:45
as well as expenditure, through a Band-Aid.
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及消耗的卡路里。
02:48
Now, what I've talked about are physiologic metrics.
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到目前為止,我所談的都僅只於生理指標。
02:51
But what I want to get to, the next frontier,
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接下來我要談談新的領域,
02:54
very quickly, and why the stethoscope
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我也會說明為什麼聽診器
02:56
is on its way out,
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正快速的被淘汰,
02:58
is because we can transcend listening to the valve sounds,
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奇異公司研發的手持超音波掃描儀,
03:02
and the breath sounds, because now,
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讓聽診不再僅侷限於
03:04
introduced by G.E. is a handheld ultra-sound.
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辨識心臟瓣膜音及呼吸音。
03:07
Why is this important? Because this is so much more sensitive.
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這項技術為什麼如此重要? 因為它非常的敏感。
03:10
Here is an example of an abdominal ultrasound,
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來看看幾個例子,腹部超音波,
03:13
and also a cardiac echo, which can be sent wireless,
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可以無線傳送的心臟超音波,
03:17
and then there's an example of fetal monitoring on your smartphone.
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及使用智慧型手機進行胎兒監測。
03:21
So, we're not just talking about physiologic metrics --
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現在談的不只是測量重要生命徵象、
03:24
the key measurements of vital signs,
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生理指標數據、
03:27
and all those things in physiology -- but also all the imaging
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生理機能,而是同時能
03:30
that one could look at in your smartphone.
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在智慧型手機上看到影像。
03:32
Now, this is an example of another obsolete technology,
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這是另一個會被淘汰的科技,
03:36
soon to be buried: the Holter Monitor.
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很快將被遺忘的24小時心電圖。
03:38
Twenty-four hour recording, lots of wires.
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可以全天候監測紀錄,有很多電線。
03:40
This is now a little tiny patch.
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現在這小小的貼片將取代它。
03:42
You can put it on for two weeks
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這貼片可以貼在身上兩周。
03:44
and send it in the mail.
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記錄的數據可以透過email傳送。
03:47
Now, how does this work? Well,
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這是如何辦到的?
03:49
there is these smart Band-Aids or these sensors
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病人在鞋子裡或手腕上穿戴
03:51
that one would put on, on a shoe or on the wrist.
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這些智慧型OK蹦或感應器
03:54
And this sends a signal
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它們會發出訊號。
03:57
and it creates a body area network to a gateway.
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這讓病人的身體成為一個連接到網路通信閘道器的訊息網路
04:01
Gateway could be a smartphone or it could be a dedicated gateway,
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閘道器可以是智慧型手機,或專用的閘道器,
04:04
as today many of these things are dedicated gateways,
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現在專用閘道器仍普遍使用,
04:06
because they are not so well integrated.
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因為兩者尚未整合好。
04:08
That signal goes to the web, the cloud,
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訊號傳到網路,也就是雲端,
04:11
and then it can be processed and sent anywhere:
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這些數據會被處理
04:13
to a caregiver, to a physician,
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並傳送給護士、醫生
04:15
back to the patient, etc.
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或是病人自己…,等等。
04:17
So, that's basically very simplistic technology
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基本上這一項技術的運作方式
04:20
of how this works.
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其實很簡單。
04:22
Now, I have this device on.
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現在我身上就貼了這個感應器。
04:24
I didn't want to take my shirt off to show you, but I can tell you it's on.
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我不會把襯衫脫下來給各位看,但是我身上真有一個。
04:27
This is a device that not only measures cardiac rhythm,
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這個裝置不只能夠測量心律,
04:31
as you saw already,
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如同您已經看到的,
04:33
but it also goes well beyond that.
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它可以做的事情遠超過這些。
04:36
This is me now. And you can see the ECG.
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您現在看到的是我的心電圖。
04:39
Below that's the actual heart rate and the trend;
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下方是我的心跳速率及模式,
04:42
to the right of that is a bioconductant.
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右邊的是生理參數,
04:44
That's the fluid status,
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它反映的是體液的狀態,
04:46
fluid status, that's really important
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對於監測心臟衰竭的病患
04:48
if you're monitoring somebody with heart failure.
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體液狀態尤其重要。
04:50
And below that's temperature,
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下方是體溫、
04:52
and respiration, and oxygen,
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呼吸、及血氧量,
04:54
and then the position activity.
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還有我的身體活動姿勢。
04:56
So, this is really striking, because this device
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這真是非常了不起!
04:59
measures seven things
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因為這個裝置可以同時
05:01
that are very much vital signs
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監測心臟衰竭病患的
05:04
for monitoring someone with heart failure. OK?
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七個重要生命徵象。
05:08
And why is this important? Well,
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為什麼這很重要?
05:10
this is the most expensive bed.
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這是一張費用最昂貴的病床,
05:13
What if we could reduce the need for hospital beds?
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要是可以減少對病床的需求會如何呢?
05:16
Well, we can. First of all, heart failure
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事實上辦不到。因為心臟衰竭
05:18
is the number one reason
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是美國病患住院及
05:21
for hospital admissions and readmissions in this country.
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再度住院的首要原因。
05:24
The cost of heart failure is 37 billion dollars a year,
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每年花在治療心臟衰竭的費用高達370億美元,
05:29
which is 80 percent related to hospitalization.
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其中80%與住院有關。
05:32
And in the course of 30 days after a hospital stay
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醫療保險Medicare支付30天的住院療程,
05:35
for a Medicare greater than 65 years or older,
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其65歲以上的病患出院後
05:38
is -- 27 percent are readmitted in 30 days,
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30天內再住院率是27%。
05:41
and by six months, over 56 percent are readmitted.
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6個月內再度住院率超過56%。
05:45
So, can we improve that? Well the idea is
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這個狀況可以改善嗎?有個臨床實驗是
05:47
we take this device that I'm wearing,
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把我身上的裝置隨機
05:49
and we put it on 600 patients with heart failure,
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裝在600位心臟衰竭患者身上,
05:53
randomly assigned, versus 600 patients
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與600位沒有裝感應器的
05:55
who don't have active monitoring,
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心臟衰竭患者作比較,
05:57
and see whether we can reduce heart failure readmissions,
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觀察是否可以降低病患的再住院率。
06:00
and that's exciting. And we'll start that trial,
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這很令人興奮,這個實驗即將開始,
06:02
and you'll hear more about how we're going to do that,
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您會聽到實驗進展的消息。
06:04
but that's a type of wireless device trial
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這只是未來幾年改變醫療的
06:07
that could change medicine in the years ahead.
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無線裝置實驗的其中一種。
06:10
Why now? Why has this all of a sudden become
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為何是現在?為何這令人振奮
06:13
a reality, an exciting direction in the future of medicine?
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的醫療發展新走向突然瞬間成真?
06:17
What we have is, in a way, a perfect positive storm.
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這是因為一場積極正面的醫療變革,促成了
06:21
This sets up consumer-driven healthcare.
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消費者導向醫療照護的形成,
06:23
That's where this is all starting.
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一切就是由此開始的。
06:25
Let me just give you specifics about why this is
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假如您尚未知悉,容我向各位報告
06:28
a big movement if you're not aware of it:
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為什麼這是一場巨大變革的細節。
06:30
1.2 million Americans
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有120萬美國人擁有
06:32
have gotten a Nike shoe, which is a body-area network
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具身體訊息網路功能的Nike運動鞋,
06:35
that connects the shoe, the sole of the shoe to the iPhone, or an iPod.
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鞋底的感應器可以連結到iPhone或iPod。
06:39
And this Wired Magazine cover article
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這篇《連線》雜誌的封面文章
06:41
really captured a lot of this; it talked a lot about the Nike shoe
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對此詳盡報導,文中對Nike運動鞋著墨甚多,
06:44
and how quickly that's been adopted to monitor exercise physiology
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談到它快速的被用於監測運動生理狀態
06:47
and energy expenditure.
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及能量消耗。
06:49
Here are some things, the principles
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有些該銘記於心的
06:51
that are guiding principles to keep in mind:
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指導原則:
06:53
"A data-driven health revolution
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「一場由數據主導的健康革命
06:55
promises to make us all
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承諾藉著密切掌控數據,
06:57
better, faster, and stronger. Living by numbers."
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將使我們活的更好、更快、更強壯。」
07:00
And this one, which is really telling,
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《連線》雜誌的七月號刊的
07:02
this was from July, this cover article:
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封面文章說:
07:05
"The personal metrics movement goes way beyond
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「這場生理指標數值個人化的變革
07:08
diet and exercise. It's about tracking every facet
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將遠超越飲食、運動的用途,它可以365天,
07:11
of life, from sleep to mood to pain,
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24小時,全年無休追蹤睡眠、
07:13
24/7/365."
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情緒、疼痛等身體的各個面向。」
07:16
Well, I tried this device.
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我試用過這個裝置。
07:19
A lot of you have gotten that Phillips Direct Life.
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大部分的人用的是飛利浦的 Direct Life,
07:22
I didn't have one of those,
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我用的不是Direct Life,
07:24
but I got the Fitbit.
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而是Fitbit(隨身生活記錄器)
07:26
That looks like this.
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就是這個,
07:28
It's like a wireless accelerometer, pedometer.
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它像是無線的加速度計或計步器。
07:31
And I want to just give you the results of that testing,
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我要測試一下讓大家看看結果,
07:33
because I wanted to understand about the consumer movement.
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我想要了解消費者運動。
07:36
I hope the, by the way, the Phillips Direct Life works better --
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喔,我希望飛利浦的Direct Life比較好用,
07:38
I hope so.
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我說真的。
07:40
But this monitors food, it monitors activity and tracks weight.
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Fitbit可以監測食物、活動、體重。
07:44
However you have to put in most of this stuff.
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但大部分你得自己輸入;
07:46
The only thing it really tracks by itself is activity,
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它唯一自動追蹤監測的是活動,
07:49
and even then, it's not complete.
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即便如此,它仍然不夠完善。
07:51
So, you exercise and it picks up the exercise.
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你運動,它會記錄下來,
07:54
You put in your height and weight, it calculates BMI,
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你輸入身高、體重,它會計算BMI,
07:57
and of course it tells you how many calories you're expending
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運動時它會告訴你耗盡了多少熱量,
08:00
from the exercise, and how many you took in,
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如果輸入你吃的所有食物,
08:03
if you go in and enter all the foods.
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它會告訴你攝取了多少熱量。
08:04
But it really wants you to enter all your activity.
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重點是要輸入你所有的活動,
08:07
And so I went to this,
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我用了Fitbit,
08:10
and of course I was gratified that it picked up
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也很滿意它記錄了
08:12
the 42 minutes of exercise, elliptical exercise I did,
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我做的42分鐘的簡單的運動。
08:16
but then it wants more information.
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但是它要求的更多,
08:18
So, it says, "You want to log sexual activity.
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它說:「輸入你的性行為;
08:21
How long did you do it for?"
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活動持續多久?」
08:23
(Laughter)
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(觀眾笑聲)
08:26
And it says, "How hard was it?"
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「有多困難?」(雙關語:有多硬?)
08:29
(Laughter)
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(觀眾笑聲)
08:30
Furthermore it says, "Start time."
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「開始時間。」
08:33
Now, this doesn't appear -- this just doesn't work,
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我沒有輸入...這樣不行啊,
08:35
I mean, this just doesn't work.
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這樣根本行不通啊。
08:37
So, now I want to move to sleep.
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好,現在來談睡眠,
08:39
Who would ever have thought you could have your own EEG
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誰想到過在自己家裡,
08:42
at your home, tagged to a very nice alarm clock, by the way?
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可以有個附腦波監測器的鬧鐘。
08:45
This is the headband that goes with this alarm clock.
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這是這個鬧鐘的頭帶,
08:48
It monitors your brainwaves continuously, when you're sleeping.
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你睡覺的時候,它會持續監測你的腦波。
08:51
So, I did this thing for seven days
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為了準備TEDMed的演講
08:53
getting ready for TEDMed.
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我試了這個裝置七天。
08:55
This is an important part of our life, one-third you're supposed to be sleeping.
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睡眠是人生的重要部分,一生中有1/3在睡覺。
08:58
Of course how many here
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在座各位有多少
09:00
have any problems with sleeping?
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有睡眠方面的問題?
09:04
It's usually 90 percent. So, you tell me you sleep better than expected.
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通常是90%,所以在座各位都睡的不錯喔!
09:07
Okay, well this was a week of
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好,這是我一個禮拜的
09:10
my life in sleeping,
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睡眠狀況。
09:12
and you get a Z.Q. score. Instead of an I.Q. score,
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這是睡眠商數,不是智力商數,
09:15
you get a Z.Q. score when you wake up.
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一早醒來你會知道你的睡眠商數。
09:17
You say, "Oh, OK." And a Z.Q. score
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你可能會想:「嗯,好。」
09:19
is adjusted to age,
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睡眠商數隨年齡而易,
09:21
and you want to get as high as you possibly can.
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得分越高越好。
09:24
So this is the moment-by-moment,
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這個圖片顯示的是
09:26
or minute-by-minute sleep.
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每分鐘的睡眠狀況。
09:28
And you see that Z.Q. there was 80-odd.
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你可以看到我得了80幾分,
09:31
And the wake time is in orange.
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橘色代表我醒著的時間。
09:34
And this can be a problem, as I learned.
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我發現這樣有問題,
09:37
Because it not only helps you with quantifying
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因為這樣一來它不僅幫助你
09:39
your sleep,
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把睡眠狀況數據化,
09:41
but also tells others you're awake.
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同時也告訴別人你醒著。
09:44
So, when my wife came in and she
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當我太太走進房間
09:47
could tell you're awake.
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她知道我是醒著的。
09:49
"Eric, I want to talk. I want to talk."
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「艾瑞克,我有話要說,我有話要說。」
09:51
And I'm trying to play possum.
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我還在裝睡。
09:53
This thing is very, very impressive.
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這真的是非常的了不起!
09:56
OK. So, that's the first night.
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好,這是第一個晚上,
09:59
And this one is now 67,
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我的分數是67分,
10:01
and that's not a good score.
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這個分數不是很好。
10:03
And this tells you, of course, how much you had in REM sleep,
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這個裝置還告訴你在快速動眼期、
10:05
in deep sleep, and all this sort of thing.
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深眠期和各個狀態的睡眠時間。
10:07
This was really fascinating because
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這真的非常吸引人,
10:09
this gave that quantitation
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因為它對睡眠的
10:11
about all the different phases of sleep.
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各個階段作定量分析。
10:13
So, it also then tells you how you do compared to your age group.
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同時也把你和同年齡的人比較一番,
10:16
It's like a managed competition of sleep.
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好像睡眠大賽似的。
10:19
And really interesting stuff.
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這個裝置真的很有趣。
10:23
Look at this thing and say, "Well, I didn't think I was a very good sleeper,
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我看著它心裡想:「嗯,我睡覺睡得不怎麼樣嘛!
10:26
but actually I did better than average in 50 to 60 year olds." OK?
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但是比起一般五、六十歲的人,我表現的還不賴喔!」
10:31
And the key thing was, what I didn't know,
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我以前所不知道的是,
10:33
was that I was a really good dreamer.
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我睡覺時作很多夢。
10:35
OK. Now let's move from sleep to diseases.
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好,談完了睡眠,來看看疾病。
10:40
Eighty percent of Americans have chronic disease,
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80%的美國人有慢性病,
10:43
or 80 percent of age greater than 65 have
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65歲以上的美國人,
10:46
two or more chronic disease,
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八成罹患兩種以上的慢性病。
10:48
140 million Americans
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有1億4千萬的美國人
10:50
have one or more chronic disease,
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罹患一種以上的慢性病。
10:52
and 80 percent of our 1.5, whatever, trillion
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1.5兆美金的醫療開銷中
10:57
expenditures are related to chronic disease.
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有80%與慢性病有關。
10:59
Now, diabetes is one of the big ones.
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糖尿病是其中之一,
11:01
Almost 24 million people have diabetes.
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大約有2千4百萬人有糖尿病。
11:04
And here is the latest map. It was published
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這是《紐約時報》一星期前公布的
11:06
just a little more than a week ago in the New York Times,
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最新糖尿病患分布地圖。
11:09
and it isn't looking good.
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狀況看起來不妙。
11:11
That is, for men, 29 percent
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在美國,60歲以上男性,
11:14
in the country over 60 have Type II diabetes,
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29%患有第二型糖尿病。
11:17
and women, although it's less, it's terribly high.
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女性雖然少一些,但仍是高得嚇人。
11:20
But of course we have a way to measure that now
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現在有血糖感應器
11:22
on a continuous basis,
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可以用它來
11:24
with a sensor that detects blood glucose,
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持續監測血糖。
11:26
and it's important because we could detect
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這很重要,因為我們可以
11:28
hyperglycemia that otherwise wouldn't be known,
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檢查出現有技術檢查不到的
11:30
and also hypoglycemia.
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高血糖症及低血糖症。
11:32
And you can see the red dots, in this particular patient's case,
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以這個測量針刺血糖值的病人為例,
11:35
were finger sticks, which would have missed both ends.
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其測量值兩側的數據被遺漏了,
11:38
But by continuous monitoring,
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藉由持續監測血糖,
11:40
it captures all that vital information.
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可以記錄所有重要的生命徵象數據。
11:42
The future of this though,
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這一科技的未來,
11:44
is being able to move this to a Band-Aid type phenomenon,
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正朝向OK蹦感應器的形式發展,
11:46
and that's not so far away.
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不久的將來就可以實現。
11:49
So, let me just give you, very quickly,
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現在我簡短的向各位報告
11:51
10 top targets for wireless medicine.
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無線醫療科技的10大目標,
11:53
All these things are possible --
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這些目標都是可以實現的,
11:55
some of them are very close,
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有些很接近完成,
11:57
or already, as you heard,
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或如您聽到的,
11:59
are available today, in some way or form.
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已經被運用於臨床上。
12:01
Alzheimer's disease:
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阿滋海默症:
12:03
there's five million people affected, and you can check
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有500萬人罹患此病,我們可以檢查這些人的
12:05
vital signs, activity, balance.
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生命徵象,活動,平衡感。
12:07
Asthma: large number, we could detect things like
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氣喘:病患眾多,可以檢測
12:10
pollen count, air quality, respiratory rate. Breast cancer,
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花粉量,空氣品質,呼吸頻率。
12:13
I'll show you an example of that real quickly.
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乳癌:稍後我會給各位一個例子。
12:16
Chronic obstructive pulmonary disease.
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慢性阻塞性肺病。
12:19
Depression, there's a great approach to that in mood disorders.
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憂鬱症:現在有很好的情緒障礙監測方法。
12:22
Diabetes I've just mentioned. Heart failure we already talked about. Hypertension:
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我已經介紹過的糖尿病和心臟衰竭。
12:25
74 million people could have continuous blood-pressure monitoring
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高血壓:7千4百萬人可以持續的監控血壓,
12:28
to come up with much better management and prevention.
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幫助醫界找到更好的血壓管理和預防方法。
12:33
And obesity we already talked about, the ways to get to that.
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我們也談過了處理肥胖及
12:36
And sleep disorders.
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睡眠障礙的方法。
12:38
This is effective around the world. The access to smartphones
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這一切可運用在全世界各地,因為手機、
12:41
and cell phones today is extraordinary.
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智慧型手機已經非常普及了。
12:44
And this article from The Economist summed it up beautifully
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這篇《經濟學人》的文章對開發中國家
12:47
about the opportunities in health across the developing world:
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衛生保健發展的時機做了一個完美的總結:
12:49
"Mobile phones made a bigger difference to the lives of more people,
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「相較於以往任何科技,行動電話正以更大的規模、
12:52
more quickly, than any previous technology."
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更快速的影響更多人的生活。」
12:55
And that's before we got going on the m-health world.
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而文章寫於無線醫療開始之前。
12:58
Aging: The problem is enormous,
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老化:問題很嚴重。
13:01
300,000 broken hips per year;
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每年有30萬個髖關節骨折病例。
13:03
but the solutions are extraordinary,
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然而我們有絕佳的解決方案,
13:06
and they include so many different things.
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包括許多琳瑯滿目的科技。
13:08
One of the ones I just wanted to mention:
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其中我要特別一提的就是iShoe:
13:10
The iShoe is another example of a sensor that
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這是個很好的例子,它的感應器可以
13:13
improves proprioception among the elderly
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提高老年人的本體感覺
13:16
to prevent falling.
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預防跌倒。
13:17
One of many different techniques using wireless sensors.
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這是無線感應器科技的其中一個應用。
13:20
So, we can change medicine across the continuum of care,
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醫療將大為改觀,包括持續性照護、
13:23
across the ages from premies or unborn children
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從早產兒、胎兒到老年人
13:27
to seniors; the pharmaceutical arena changes;
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各年齡層的醫療、整個製藥領域,
13:30
the full spectrum of disease -- I hope I've given you a sense of that --
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整個疾病醫療過程。希望我說得夠清楚,
13:33
across the globe.
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全球醫療也將改變。
13:35
There are two things that can really accelerate this whole process.
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有兩件事更加快了這個過程。
13:38
One of them -- we're very fortunate -- is to develop a dedicated institute
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第一,我們非常幸運成立了專門研究無線醫療的機構,
13:42
and that's work that started with the work that Scripps with Qualcomm ...
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斯克利普斯研究院和高通公司是這方面的先驅;
13:48
and then the great fortune of meeting up with Gary and Mary West,
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再者就是非常幸運的遇到蓋瑞和瑪莉威斯特夫婦,
13:51
to get behind this wireless health institute.
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他們大力襄助這個無線醫療研究機構。
13:54
San Diego is an extraordinary place for this.
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聖地牙哥是個絕佳的地點,
13:56
There's over 650 wireless companies,
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有650家無線技術的公司,
13:59
100 of which or more are working in wireless health.
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其中100多家專攻無線醫療領域。
14:02
It's the number one source of commerce, and interestingly
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有最豐富的無線醫療商務資源,
14:05
it dovetails beautifully with over 500 life science companies.
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天衣無縫的搭配500多家生命科學公司。
14:08
The wireless institute,
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威斯特無線健康研究院
14:11
the West Wireless Health Institute,
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是這兩位卓越非凡的人
14:13
is really the outgrowth of two extraordinary people
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努力的成果,
14:17
who are here this evening:
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今晚他們也來到了現場 —
14:19
Gary and Mary West. And I'd like to give it up for them for getting behind this.
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蓋瑞和瑪莉威斯特夫婦,在此我要感謝威斯特夫婦的鼎力相助。
14:22
(Applause)
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(觀眾鼓掌)
14:26
Their fantastic philanthropic investment made this possible,
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威斯特夫婦慷慨的慈善投資使這一切能夠實現,
14:29
and this is really a nonprofit education center
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就是這所即將開幕營運的
14:32
which is just about to open. It looks like this,
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非營利教育中心,這是它的外觀。
14:35
this whole building dedicated.
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威斯特研究院將完全致力於無線醫療的研究。
14:38
And what it's trying to do is accelerate this era:
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也正嚐試加速無線醫療時代的發展:
14:40
to take unmet medical needs, to work and innovate --
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針對有待解決的醫療需求,研發創新。
14:43
and we just appointed the chief engineer, Mehran Mehregany,
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我們在星期一剛宣布任命了
14:46
it was announced on Monday --
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首席工程師 Mehran Mehregany。
14:48
then to move up with development,
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我們自許要與時俱進,
14:50
clinical trial validation and then changing medical practice,
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進行臨床試驗,改善醫療現況。
14:53
the most challenging thing of all,
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最大的挑戰在於,
14:56
requiring attention to reimbursement, healthcare policy, healthcare economics.
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喚起大眾對醫療賠償、健保政策及財政的關注。
14:59
The other big thing, besides having this fantastic
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有這所研究機構催化醫療變革之外,
15:02
institute to catalyze this process
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另一件重要的事是 —
15:05
is guidance,
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發展方向的指引,
15:08
and that's of course relying on the fact that medicine goes digital.
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這有賴於醫療數位化。
15:11
If we understand biology from genomics and omics
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我們從基因組學和體學來了解生物學,
15:15
and wireless through physiologic phenotyping, that's big.
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透過無線科技了解生理表型分析是重大的進展。
15:19
Because what it does is allow a convergence like we've never had before.
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因為這是人類知識史無前例的大匯集。
15:22
Over 80 major diseases have been cracked at the genomic level,
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超過80%重大疾病的基因已被破解,
15:27
but this is quite extraordinary: More has been learned about
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這是非凡的成就— 在過去這兩年半
15:30
the underpinnings of disease in the last two and a half years
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我們對於疾病發生的根本成因的瞭解
15:32
than in the history of man.
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超越了歷史的任何一個時期。
15:34
And when you put that together with, for example,
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把這一切搭配iPhone的
15:36
now an app for the iPhone with your genotype
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應用軟體,針對個人遺傳基因
15:39
to guide drug therapy ...
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來引導選擇藥物治療。
15:41
but, the future -- we can now tell who's going to get Type II diabetes
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現在我們可以根據常見的基因變異,
15:45
from all the common variants,
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預測誰會得到第二型糖尿病,
15:47
and that's going to get filled in more
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而未來,我們對造成第二型糖尿病
15:49
with low-frequency variants in the future.
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的較不常見的變異,會有更多了解。
15:51
We can tell who's going to get breast cancer
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我們可以從各種基因
15:53
from the various genes.
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預測誰會得到乳癌,
15:55
We can also know who's likely to get atrial fibrillation.
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也可以預測誰有可能罹患心律不整(心房纖維顫動),
15:58
And finally, another example: sudden cardiac death.
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以及心因性猝死。
16:01
Each of these has a sensor.
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針對每項疾病我們研發出感應器。
16:03
We can give glucose a sensor for diabetes to prevent it.
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糖尿病患者能夠運用血糖感應器來事先防範。
16:07
We can prevent, or have the earliest detection possible,
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我們可以用超音波掃描儀
16:10
for breast cancer with an ultrasound device
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來預防或儘早
16:13
given to the patient.
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驗出乳癌,
16:15
An iPatch, iRhythm, for atrial fibrillation.
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讓心律不整患者配戴iRhythm,
16:18
And vital-signs monitoring to prevent sudden cardiac death.
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藉由監測生命徵象預防心因性猝死,
16:22
We lose 700,000 people a year in the U.S. from sudden cardiac death.
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每年美國有70萬人死於心因性猝死。
16:25
So, I hope I've convinced you of this,
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我希望傳達給各位的是 —
16:28
of the impact on hospital clinic resources is profound
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無線裝置對醫療院所資源的影響極其深遠,
16:32
and then the impact on diseases is equally impressive
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對於疾病也同樣將帶來巨大、深遠的影響,
16:35
across all these different diseases and more.
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包括剛剛談過的,及其他更多的疾病。
16:38
It's really taking individualized medicine to a new height
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醫療無線裝置將把個人化醫療帶向更高的水平、
16:42
and it's hyper-innovative,
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一個空前創新的境界。
16:45
and I think it represents the black swan of medicine.
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我認為它將引發醫藥界的黑天鵝效應。
16:49
Thanks for your attention.
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感謝各位的聆聽。
16:52
(Applause)
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(觀眾掌聲)
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