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更新时间:2013-12-26 13:19:03 来源:华尔街日报中文网 作者:佚名

5 High-Tech Fixes For Patients

From virtual doctor visits to online diagnoses, information technology is rapidly changing the way patients interact with the health system. Here are some innovations that are catching on more broadly and could improve care in 2014:


Monitor Long-Distance


An electronic intensive-care unit, or eICU, lets critical-care doctors and nurses check on patients in several hospitals from a remote command center with a bank of monitors displaying patients' vital signs. They can alert bedside staff if they see a subtle change in a patient that could signal a worsening condition. Remote monitoring by specialists is also catching on for emergency rooms and surgical units to help evaluate patients with stroke, seizures and other conditions.


Patients in a hospital with an eICU program were 26% more likely to survive their stay and were discharged 20% faster than those receiving usual ICU care, according to a study published earlier in December in the journal CHEST. The study analyzed some 120,000 patients in 56 ICUs over five years.


Video cameras can be activated if the remote team needs to visually check the patient, and can be used to check regularly on patients who might be at risk for falls, according to Brian Rosenfeld, an inventor of the eICU technology and chief medical officer for telehealth at Philips Healthcare, a unit of Dutch technology giant Royal Philips that purchased his company in 2008. As more evidence of its benefits has emerged, resistance among some critical-care doctors to having a remote doctor looking over their shoulder has dissipated, he says, but some 'still think they are delivering perfect care and no one can help them.'

eICU电子技术发明者、Philips Healthcare首席医疗长布莱恩•罗森菲尔德(Brian Rosenfeld)称,摄像机可以在远程治疗团队需要查看病人时启动,也可以用于定期检查那些可能面临病情恶化风险的病人;Philips Healthcare是荷兰皇家飞利浦电子公司(Royal Philips Electronics NV)在2008年收购的子公司。他表示,由于有越来越多的证据证明该技术的好处,一些重症治疗医生消除了对远程医生的抵触情绪,不过仍然有些医生认为,他们可以提供完美治疗,没有人能够帮助他们。

The eICU helps especially in rural areas where there can be a shortage of specialists. Phoenix-based hospital-and-health system Banner Health currently monitors and supports more than 450 ICU beds across several Western states from command centers in Mesa, Ariz., and Greeley, Colo., and even uses some doctors in a Tel Aviv, Israel, center to cover shifts.

eICU尤其可以为缺少专家的农村地区提供帮助。费尼克斯(Phoenix)医院健康系统Banner Health目前监护及支持西部几个州的450多个ICU病床,其指挥中心位于阿桑那州梅萨(Mesa)和科罗拉多州格里利(Greeley),甚至动用了以色列特拉维夫(Tel Aviv)中心的一些医生参与轮班。

Crowdsource an Ailment


Patients can crowdsource their symptoms to find a diagnosis. As strange as it sounds, health experts say this may hold promise. On a new website, CrowdMed.com, patients who haven't been able to get a firm diagnosis can post their symptoms online to crowdsource an answer.

病人可以上传他们的症状,利用众包服务获得诊断。该服务听起来就像其名字一样奇怪,不过健康专家称,该服务大有前途。在一个新网站 CrowdMed.com上,那些未能确诊的病人可以把他们的症状发布在网上,通过群众智慧寻找答案。

Founded by technology entrepreneur Jared Heyman after his sister Carly went three years with an undiagnosed illness, CrowdMed lets users offer a cash reward that goes directly to the 'medical detectives' -- be they laypeople or physicians -- who help solve their case. Medical detectives may suggest a diagnosis and bet points on others' suggestions. Each diagnosis is treated as a stock with a share price that moves based on 'demand' for the diagnosis. CrowdMed uses an algorithm to calculate the probability of each diagnosis being correct according to betting behavior, ranks the diagnoses from most to least likely, and presents the patient with the top 3 to 6. The average reward on the site is currently $200, the company says. Detectives split the rewards based on how many points they bet on the correct diagnosis.

该网站是技术型创业者贾里德•海曼(Jared Heyman)创办的,之前他妹妹有三年时间被疑难病困扰而没有确诊。CrowdMed让用户提供现金奖励,直接转给帮助他们解决问题的“医学神探”,无论他们是外行还是医生。医疗神探可以提出一个诊断建议,并为其他诊断建议押注点数。每个诊断都可视为一个股票,股票价格根据该诊断的“需求”波动。CrowdMed使用一种算法基于押注点数计算每个诊断正确的概率,按最可能到最不可能来排列,并向病人提供排名前三至前六的诊断。公司表示,目前网站上的平均奖金为200美元。医学神探们将根据他们对正确诊断所押注的点数来分享奖金。

Mr. Heyman says the idea isn't to replace doctors, but to come up with a list of possibilities a doctor might not have considered. Before the site launched, doctors diagnosed his sister with a disorder that includes early menopause symptoms. CrowdMed used her case to test the system later and within three weeks it was diagnosed correctly.


Luke Hoelscher, 31, recently posted his case on CrowdMed.com, after what he describes as several frustrating years of going from doctor to doctor with undiagnosed symptoms that included blurry vision, severe light sensitivity, bodily pain, and fatigue. He is offering a $500 reward. A former software engineer who can no longer work due to his health issues, Mr. Hoelscher says he has yet to find an answer through the site, but is optimistic. 'There have to be people out there who have dealt with what I am dealing with,' he says.

31岁的卢克•霍尔舍(Luke Hoelscher)最近在CrowdMed.com发布了他的症状——视力模糊、对光极度敏感、身体疼痛和疲劳。几年来,他看过了很多医生,但都未能就他的病情作出诊断。他提供了500美元的奖金。由于身体原因,Hoelscher已经无法工作。这位曾经的软件工程师说,他还没有通过网站找到答案,但他对此感到乐观。他说,网站上肯定有和我症状相同的人。

Consult Via Video


Hospitals, insurers and health systems are increasingly allowing patients to make an appointment online or consult a physician via video chat. Insurer Cigna, for example, recently teamed up with Sunrise, Fla.-based MDLive to allow some health-plan members to schedule a virtual consultation with a doctor for nonemergency situations such as allergies and sinus infections.


Sharecare, an online health-and-wellness site whose founders include celebrity doctor Mehmet Oz, recently launched AskMD, an app that collects information about symptoms, locates doctors, filters results by insurance, specialty and distance and directs users to the nearest emergency room if it looks like they need one. Hospital Corp. of America, a major hospital chain, is a sponsor of the launch, and some of its affiliated doctors and hospitals will be featured.

医疗和健康网站Sharecare(创始人包括名人医生Mehmet Oz)近期推出了一款名为AskMD的应用程序,该程序收集用户的症状信息,定位医生,通过保险、专长和距离等条件来筛选结果,并且如果用户需要就医的话就引导他们去最近的急诊室。大型连锁医院运营商Hospital Corp. of America是该程序的一个赞助商,该公司旗下的一些医生和医院将被重点介绍。

Text a Nurse


When Valerie Weichart, 56, was hospitalized recently for back surgery at St. Rita's Medical Center in Lima, Ohio, she was provided with a tablet device. It allowed her to view her medical chart and lab-test results, read up on her medications, see bios and photos of the staff caring for her, and text a nurse for help. St. Rita's parent, Catholic Health Partners, aims to roll out the system to its 23 hospitals after having completed a successful pilot. The system, called MyChartBedside, is linked to patients' electronic medical records. Patients can also use the device to surf the Web and play games.

最近,56岁的Valerie Weichart在俄亥俄州莱马的St. Rita's Medical Center住院进行背部手术。医院向她提供了一个平板设备,她可以从中查看她的病历和实验室检验结果,仔细研究她的用药,浏览照顾她的员工的简历和照片,并且可以给护士发信息寻求帮助。若试用成功,St. Rita的母公司Catholic Health Partners计划将该系统推广至旗下23家医院。这个名为MyChartBedside的系统与病人的电子病历相连接。病人也可以使用该装置来浏览网页和玩游戏。

'I felt more comfortable knowing what my medications were, so I didn't have to ask so many questions,' Ms. Weichart says.


NewYork-Presbyterian Hospital also has been testing arming patients with tablets. 'We worried at first about how nurses would adjust to it, but they really like it,' says hospital chief executive Steven Corwin. The units are quieter without the ring of call buttons. The messaging system makes it easier for nurses to prioritize patient needs and requests. And patients are more fully engaged in their own care, Dr. Corwin says.

NewYork-Presbyterian Hospital也在试验向病人提供平板设备。这家医院的首席执行长Steven Corwin表示,一开始他们担心护士可能无法适应,但实际上他们很喜欢这个系统。病房更安静了,没有人按呼叫按钮了。Corwin说,这个信息传递系统让护士更容易确定病人需求的轻急缓重,病人也更加了解自己的病情。

Calculate the Cost of Care


With the coming changes in insurance coverage, calculating copayments and other out-of-pocket costs could be daunting. Insurers and health plans are offering cost estimates online and through mobile apps that calculate how much patients will have to pay out of pocket, how much a plan will pay, and available in-network reduced rates. UnitedHealthcare's myHealthcare Cost Estimator, launched last year, recently added inpatient hospital information including knee replacement, childbirth, and spinal surgery. The costs can vary widely. For example, the company says, childbirth, including prenatal and postnatal care can range from $9,699 to $29,076 in the New York City area. In a survey of its users, 67% said the calculator gave them the confidence to make better cost choices.

鉴于医疗覆盖范围即将调整,计算医保计划支出和其他现付支付将是非常麻烦的事情。保险商和医保计划将在网络上提供费用预估,并通过移动应用程序计算病人需要现付多少费用以及医保计划应支付多少费用。UnitedHealthcare去年推出了医疗费用计算程序myHealthcare Cost Estimator,该程序最近增加了膝关节置换、生产和脊柱手术等住院病人的信息。这些医疗开支相差很大。该公司称,举个例子,纽约市的生产(包括产前和?后护理)费用为9,699美元到29,076美元不等。在对该公司用户进行调查时,67%的人表示医疗费用计算程序让他们有信心作出更好的医疗支出选择。