TEDMED 2015
Todd Coleman: A temporary tattoo that brings hospital care to the home
托德・科尔曼: 临时纹身，将医院带回家
Filmed:
Readability: 4.7
1,489,379 views
假如在家中可以得到和在医院中相同精准度的检测结果会怎样呢？生物电子领域的创新者托德・科尔曼分享了他研发一种便携式，柔性电子健康检测设备的故事，为医疗科技的革命性变化，更亲民的药物带来了可能。
Todd Coleman - Bioelectronics innovator
UCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health. Full bio
UCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health. Full bio
Double-click the English transcript below to play the video.
00:13
Please meet Jane.
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这是简。
00:15
She has a high-risk pregnancy.
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她属于高风险怀孕人群。
在长达24周的时间里，
00:17
Within 24 weeks,
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她都要躺在医院的病床上，
00:19
she's on bed rest at the hospital,
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时刻被监视，以免发生早产。
00:21
being monitored
for her preterm contractions.
for her preterm contractions.
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00:25
She doesn't look the happiest.
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她看起来并不开心。
一部分是因为她需要
携带这些笨重的检测带，
携带这些笨重的检测带，
00:26
That's in part because it requires
technicians and experts
technicians and experts
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以便技术人员与专家
监测她子宫的收缩情况。
监测她子宫的收缩情况。
00:30
to apply these clunky belts on her
to monitor her uterine contractions.
to monitor her uterine contractions.
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00:35
Another reason Jane is not so happy
is because she's worried.
is because she's worried.
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简不高兴的另一个原因是她很担心。
00:40
In particular, she's worried
about what happens
about what happens
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具体来说，她担心的
是在医院病床上躺了十天之后的情况。
00:43
after her 10-day stay
on bed rest at the hospital.
on bed rest at the hospital.
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00:47
What happens when she's home?
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她回家的话会发生什么呢？
如果选择提前生产，
结果将是难以承受的。
结果将是难以承受的。
00:49
If she were to give birth this early
it would be devastating.
it would be devastating.
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00:53
As an African-American woman,
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作为一个非裔美国妇女，
出现早产或是死胎的几率
00:55
she's twice as likely
to have a premature birth
to have a premature birth
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00:59
or to have a stillbirth.
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是一般人的两倍。
01:01
So Jane basically has one of two options:
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所以简基本只能二选一：
继续呆在医院的病床上，
01:04
stay at the hospital on bed rest,
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01:07
a prisoner to the technology
until she gives birth,
until she gives birth,
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成为科技的奴隶，
直到她生产为止，
直到她生产为止，
01:11
and then spend the rest
of her life paying for the bill;
of her life paying for the bill;
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并用余生去偿还账单；
01:14
or head home after her 10-day stay
and hope for the best.
and hope for the best.
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或是在10天后选择回家，祈求天助。
01:20
Neither of these two options
seems appealing.
seems appealing.
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这两种选择听起来都不怎么样。
01:24
As I began to think
about stories like this
about stories like this
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当我听说这些故事，
尝试去思考它们，
01:26
and hear about stories like this,
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我就开始质问自己：
01:28
I began to ask myself and imagine:
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难道没有第三种选择吗？
01:30
Is there an alternative?
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有没有一种办法让人们
既能从医院中值得信任的人手上
既能从医院中值得信任的人手上
01:31
Is there a way we could have
the benefits of high-fidelity monitoring
the benefits of high-fidelity monitoring
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拿到高可信度的监测结果，
01:36
that we get with our trusted
partners in the hospital
partners in the hospital
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又能在家中正常生活呢？
01:39
while someone is at home
living their daily life?
living their daily life?
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01:42
With that in mind,
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带着这种想法，
我鼓励我研发团队中的成员
01:44
I encouraged people in my research group
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去与一些聪明的材料学家合作，
01:46
to partner with some
clever material scientists,
clever material scientists,
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我们聚在一起，集思广益。
01:49
and all of us came together
and brainstormed.
and brainstormed.
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01:52
And after a long process,
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很长一段时间过去之后，
我们提出了一种设想，
一个点子，
一个点子，
01:54
we came up with a vision, an idea,
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那就是一种便携式的系统，
01:56
of a wearable system that perhaps
you could wear like a piece of jewelry
you could wear like a piece of jewelry
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就像佩戴珠宝或是
贴块儿膏药一样容易操作。
贴块儿膏药一样容易操作。
02:00
or you could apply
to yourself like a Band-Aid.
to yourself like a Band-Aid.
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02:03
And after many trials and tribulations
and years of endeavors,
and years of endeavors,
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在经过许多次失败的尝试和
多年的努力之后，
多年的努力之后，
我们终于做出了这款柔性电子贴膜。
02:07
we were able to come up
with this flexible electronic patch
with this flexible electronic patch
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02:11
that was manufactured
using the same processes
using the same processes
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它的制作过程与
生产电脑芯片的过程大同小异，
02:13
that they use to build computer chips,
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02:16
except the electronics are transferred
from a semiconductor wafer
from a semiconductor wafer
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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。
相贴合的柔性材料上。
02:21
onto a flexible material
that can interface with the human body.
that can interface with the human body.
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这套产品的厚度只相当于
人类的头发直径。
人类的头发直径。
02:25
These systems are about
the thickness of a human hair.
the thickness of a human hair.
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它们能检测我们需要的信息，
02:30
They can measure the types
of information that we want,
of information that we want,
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02:33
things such as:
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比如：
02:35
bodily movement,
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人体的运动，
02:36
bodily temperature,
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体温，
02:38
electrical rhythms of the body
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人体电信号节律，
02:39
and so forth.
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等等其他信息。
02:41
We can also engineer these systems,
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我们还可以改造这套系统，
02:43
so they can integrate energy sources,
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使它们可以整合能源，
或者拥有无线电传输功能。
02:46
and can have wireless
transmission capabilities.
transmission capabilities.
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02:50
So as we began to build
these types of systems,
these types of systems,
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因此，当我们开始创建这套系统，
02:54
we began to test them on ourselves
in our research group.
in our research group.
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我们就把自身当作实验对象。
02:58
But in addition, we began to reach out
to some of our clinical partners
to some of our clinical partners
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另外，我们也联系了在圣地亚哥的
合作诊所，
03:02
in San Diego,
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在不同的病患身上
依据不同临床状况做测试，
依据不同临床状况做测试，
03:03
and test these on different patients
in different clinical conditions,
in different clinical conditions,
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03:07
including moms-to-be like Jane.
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也包括一些像简一样
即将作母亲的人。
即将作母亲的人。
03:10
Here is a picture of a pregnant woman
in labor at our university hospital
in labor at our university hospital
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这是一位正在我们大学医院
接受传统腰带法
检测子宫收缩情况的孕妇。
检测子宫收缩情况的孕妇。
03:15
being monitored for her uterine
contractions with the conventional belt.
contractions with the conventional belt.
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03:20
In addition,
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同时，
她也使用了我们的柔性电子贴片。
03:22
our flexible electronic patches are there.
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03:25
This picture demonstrates waveforms
pertaining to the fetal heart rate,
pertaining to the fetal heart rate,
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这张图演示了
胎儿心率的波形图。
胎儿心率的波形图。
03:29
where the red corresponds
to what was acquired
to what was acquired
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其中，红色对应传统腰带的
03:32
with the conventional belts,
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采集结果，
03:34
and the blue corresponds to our estimates
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蓝色对应我们用柔性电子检测贴片
以及我们的算法做出的预估值。
03:36
using our flexible electronic systems
and our algorithms.
and our algorithms.
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03:40
At this moment,
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这个结果，
给予了我们莫大的精神鼓舞。
03:42
we gave ourselves a big mental high five.
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03:45
Some of the things we had imagined
were beginning to come to fruition,
were beginning to come to fruition,
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我们所梦想的这一切
已经开始取得初步成果，
已经开始取得初步成果，
03:48
and we were actually seeing this
in a clinical context.
in a clinical context.
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我们也能在真正的
临床背景下目睹进展。
临床背景下目睹进展。
03:52
But there was still a problem.
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但仍然存在一个问题。
03:53
The problem was, the way
we manufactured these systems
we manufactured these systems
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我们生产这种系统的
能效不足，
03:57
was very inefficient,
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产率低下，
03:58
had low yield
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而且出错率高。
04:00
and was very error-prone.
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04:02
In addition,
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另外，
当我们与医院中的护士们交流时，
04:03
as we talked to some
of the nurses in the hospital,
of the nurses in the hospital,
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她们希望我们能确保
04:05
they encouraged us to make sure
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医院里常用的医用胶布
04:07
that our electronics worked
with typical medical adhesives
with typical medical adhesives
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也能作为我们系统的载体。
04:12
that are used in a hospital.
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04:14
We had an epiphany and said,
"Wait a minute.
"Wait a minute.
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我们茅塞顿开，回答道：“等一下，
04:16
Rather than just making
them work with adhesives,
them work with adhesives,
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与其只是让系统和胶布绑定，
不如干脆把系统直接内置在胶布上
04:19
let's integrate them into adhesives,
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04:23
and that could solve
our manufacturing problem."
our manufacturing problem."
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这也会同时解决
批量生产上的问题。”
批量生产上的问题。”
04:26
This picture that you see here
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你们现在看到的这张图，
展现了我们通过
简单晶片表层剥离技术，
简单晶片表层剥离技术，
04:28
is our ability to embed these censors
inside of a piece of Scotch tape
inside of a piece of Scotch tape
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使将检测系统整合入
透明胶带中的能力。
透明胶带中的能力。
04:32
by simply peeling it off of a wafer.
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04:36
Ongoing work in our research group
allows us to, in addition,
allows us to, in addition,
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我们实验小组的持续研究还让我们
能够将集成电路做进柔性胶带中，
04:39
embed integrated circuits
into the flexible adhesives
into the flexible adhesives
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实现信号放大，数字化，
04:43
to do things like amplifying signals
and digitizing them,
and digitizing them,
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加工处理，
04:47
processing them
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以及无线电传输的编码工作。
04:48
and encoding for wireless transmission.
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04:51
All of this integrated
into the same medical adhesives
into the same medical adhesives
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这一切都被整合进入
这同一款医用胶布当中。
04:55
that are used in the hospital.
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04:57
So when we reached this point,
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当我们达到这个目标时，
我们又面临了来自工程，
04:59
we had some other challenges,
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来自实用领域的新挑战，
05:01
from both an engineering
as well as a usability perspective,
as well as a usability perspective,
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我们需要确保它简单易用。
05:05
to make sure that we could
make it used practically.
make it used practically.
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05:09
In many digital health discussions,
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在许多数字化健康讨论当中，
人们坚信一个观点，
那就是我们可以将数据轻松数字化，
那就是我们可以将数据轻松数字化，
05:11
people believe in and embrace the idea
that we can simply digitize the data,
that we can simply digitize the data,
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将其无线传输，
05:16
wirelessly transmit it,
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发送到云端，
05:18
send it to the cloud,
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并在云端当中
05:19
and in the cloud,
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提取有价值的信息进行分析。
05:21
we can extract meaningful
information for interpretation.
information for interpretation.
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05:24
And indeed, you can do all of that,
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确实，这些都能实现，
前提是系统不存在能耗问题。
05:26
if you're not worried
about some of the energy challenges.
about some of the energy challenges.
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想一下简。
05:29
Think about Jane for a moment.
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她并不居住在帕洛阿尔托，
05:31
She doesn't live in Palo Alto,
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也不住在贝弗利山庄。
05:33
nor does she live in Beverly Hills.
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05:35
What that means is,
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这意味着什么呢？
我们必须充分考虑她的数据流量，
发出持续的信号流
发出持续的信号流
05:36
we have to be mindful about her data plan
and how much it would cost
and how much it would cost
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是否会导致高昂的开销。
05:39
for her to be sending out
a continuous stream of data.
a continuous stream of data.
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05:44
There's another challenge
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还有另一个挑战，
这并不是每一个医疗领域的
从业者都愿提及的。
从业者都愿提及的。
05:45
that not everyone in the medical
profession is comfortable talking about.
profession is comfortable talking about.
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那就是，简对待医疗机构
05:49
And that is, that Jane
does not have the most trust
does not have the most trust
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没有充分的信任。
05:52
in the medical establishment.
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05:54
She, people like her, her ancestors,
have not had the best experiences
have not had the best experiences
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她，还有和她一样的人们，
他们的前辈们都曾经
他们的前辈们都曾经
对医生，医院，或是保险公司留下过
05:59
at the hands of doctors and the hospital
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06:03
or insurance companies.
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不好的印象。
06:05
That means that we have to be mindful
of questions of privacy.
of questions of privacy.
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这表明我们必须注意
个人隐私的问题。
个人隐私的问题。
简可能会为
06:08
Jane might not feel that happy
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06:10
about all that data
being processed into the cloud.
being processed into the cloud.
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数据全部传送至云端而感到担忧。
06:14
And Jane cannot be fooled;
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通过读新闻，
06:17
she reads the news.
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简是不会轻易被骗的。
她知道如果
联邦政府系统都可以被黑，
联邦政府系统都可以被黑，
06:18
She knows that if the federal
government can be hacked,
government can be hacked,
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如果“财富”500强企业
都可以被黑，
都可以被黑，
06:21
if the Fortune 500 can be hacked,
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06:24
so can her doctor.
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她医生的系统也可能被黑。
06:27
And so with that in mind,
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想到这一点，
我们不由得灵机一动：
06:28
we had an epiphany.
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06:30
We cannot outsmart
all the hackers in the world,
all the hackers in the world,
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既然不能做到比世界上
所有的黑客都更加聪明，
所有的黑客都更加聪明，
不如我们把自己变小，
淡出他们的目标。
淡出他们的目标。
06:33
but perhaps we can present
them a smaller target.
them a smaller target.
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06:36
What if we could actually,
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如果说我们可以
将原本在云端当中进行的
06:39
rather than have those algorithms
that do data interpretation
that do data interpretation
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数据算法过程
06:43
run in the cloud,
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06:44
what if we have those algorithms run
on those small integrated circuits
on those small integrated circuits
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转移到一个内嵌于贴片的小型
集成电路当中呢？
06:48
embedded into those adhesives?
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06:50
And so when we integrate
these things together,
these things together,
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这样我们就能做到彻底的整合，
借此来想像一下未来，
06:54
what this means is that now
we can think about the future
we can think about the future
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像简一样的人们
可以过着正常人的生活，
可以过着正常人的生活，
06:57
where someone like Jane can still
go about living her normal daily life,
go about living her normal daily life,
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同时被监控着，
07:01
she can be monitored,
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她也不需要找第二份工作
07:03
it can be done in a way where
she doesn't have to get another job
she doesn't have to get another job
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来支付数据流量，
07:06
to pay her data plan,
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我们也能缓解
她的部分疑虑和担忧。
她的部分疑虑和担忧。
07:08
and we can also address
some of her concerns about privacy.
some of her concerns about privacy.
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07:12
So at this point,
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基于这种情况，
我们对自己的表现很满意。
07:14
we're feeling very good about ourselves.
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我们做到了，
07:16
We've accomplished this,
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我们成功解决了
关于个人隐私的问题，
关于个人隐私的问题，
07:17
we've begun to address some
of these questions about privacy
of these questions about privacy
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我们觉得这件事基本告一段落了。
07:20
and we feel like, pretty much
the chapter is closed now.
the chapter is closed now.
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所有人从此过上幸福的生活，
是这样吗？
是这样吗？
07:24
Everyone lived happily ever after, right?
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07:28
Well, not so fast.
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不，还没这么快。
（笑声）
07:30
(Laughter)
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就像我之前提到的，
还有一件我们需要记住的事情，
还有一件我们需要记住的事情，
07:31
One of the things we have to remember,
as I mentioned earlier,
as I mentioned earlier,
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那就是简对于医疗机构
没有充分的信任。
没有充分的信任。
07:34
is that Jane does not have the most trust
in the medical establishment.
in the medical establishment.
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我们必须要意识到
07:38
We have to remember
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健康服务的两极分化在不断扩大，
07:39
that there are increasing
and widening health disparities,
and widening health disparities,
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在适当护理管理方面
仍存在不公平的现象。
仍存在不公平的现象。
07:42
and there's inequity in terms
of proper care management.
of proper care management.
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07:46
And so what that means
is that this simple picture
is that this simple picture
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也就是说，
简和她的数据的简单构图——
07:49
of Jane and her data --
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07:50
even with her being comfortable
being wirelessly transmitted to the cloud,
being wirelessly transmitted to the cloud,
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当她已经能舒适的
将数据传送至云端,
将数据传送至云端,
在必要时才让医生来干预——
07:54
letting a doctor intervene if necessary --
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这还并非故事的全部。
07:57
is not the whole story.
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07:59
So what we're beginning to do
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所以我们下一步的目标，
是去思考如何让值得
被信任的机构成为
被信任的机构成为
08:00
is to think about ways to have
trusted parties serve as intermediaries
trusted parties serve as intermediaries
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像简这样的病患
和医生之间的中间人。
和医生之间的中间人。
08:05
between people like Jane
and her health care providers.
and her health care providers.
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举个例子，
我们已经开始和教会合作，
我们已经开始和教会合作，
08:08
For example, we've begun
to partner with churches
to partner with churches
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我们考虑那些是
教会成员的护士们,
教会成员的护士们,
08:11
and to think about nurses
that are church members,
that are church members,
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她们是被信赖的群体，
08:14
that come from that trusted community,
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让她们成为像简
一样的人们的健康私教。
一样的人们的健康私教。
08:16
as patient advocates and health coaches
to people like Jane.
to people like Jane.
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08:21
Another thing we have going for us
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随之而来的还有一件事，
许多保险公司也陆续的
08:23
is that insurance companies, increasingly,
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开始关注我们的这些想法。
08:25
are attracted to some of these ideas.
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08:27
They're increasingly realizing
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他们逐渐意识到
可能花费一点儿钱
08:29
that perhaps it's better
to pay one dollar now
to pay one dollar now
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去支付便携式设备
和健康教练，
和健康教练，
08:32
for a wearable device and a health coach,
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要比之后因孩子早产
08:35
rather than paying 10 dollars later,
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08:38
when that baby is born prematurely
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而要常住新生儿ICU，
医院中最贵的部门之一，
08:40
and ends up in the neonatal
intensive care unit --
intensive care unit --
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从而产生的大比花销要稍微好点儿。
08:43
one of the most expensive
parts of a hospital.
parts of a hospital.
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08:47
This has been a long
learning process for us.
learning process for us.
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我们经历了漫长的学习过程。
08:50
This iterative process of breaking
through and attacking one problem
through and attacking one problem
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这个反复的过程——
每当突破一个问题，
每当突破一个问题，
并不感到满足，
08:54
and not feeling totally comfortable,
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而是接着提出下一个问题，
08:56
and identifying the next problem,
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这帮助我们
遵循这样一条道路，
遵循这样一条道路，
08:58
has helped us go along this path
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就是不仅为了科技创新，
09:00
of actually trying to not only
innovate with this technology
innovate with this technology
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而且为了造福真正需要他们的人。
09:03
but make sure it can be used for people
who perhaps need it the most.
who perhaps need it the most.
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09:07
Another learning lesson
we've taken from this process
we've taken from this process
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我们学会的另一件事，
一件非常谦卑的事，
09:10
that is very humbling,
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是伴随着科技的迅速发展，
09:11
is that as technology progresses
and advances at an accelerating rate,
and advances at an accelerating rate,
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我们必须铭记使用
这些科技的是人类，
这些科技的是人类，
09:16
we have to remember that human beings
are using this technology,
are using this technology,
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我们必须铭记
09:20
and we have to be mindful
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这些人——
他们有血有肉，
他们有血有肉，
09:21
that these human beings --
they have a face,
they have a face,
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他们有自己的名字，
09:25
they have a name
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他们有自己的生活。
09:26
and a life.
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在简的例子中是这样，
09:27
And in the case of Jane,
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还有她即将出生的孩子。
09:29
hopefully, two.
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09:32
Thank you.
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谢谢。
（鼓掌）
09:33
(Applause)
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ABOUT THE SPEAKER
Todd Coleman - Bioelectronics innovatorUCSD bioengineering professor Todd Coleman integratively spans the disciplines of medical electronics, machine learning and public health.
Why you should listen
Todd Coleman's research develops multi-functional, flexible bioelectronics and novel analytics methods to benefit patients and clinical decision-makers.
After a PhD in electrical engineering at MIT, Coleman did a neurosciences post-doc and became an assistant professor in electrical and computer engineering and neuroscience at University of Illinois before joining the faculty of UCSD. An avid public health advocate, Coleman understands the value of collaborating with community health programs to truly implement and deliver sustainable innovations to those who need it most.
Todd Coleman | Speaker | TED.com