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- 七字解码玄机资料 - wg418.com

2018-07-22 01:42 来源:二四六天天好彩64407.com

   - 七字解码玄机资料 - wg418.com

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  二四六天天好彩 天天好彩 246天天好彩免费资料大全

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2018-07-22 11:13   新浪财经 微博 收藏本文  
图为《新闻周刊》杂志封面图为《新闻周刊》杂志封面
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  导读:《新闻周刊》封面文章称,数据与人工智能相结合直到这两年才出现,但有可能导致颠覆其它太多行业的那种自动化。很多医疗保健公司正好专注于降低医疗保健成本、同时提高其效果和为更多人所用的“三赢”前景。

  几十年来,技术毫不留情地推动手机、笔记本电脑、电器和整个产业成本下降但产品更加好用——然而医疗保健行业却顽固停留在另一个世界,科技使得一切更贵更复杂。

  如今创业公司正在医疗保健行业应用人工智能、海量数据和自动化,以期急剧降低医疗保健成本,同时提高效率。如果这一影响深刻的趋势得到发展,那么五到10年内,美国国会便不用对付医疗补助(Medicaid)和医保费用的爆炸性增长,而是有可能要设法处理一大批意外成果。目前对废除奥巴马医改法案的争论将成为和讨论水蛭吸血法优点一样的落后之举。

  难以置信?一个证据是有关糖尿病——全球最费钱疾病——的大风暴。在美国,大约3000万人患糖尿病,占总人口近10%。部分专家预计,10年内中国糖尿病患者数量将超过美国总人口。绝大多数糖尿病患者每年医药开支将达5000-10000美元,有并发症的糖尿病患者就医费用可达数十万美元。据美国疾病控制与预防中心,这些费用加上糖尿病人损失的工资,美国一年便损失逾2450亿美元。

  这是一个有待解决的大问题,解决后将赢得大批现金和客户——这就是糖尿病让企业家趋之若鹜的原因。其中一个企业家是恩肯(Sami Inkinen)。他是房地产网站Trulia联合创始人,长期以来是位耐力很强的运动员,多次参加三项全能和铁人项目。2014年,恩肯和妻子从加州划船到夏威夷。所有这些都不符合患糖尿病的典型特征,然而在2011年参加三项全能后不久,恩肯被查出患有2型糖尿病。像很多发奋的、异常聪明的数据极客一样,恩肯深入研究,以了解有关自己病况的一切。

  这导致恩肯结识加州大学戴维斯分校医学研究员菲尼博士(Stephen Phinney)俄亥俄州立大学科学家沃莱克(Jeff Volek 。菲尼和沃莱克合著了两本关于低糖饮食的书,发表了很多糖尿病患者经常调整饮食和生活方式可逆转病情的论文。糖尿病几乎从未这样治疗过,因为这种方式对绝大多数人来说太困难而无法坚持。这要求医疗专家进行太多的指导和监督,相当于必须请一位居家医生。

  恩肯说服菲尼和沃尔克,通过技术可在智能手机上打造一位实际上的居家医生和糖尿病康复指导师。于是三人在2014年共同创立Virta Health公司。该公司一直未公开,直到今年3月发布应用。恩肯向本刊表示,“我觉得有责任这样做,这么多的人患糖尿病,但什么也没做好;我们可以结合科学与技术,以低得多的成本解决这个问题,同时做到安全。”

  Virta如何展开工作,以及其方式对未来医疗保健如此重要的原因如下所述。在前端,Virta是一个智能手机应用。注册的糖尿病患者同意定期输入血糖水平、体重、血压、日常活动等数据。一些用户手动输入信息,另一些使用Fitbit之类智能设备或联网体重计自动输入。该应用还经常要求患者回答有关情绪、能量水平和饥饿的多项选择题,即人工智能软件用来分析了解该患者、寻找警报信号和症状、指导Virta医生的更多数据。

  在后端,Virta聘请医生,他们从Virta软件得到更新信息流,在这些数据的帮助下做出各患者饮食和用药如何调整的决定,或其它有可能影响患者健康的任何决定。恩肯称,所有临床决定始终由医生做出,但Virta的软件提高了10倍的效率。Virta系统的临床试验显示,如果一切顺利,患者遵守该计划严格的饮食和用药控制,糖尿病是能够逆转的。曾经依赖胰岛素控制病情的患者大约87%要么胰岛素剂量减少,要么完全不再用胰岛素——相对于昂贵、侵入性、重症糖尿病患者最后治疗手段的减重手术,这是一个成功的比例。

  通过利用人工智能软件、智能手机和云计算,Virta使得医生持续交流的患者数量超过在诊所或医院所能交流患者数量多出很多倍,给糖尿病患者一个口袋医生和保卫天使。结果便形成对糖尿病患者大有希望的疗法,有可能使很多患者脱离用药,不用就医。这反过来又将大大降低糖尿病治疗总体费用。

  Virta只是致力于解决糖尿病的众多创业公司之一。相比公司计划自动化程度很高,但较少以医生为导向的公司。该公司今年3月份融资5250万美元,制造一种无线血糖仪,上传患者数据。人工智能软件了解患者,发送一系列旨在帮助患者管理疾病、远离医院的提示和信息。不过另一家创业公司采取更加医学化的办法,发明一种似乎能造成肠道改变而逆转糖尿病的导管。

  创业公司跟踪机构Crunchbase列出了大约130家涉足糖尿病某些方面的科技公司。虽然这些创业公司很多将失败,但很难想象其中一些创业公司不会产生重大影响。

  这些努力对我们大家都很重要,因为糖尿病吸走了很多医疗资源。协助创立Livongo的风投资本家表示,科技能帮助美国每年节省1000亿美元糖尿病有关费用。设想即使20%的糖尿病患者可以停药,不用怎么看医生,所有这些医疗资源将得到解放,供其他患者和其他疾病使用,这将推动所有人的医疗保健费用下降。恩肯表示,如果我们希望大大降低医保费用,我们需要设法从根本上解决新陈代谢类健康问题(比如糖尿病);我以我的房子打赌,15年内,未来的医疗保健公司跟我们今天做的一样,不是在疾病已成时治疗疾病,而是在疾病形成过程中设法逆转。

  过去十年来,美国患者的病历已经数字化并输入相关软件。但这并未推动医疗保健成本降低,事实上随着系统安装和医疗专业人员学习使用可能笨重的软件,医疗保健费用还不断增加。美国最大的电子病历公司Epic Systems处理全国54%的患者病历,但得到的评价并不好,因为它的软件难以使用,浪费医生护士时间。一份报告显示,大约30%Epic客户不会向同行推荐。一项调查显示,30%的医护人员不满意医院的电子病历系统,对Epic的系统最不满意。

  不过电子病历带来了更大的好处:海量医疗信息现已数字化。随着更多的医疗交流在网上进行,我们所能收集的数据种类就更多。物联网设备——无论是Fitbits、联网血糖仪还是如苹果AirPods之类能获取生物测量数据的潜在新设备——将增加更多数据。所有这些数据能有助于人工智能软件从总体上了解疾病和具体患者,为技术应用开辟新道路。

  人工智能的部分新应用将直接提高医疗保健行业令人可悲的低效率。Qventus是一家创业公司,利用人工智能获取一家医院的所有数据,以了解如何解放医护人员,改善治疗结果。Qventus CEO加格(Mudit Garg)向本刊表示,两年前这种工作还显得没什么吸引力,但如今就派上用场了。

  Qventus客户之一,阿肯色州史密斯堡医院Mercy Hospital Fort Smith利用同样的资源诊治患者数量一年增加3000名,增幅18%。在此科技再次增加医疗服务供应,有可能改变迫使医疗费用不断上涨的成本要素。

  人工智能还开始使医生的部分工作自动化。IBMWatson利用机器学习和大规模计算能力思考问题,料成为地球上最优秀的诊断专家。其软件能够吸收各种各样的可得(和匿名)患者数据,以及每年发表的远超任何人阅读量的成千上万医学论文。这套系统甚至可跟上新闻学习,比如哪些地区受到某一类传染病影响,这或许有助于对最近前往该地的旅行者进行诊断。通过询问患者一系列问题,Watson可迅速缩小患者患病的可能原因范围。如今IBM正与Cleveland Clinic等大医院合作试点,把Watson交到医生手里,医生学习如何使用如一位聪明助手的这种技术。

  不过,通过智能手机或别的设备人人享用Watson或类似人工智能的那一天将到来。亚马逊正在开始走这条路,与HealthTap合作,在其语音激活人工智能设备Alexa上推出人工智能医生Dr. A.I.。尚不清楚Dr. A.I.实力是否接近Watson,但其运行理念一致。只需说出你医疗方面的问题,它们就会问你问题,以帮助缩小可能范围。

  随着医疗人工智能的发展,创业公司还在发明新型基因医药。16年前,人类基因组计划(Human Genome Project)和遗传学家文特尔(Craig Venter)成立的创业公司Celera Genomics一天内各自发布人类基因组测序结果。文特尔说,Celera Genomics完成该工作在一台超级计算机上用时2万处理器时。今年,创业公司Color Genomics提供249美元的基因检测,能够对人体绝大多数相关基因测序。该公司的目标是大大降低基因测序的价格和难度,让每个人都能承担,所得数据将报告被测者终生健康情况。

  将个人遗传数据与Watson所能吸收的各种数据结合,我们即将能够创造至少具备患病时首诊医生功能的人工智能软件。人们将越来越多地向智能手机或AlexaDr. A.I.谈自己的健康问题,必要的话上传表现症状的图片。如果该系统掌握你的医疗记录和基因数据,那么它对你病情的了解将超过凭直觉的任何医生。

  在很多情况下,这些应用也许会告诉用户情况并不严重——相当于 “早上叫用户吃两片阿司匹林”的机器人。其它时候也许会建议用户去医院检查或拍个X光片。如果应用像这样发挥作用,就医造成的交通拥堵很大程度上将消失。

  总之,今后几年我们将发现一系列减少我们对医保体系需求但又能让我们所有人获得更多医疗服务的科技应用。医生将被解放,去做患者真正需要其注意的更好工作。理论上这一切都将使人们更加健康。如果我们大家更加健康,使用的医疗保健服务减少,那么按照供需规律,整体医疗保健成本将大降。

  不过,未来还存在一些障碍,正如特朗普总统最近所说, 谁也不知道医疗保健问题能够这么复杂。

  医疗经济学很不可思议。首先,一般规律不适用于高度管制行业,由于人命关天,医疗保健行业也许是美国和全世界管制程度最高的行业。在绝大多数国家,监管部门不允许人工智能软件越界独立提供诊断或临床意见——诊断或临床意见严格属于医生权限范围。Fractyl之类的新医疗设备必须得到食品药品管理局批准。游说分子常常延缓监管改革,以维持现状,以利于现有利益团体收取高价。

  在美国,有关个人医疗保健的决定常常受到保险公司、支付医保费用的雇主和联邦医疗保险(Medicare)影响。与绝大多数国家不同,医疗保健消费者对价格和质量情况了解不多,因而不能权衡选择和做出理性选择。此外,我们对健康的看法不同于我们所买的任何其它东西。很多人不满意医疗保健——如果能够负担,我们总是希望得到更多、更好的医疗保健服务。今年3月公布的一项研究显示,远程医疗推动人们为一些平常会忽略的小病寻求医治。只有12%的远程医疗是原本会亲自就医的患者,其余88%是新需求。

  绝大多数新型医疗技术直到最近都是高端产品,这成为医生和医院为过去不可能提供的服务收取更高费用的一个原因。想想核磁共振设备或手术机械臂吧。这些设备提高了生命质量,但增加了费用。2008年,国会预算办公室得出结论:“推动医疗保健费用长期增长的最重要因素是新医疗技术和服务的出现、采用和广泛传播。”

  下一波医疗保健技术则不同。数据与人工智能相结合直到这两年才出现,这有可能导致颠覆其它太多行业的那种自动化。很多医疗保健公司正好专注于降低医疗保健成本、同时提高其效果和为更多人所用的“三赢”前景。当然,还有挑战需应对,比如确保我们高度敏感的医疗数据受到保护和私密——尽管这些数据已在各种网络和系统使用。

  随着创业公司将这些技术搬上网络,它们通常避开保险公司,而是在消费者或支付医保费用的雇主身上寻找需求。比如,Livongo向公司指出,每位糖尿病员工每年花费公司数千美元费用,购买Livongo服务将节省费用,因为这些员工能够更好地管理其病情。Livongo到去年已有50多家大客户,其中包括QuickenOffice DepotOffice Max S.C. Johnson & Son。随着这种想法在医疗保健创业公司流行,一旦雇主和消费者拥护新技术,保险公司、监管部门和医疗保健体系将不得不随之支持。

  如果这样的局面出现,技术前景和经济力量最终将阻止或逆转美国和全世界医疗保健费用攀升。如果幸运的话,这一进展将使得美国总统和国会议员哑口无言。(柠楠/翻译)

责任编辑:张玉洁 SF107

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文章关键词: 新闻周刊 人工智能 医保 美国

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