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