[2009.04.16] Medicine goes digital 药物数字化进程

A special report on health care and technology

对医疗保健和技术的特别报道

 

 

Medicine goes digital

药物数字化进程

 

Apr 16th 2009
From The Economist print edition

 

 

The convergence of biology and engineering is turning health care into an information industry. That will be disruptive, says Vijay Vaitheeswaran (interviewed here), but also hugely beneficial to patients

 

 

生物学和工程学的融合使得医疗保健成为了信息产业。Vijay Vaitheesearan表示，这会引起混乱，但同时病人会大为受益。

 

 

INNOVATION and medicine go together. The ancient Egyptians are thought to have performed surgery back in 2750BC, and the Romans developed medical tools such as forceps and surgical needles. In modern times medicine has been transformed by waves of discovery that have brought marvels like antibiotics, vaccines and heart stents.

 

 

创新和药物一起发展。古代埃及人被认为早在公元前2750年就进行了外科手术，罗马人发明了医疗工具，如医用钳子和手术用针。到了现代，发现探索的浪潮给人们带来了诸多奇迹，如抗生素，育苗和心脏支架。这些都促进了医药的改革。

 

Given its history of innovation, the health-care sector has been surprisingly reluctant to embrace information technology (IT). Whereas every other big industry has computerised with gusto since the 1980s, doctors in most parts of the world still work mainly with pen and paper.

 

 

考虑到创新的历史，医疗保健行业迟迟没有拥抱信息技术（IT），这是颇为令人吃惊的。自从19世纪80年代，其他大型的产业都兴致勃勃地接受电脑化进程，而世界大多数地区的医生仍旧是与笔和纸打交道。

 

 

But now, in fits and starts, medicine is at long last catching up. As this special report will explain, it is likely to be transformed by the introduction of electronic health records that can be turned into searchable medical databases, providing a “smart grid” for medicine that will not only improve clinical practice but also help to revive drugs research. Developing countries are already using mobile phones to put a doctor into patients’ pockets. Devices and diagnostics are also going digital, advancing such long-heralded ideas as telemedicine, personal medical devices for the home and smart pills.

 

 

虽然医药行业改变的步伐时断时续，但现在该行业终于逐渐赶上了这一趋势。此次的特别报道将会向你阐释，电子健康记录的出现将有可能改革医药行业。该记录可转变为可搜索式的医疗数据库，为药物提供一个“智慧的网络”，不仅会改进临床实践，还有助于重振药物研究。发展中国家已经通过使用移动电话，使得医生陪伴着病人，寸步不离。医疗设备和诊断法也变得数字化，极大促进了长久以来就梦想的远程开药，家庭个人医疗设备和聪明药的发展。

 

 

The first technological revolution in modern biology started when James Watson and Francis Crick described the structure of DNA half a century ago. That established the fields of molecular and cell biology, the basis of the biotechnology industry. The sequencing of the human genome nearly a decade ago set off a second revolution which has started to illuminate the origins of diseases.

 

 

现代生物学的第一次技术革命始于在半个世纪前，James Watson和Francis Crick成功描述了DNA的结构。这一举动建立了分子细胞生物学，也奠定了生物技术行业的基础。大约10年前的人类基因组排序引发了第二次革命，这一举动为人类探寻疾病的根源指明了道路。

 

 

The great convergence 伟大的融合

 

Now the industry is convinced that a third revolution is under way: the convergence of biology and engineering. A recent report from the Massachusetts Institute of Technology (MIT) says that physical sciences have already been transformed by their adoption of information technology, advanced materials, imaging, nanotechnology and sophisticated modelling and simulation. Phillip Sharp, a Nobel prize-winner at that university, believes that those tools are about to be brought to bear on biology too.

 

 

现在，该行业相信第三次革命即将来临：生物学和工程学的融合。MIT最近的一项报告显示，信息技术，先进材料，成像技术，纳米技术和建模仿真技术的运用已经推进了自然科学的改变。MIT的一名诺贝尔获得者Phillip Sharp 相信，这些工具将会运用到生物学，并对其产生影响。

 

 

Robert Langer, a biochemist at MIT who holds over 500 patents in biotechnology and medical technologies and has started or advised more than 100 new companies, thinks innovation in medical technologies is about to take off. Menno Prins of Philips, a Dutch multinational with a big medical-technology division, explains that, “like chemistry before it, biology is moving from a world of alchemy and ignorance to becoming a predictable, repeatable science.” Ajay Royyuru of IBM, an IT giant, argues that “it’s the transformation of biology into an information science from a discovery science.”

 

 

MIT的生化学家Robert Langer掌握着500多项生物技术和医疗技术的专利。作为众多公司的创建者和作为其它公司的顾问，他服务于100多家新兴公司。他认为，医疗技术的创新将会迎来腾飞。Menno Prins of Philips是一家荷兰跨国公司，拥有大型医疗技术分支机构。该公司解释到，“就像以前的化学，生物走出了一个充满炼金术和无知的世界，成为一个可预测，可重复的科学。” IT巨头IBM公司的Ajay Royyuru表示，“生物学从一个探索发现科学发展成为了一门信息科学。”

 

 

This special report will ask how much of this grand vision is likely to become reality. Some of the industry’s optimism appears to be well-founded. As the rich world gets older and sicker and the poor world gets wealthier and fatter, the market for medical innovations of all kinds is bound to grow. Clever technology can help solve two big problems in health care: overspending in the rich world and under-provisioning in the poor world.

 

 

本次特别报道将询问，这个伟大的愿景有多大可能会成为现实。行业内的一些乐观见解似乎有依有据。随着富裕国家人口变得老龄化，多病化，贫困国家人口变得更富有，更肥胖，各种医药创新的市场必将得到成长。先进的技术会解决医疗保险的两大问题：富裕国家的过度开支和贫困国家的供给不足。

 

 

But the chances are that this will take time, and turn out to be more of a reformation than a revolution. The hidebound health-care systems of the rich world may resist new technologies even as poor countries leapfrog ahead. There is already a backlash against genomics, which has been oversold to consumers as a deterministic science. And given soaring health-care costs, insurers and health systems may not want to adopt new technologies unless inventors can show conclusively that they will produce better outcomes and offer value for money.

 

 

但这需要时间，并且仅仅是一个改革，而非革命。富裕国家冥顽不化的医疗体系也许会抵制新兴技术，而贫困国家则会大步前进。基因组学的出现已经遭遇了一些不良反应：作为确定性的科学，基因组学被大量地出售给消费者。考虑到医疗保健费用的飙升，除非投资者们能确保他们会带来更好的结果和能创造金钱的价值，否则保险商和医疗保健体系不会采取新的技术。

 

 

If these obstacles can be overcome, then the biggest winner will be the patient. In the past medicine has taken a paternalistic stance, with the all-knowing physician dispensing wisdom from on high, but that is becoming increasingly untenable. Digitisation promises to connect doctors not only to everything they need to know about their patients but also to other doctors who have treated similar disorders.

 

 

如果这阻碍能得到解决，那么最大的受益者将是病人。在过去，无所不知的医生高高在上，医药也是一个基于家长式关系上的产物。但这一做法越来越站不住脚。数字化将会通过网络使医生得到病人的一切信息，同时也会让他们和其他治疗过相似病历的医生相互交流。

 

 

The coming convergence of biology and engineering will be led by information technologies, which in medicine means the digitisation of medical records and the establishment of an intelligent network for sharing those records. That essential reform will enable many other big technological changes to be introduced.

 

 

对于即将到来的生物学与工程学的融合，信息技术将会起到主导作用。而对于药物而言，这就是意味着将药物记录数字化，并建立一个分享这些记录的智能网络。这个关键的改革将会带来其它重要的技术改变。

 

 

Just as important, it can make that information available to the patients too, empowering them to play a bigger part in managing their own health affairs. This is controversial, and with good reason. Many doctors, and some patients, reckon they lack the knowledge to make informed decisions. But patients actually know a great deal about many diseases, especially chronic ones like diabetes and heart problems with which they often live for many years. The best way to deal with those is for individuals to take more responsibility for their own health and prevent problems before they require costly hospital visits. That means putting electronic health records directly into patients’ hands.

 

同样重要的是，病人也会得到这些信息，使其更有能力在管理自己健康事物时起到更大的作用。这是具有争议的，但同时也是有依据的。许多医生和一些病人认为，他们缺乏足够的知识来做出恰当的决定。但事实上，病人们对很多疾病有着深入的了解，尤其是慢性病如糖尿病和心脏病。虽然患有这些慢性病，病人通常能够活上很长的一段时间。解决这个问题的办法就是每个人都需对自己的健康尽起责任，在他们需要上医院打花一笔之前预防这些疾病的形成。这意味着病人亲自掌握电子健康记录。

 

译者/megrady: http://www.ecocn.org/bbs/viewthread.php?tid=18744&extra=page%3D1