以下为个人学习笔记和习题整理
课程:Health Informatics-Johns Hopkins University @ coursera
https://www.coursera.org/specializations/health-informatics

# Health Information Technology for Patients

In this video, we'll start off with talking about health information technology for patients and explore what's going on today and maybe what's going on in the future.
在这个视频中,我们将从针对患者的健康信息技术开始,探讨现在已经发生的,以及未来可能发生的事。

So, you've all been to the doctor, and you've all filled out pieces of paper and clipboards.
大家都看过医生,都填过一些纸和笔记板。

In fact, you've probably filled out 15 pieces of paper on clipboards and wondering why the heck is this not computerized the way everybody else's is.
事实上,你可能已经在笔记板上填了 15 张纸,并且想知道为什么这没有像别的地方一样计算机化。

The good news is that we do have these sorts of questionnaires now on tablets, and you can fill them out either in a doctor's office or at home.
好消息是,现在在平板电脑上确实有这类问卷,您可以在医生办公室或家里填写这些问卷。

So, what questions might come up if you're filling these questionnaires at home is like, what is the accuracy of this information, how should you use this information?
如果您在家填写这些问卷,可能会出现哪些问题?这些信息的准确性是多少?您应该如何使用这些信息?

But wait, there's more, there are coming different types or new types of questionnaires.
但是等等,这里还有更多不同类型的,或者新类型的问卷。

Sometimes these are called patient reported outcome forms or patient questionnaires.
有时,这些被称为由患者报告的结局表格,或患者问卷。

We're asking information that can come only from the patient, like, how do you feel, are you depressed, are you able to walk, are you able to do the things that you normally do, how do you sleep?
我们询问一些只能由患者提供的信息,例如,您的感觉如何,您是否沮丧,是否能够走路,是否能够做您常做的事,睡觉如何?

These are not things that we get typically from the clipboard type of questionnaire, we need to get this information.
这些不是我们通常从剪贴板式的调查表中获得的东西,而我们需要获取这些信息。

The type of informatics question that comes out of this is, well, what do you do with this information? Is it true? Can you make clinical decisions based on this?
由此产生的信息学问题的类型是,您如何处理这些信息? 这些是真实的吗?您可以据此做出临床决策吗?

If somebody says they're suicidal on this form that's been filled out at home on a computer, what obligations do you have to intervene?
如果有人在家里用计算机填写这份表格,说他有自杀倾向,那么您有义务采取哪些干预措施?

Making the questionnaire available may raise new questions and new problems about what to do with the information.
提供调查表可能会引起有关如何处理信息的新问题。

You may notice at the top of this, it's called a computer adaptive testing, and here it's the machine, rather the piece of paper the machine can kind of skip around and ask questions that are more relevant to you.
您可能会注意到顶部这里,一个计算机自适应的测试。机器不像纸,机器可以跳过并提出与您更相关的问题。

This can be done through skip logic like if you answer this then answer that, or it can be more sophisticated.
这些可以通过跳过逻辑来完成,比如你先回答了这个再回答了那个,或者他可以更复杂。

Well, if I've established that you're not suicidal, so I'm not going to pursue the suicidal questions, adding the questionnaire on a computer using more capability than you could have on a piece of paper.
好吧,如果我确定您没有自杀倾向,那么我就不会继续追问自杀相关的问题。在计算机上填写调查表,可以比在纸上拥有更多的功能。

I already mentioned that patients may fill things out at home, the main way that patients see their health data these days that's connected to the doctor or the hospital is through something called a patient portal.
前面已经提到过,患者可能在家中填写东西。患者主要通过一个所谓的患者门户,来查看他们这些天的健康数据,并与医生或者医院联系。

patient-portal

You can see the types of information that patients can get at through the patient portal.
你可以看到患者通过这个门户可以获得的信息类型。

It can range anywhere from their appointments, through real patient data like lab testing, to secure messaging, to the entire patient record.
它的范围很广,从预约,到真实的患者数据,如实验室测试,到安全消息传递,再到整个患者记录。

Well, how does medical care change where the patient can see everything?
那么,医疗如何改变患者可以看到的一切?

Are the notes more honest?
这些记录更诚实吗?

We know that there are better because patients will correct errors so that's great, but do in fact the conditions change what they write because they don't want to write something about their mental capacity patients, mental capacity or capabilities.
我们知道有更好的选择,因为患者会纠正错误,这样的确很棒。但实际上,由于他们不想写一些有关心智能力的内容,病情会改变他们写下的东西。

No surprise that we have a digital medical devices.
我们拥有数字医疗设备也就不足为奇了。

You've all probably have had your blood pressure taken by a digital sphygmomanometer, a digital blood pressure cuff.
你们可能都已经通过数字血压计、数字血压袖带测量过血压。

Increasingly, there are digital tools for the direct acquisition of medical data.
越来越多的数字工具可以直接获取医疗数据。

So, there are digital stethoscopes, and digital otoscopes, and digital ophthalmoscope.
比如数字听诊器,数字耳镜和数字眼底镜。

The thing that's interesting when you have these digital formats is that you now can record what the doctor has seen, so that's interesting and that's great for record keeping. It's great for teaching.
有趣的是,当使用这些数字格式时,您可以记录医生所见的内容,而且对于保存记录非常有用。 非常适合教学。

You might even have decision support.
你甚至可能有决策支持。

So imagine that you have a digital stethoscope, and the machine is listening in the same time that you are, and could point out by the way, did you hear the abnormal heart sounds that may indicate something bad?
那么想象一下你有一个数字听诊器,在你听诊的同时,机器也在听,并且可以顺便指出,你是否听到一些可能提示病变的异常心音?

Finally, we've all heard about wearables and devices or Internet of Things.
最后,我们都听说过可穿戴设备或物联网。

Increasingly, there's lot of devices around the patient.
病人周围有越来越多的设备。

Many of you probably use a fitness tracker, you may have a phone that tracks your heart-rate and such.
你们中的很多人可能都使用了健身追踪器,你可能拥有一部可以追踪心律或其他指标的手机。

There are engineer's coming out with devices all the time.
新设备层出不穷。

A fun one is a contact lens that can measure the glucose level in the fluid on your eye so now a diabetic might not need to prick themselves to get blood to measure the glucose, the contact lens could do it for them, or there might be a chip that they can lick and that chip can now measure basic laboratory values.
其中一个有趣的设备是一副隐形眼镜,可以测量眼中液体的葡萄糖水平,这样糖尿病患者就可以无需穿刺来检测血糖,隐形眼镜可以为他们做这些。或者可能有一种芯片,患者可以舔一下芯片,该芯片就可以测量基本的实验室值。

I already mentioned digital stethoscopes to the heart, to the lung.
我已经提到过和心脏、肺部有关的数字听诊器。

There are devices that can read brainwaves, and a whole number of other devices.
还有可以读取脑电波的,以及其他很多设备。

So again, we have informatics problems come out of these.
同样,我们也遇到了信息学方面的问题。

If you have continuous blood-pressure monitoring at home, well, that's a lot of data and number one where is it that it get stored, but even more importantly what does it mean?
如果您在家中连续测量血压,那将获得很多数据,首先这些数据存储在哪里,其次更重要的是,这意味着什么?

A whole science and practice of blood pressure management has been based on blood pressures that were obtained infrequently at doctors' offices.
整个血压管理的科学和实践,都是基于在医生办公室很少获得的血压。

Well, how did those blood pressures compare with what you get at home?
那么,这些血压与您在家得到的血压相比如何?

How do you judge whether or not a blood pressure medication is working if you're getting all these blood pressure measurements all the time?
如果您一直在进行血压监测,您如何判断降压药是否有效?

So, having a device and getting a lot of data is terrific, what the information we get out of that data is not clear and what knowledge we have to work with that information may not be clear as well.
因此,拥有一台设备并获取大量数据是惊人的,我们从数据中获得的信息还不清楚,而我们必须使用哪些知识也可能不清楚。

So, that's it for our grand tour, a very quick tour of the new and upcoming IT for patients.
以上就是针对患者的,一些新的、即将推出的信息化技术的快速概览。