「新科技 vs. 醫療產業」
- 由雲端運算及 App 浪潮談起

蔡孟儒 (Raymond)
台灣微軟
資深技術推廣協理
關於我…
• 1999年於南加大(University of Southern California)取得M.S. Degree
in Computer Science後,留美由一間小新創公司的軟體工程師開始職
涯;後歷任 US. Intera...
新科技被廣為應用前,總會遇到阻礙
• 柏拉圖警告: 書寫會削弱記憶力;同時擔心書面
文字只是口語的虛影,無法充分表現意義。
• 數百年後,古騰堡的印刷機以其產出的創新文
件備遭批評,反對者宣稱印刷機破壞了寫作者
與紙頁之間那種自然而且近乎靈性般...
4

Agenda

• 雲端運算 + App 浪潮
• 你的未來舞台
5

雲端運算 Cloud Computing
6

你今天刺青了嗎?
7

刺青貼紙!

Sample footer on all content slides.
8

New Business Model (創新的商業模式)

傳統刺青行業

刺青貼紙
9

雲端運算對各產業最大的挑戰:
進入新商業模式之破壞式創新

Capital expense

New Business Model
vs.
Cost Saving
Operating expense
10

New Business Model is a Big Deal!
刺青貼紙
使用者人數大增

雲端服務
Performance, Load Balance,
Computing/Networking/Storage usage,

e...
11
12
13

New Business Model in Healthcare?
傳統的醫療「宇宙觀」
…
Consumers are forced to interact with individual healthcare-related facilities…
C
C4
4

Facility
C1

C5
C2
C3...
傳統醫療「宇宙觀」的 ―Copernican Shift‖ (哥白尼轉
移)
New
Business Model
Provider
• Education
• Encounter Management

C4
Payer
• Disease ...
16

New Business Model (創新的商業模式)

EMR

PHR
17

New Business Model is a Big Deal!
18

PHR 之實踐: HealthVault
19

App 風潮方興未艾?
Most things:

(

&

http://blogs.cisco.com/news/the-internet-of-things-infographic/

)
21

Future Vision in Healthcare
PC 持平、智慧型手機暴衝、平版電腦後起之秀

Sample footer on all content slides.
23

平版查房

Sample footer on all content slides.
App 世代…
和企業 IT 支出的關係?
$37.4
Billion

85 Million

9.2%

1/3rd

* IDC, Worldwide and U.S. Custom Application Development Ser...
使用者的行為改變? Apps vs. Web

http://gigaom.com/2012/12/05/us-spends-35-percent-more-time-using-apps-in-2012-while-web-usage-dro...
26

雲端? App 浪潮? 只是另一個泡沫吧!
27

Hype Cycle (成熟曲線): 泡沫-成熟前之必然!
29

護士:「我才不管什麼最新科技,讓我
取得最即時正確的資料,才是王道。」
30

如何讓中風病人願意持續復健?
2001/9/11
32

Dr. Mark Smith (left) and Dr. Craig Feied (right), MedStar Health‘s Washington Hospital Center

“Instant access to pat...
33

醫療院所內的「資訊孤島」現象
IHI Triggers
PHR Integration
Quality Scorecard
Ambulatory vs. Inpatient
Infection Tracking

Core Measur...
急診室醫師: Dr. Allen

Dr. Allen 登入.
Recent X-Rays
and readings

Recent labs

No. of
ER visits

Chief
Complaint

Recent CT scan

Recent medications

No. of dic...
ER Workflow

Past complaints

Range of ages

Old CT scans and
EKGs are available
for comparison

急診室醫師: Dr. Allen

一按即取得某病...
ER Workflow

Past Medical
History

Diagnoses of
Heart Disease
back to 1994

急診室醫師: Dr. Allen

點入查看過往過往問診歷史,發現有心臟病發記錄及處置。
ER Workflow

2004: Heart Attack

2005: No
Heart Attack
2007: Today’s Visit

急診室醫師: Dr. Allen

以圖表檢查檢查報告及發病紀錄。
ER Workflow

Tools allow
manipulation
for more
precise
asessment

急診室醫師: Dr. Allen

由 PACS 系統拉出X光片,了解心律調整器之安裝現況。
60%
of Clinician time is spent
searching or waiting for
patient information
Only 16% of time is available
for direct patie...
41

上「真正的」雲端沒那麼簡單…
(Big Deal!)
斯斯雲端有三種…
Health Example

Patient Admin
Anti Malware
Email

Elec. Health Rec.
Personal Health
Information
Pandemic/Disaster
ERP

Pat...
Health Example
”
Patient Admin
Anti Malware

Anti Malware
Email

Elec. Health Rec.
Personal Health
Information
Pandemic/Di...
Health Example
Electronic Health
Records
Patient Admin
Anti Malware
Email

我要繼續維護這個用MUMPS
寫的HER系統,成本太高了!
Electronic Health...
Health Example
Electronic Health
Records

Patient Admin
Anti Malware
Email

Personal Health
Information
Pandemic/Disaster
...
Health Example

Patient Admin
Anti Malware
Email

Personal Health
Information
Pandemic/Disaster
ERP

市面上找不到符合本院需求的ERP系統,
而...
Health Example
Electronic Health
Records

Patient Admin
Anti Malware
Email

Personal Health
Information

ERP

我需要連結病人及一般使用...
49

小小結

• 雲端運算 + App 浪潮
雲端運算: New Business Model

移動性裝置->鄉村包圍城市
C
C
4
4

C
1

C
C
3
3

Facility
C
2

C5
C
5

Hype Cycle: ...
他們有何共通之處?

?

3
微軟潛能創意盃 (Imagine Cup)
• 微軟潛能創意盃 (Imagine Cup)從2003年開始,每年皆吸引超過100個
國家,總計超過35萬學生精英組隊參加。
重要軌跡
年份

紀錄簡介

2003 年

首屆潛能創意盃亞太地區亞軍...
2013 潛能創意盃台灣區決賽 花絮
「雲端運算 + App 浪潮」的真實應用!
「全方位聽力解決方案(Omni-Hearing Solution)」以 「跨領域能力整合
現有助聽產業、智慧型行動裝置和最新雲端科技」為設計主題;期望能
突破現有助聽設備的限制,以解決因人口老化而衍生...
2013/07 曾志朗院士率團遠赴俄羅斯聖彼得堡
台灣「全方位聽力解決方案(Omni-Hearing Solution)」團隊榮獲軟體設
計組「世界公民」(World Citizenship)及「全球婦女賦權獎」(Women‗s
Empower...
DreamSpark
學生夢想火花計畫

免費為學生提供 Microsoft 開發工具及軟體:
追求自己的夢想,開創新世代的重大技術突破,或藉此踏出職
場生涯的第一步。
56

總結

• 雲端運算 + App 浪潮
雲端運算: New Business Model

移動性裝置->鄉村包圍城市
C
C
4
4

C
1

C
C
3
3

Facility
C
2

C5
C
5

Hype Cycle: 泡...
與我無關? 別小看自己!

?

3
58

參考資料
• 潛能創意盃 (Imagine Cup): http://www.imaginecup.com
• 學生夢想火花計劃 (DreamSpark): http://www.dreamspart.com
59

© 2011 Microsoft Corporation. All rights reserved. This material is provided for
informational purposes only. Microsof...
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20131031 中國醫藥大學醫務管理所 健康產業管理論壇演講邀請

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「新科技 vs. 醫療產業」 - 由雲端運算及 App 浪潮談起

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  • On the business side, this opportunity is true as well since apps are an increasingly important part of the all-up IT stack. You guys have a ton of experience to do a ton of work all up and down that stack and I’m thrilled to tell you about the opportunity on the app side to continue providing value to your partners.The app services market is huge. Last year, the total dollar amount was $37.4 billion. Not only that, it’s growing extremely quickly: 9.2%. A big part of that is tablet apps specifically. One in five businesses is building custom tablet apps. That’s something you should be doing both for business consumers and also for your line-of-business needs. To put it in context, we’re talking 7 billion people in the world, 85 billion apps downloaded last year. That’s a lot of apps and as you know, that number is only skyrocketing. Last year, one-third of all IT costs for businesses were associated with app support and development. Not only is that a lot of money, it’s a big opportunity and Windows 8 is going to be a big player in this regard. I’m here to tell you exactly how you can take advantage of that opportunity on Windows 8.
  • Disparate systems are great for individual patient workflows but they are generally not designed to support systematic reviews or to bring groups of patients together to understand how care is being delivered to a wider audience 1) Diabetics 2) CHF 3) Acute MI 4) Deep Venous ThrombosisThese common diseases require distinct care patterns and procedures. The data used to facilitate quality for each Dx is unique.Clinical nurse managers need to be able to get at “group” data as well as drill down into individual care history to understand how your institution is performing.Amalga enables this by pulling all your data from different systems together in an easy to use, implement and understand client.Nurses, MDs, security personnel can all use the “client” and “Smart Lists” either developed by themselves or colleagues.The key point is that having all the data in one place creates an entirely new “Asset” that functions as a platform to “dive off from” and or build broader tools upon.
  • 20131031 中國醫藥大學醫務管理所 健康產業管理論壇演講邀請

    1. 1. 「新科技 vs. 醫療產業」 - 由雲端運算及 App 浪潮談起 蔡孟儒 (Raymond) 台灣微軟 資深技術推廣協理
    2. 2. 關於我… • 1999年於南加大(University of Southern California)取得M.S. Degree in Computer Science後,留美由一間小新創公司的軟體工程師開始職 涯;後歷任 US. Interactive Inc.資深工程師、Sierra Systems專案技術 主管等職。 • 2005回台後加入微軟,擔任微軟技術中心資深顧問,目前擔任開發工 具暨平台推廣處資深協理;負責微軟開發技術及平台在學校、中小企 業及新創公司的導入及應用。 • 具多年協助企業、新創公司及軟體業者導入新一代技術平台之經驗, 如 Windows Azure公有雲解決方案、企業搜尋解決方案、企業單一整 合平台及 Windows 8/Phone Apps、Kinect等開發應用。
    3. 3. 新科技被廣為應用前,總會遇到阻礙 • 柏拉圖警告: 書寫會削弱記憶力;同時擔心書面 文字只是口語的虛影,無法充分表現意義。 • 數百年後,古騰堡的印刷機以其產出的創新文 件備遭批評,反對者宣稱印刷機破壞了寫作者 與紙頁之間那種自然而且近乎靈性般的連結。 • 打字機在一八七○年代出現的時候,也沒有獲 得普遍的喜愛,反對者認為這種機器打印出來 的文件缺乏人性氣息,並會導致書寫技能衰退。 A Better Pencil: Readers, Writers, and the Digital Revolution Dennis Baron, professor of English and linguistics at the University of Illinois at Urbana-Champaign.
    4. 4. 4 Agenda • 雲端運算 + App 浪潮 • 你的未來舞台
    5. 5. 5 雲端運算 Cloud Computing
    6. 6. 6 你今天刺青了嗎?
    7. 7. 7 刺青貼紙! Sample footer on all content slides.
    8. 8. 8 New Business Model (創新的商業模式) 傳統刺青行業 刺青貼紙
    9. 9. 9 雲端運算對各產業最大的挑戰: 進入新商業模式之破壞式創新 Capital expense New Business Model vs. Cost Saving Operating expense
    10. 10. 10 New Business Model is a Big Deal! 刺青貼紙 使用者人數大增 雲端服務 Performance, Load Balance, Computing/Networking/Storage usage, etc 生產力需大幅增加 增加服務及銷售據點 流量及需求變動劇烈 管理、行銷、財務流程的改變 Productivity, Architecure re- design Scalability, High Availability Dynamic, Flexibility & Automation Management, Security, Marketing, etc
    11. 11. 11
    12. 12. 12
    13. 13. 13 New Business Model in Healthcare?
    14. 14. 傳統的醫療「宇宙觀」 … Consumers are forced to interact with individual healthcare-related facilities… C C4 4 Facility C1 C5 C2 C3 C3
    15. 15. 傳統醫療「宇宙觀」的 ―Copernican Shift‖ (哥白尼轉 移) New Business Model Provider • Education • Encounter Management C4 Payer • Disease Management • Cost Containment Consumer Employer • Benefits Management • Corporate Wellness C5 C3 Supplier • Consumer Safety • Lifestyle Management Consumer Services • Diest and Fitness • Wellness In 1543,哥白尼提出太陽為宇宙中心的學說、認為地球是與其它行星在同心圓上圍繞太陽運轉, 推翻了自亞里斯多德、托 勒密以降兩千多年, 廣為當時世人深信不疑的地球為宇宙中心的觀念。 因此哥白尼式的轉變 Copernican shift ,被用來 形容結果與認知大相逕庭,或出乎意料, 180度的轉變。
    16. 16. 16 New Business Model (創新的商業模式) EMR PHR
    17. 17. 17 New Business Model is a Big Deal!
    18. 18. 18 PHR 之實踐: HealthVault
    19. 19. 19 App 風潮方興未艾?
    20. 20. Most things: ( & http://blogs.cisco.com/news/the-internet-of-things-infographic/ )
    21. 21. 21 Future Vision in Healthcare
    22. 22. PC 持平、智慧型手機暴衝、平版電腦後起之秀 Sample footer on all content slides.
    23. 23. 23 平版查房 Sample footer on all content slides.
    24. 24. App 世代… 和企業 IT 支出的關係? $37.4 Billion 85 Million 9.2% 1/3rd * IDC, Worldwide and U.S. Custom Application Development Services 2012–2016 Forecast, doc #234645, May 2012. **IDC Predictions 2012: Competing for 2020, doc #231720, December 2011. ***Gartner, IT Metrics: IT Spending and Staffing Report, Jan. 2012
    25. 25. 使用者的行為改變? Apps vs. Web http://gigaom.com/2012/12/05/us-spends-35-percent-more-time-using-apps-in-2012-while-web-usage-drops/ 2012
    26. 26. 26 雲端? App 浪潮? 只是另一個泡沫吧!
    27. 27. 27 Hype Cycle (成熟曲線): 泡沫-成熟前之必然!
    28. 28. 29 護士:「我才不管什麼最新科技,讓我 取得最即時正確的資料,才是王道。」
    29. 29. 30 如何讓中風病人願意持續復健?
    30. 30. 2001/9/11
    31. 31. 32 Dr. Mark Smith (left) and Dr. Craig Feied (right), MedStar Health‘s Washington Hospital Center “Instant access to patient information is key to lifesaving care, especially in the emergency room and intensive-care unit, where delays may mean the difference between life and death.” — Dr. Mark Smith “The reality is that most hospitals have islands of data that can’t easily be shared with other systems because of disparate data types.” — Dr. Craig Feied
    32. 32. 33 醫療院所內的「資訊孤島」現象 IHI Triggers PHR Integration Quality Scorecard Ambulatory vs. Inpatient Infection Tracking Core Measures Charge & Payment Analysis Rapid Response Care Quality Analysis Throughput Tracking Financial System Labor and Delivery Time and Attendance Ambulatory EMR Integrated Clinical Information System Lab Anatomic Pathology Dictation EMPI Patient Monitoring System Advanced Visualization Hospice Ambulatory Specialty Laboratory Blood Bank PACS CT Interface Engines Anesthesia Ultrasound Ventilators Budgeting Other Medical Devices Fetal Monitors
    33. 33. 急診室醫師: Dr. Allen Dr. Allen 登入.
    34. 34. Recent X-Rays and readings Recent labs No. of ER visits Chief Complaint Recent CT scan Recent medications No. of dictations Days since last visit Arrival time Age and sex ER Workflow 急診室醫師: Dr. Allen 急診室「白板」(Excel-like: 排序、搜尋、過濾, etc.) – Dr. Allen 即時觀察所照顧病人之生理訊號、是否有最新檢查報告出爐, etc.
    35. 35. ER Workflow Past complaints Range of ages Old CT scans and EKGs are available for comparison 急診室醫師: Dr. Allen 一按即取得某病人的完整病史、藥史、過敏史。 發現曾作過不尐次的CT Scan。
    36. 36. ER Workflow Past Medical History Diagnoses of Heart Disease back to 1994 急診室醫師: Dr. Allen 點入查看過往過往問診歷史,發現有心臟病發記錄及處置。
    37. 37. ER Workflow 2004: Heart Attack 2005: No Heart Attack 2007: Today’s Visit 急診室醫師: Dr. Allen 以圖表檢查檢查報告及發病紀錄。
    38. 38. ER Workflow Tools allow manipulation for more precise asessment 急診室醫師: Dr. Allen 由 PACS 系統拉出X光片,了解心律調整器之安裝現況。
    39. 39. 60% of Clinician time is spent searching or waiting for patient information Only 16% of time is available for direct patient care. Seeking Data Patient Care Source: MedStar Health Washington Hospital Center Clinician Landscape Doctors are frustrated
    40. 40. 41 上「真正的」雲端沒那麼簡單… (Big Deal!)
    41. 41. 斯斯雲端有三種…
    42. 42. Health Example Patient Admin Anti Malware Email Elec. Health Rec. Personal Health Information Pandemic/Disaster ERP Patient Admin 這個系統有太多客製化;而且營運 成本實在太高了!
    43. 43. Health Example ” Patient Admin Anti Malware Anti Malware Email Elec. Health Rec. Personal Health Information Pandemic/Disaster ERP Email 及防毒產品已是很一般性的服務 ,不但沒有客製化需求,委外營運的 話成本可以降得很低。 Email
    44. 44. Health Example Electronic Health Records Patient Admin Anti Malware Email 我要繼續維護這個用MUMPS 寫的HER系統,成本太高了! Electronic Health Records Personal Health Information Pandemic/Disaster ERP
    45. 45. Health Example Electronic Health Records Patient Admin Anti Malware Email Personal Health Information Pandemic/Disaster ERP 系統使用者為一般民眾,隨時可能 Pandemic/Disaster 有暴量使用的情形。
    46. 46. Health Example Patient Admin Anti Malware Email Personal Health Information Pandemic/Disaster ERP 市面上找不到符合本院需求的ERP系統, 而且目前維護及營運成本都在可控制的範 圍。
    47. 47. Health Example Electronic Health Records Patient Admin Anti Malware Email Personal Health Information ERP 我需要連結病人及一般使用者的資料,同時 又要提供外部服務給其他合作的醫護中心、 健局,同時要確保安全性及隱私權。 Pandemic/Disaster HealthVault
    48. 48. 49 小小結 • 雲端運算 + App 浪潮 雲端運算: New Business Model 移動性裝置->鄉村包圍城市 C C 4 4 C 1 C C 3 3 Facility C 2 C5 C 5 Hype Cycle: 泡沫是必然 使用者才是王(后)!
    49. 49. 他們有何共通之處? ? 3
    50. 50. 微軟潛能創意盃 (Imagine Cup) • 微軟潛能創意盃 (Imagine Cup)從2003年開始,每年皆吸引超過100個 國家,總計超過35萬學生精英組隊參加。 重要軌跡 年份 紀錄簡介 2003 年 首屆潛能創意盃亞太地區亞軍,並獲邀參加世界總決賽。 2006 年 數位創作組台灣代表隊獲世界前 6強頭銜。 2007 年 台灣代表隊「 Circle 」打敗全世界兩百多隊參賽者,獲得數位創作組全球亞軍。 2008 年 台灣取得軟體設計組、數位創作組、嵌入式系統開發組全球總決賽資格,創下新紀錄。 2009 年 台灣參賽人數成長近 3倍。晉級全球競賽第二輪隊伍將近 100 組,成長 將近 4 倍。 2009 年 打敗眾多強隊取得台灣代表權的兩支隊伍。最後於全球競賽中寫下嵌入式系統組世界前 發組世界前 6強的佳績。 2010 年 與教育部合作推出國際競賽台灣代表隊培育計畫,由產官學精英組成教練團,提供學生訓練與建議。 2010 年 台灣學生從 113 個國家、 32萬5千名全球學生精英脫穎而出,首次勇奪包含嵌入式系統組、數位創作組、 展望未來 2020 組等三項世界冠軍。 2011 年 台灣學生從 165 個國家、 35萬2千名全球學生精英脫穎而出,蟬連嵌入式系統組世界第一、數位創作組世 界第三。 12 強,以及軟體開
    51. 51. 2013 潛能創意盃台灣區決賽 花絮
    52. 52. 「雲端運算 + App 浪潮」的真實應用! 「全方位聽力解決方案(Omni-Hearing Solution)」以 「跨領域能力整合 現有助聽產業、智慧型行動裝置和最新雲端科技」為設計主題;期望能 突破現有助聽設備的限制,以解決因人口老化而衍生嚴重的聽障問題。
    53. 53. 2013/07 曾志朗院士率團遠赴俄羅斯聖彼得堡 台灣「全方位聽力解決方案(Omni-Hearing Solution)」團隊榮獲軟體設 計組「世界公民」(World Citizenship)及「全球婦女賦權獎」(Women‗s Empowerment Award-UN Women)兩競賽項目亞軍!
    54. 54. DreamSpark 學生夢想火花計畫 免費為學生提供 Microsoft 開發工具及軟體: 追求自己的夢想,開創新世代的重大技術突破,或藉此踏出職 場生涯的第一步。
    55. 55. 56 總結 • 雲端運算 + App 浪潮 雲端運算: New Business Model 移動性裝置->鄉村包圍城市 C C 4 4 C 1 C C 3 3 Facility C 2 C5 C 5 Hype Cycle: 泡沫是必然 使用者才是王(后)!
    56. 56. 與我無關? 別小看自己! ? 3
    57. 57. 58 參考資料 • 潛能創意盃 (Imagine Cup): http://www.imaginecup.com • 學生夢想火花計劃 (DreamSpark): http://www.dreamspart.com
    58. 58. 59 © 2011 Microsoft Corporation. All rights reserved. This material is provided for informational purposes only. Microsoft makes no warranties, express or implied.

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