2021年全球醫(yī)療行業(yè)展望智慧醫(yī)療的變革Proposal

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11161823252722312021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革232021GlobalhealthcareoutlooklTheevolutionofsmarthealthcare4智慧醫(yī)療的定義5構(gòu)。醫(yī)療效勞提供鏈的所有成員經(jīng)常在多個地點開展工作〔醫(yī)院、醫(yī)生辦公室、零售醫(yī)療診所、診斷實驗室〕?；颊呖梢赃x擇住在離醫(yī)療機(jī)構(gòu)較遠(yuǎn)的城市或者國家。而且健康檔案通常以不同格式保存在不同的系統(tǒng)中，因此臨床醫(yī)生可能協(xié)調(diào)就診預(yù)約和程序，分享檢查結(jié)果以及讓患者參與治療方案上遇到困難。也就是說，醫(yī)療機(jī)構(gòu)能夠努力工作但未必能“智慧〞工作。2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革6醫(yī)療行業(yè)利益相關(guān)方面臨的最主要

挑戰(zhàn)培養(yǎng)未來勞動力斷變化的醫(yī)療經(jīng)濟(jì)環(huán)境下積極創(chuàng)造利潤提升消費者參與度并改善患者體驗從“規(guī)模〞到“價值〞的戰(zhàn)略轉(zhuǎn)變2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革重了早已有限的財力資源的負(fù)擔(dān)，因此預(yù)計前述趨勢將會持續(xù)下去。到2021年，全球主要地區(qū)的醫(yī)療總支出預(yù)計將增加至8.7萬億美元，而2021年為7萬億美元10〔圖2〕。復(fù)合年均增長率〔2021年-2021年〕2021(P)2021全球北美

西歐亞洲及

太平洋地區(qū)8,734.67,077.1

4,083.63,306.2

2,006.6

1,645.7

1,964.91,537.5 400.5 拉丁美洲 355.7 138.9 中東與非洲 112.7 246.1 轉(zhuǎn)型期經(jīng)濟(jì)體 170.9 10億美元資料來源：?世界行業(yè)展望——醫(yī)療與制藥業(yè)?，經(jīng)濟(jì)學(xué)人智庫，2021年6月。74.3%4.3%4%5%2.4%4.2%7.5%2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革2021年全球醫(yī)療行業(yè)面臨的問題在不明朗且不斷變化的醫(yī)療經(jīng)濟(jì)環(huán)境下積極創(chuàng)造利潤 美瑞日德瑞法荷丹奧比加挪英芬新愛澳意西葡冰斯希智捷以韓盧斯匈波愛土 國士本國典國蘭麥地利拿威國蘭西爾大大班萄島洛臘利克色國森洛牙蘭沙耳 利時大蘭蘭利利牙牙文共列堡伐利尼其 亞尼和克亞 亞國共 和 國資料來源：經(jīng)合組織人口、治療和根底設(shè)施導(dǎo)致支出增加在應(yīng)對一些持續(xù)性挑戰(zhàn)，包括遏制并治療傳染病和慢性病。慢性病〔糖尿病、慢性心臟病和阿茲海默病〕曾是興旺國家的特征，而現(xiàn)在由于生活方式的變化，慢性病逐步成為全球共同的健康和成本問題。17 8 2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革各國的醫(yī)療支出存在巨大差異〔圖3〕。遺憾的是，較高的支出水平并不總是能夠產(chǎn)生更好的療效和價值。例如，2021年美國醫(yī)療支出占國內(nèi)生產(chǎn)總值的16.9%，并將繼續(xù)在醫(yī)療行業(yè)比類似國家投入更多，但卻在經(jīng)濟(jì)合作與開展組織〔“經(jīng)合組織〞〕國家的預(yù)期壽命排名較低。12目前美國醫(yī)療支出每年超過3萬億美元，預(yù)計到2024年的增長速度將會提高。主要的支出種類包括醫(yī)院醫(yī)療效勞〔1萬億美元〕、內(nèi)科醫(yī)生〔6,349億美元〕和處方藥〔326億美元〕。13圖3：各國醫(yī)療支出 2021年醫(yī)療支出占國內(nèi)生產(chǎn)總值比例 16.9日本政府于2021年4月開始允許醫(yī)藥公司無需通過企業(yè)并購就可建立非盈利控股公司，旨在推動組織性改革。根據(jù)這項方案，控股公司可以管理該地區(qū)的多家醫(yī)療機(jī)構(gòu)/養(yǎng)老院。對于面臨患者人口下降但需要提高經(jīng)營效率的農(nóng)村地區(qū)醫(yī)療機(jī)構(gòu)而言，這一方案將非常有效。醫(yī)療行業(yè)以及各地均在開展合資、公私合作和其他合作方式。政府、醫(yī)療機(jī)構(gòu)和保險公司紛紛制定健康方案推進(jìn)公共健康工作。醫(yī)院與生物科技公司開始合作開發(fā)個性化的治療，尤其針對癌癥。102021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革規(guī)模?按次付費的支付制度；財務(wù)風(fēng)險有限?醫(yī)療機(jī)構(gòu)有動機(jī)增加費率、?？?集中 領(lǐng)域以及數(shù)量；醫(yī)療機(jī)構(gòu)分散〔問題〕?對治療效果和信息分享的關(guān)注有限動偵測疾病，并預(yù)期能夠預(yù)防或減緩病情惡化速度。32日本政府已推出一系列改革方案，最具代表性的是建立綜合社區(qū)醫(yī)療效勞系統(tǒng)，以統(tǒng)一方式結(jié)合醫(yī)療效勞、長期護(hù)理、住房和生活支援效勞，使日本的老年人可以在本社區(qū)接受持續(xù)的優(yōu)質(zhì)醫(yī)療效勞，而無需住院33。2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革從“規(guī)模〞到“價值〞的戰(zhàn)略轉(zhuǎn)變醫(yī)療效勞繼續(xù)從按次付費補償模式過渡到基于療效與價值的付費模式〔圖4〕：圖4：從“規(guī)模〞到“價值〞的持續(xù)轉(zhuǎn)變12新加坡衛(wèi)生部把國家最重要的醫(yī)療改革問題和趨勢分類為三大轉(zhuǎn)變，稱為“三大轉(zhuǎn)變方向〞，即“病患護(hù)理從醫(yī)院轉(zhuǎn)向社區(qū)〞、“從效勞品質(zhì)轉(zhuǎn)為效勞價值的追求〞以及“從醫(yī)療護(hù)理轉(zhuǎn)至全民健康〞。34衛(wèi)生部的生產(chǎn)力提升工程主要針對四個范疇，從而提供優(yōu)質(zhì)的醫(yī)療效勞和提升價值：幫助患者更有效地參與醫(yī)療體系，而不影響醫(yī)療質(zhì)量；把人工密集的活動自動化，以增加運營效率；簡化工作流程，增加崗位角色，讓醫(yī)護(hù)人員學(xué)習(xí)新技能，以提高工作效率和生產(chǎn)力，并且更全面地滿足患者需要；讓患者、護(hù)理者和志愿者有自助和自我照顧的能力。英國國家醫(yī)療效勞體系于2021年制定的?五年規(guī)劃?〔FiveYearForwardView〕訂立了一套適用到2021年的清晰措施：國家醫(yī)療效勞體系已經(jīng)是工業(yè)化國家中最為精干的公營醫(yī)療效勞體系，而國家醫(yī)療效勞體系的?十大效益規(guī)劃?〔TenPointE?ciencyPlan〕詳列以更13健康，包括使用受規(guī)管和有效的健康應(yīng)用程序和穿戴式設(shè)備。43“健全自我〞出現(xiàn)的其中一個跡象，是用作獲取醫(yī)療效勞和信息的移動通信裝置越來越普及。44從穿戴式健康追蹤器、智能裝置到電腦網(wǎng)絡(luò)，移動醫(yī)療市場的規(guī)模僅在四年內(nèi)已增長一倍。45事實上，當(dāng)前有超過100,000個移動醫(yī)療應(yīng)用程序，46預(yù)測到2021年末醫(yī)療應(yīng)用程序市場的收益將增長至260億美元。47上述裝置和效勞鼓勵消費者積極管理自身健康、體格和整體健康狀況，同時，也可能獲得更為廣泛的益處。從人口健康的角度而言，所有醫(yī)療成本中75%是因可預(yù)防狀況產(chǎn)生，48如上文所述的反響裝置對于推動健康的行為變化有莫大幫助。49人際暴力：面臨蓄意運用軀體的力量或權(quán)力〔威脅或?qū)嶋H的〕造成或極有可能造成損傷、死亡、精神傷害等的行為家庭和社會支持：缺乏可溝通、提供培育和幫助應(yīng)付日常生活的關(guān)系就業(yè)和收入：無法找到工作或維持一份工作或者賺取穩(wěn)定收入14影響健康的社會決定因素健康相關(guān)的社會需求一般指在醫(yī)療效勞系統(tǒng)以外影響健康且超出個人控制范圍的因素。55一般分類如下：15所有興旺國家均日益關(guān)注“弱勢〞或“問題家庭〞〔定義為與當(dāng)?shù)卣煌块T，如兒童或青年福利系統(tǒng)有接觸的家庭〕。這些家庭甚少成功突破惡性循環(huán)，導(dǎo)致長期貧窮、物資匱乏和跨代依賴政府支援。對于最為依賴家庭的成員，尤其是兒童和青少年，生活于弱勢家庭使他們更有可能面臨貧窮生活的影響。由于當(dāng)前無法解決這些弱勢家庭面對的影響健康的社會決定因素，因此增添了不必要的成本和社會壓力。56社會決定因素也可影響治療成效和醫(yī)療體系的付費模式。舉例來說，盡管頂級醫(yī)院可能能夠很有效地處理某一急性健康問題，但患者的狀況可能因為出院后重返不健康的環(huán)境而惡化。住屋情況不穩(wěn)定、糧食不平安、患者家庭或個人關(guān)系的暴力行為或者其他因素可致使患者最終因健康情況惡化而再次入院，使醫(yī)院難以取得激勵和/或防止經(jīng)濟(jì)處分。57越來越多醫(yī)院和醫(yī)療系統(tǒng)在努力解決如何有效地把社區(qū)和臨床效勞連接起來的挑戰(zhàn)，從而長遠(yuǎn)地改善治療效果。例如許多醫(yī)院如今進(jìn)行社會需求篩檢，即使部分篩檢工作看來只是偶爾和臨時進(jìn)行，而非恒常和有系統(tǒng)。58局部醫(yī)療體系雇用社區(qū)健康助理，他們是非持牌的專業(yè)人員，負(fù)責(zé)評估患者的需要、聯(lián)系根底醫(yī)療效勞和個案管理團(tuán)隊以及協(xié)調(diào)轉(zhuǎn)介個案。59其他醫(yī)院和醫(yī)療效勞機(jī)構(gòu)與叫車效勞合作，以解決交通運輸問題。602021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革16172021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革不確定性程度低中高18遠(yuǎn)程醫(yī)療實驗早

期運

用早

期大

規(guī)

模

運

用后期大規(guī)模運用落伍資料來源

：

德勤研究31%31%38%28%46%26%目前

，

日本正試驗以醫(yī)護(hù)機(jī)器人輔助老齡人

。

80

中國臨床醫(yī)生正使用人工智能支持肺部

、

眼部和皮膚病的影像診斷

。

一家美國新興企業(yè)正使用人工智能采集流經(jīng)一家醫(yī)院的所有數(shù)據(jù)

，

以了解如何騰出醫(yī)生和護(hù)士人手

，

為更多患者診癥和改善療效

：

其中一個客戶能夠以相同資源每年多治療

3,000

個患者

，

增幅達(dá)

18%

。

81 開始階段選擇最正確治療方法，從而避 免陷入昂貴、高風(fēng)險且反復(fù)試錯的診 療手法中。86?生物傳感器和追蹤器。生物傳感器歸 屬于正快速縮小的可穿戴設(shè)備和醫(yī)療 裝置，它使消費者和臨床醫(yī)生能更加 全面地監(jiān)察和追蹤患者健康，從而及 早干預(yù)，甚至提早預(yù)防，以減少對患者 生活的侵?jǐn)_。871989

90同樣地

，

新興經(jīng)濟(jì)日益增長的醫(yī)療服務(wù)需求，將帶動大量醫(yī)院方案與興建。的患者

，

如復(fù)雜個案和病重者

，

將很有可能仍然需要住院醫(yī)療效勞。圖6：醫(yī)療效勞支出〔按職能排列〕——經(jīng)合組織國家平均值 Hospitalinpatientservices 醫(yī)院住院效勞 Oupatientservicesandlong-termcare 門診效勞和長期護(hù)理 Other(includesdrugspendingandgovernmentservices) 其他〔包括藥物支出和政府效勞〕資料來源：經(jīng)合組織2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革212021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革22提升消費者參與度并改善患者體驗許多創(chuàng)業(yè)者和醫(yī)療消費者提出一些根本問題：為何患者體驗不能更為個性化？為何系統(tǒng)不能更加方便？為何患者必須去集中地點就醫(yī)？為何在患者參與前，醫(yī)療方案、醫(yī)院和醫(yī)生全都同意有關(guān)價格和者。99根據(jù)德勤?2021年美國醫(yī)療消費者調(diào)查報告?顯示，從醫(yī)療機(jī)構(gòu)獲取個性化醫(yī)療效勞〔包括明確溝通和體貼度〕是受訪者關(guān)注的首要醫(yī)療效勞重點〔圖7〕：65

歲以上圖7：消費者表示醫(yī)療機(jī)構(gòu)提供的個性化醫(yī)療效勞是他們關(guān)注的首要醫(yī)療重點 不同年齡段的醫(yī)療效勞個性化偏好不同 14 12 10 8 6 4 2 0 16-24歲 從醫(yī)院就診到后續(xù)隨訪均最看重與醫(yī)療機(jī)構(gòu)的明確溝通 在醫(yī)院就診和檢查中最看重醫(yī)療機(jī)構(gòu)的溝通和體貼度資料來源：德勤?2021年美國醫(yī)療消費者調(diào)查報告?2021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革1.5%60%患者評級上升

10%

而成為優(yōu)等評級醫(yī)院的利潤增加

：圖

8

：擁有優(yōu)秀患者評級的醫(yī)院具備更高的盈利能力我們分析發(fā)現(xiàn)

，

提供獨特體

驗的醫(yī)療機(jī)構(gòu)通常展現(xiàn)出強(qiáng)勁的財務(wù)業(yè)績和有效運營提升財務(wù)績效優(yōu)等

vs

中等評級導(dǎo)致財務(wù)績效

產(chǎn)生差異提高運營效率患者花費〔按調(diào)整后的每個病人每天〕差等中等優(yōu)等患者滿意度導(dǎo)致優(yōu)等和中等評級醫(yī)院的凈患者收入〔按調(diào)整后的住院天數(shù)〕產(chǎn)生444美元的差異資料來源：?德勤：患者體驗的價值?〔Deloitte:ValueofPatientExperiences〕，2021年232021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革醫(yī)院采用數(shù)字解決方案推動增加全渠道的患者就診時機(jī)，包括客戶應(yīng)用程序、患者信息門戶系統(tǒng)、個性化數(shù)字資料冊和自助檢查終端，能夠提供更個性化的醫(yī)療效勞，與消費者進(jìn)行更好的交流，提升患者體驗。100加強(qiáng)醫(yī)療機(jī)構(gòu)與消費者交流的其他數(shù)字渠道和工具包括：?利用社交媒體改善患者體驗：社交媒 體為醫(yī)療效勞機(jī)構(gòu)提供了豐富的數(shù)據(jù) 來源，能夠?qū)崟r追蹤消費者經(jīng)歷和人 口健康趨勢，比目前的途徑效率更高。?遠(yuǎn)程醫(yī)療：遠(yuǎn)程醫(yī)療更便于消費者獲取 醫(yī)療效勞，同時還能減少就醫(yī)次數(shù)和 出行時間。這種便捷的醫(yī)療效勞模式 有可能提高自我護(hù)理、預(yù)防并發(fā)癥以 及減少急診次數(shù)。101242021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革252021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革培養(yǎng)未來勞動力262021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革打破依賴圈：解決困難家庭面臨的醫(yī)療不平等問題盡管西歐的預(yù)期壽命延長，但困難家庭仍面臨嚴(yán)重的醫(yī)療不平等問題。獲得優(yōu)質(zhì)醫(yī)療效勞十分重要，但也僅占醫(yī)療不平等問題的15%-25%。關(guān)鍵的是，推動死亡率和健康狀況欠佳趨勢的是一系列社會決定因素，包括教育質(zhì)量、住房、就業(yè)、工作環(huán)境和福利。推動健康社區(qū)開展隨著醫(yī)療行業(yè)轉(zhuǎn)向在患者患病前先行治療，社區(qū)合作方和政府機(jī)構(gòu)均參與進(jìn)來，旨在解決教育和住房等社會因素。然而更多參與者意味著情況更復(fù)雜，尤其是資金。而其中一個可能的解決方案就是采用軸心模式〔hubmodel〕。解決醫(yī)院醫(yī)療方面的社會決定因素：醫(yī)院和醫(yī)療系統(tǒng)如何對社會需求展開投入？我們對300家醫(yī)院和醫(yī)療系統(tǒng)進(jìn)行了調(diào)查，探討了醫(yī)療體系外的各項因素〔醫(yī)療方面的社會決定因素〕如何影響患者的長期幸福以及醫(yī)療機(jī)構(gòu)可以采取哪些措施解決這些挑戰(zhàn)。德勤2021年美國醫(yī)療系統(tǒng)公司首席執(zhí)行官調(diào)查報告：風(fēng)云變幻，逆風(fēng)前行醫(yī)院與醫(yī)療系統(tǒng)公司的首席執(zhí)行官在充滿變數(shù)的世界中尋求開展時，面臨越來越多的困境。因此首席執(zhí)行官面臨哪些主要問題和趨勢？自2021年與醫(yī)療系統(tǒng)公司首席執(zhí)行官對話后，我們訪問中呈現(xiàn)的主要主題均未發(fā)生變化，但緊要事項已然不同。首席執(zhí)行官并未從未來角度考慮這些問題，而是準(zhǔn)備在當(dāng)下解決它們。27尾注1.World

Industry

Outlook,

Healthcare

and

Pharmaceuticals,

The

Economic IntelligenceUnit,June20212.Ibid3.Ibid4.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June2021,citingtheWorldHealthOrganization(WHO)5.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June2021,citingtheJointUNProgrammeonHIV/AIDS (UNAIDS)6.Ibid7.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June2021,citingtheInternationalDiabetesFederation8.Thefutureawakens:Lifesciencesandhealthcarepredictions2022,Deloitte UKCentreforHealthSolutions,November2021, en/pages/life-sciences-and-healthcare/articles/healthcare-and-life-sciences- predictions.html.Dementiastatistics.Alzheimer’sDiseaseInternational,2021. Seealso9.Ibid10.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June202111.Ibid12.OECDHealthStatistics202113.CentersforMedicareandMedicaidServices(CMS)“NHETables〞and“Historical andProjections1960-2024〞NationalHealthExpenditureProjections,2021–25: HealthAffairs14.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June202115.“GrattanInstitute:ageingpopulation‘willnotcausecollapseofhealth system,’〞TheGuardian,21July,2021, news/2021/jul/21/grattan-institute-ageing-population-will-not-cause-collapse- of-health-system16.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June202117.Ibid18.Peterson-KaiserHealthSystemTracker,AnalysisofTruvenHealthAnalytics MarketScan19.ANAHP–Observatório202120. five-year-forward-view/executive-summary21.“China’s‘zeromarkup’hospitalreformsmixedbagforpatenteddrugs,〞 BioWorld,2021, hospital-reforms-mixed-bag-patented-drugs-2.22.“TheimpactofChina’sZero-MarkupDrugPolicyoncountyhospitalrevenue andgovernmentsubsidylevels,〞ResearchGate,February2021,s:// /publication/273485851_The_impact_of_China%27s_Zero- Markup_Drug_Policy_on_county_hospital_revenue_and_government_subsidy_ levels23.BMIResearch–BrazilPharmaceuticals&HealthcareReport20213Q24.Deloitte2021SurveyofUSHealthSystemCEOs:Movingforwardinanuncertain environment.Chapter3:Marginpressureandthesearchfornewrevenue streams,DeloitteCenterforHealthSolutions,2021,citingN.A.,“Distributionof Inpatientvs.OutpatientRevenues,1994–2021,TrendwatchChartbook2021.〞 2021.Availableat table4-2.pdf].25.

The

uncertain

road

ahead:

Could

technology

offer

hospitals

relief

from increasingmarginpressures?,DeloitteCenterforHealthSolutions, 2021, care/articles/hospital-financial-performance-emerging-technologies. html?id=us:2sm:3ab:dohcg:eng:lshc:111017&pkid=100478726.Ibid27.CRGroupwebsite28.Deloitte2021SurveyofUSHealthSystemCEOs:Movingforwardinan uncertainenvironment.Chapter3:Marginpressureandthesearchfornew revenuestreams,DeloitteCenterforHealthSolutions,202129.Ibid30.High-valuehealthcare:Innovativeapproachestoglobalchallenges,Deloitte, 202131.High-valuehealthcare:Innovativeapproachestoglobalchallenges,Deloitte, 2021,citingRobertoTapia-Conyer,HéctorGallardo-Rincón,andRodrigo Saucedo-Martinez,“CASALUD:aninnovativehealth-caresystemtocontroland preventnon-communicablediseasesinMexico,〞PerspectivesinPublicHealth 135,no.4(2021),p.180-90,32.High-valuehealthcare:Innovativeapproachestoglobalchallenges,Deloitte, 2021,citingRobertoTapia-Conyeretal.,“Enablersandinhibitorsofthe implementationoftheCasaludmodel,aMexicaninnovativehealthcaremodel fornon-communicablediseasepreventionandcontrol,〞HealthResearchPolicy andSystems14,no.51(2021),DOI:10.1186/s12961-016-0125-0.33.FutureoftheIntegratedCommunityCareSystem:fromCarebySocietytoCare inLocalCommunities. Future_of_the_Integrated_Community_Care_System_from_Care_by_Society_to_ Care_in_Local_Communities34. speeches_d/2021/speech-by-minister-fo-health--mr-gan-kim-yong--at-the- moh-commit.html)35.“TransformationofHealthSystemNeededtoImproveCareandReduce Costs,〞newsrelease,NationalAcademies,6September,2021,://www8. /onpinews/newsitem.aspx?RecordID=1344436.37.38.“ReducingLow-ValueCare,〞HealthAffairsBlog,20September,2021, /blog/2021/09/20/reducing-low-value-care/39.“Transformation

of

Health

System

Needed

to

Improve

Care

and

Reduce Costs,〞newsrelease,NationalAcademies,6September,2021,://www8. /onpinews/newsitem.aspx?RecordID=1344440.EsNash,“Defininganddeliveringpopulationhealth,〞AViewfromtheCenter, DeloitteCenterforHealthSolutions,15October,2021.Availableat[://blogs. deloitte/centerforhealthsolutions/definingand-delivering-population- health/]41.HospitalCEOseries:Chapter2:Populationhealthandvalue-basedcare, DeloitteCenterforHealthSolutions,202142.TheStateCouncilofthePeople’sRepublicofChina43.Thefutureawakens:Lifesciencesandhealthcarepredictions2022,Deloitte UKCentreforHealthSolutions,November2021, en/pages/life-sciences-and-healthcare/articles/healthcare-and-life-sciences- predictions.html.44.SasanAdibi,MobileHealth:ATechnologyRoadMap(Switzerland:Springer InternationalPublishing,2021). 282021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革45.

“Closing

the

wellness

gap:

Fusing

mobile

technologies

with

behavioral sciencetoimprovehealthoutcomes,〞DeloitteInsights,December15,2021,

improving-health-outcomes-mobile-health-care.html#endnote-sup-4,citing research2guidance,mHealthappdevelopereconomics2021:Thestateofthe artofmHealthpublishing,May6,2021, r2g/research2guidance-mHealth-App-Developer-Economics-2021.pdf.46.Ibid47.Thefutureawakens:Lifesciencesandhealthcarepredictions2022,Deloitte UKCentreforHealthSolutions,November2021,s://www2.deloitte. com/uk/en/pages/life-sciences-and-healthcare/articles/healthcare-and-life- sciences-predictions.html,citingmHealthappdevelopereconomics2021. Research2Guidance,2021.Seealso:s://research2guidance/product/ mhealth-app-developer-economics-2021/48.AmericanPublicHealthAssociation,Preventionandpublichealthfund: dedicatedtoimprovingournation’shealth,s:///~/media/ files/pdf/factsheets/160127_pphf.ashx.49.Closingthewellnessgap:Fusingmobiletechnologieswithbehavioralscience toimprovehealthoutcomes,DeloitteUniversityPress,15December,2021,

improving-health-outcomes-mobile-health-care.html50.WullianallurRaghupathiandVijuRaghupathi,“BigDataInHealthCare:Using AnalyticsToIdentifyAndManageHigh-RiskAndHigh-CostPatients,〞Health Affairs33,no.7(2021):pp.1123-1131,DOI:10.1377/hlthaff.2021.0041.51.JessePines,DavidNewman,RandyPilgrim,andJeremiahD.Schuur,“Strategies forIntegratingCost-ConsciousnessintoAcuteCareShouldFocuson RewardingHigh-ValueCare,〞HealthAffairs32,no.12(2021):pp.2157-2165, DOI:10.1377/hlthaff.2021.0685.52.MichaelFurukawa,VaishaliPatel,DustinCharles,MatthewSwain,and FarzadMostashari,“HospitalElectronicHealthInformationExchangeGrew Substantiallyin2021-12,〞HealthAffairs32,no.8(2021):pp.1346-1354,DOI: 10.1377/hlthaff.2021.0010.53. health-care/us-lshc-dchs-convergence-of-trends.pdf54.RobertWoodJohnsonFoundation,“Whyweneedacultureofhealth,〞March 202155.HealthPolicyBrief:TheRelativeContributionofMultipleDeterminantsto HealthOutcomes,〞HealthAffairs,21August,202156.Breakingthedependencycycle:Tacklinghealthinequalitiesofvulnerable families,DeloitteUKCentreforHealthSolutions,June2021,s://www2. deloitte/uk/en/pages/life-sciences-and-healthcare/articles/breaking- dependency-cycling.html57.Socialdeterminantsofhealth:Howarehospitalsandhealthsystemsinvesting inandaddressingsocialneeds?DeloitteCenterforHealthSolutions,2021,

health-care/us-lshc-addressing-social-determinants-of-health.pdf58.

Social

determinants

of

health:

How

are

hospitals

and

health

systems

investing inandaddressingsocialneeds?DeloitteCenterforHealthSolutions,2021,

health-care/us-lshc-addressing-social-determinants-of-health.pdf59.Navigatingbundledpayments:Strategiestoreducecostsandimprovehealth care,DeloitteCenterforHealthSolutions,January202160.62.Ibid63.Deloitte2021SurveyofUSHealthSystemCEOs:Movingforwardinan uncertainenvironment.Chapter3:Marginpressureandthesearchfornew revenuestreams,DeloitteCenterforHealthSolutions,202164.“Disruptingthesocialdeterminantsofhealth:Fromexponential medicinetoexponentialhealth,〞AViewfromtheCenter,DeloitteCenter forHealthSolutions,8November,2021, centerforhealthsolutions/disrupting-the-social-determinants-of-health-from- exponential-medicine-to-exponential-health/65.Socialdeterminantsofhealth:Howarehospitalsandhealthsystemsinvesting inandaddressingsocialneeds?DeloitteCenterforHealthSolutions,2021,

health-care/us-lshc-addressing-social-determinants-of-health.pdf66.“BrazilianInsurersTakeOn‘ProstheticMafia’,〞16December,2021,Lowell, Neumann,Nickey, on-prosthetic-mafia/67.NationalHealthandFamilyPlanningCommissionofChina68.SecurityGuidelinesforHealthInformationSystems,MinistryofHealth,Japan69.“Arevolutionarydigitaltoolforthehealthcareindustry:TheInternet-of-Things,〞 InsideMagazine-Issue15,Deloitte,June2021, en/pages/life-sciences-and-healthcare/articles/digital-health-iot.html70.Cognitivehealthcarein2027:Harnessingadata-drivenapproachin personalizedhealthcare,DeloitteUniversityPress,2021,s://dupress. deloitte/dup-us-en/focus/cognitive-technologies/cognitive-health-care- in-2027.html71.Thehospitalofthefuture:Howdigitaltechnologieswillchangehospitals globally,DeloitteCenterforHealthSolutions,202172.“Arevolutionarydigitaltoolforthehealthcareindustry:TheInternet-of-Things,〞 InsideMagazine-Issue15,Deloitte,June2021, en/pages/life-sciences-and-healthcare/articles/digital-health-iot.html73.TheDailyDot,12May,2021, ransomware-malware-attack-nhs/74.“UKNHSransomwarecyberattackspreadsacrosstheglobe,〞Clinical Innovation+Technology,12May, topics/privacy-security/uk-nhs-ransomware-cyberattack-spreads-across-globe75.“2021DataBreachInvestigationsReport,〞VerizonCommunications,2021. [://verizonenterprise/verizon-insights-lab/dbir/2021/].76.“2021onTracktoExceed2021Trendof‘OneHealthDataBreachPerDay,’〞 BreachBarometerReport:Mid-YearReview,Protenus,Inc.&DataBreaches. net, Year%20Review/2021%20Protenus%20Breach%20Barometer%20Mid%20 Year%20Review.pdf].77.ElizabethSnell,“HealthcareDataBreachCostsHighestfor7thStraightYear,〞 HealthITSecurity,20June,2021.Availableat[s://healthitsecurity/ news/healthcare-data-breach-costs-highest-for-7th-straight-year].78.European

Commission,

79.NationalInstitutesofHealth’sNationalHumanGenomeResearchInstitute,

80.WorldIndustryOutlook,HealthcareandPharmaceuticals,TheEconomic IntelligenceUnit,June202181.“HowArtificialIntelligencewillCureAmerica’sSickHealthCareSystem,〞Newsweek,24May,2021,america-sick-health-care-system-614583.html61.“Disruptingthesocialdeterminantsofhealth:Fromexponential medicinetoexponentialhealth,〞AViewfromtheCenter,DeloitteCenter forHealthSolutions,8November,2021, centerforhealthsolutions/disrupting-the-social-determinants-of-health-from- exponential-medicine-to-exponential-health/292021年全球醫(yī)療行業(yè)展望l智慧醫(yī)療的變革82.“MyTake:Inaneraofexponentials,healthcareisonthecuspofapotential majortransformation,〞HealthCareCurrent,DeloitteCenterforhealth Solutions,3October,2021, life-sciences-and-health-care/articles/health-care-current-october3-2021. html?id=us:2em:3na:hcc:awa:chs:100317#183.Ibid84.Ibid85.“Precisionmedicine:Bridgingthegapbetweenpotentialandreality,〞Aview fromtheCenter,DeloitteCenterforHealthSolutions,23July,2021;citing FDAdefinition medicine-bridging-the-gap-between-potential-and-reality/86.2021Globalhealthcareoutlook:Battlingcostswhileimprovingcare,Deloitte, 202187.2021Globalhealthcareoutlook:Makingprogressagainstpersistentchallenges, Deloitte,2021,citingTop10healthcareinnovations:Achievingmoreforless, DeloitteCenterforHealthSolutions,202188. expensive-hospital-expansion-renovation-projects-of-2021.html89.europa.eu/rapid/press-release_BEI-06-41_en.doc90.91.92.93.VCBeat

Research94.Thehospitalofthefuture:Howdigitaltechnologieswillchangehospitals globally,DeloitteCenterforHealthSolutions,202195.Thefutureawakens:Lifesciencesandhealthcarepredictions2022,Deloitte UKCentreforHealthSolutions,November2021,s://www2.deloitte. com/uk/en/pages/life-sciences-and-healthcare/articles/healthcare-and-life- sciences-predictions.html,citingmHealthappdevelopereconomics2021. Research2Guidance,2021.Seealso:s://research2guidance/product/ mhealth-app-developer-economics-2021/96.“HealthcareanalyticsmarkettoreachUSD18.7billionby2021,〞newsrelease, MedicalMarketResearch,August2021, research/medical/192126-healthcare-analytics-market-worth-18-7-billion- by-202197.Analyticstoimproveoutcomesandreducecost:Healthsystemsandhealth planscanworktogethertojointlywintheshiftfromvolumetovalue.Findings fromtheDeloitteCenterforHealthSolutions2021USHealthPlanAnalytics Survey, articles/population-health-analytics.html98.Thehospitalofthefuture:Howdigitaltechnologieswillchangehospitals globally,DeloitteCenterforHealthSolutions,202199.Ibid100.Thehospitalofthefuture:Howdigitaltechnologieswillchangehospitals globally,DeloitteCenterforHealthSolutions,2021101.Top10healthcareinnovations:Achievingmoreforless,DeloitteCenterfor HealthSolutions,2021102.2021GlobalHealthCareOutlook:Makingprogressagainstpersis