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工商時報【寇惠植(安侯建業聯合會計師事務所執行董事/生技暨長照銀髮產業服務團隊指導會計師)、謝邦昌(臺北醫學大學管理學院院長)】

大數據、物聯網( IoT)以及人工智慧(AI)和攜帶式裝置的發展,與網路無國界的概念,使醫療相關產業同樣面臨數位化轉型議題。透過物聯網,患者與醫師、患者與各地的患者之間,有了新的數位化鏈結,而建立鏈結關係的便是「數據」。攜帶式裝置與物聯網的應用,也讓醫療設備不再僅僅是醫院裡面大型的儀器與操作面板,攜帶式裝置成為醫療儀器與專業醫護人員的延伸。而這些每日快速產生、大量且類型多樣化的資料,也隨著人工智慧和大數據資料處理,提供醫學研究領域更多深入洞察、加值服務應用分析的機會。

穿戴式裝置

提升數據質量與即時性

行動醫療應用發展基礎,由於物聯網技術逐漸成熟,行動醫療與健康照護的需求日趨明顯,加上面臨少子化與高齡化社會的問題,以及事前預防勝於事後治療之照護概念興起,行動醫療科技未來將扮演著重要的照護角色,不僅可進行自我健康管理,亦可提供個人化資訊,協助行動醫療領域的應用。

醫療大數據的取得

須兼顧隱私及貼身服務

穿戴式裝置和大數據資料處理技術的進步,不僅記錄病患健康狀況相關數據,透過無線通訊技術自動回傳至醫療中心終端,幫助醫生和病患本人即時獲得各項生理監測數據。然而這樣的應用概念,首先所面臨的挑戰便是數據來源的取得,除了有法律和隱私議題需要解決,若要對病患提供完整的服務評估,僅僅有穿戴式裝置的監測數據是不夠的,如何獲取更完整資料來源,達到最完整評估,是目前醫護大數據資料平台極力想達成的目標。

智慧型感測裝置

與行動遠端照護相輔相成

高齡化社會來臨,改變了人口結構,醫療服務發展轉為以慢性疾病為主,隨著慢性疾病發生率逐漸攀升,相關治療費用也持續增加,因此如何達成早期發現與預防的效果,而達到降低醫療支出的目的,更是目前大家關注的焦點。據國發會最新統計推估,2025年台灣老年人口比重將跨越20%門檻,奔向超高齡社會。透過智慧型感測器與先進的應用工具,進行身體數據的資訊蒐集與管理,將資料回傳到醫療的中央資料庫。更能利用遠端視訊設備、醫療監測、遠距監測介面來觀察病人情況,並針對醫療流程管理進行改善。

行動醫療數據、電子病歷、機器學習促成精準醫療

大數據資料分析應用於電子病歷與行動感測數據,除了方便醫生與病患使用,更重要的是後端的運算系統,能利用機器學習演算法計算獲得病人的健康指數,從資料細節中來探究健康指數,發現病患發病潛在因素,從而及時發現問題。隨著智慧感測裝置與電子病歷累積足夠的大量資料,能夠透過機器學習演算法應用於醫療領域中,然而透過電子病歷與手術後患者的感測數據回傳,藉由機器學習演算法判斷哪些患者具有較高的疾病 復發機率需要再度住院治療的情況發生,使用預測模型讓醫院可以提前預測緊急情況發生,提高治療效果並降低營運成本。

新政府目前推動打造的「亞洲?矽谷推動方案」從IT到IoT的全面轉型升級發展計畫中提及:以全球(亞洲)需求導向為原則,結合台灣利基與優勢。全球(亞洲)可能共同面臨問題中高齡化的照護及健康醫療是其中一個重要課題,我們可以善用台灣過去ICT產業的發展利基,再加上完整醫療大數據的優勢,為照護、醫療及生技醫藥的發展畫一個藍圖,也為台灣下一個經濟奇蹟作努力。我們將目前產業最夯的幾個議題來探討不外乎是:醫療科技、健康照護、數位金融及大數據。而這些議題都是圍繞著大數據的應用,彼此之間可以交互創新產業的發展。。

醫療科技及健康照護

越來越智慧

傳統上二者結合的產業不外乎是做出一些輔具來改善需要照顧的患者及高齡化的長者,現在加上ICT及IoT後蒐集的大數據,可以將這些醫療科技做得更智慧,提供更好的照護服務。如大家熟悉的穿戴式裝置就有更多可以發展的空間,建置了雲端來蒐集數據,發展出遠距照護及遠距醫療,透過雲端大數據分析,提供醫療照護應用,這必定是未來智慧醫療發展的趨勢。未來照護的發展也將伴隨著機器人的開發有更大的進步;醫療照護機器人將成為數據蒐集的管道,進一步利用這些數據來進行雲端分析可改善照護模式。運用醫療科技可打造一個未來科技的照護環境,這樣的結合將給更多ICT產業發展的目標。

結合金融產業

醫療科技更創新

數位金融在醫療上除了支付的概念外,結合醫療科技也可以創新產業,運用穿戴式裝置來蒐集的資訊可以給保險公司提供更加個人化的保單及醫療照顧,甚至可以監測保戶健康或鼓勵保戶注意健康來做為預防醫學的一部分,若再加上數據的蒐集及雲端分析,可以為保險公司作為保費訂價的決策,這樣的結合可以為金融產業有更多創新服務模式。

健康照護加數位金融

服務客製化

銀行金融服務常常也是數據的來源,客戶的消費習慣及與喜歡那些商家及品牌,可以從他的刷卡付費行為做分析,如此的個人化的資料可以做為未來提供健康照護的服務模式量身訂做,讓照護多帶一點人性及溫暖。例如喜歡品酒,未來需要照護時可以適當加入照護的生活中,喜歡旅遊,照護的安排上也可以妥為規畫或給予建議。

提到生技醫療產業的連結,一般人想到的都是硬梆梆的科技或帶點銅臭的金融,事實上所有的產業都與銀髮生技醫療產業有相關,例如將營建業結合保險業者建構銀髮宅,網通業也能將照護及輔具業者加以整合構建平台等。銀髮生技醫療產業的發展也應以人為出發點,所以若要結合各產業的發展,另外考慮一些文創思維的加入,發展高齡化生活的文創產業,例如如何照顧自己高齡生活的課程及創建銀髮俱樂部開拓銀髮族多元生活等。

由於大數據的發展,人類的生活將有更加突破的進步,生技醫療及銀髮照護產業的未來應該取決於數據資料的蒐集與分析,在資訊化的時代中數據是任何產業發展的原料,誰能掌握數據、分析數據及解讀數據,將會是這個產業最後的贏家,所以當產業界在規劃跨足銀髮生技醫療產業的未來方向時,除了在自身的產業上去思索如何聯結外,尚可以進一步的將產品的發展結合大數據及物聯網,創造出跨界發展的銀髮生技醫療大數據產業。

下面附上一則新聞讓大家了解時事

道奇主場面對小熊,系列戰第3戰道奇先發投手Rich Hill(希爾)大突破,一掃季後賽短命先發陰霾,繳出6局無失分好投,成功封鎖小熊打線,幫助道奇6局結束取得4:0領先。

Hill本場比賽之前季後賽累積2場先發都撐不到5局就退場,合計只投7局,被敲9支安打,掉了5分,儘管送出13K,不過也有4次保送,防禦率高達6.43,表現並不理想。

本場比賽Hill完全找回身手,主投6局,只被敲2支安打,送出6K、2次保送,沒有失掉任何分數,是道奇打完6局能取得領先的關鍵人物之一。

Hill只在2局上遇到比較大的麻煩,控球出狀況接連送出2次保送,隨後捕手又發生捕逸,讓小熊1人出局攻占二、三壘,所幸Hill及時回穩,先三振掉Addison Russell,之後再讓Miguel Montero擊出滾地球出局,Hill沒有失分安全下庄,一路投完6局沒有失掉分數。

★更多相關新聞

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唐納森帶頭衝 藍鳥絕處逢生 扳回一城
回魂的希爾:這是我生涯最重要的一戰
道奇連兩戰完封小熊 寫下隊史紀錄
道奇最後一道防線 王牌柯蕭何時上?

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If you don't like baseball, watch baseball, or know what baseball is, know this — the 2016 World Series is different.?

When the Cleveland Indians host the Chicago Cubs in a best-of-seven series

... 較多If you don't like baseball, watch baseball, or know what baseball is, know this — the 2016 World Series is different.?

When the Cleveland Indians host the Chicago Cubs in a best-of-seven series beginning Tuesday night, we won't just witness another run-of-the-mill Fall Classic. This year's matchup is steeped in history, characterized by decades of suffering, and features two teams who know a whole lot about losing.?

By the end of this World Series, one city will hoist the championship trophy for the first time in a very, very, long time.?

SEE ALSO: 經典The dark side of a feel-good World Series

The Cubs haven't won a World Series since 1908, the longest championship drought in North American professional sports. They haven't even been to a World Series since 1945.?

Chicago's franchise is supposedly cursed, and the years of bad luck and losing seasons prove it.?

But a revamped front office and minor-league farm system have turned the Cubs from lovable losers to a national powerhouse. They showed up at Spring Training with the best odds of winning the World Series and led baseball with 103 wins during the regular season. ?

It's easy to root for this year's Cubs, until you remember who's in the other corner.

Image: Jamie Squire/Getty Images

The Indians haven't won a World Series since 1948, the second longest championship drought in baseball. Cleveland stumbled through the 1970s and '80s, failing to make the postseason every season in a 24-year span. Its last World Series appearances — both losses, of course — came in 1995 and 1997.?

The history of this World Series is huge, and each team's drought will be hyped constantly. But there's more to this matchup.

So, if you're just tuning in, here are our five biggest storylines to watch during the 112th World Series.?

1. Battle of the bullpens



The Cubs and Indians have one very specific thing in common —?in July, they both picked up two of the best relief pitchers in baseball, courtesy of the New York Yankees. The Indians, who traded for Andrew Miller, and the Cubs, who traded for Aroldis Chapman, understood the value of a shut-down bullpen in the postseason, and made sure to stock up on elite relievers.?

Andrew Miller has been unbeatable.

Image: Elsa/Getty Images

The results have been undeniable.?

Miller struck out 21 batters in 11.2 scoreless postseason innings for the Indians, earning MVP honors in the American League Championship Series. He's at the helm of a monster bullpen with a 1.67 ERA in the playoffs.?

Cleveland's strategy this postseason is simple —?get an early lead and let the bullpen save it.?

Though the Cubs' bullpen might not have the flashiest postseason numbers this year — a 3.53 ERA and a couple blown saves — it still features Chapman, who fires 100-mph fastballs right by hitters on a regular basis.?



Image: mlb

Keep an eye on the bullpen. This series could hinge on the guys emerging from it.?

2. The fountain of youth



You can bet Fox announcers will constantly tout the young talent of both World Series teams, particularly Chicago.?

The average age of the Cubs infield — featuring All-Star Addison Russell, NLCS co-MVP Javier Baez, 2015 Rookie of the Year Kris Bryant and MVP candidate Anthony Rizzo — is 24 years old.?

Russell and Baez are only 22 and 23, respectively. They epitomize the Cubs' philosophy of developing young superstars and complimenting them with big-budget free agent signings.?

Clearly, that model has worked.?

Javier Baez was the Cubs' co-MVP of the NLCS.

Image: mlb

The Indians have shallower pockets, and couldn't afford to take the powerhouse approach. Instead, Cleveland relies on contributions from more frugal pick-ups like Rajai Davis and Mike Napoli.?

They still boast a solid young core that features All-Star shortstop Francisco Lindor (22), José Ramirez (24) and rookie Tyler Naquin (25). Rookie starting pitcher Ryan Merritt (24) made only one major league start before helping the Indians clinch a World Series berth last week.?

For a World Series soaked in historical context, this Fall Classic belongs to the kids.?

3. It starts with starting pitching



With all eyes on the bullpen, starting pitching could be the Cubs' not-so -secret weapon.?

Chicago boasts a deep starting rotation that led the majors with a 2.96 ERA during the regular season. Between Jon Lester — who's posted a 0.86 ERA in three postseason games — Jake Arrieta and Kyle Hendricks, the Cubs are set.?

The Indians had a brilliant starting rotation of their own at one point this season, but lost two of their talented arms to injury. There are murmurs of one of them returning, but more on that later.

Aside from Game 1 starter and former Cy Young Award winner Corey Kluber, the Indians have relied on good — but not elite — starting pitchers who turn in gutsy performances.?

Corey Kluber won 18 games in 2016.

Image: Maddie Meyer/Getty Images

Josh Tomlin is largely untested. Trevor Bauer bled himself off the mound last week. Ryan Merritt has two major league starts to his name.

Still, the Indians starting rotation has an impressive 1.86 ERA this postseason.

But don't let the numbers fool you. Chicago has an edge here.?

4. Comeback kids



This World Series will feature elite relief pitching, the best of the best. Games will surely come down to the late innings.

But here's something to chew on.?

This postseason, the Cubs have scored 17 runs in the seventh inning or later, the best of any team. They've thrived on comeback wins, and never seem to go down quietly.

Image: Jamie Squire/Getty Images

How many have the Indians scored in the seventh or later?

Zero.?

Cleveland appears incapable of putting runs on the board with their backs against the wall. Their game plan, as mentioned, is to get an early lead and turn things over to the bullpen.

That might not work against a team like the Cubs.?

Chicago's bullpen is beatable, but it's still formidable in the late innings, a time when the Indians' bats seem to be incredibly weak.?

5. Reviving the dead



Chicago won more than 100 games without Kyle Schwarber, one of the Cub's elite young superstars. Schwarber hit five postseason home runs last year, but tore his ACL just two games into this season.?



Now, there's talk he might be back.?

Since coming off the disabled list on Saturday, Schwarber has been getting back into playing shape in the Arizona Fall League (AFL). Depending on his performance in an AFL game Monday night, the Cubs could activate him for a designated hitter role in the World Series on Tuesday.?

There's sure to be rust, but if Schwarber performs anything like the player he was in 2015, he could be a difference-maker.?

For Cleveland, it's looking like starting pitcher Danny Salazar will return as well.

The All-Star right-hander, who struck out more than 10 batters per nine innings during the regular season, has been sidelined with a forearm strain since Sept. 9. It's unclear whether or not Salazar will start, considering the long layover, but he would bring stability to a starting rotation that desperately needs it.?

Both teams aren't taking any chances. They want their best lineups on the field.

Image: Maddie Meyer/Getty Images

This World Series figures to be epic, not only because of the historical context, but because of how each team's strengths counter the other's. Chicago's bats are scary, but Cleveland's pitching is hot. The Indians' bullpen is ferocious, but the Cubs know how to score late.?

Regardless, one of these long-suffering franchises will see relief soon. A historic championship drought will be quenched with a champagne shower.?

The loser? Well, they're already used to losing, and can wait just a little longer.?

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2016年10月25日週二 台北標準時間上午6時37分





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