Mr.Zou: Hello, welcome to Dialogue, I am Zou Yue in Beijing. Thanks to rapidly logical technology advances in recent years, the global smart healthcare market is expected to witness lucrative growth. As one of the most populated country in the world, how can China  best develop smart medicine? How will the technological progress help to solve China healthcare problems? And in what ways will smart medicine change our lives? To talk about these and more, I am happy to be joined in the studio by Professor Li Mengtao from the Department of Rheumatology at Peking Union College Hospital and Dr. Xiao Fei, CEO of Changzheng Cinkate Pharmaceutical Corp.

CCTV邹悦：大家好，欢迎来到央视“对话”节目。我是邹悦，这里是北京。得益于近几年技术的快速发展，全球智慧医疗市场有望迎来可观的增长。作为世界上人口最多的国家之一，中国该如何发展智慧医学?如何用技术进步帮助解决中国的医疗问题？智慧医学又将如何改变我们的生活？为了讨论这些话题，我很高兴邀请到了北京协和医院风湿科的李梦涛教授和长征欣凯制药的CEO肖飞先生。

Mr. Zou: So today, we’ll talk about China’s healthcare industry and how will smart medicine change this. Let’s first talk about where are we now. What is your evaluation of China’s healthcare system at this moment? Some people divided into two parts, the previous 30 years, we have universal healthcare, and now is pretty much everybody on his own.

邹悦：今天，我们谈谈中国的医疗行业和智慧医疗可能产生的影响。首先，让我们了解一下中国的医疗现状。您怎么评价现在中国的医疗体系？有些人把它一分为二：前30年我们有全民医疗，但现在几乎都是靠自己。

Mr. Li :I think that the situation of Chinese Healthcare does similar situation with other countries. Because, you know, for the human being, for the patients, their demands are raised. From time to time, we are thinking about how to improve that, but not everyone will satisfy with the healthcare at any time.

北京协和医院李梦涛:我认为中国医疗的现状和许多其他国家的状况相似。因为，你知道，对于患者来说，医疗需求在不断增加。我们也时常在思考该如何改善，但任何时候都无法让每个人都满意。

Mr. Xiao: Actually, looking back to our China development, China used to be a country with limited resource and cover the whole population for this so-called universal universal healthcare. Actually, Chairman Mao established a new China and so he targeted this universal healthcare. And by that time, China was extremely poor and went through this early development, and everywhere needed the money. But actually, China had its primary healthcare system established. And in countryside, have “barefoot” doctor, that’s only a group of people, graduated from middle school, get some basic knowledge, and clean the wound, and work in the commune, and help vaccinated, you know, give them vaccine.

长征欣凯制药肖飞：回顾中国的发展，中国曾经以有限的（医疗）资源建立起了覆盖所有老百姓的所谓全民医疗。事实上，毛主席在新中国成立后就想搞全民医疗。那时的中国一穷二白，正处于早期发展阶段，各个地方都需要用钱。但就在这种情况下，中国建立起了初级医疗保健体系。在农村有“赤脚”医生，由几个人组成小团队，他们从中学毕业，掌握了一些基本知识，能给伤口清清创，在公社帮忙打打预防针。

Mr.Zou: They were not very professionally trained, they provided very basic health care.

邹悦：他们没有受过非常专业的训练，他们提供的医疗保健服务非常基础。

Mr. Xiao: Basic, very basic healthcare. And for the, you know, this commune, and each commune is a working unit, have this small clinical hospital. They can do appendicectomy and some very small surgery, and so these “barefoot” doctor can bring those peasants or farmers to the commune hospital. If the commune doctor, as doctor maybe just graduate from some training program, can do some primary treatment to this village farmer, and then they can refer some complicate case to the county hospital, this county hospital like, can do colonectomy, but if county doctor was trained, graduated from medical school, they cannot handle the situation like hepatoma. And so threy can refer those patients to provincial hospital, so layer by layer, tier by tier, have this primary healthcare system established in the city and each of factory has this factory nurse or doctor and if some accidents happened, ,they take care, and if they cannot handle, they send to their working unit, you know, hospital, like…..

肖飞：是的，非常基础的医疗。当时以公社为工作单位，它们都有那种小诊所，能做阑尾切除和一些非常小的手术。所以“赤脚”医生可以把农民带到公社诊所。公社医生只是从某些培训项目毕业的，他们可以给村里的农民提供初级医疗服务，如阑尾切除。在遇到复杂病例时，可以把病人转诊到县级医院。这些县医院医生是从医学院毕业的，县医院比方说可以做胆囊切除术，但无法处理更复杂的情况，比如肝癌。此时，他们就可以把病人转诊到省级医院。就这样，一级一级、一层一层在农村及城镇建立起了当时的初级医疗保健系统。每个工厂也都有自己的厂医和护士，如果有事发生，他们就负责医护，如果他们处理不了，就负责转诊……

Mr. Zou: It seems that with market reform, this kind of institutional arrangement has been in a kind of shock. It cannot adapt to a new market economy, because the medical resource congregated in the top level, and the grassroot level is very insufficient. How can we make, what kind of forms we can make the system work better for those people living at the bottom?

邹悦：随着市场改革，这种机构设置受到了冲击。它不能适应新的市场经济，因为医疗资源都集中在上层，草根阶层非常匮乏。我们要把医疗系统建成什么形式才能更好地服务底层百姓呢？

Mr Li : I think that is the topic we will talk about. We call it smart medicine, we usually like to call it, like the data, we will share the medical data, because for patients, you know, is a general population , they will have a disease for a long time, and the medical data is very important for the diagnosis and treatment, but in china by now, even in a big city ,in a big hospital , so where is the medical data? It’s only in the hospital , it’s hard to be shared. So that’s the problem.

李梦涛：我想这是我们要谈的话题。我们称之为智慧医疗，我们通常喜欢叫它，比方说数据，我们会共享医学数据。因为对于患者来说，你知道，也就是普通民众，他们可能有很长的病史，医学数据对于诊断和治疗非常重要，但是如今在中国，即使是大城市、大医院，医学数据库在哪儿呢？只有医院里才有，而且很难被共享。所以这就是问题。

Mr. Zou:So you mention one aspect of smart medicine, while smart medicine that will cover a lot of areas. For example, big data, internet -based hospitals, smart devices, artificial intelligence. Do you think technology will change the industry of healthcare? Once for all.

邹悦：所以您提到的是智慧医疗的一个方面，但它的覆盖面其实更宽，比如大数据、网络医院、智能设备、人工智能。您觉得这些技术是否能改变医疗行业？一劳永逸。

Mr.Xiao : No, I think that’s the incremental step by step. Actually look back past 30 years, as we started this market-driven medical care of healthcare system and follow almost United State’s style.We have several tiers, and especially in major cities, like doctor Li’s hospital, Union Hospital, and the patients have to line up at early morning to register, so I think, you know, in China, we have hospitals, and patients always complain it’s very difficult to see the doctor, it’s very expensive. However, when we review the whole system and everybody can see doctor Li, if they get up early ,if they line up.

肖飞：不，我认为要一步一步来。事实上回首过去的30年，当我们开始建立以市场为导向的医疗体系，很大程度上都是在学习美国模式。医院分好几个层级，尤其在大城市，像李医生所在的协和医院，患者必须大清早就排队挂号。所以，在中国，我们有很多医院，但患者还总在抱怨看病难、看病贵。然而，当我们审视整个体系就会发现，只要患者起早排队，每个人都能看李医生的门诊。

Mr. Zou: Because of the technogical change?

邹悦：是因为技术带来的改变？

Mr. Xiao: No, because the system just set up that everybody can line up and then no matter what their condition, probably he just see a patient just want to do a consultation or do a confirmation for other doctors’ opinion, and waste his time. So this is the problem of our current healthcare system. Too easy to see doctor or go to the major hospital, without primary care and cause this problem so system itself cause a problem.

肖飞：不是，因为我们的医疗体系就决定了不管是谁、不管他是什么情况都能排队挂上专家的号。可能病人只是来咨询，或是来确认其他医生所说的是否正确，但浪费了医生的时间。所以这就是我们当前医疗体系的问题。看病太容易，上大医院太容易，没有初级医疗才导致了问题的产生。所以是体系本身导致了问题的发生。

Mr Zou: Do you agree, Professor Li? Because of the scarcity of excellent medical resources like your hospital, and doctors like you, the distribution is a problem. By establishing a primary care we can make the system work more efficiently.

邹悦：您同意吗，李教授？因为像您这么优秀的医生，像您单位这么优秀的医院是非常稀缺的医疗资源，所以资源分配就是个问题。通过建立初级医疗，我们能让这个体系更有效地运转。

Mr Li: Yes, I believe, I think that the concept and the direction is correct. Because how we can distribute our experience? and I think the technology can help us.

李梦涛:是的，我也这么认为。我认为这个概念和方向是正确的。因为我们怎么能传递我们的经验呢？我认为技术能够帮助我们。

Mr. Zou: What kind of technology are you referring to?

邹悦：您指的是什么样的技术？

Mr. Li : Because you already emphasize the data.

李梦涛:你刚才强调的数据。

Mr. Zou : Data is one thing.

邹悦：数据是一个方面。

Mr. Li: Yes, big data.

李梦涛:是的，大数据。

Mr. Zou: Sharing the patients’ data of all hospitals. So tell me what is the problem? I know that when I go to a hospital, my medical record is exactly stored in that hospital’s computer. I think this is very easy to connect databases in all hospitals into a gigantic system nationwide. What is keeping you from doing that?

邹悦：所有的医院共享患者数据。那么请告诉我问题在哪儿？我知道我去医院的时候，我的病历就储存在医院的电脑里。我觉得把各个医院的数据库都链接到一个统筹全国的庞大系统中是非常简单的一件事。是什么在阻碍你们做这样一件事呢？

Mr. Xiao: Right now each hospital so called the public hospital is run as an enterprise, you know, each hospital may have their own information.

肖飞：现在各家所谓的公立医院都更像是企业一样经营，各家医院都有自己的数据系统。

Mr. Zou: So they want to keep their information secret without sharing with other.

邹悦：所以他们想把自己的资料保密起来，不透露给其他（医院）。

Mr.Xiao：That’s right, one part. The other part is that they have different system. Because some use IBM, some use Oracle.

肖飞：对的，这是一方面。另一方面是这些医院所用的系统不同。因为有些在用IBM，有些在用Oracle。

Mr.Zou: That’s technology barrier.

邹悦：那是技术壁垒。

Mr. Xiao: And also, you know, that’s hospitals can have suspicious to expose the data because a lot of dispute on, you know, this details, plus, if patient left hospital, there is no follow up data. That’s the major problem.

肖飞：还有，这些医院对数据曝光有顾虑，因为争议很大。再加上，如果病人离开医院，就没有了随访数据，这是主要问题。

Mr. Zou: We don’t know the outcome of the patients. Like, two third as I know, Dr. Li can confirm on the data. Two third of patient went to Union Hospital for this diagnosis or treatment, were not Beigingnese.

邹悦：我们不知道病人的预后。就比如，据我所知有三分之二来协和医院就诊的病人都不是北京人。

Mr. Xiao: And after they have been diagnosis and doctor prescript this medicines to them they just lost. There is no data after they left the hospital. So that’s another issue. So technology may solve this problem or cease this problem.

肖飞：在他们确诊后，医生给他们开了处方，他们就消失了。没有他们在离开医院后的数据。所以技术或许能解决或终止这个问题。

Mr. Zou : So, both doctors and professionals agree that this kind of technology like big data can help improve healthcare and the patients also recognize this.

邹悦：所以，医生和专家们都认为像大数据这样的技术可以改善医疗，病人也意识到了这一点。

Mr. Zou: What can hospitals, governments, pharmaceutical companies do together to help establish such system? Who should take the lead? Do you think there is also privacy concern？Information of their health record?

邹悦：医院、政府和医药公司怎样才能共同建立起这样的体系呢？谁来主导？您觉得会有个人隐私上的担心吗？对他们健康资料隐私的担忧？

Mr.Xiao: No, privacy is not a big issue in China. You see, there are patients when they get disease like tumor or like rheumatoid arthritis, they call around the family member and friends and try to…

肖飞：隐私在中国并不是一个大问题。你看，有些病人在得了肿瘤或者类风湿关节炎这样的病之后，他们会找亲朋好友寻求建议……

Mr. Zou: Privacy is not the concern.

邹悦：隐私不必担心。

Mr.Xiao: No, not the concern, just education. We have done a trial. Because Dr. Li and his team is working on this largest hospital based data collection and biological sample collections, and we try to connect to his system, do the follow up data collection and we have already work on more than 400 hospitals and 700 rheumatologists and then educated patients, let them know data is important and develop this APP.

肖飞：不，不用担心，教育就行。我们做了一个研究。基于李医生和他们的团队正在建立中国最大的院内风湿病数据平台和生物学样本收集体系，所以我们想接上他们的系统，收集随访数据。我们已经与超过400家医院的700位风湿病学专家一起合作，教育病人，让他们知道数据的重要性，由病人自己管理自己的数据，还开发了一款应用软件。

Mr. Zou: What is the government stands on this? The health ministry? They support it?

邹悦：政府是什么态度呢？卫生部，他们支持吗？

Mr.Xiao: Yes, yes, I ……

肖飞：支持。

Mr. Zou: You mean morally or institutionary?

邹悦：你指的是道义上的支持还是制度上的支持？

Mr. Xiao: I report our protocol to the central government. This called family planning and public health administration. They support this trial and because we are… our medical system never follow up outcome, not outcome driven. That’s only volume driven. So this is the problem. We try to educate patients, let patients change their role from passenger to copilot and learn the knowledge and manage themselves.

肖飞：我向国家卫生和计划生育委员会汇报了我们的工作进展。他们支持这项研究，因为我国的医疗系统从来没有主动跟踪治疗效果，不是以结果为导向的，只追求就诊量。所以这就是问题。我们尝试去教育病人，让他们的角色从乘客变为副机长，学习（疾病）知识，自我管理疾病。

Mr Zou : And you believe they can also become a pushing force for the government more activly adopting something.

邹悦：你相信这些病人也是一股推动力，让政府更积极采纳某些事。

Mr. Xiao : Yes, from reactive to proactive. And after education we found 86% of patients can handle their data entry. You know doctors, nurses are very busy, they are hard to entry the data and so the patients can do that. Educate or family member can do that. We form a community and then they collaborate on data entry and they do self-evaluation on disease activity. All the data synchronize with doctor’s terminal. So we did this the methodology validation. We show 86% of patients can master this technology.It is simple，they all have smart phones . And then we did the cross section study, we found we could reach to target’s effectives rate that’s 34%.

肖飞：是的，从被动的应对变成积极主动出击。在（患者）培训后，我们发现86%的病人可以学会怎么输入自己的数据。大家知道，医生、护士都是非常忙的，他们没空录数据，所以可以让病人来做。培训病人来做或者让家属来做。

我们建了这样一种“生态”关系：患者可以录入数据、自我评价疾病活动度，所有的数据都和医生端同步。我们做了方法学验证。我们发现86%的病人可以掌握这项技术，容易操作及使用，同时，患者几乎都有智能手机。 之后，我们又作了横断面研究，我们又发现这些患者的达标率为34%。

Mr. Zou : So in essence they can master the technology. They can use them to their own manage.

邹悦：所以其实他们能掌握这门技术，他们能用这些来作自我管理。

Mr. Xiao: Yes, after using this technology repeatedly, we found after 5 time evaluations, monthly evaluation, the effective rate is up to 80%, from 34%.

肖飞：是的，在反复使用这项技术（APP）后，我们发现5次评估（每月评估）的患者，达标率从34%提高到了80%。

Mr Zou：Let’s continue our talks on smart medicine. You mentioned one thing that is a big data. With big data actually we can create electronic health record for each and everybody and that will make the practice of medicine more effective.

邹悦：让我们回到智慧医疗的话题。你们提到一件事，那就是大数据。事实上，有了大数据我们能为每一个人创建电子病历，那会让医学实践更高效。

Mr. Zou：Professor Li, is that the future of medicine? Because everybody will look at their record of their whole life’s problems, what drugs they have taken, what treatment they have been through, and that will make your diagnosis or treatment even better.

邹悦：李教授，那是医疗行业的未来吗？因为每个人都可以看到他们一生的病历记录，吃过什么药、接受过什么治疗，这将让您的诊断和治疗变得更好。

Mr. Li : Yes, I believe that, because you know and for the international countries they just do that and try to solve the problem for years like the States and the government encourage to set this kind of medical record but…

李梦涛：是的，我相信。因为你知道，国际上也是这样的趋势，数年来一直想要解决医疗上的问题，比方说美国，他们的政府也鼓励建立这样的医疗记录体系，不过……

Mr. Zou : So they also run into problems?

邹悦：他们也遇到了问题？

Mr. Li : Yes, they all have the problem. Our government also encourage we could have this, the housecare for the people, the general people, then, if the patients, the people have some disease, they will have medical record. So the medical record with the high technology will be the, our future.

李梦涛：是的，他们都遇到了问题。我国政府也鼓励我们为广大民众建立这样的电子健康记录系统，这样如果老百姓有了病，他们就会有医疗记录。所以融入高科技含量的医疗记录将是我们的未来。

Mr. Zou : Why big data is so important for medical care? With more data means you have more knowledge about a single patient or a disease? How would it help your practice your professional?

邹悦：为什么大数据对医疗如此重要呢？有了更多的数据，是否意味着您对一个病人和疾病了解得更多？它对您的专业、您的工作有什么帮助？

Mr. Li : Because the disease is very complicated and when we to take care of patients we all think about not only the gender, the age, their history, may be the environment. And a lot of information is very complicated. So if we have this kind of data, so we already have the background of patients. If the patients already have a very definite diagnosis, and treatments and response, outcome…

李梦涛：因为疾病非常复杂，当我们诊治病人的时候我们不光要考虑病人的性别、年龄、病史，可能还要考虑环境。许多信息都是非常复杂的。所以，如果我们有这样的数据，那么我们就掌握了病人的背景。如果病人已经诊断明确，治疗明确，反应明确，那么结局……

Mr. Zou : Will be better.

邹悦：会更好。

Mr Li : Yeah, will be better. And when we can give a decision, and to benefit our patients？

李梦涛：是的，会更好。我们什么时候能下这个决定，让病人获益呢？

Mr. Zou : What about the problem that we raised in the beginning of the program? Will we solve the problem of redistribution of excellent quality and medical care resources? Can machine take over some of the medical jobs that humans are doing?

邹悦：我们在节目一开始提出的问题该怎么解决呢？我们能解决优质医疗资源的再分配问题吗？现在由人在做的医疗工作，是否能让机器承担一部分？

Mr Xiao: I am sure that, because right now just like we did survey, and on 300 professions and clinicians, they give us the answer that in their clinic, close to half of the patients, They don’t need to see them in face. And they can solve the problem trough the other way like e-mail like phone call like one answer like a consultation. And so that’s …

肖飞：我相信可以。因为正如我们对300位专家和临床医生所做的调查，他们告诉我们，在门诊工作中，将近一半的病人都不需要来看门诊。他们可以通过其他渠道来解决问题，比如Email、比如打电话、比如通过互联网咨询。所以那是……

Mr. Zou Z: Through technologies.

邹悦：可以通过技术解决的。

Mr. Xiao: Yeah! We can use technology. Actually in MGH, Massachusetts General Hospital ,they did a study, 3/4 of the patients, 75% of American patients doesn’t need to stop by clinic. They can use the other way, this tele medicine stuff to solve problem. Internet technology enables doctors to work remotely.

肖飞：是啊！我们可以利用技术。事实上，麻省总医院他们作了一项研究，发现四分之三的患者，也就是75%的美国病人不需要看门诊。他们可以利用其他渠道，远程医疗之类的技术平台来解决问题。互联网技术让医生可以远程会诊。

Mr. Zou: Do we still have to rely on humans to do the pre-selecting of which patients go to where?

邹悦：我们是否依然要靠人工来做患者分诊的初步筛选？

Mr Xiao: Right now, we can not avoid that. We are talking about these follow up patients, because like in China, the patients stop by clinic, see doctor Li at the first time, he makes the diagnosis and treatment regimen ready let them go home, and then they come back a month later, same questions and continue the treatment and maybe just answer some simple questions, Okay, continue that treatment, because he evaluate the patients, you know, get better results and continue this regiment   going, but they are  lining up for half a day and see Doctor Li, and have five minutes’ consultation.

肖飞：目前我们还无法避免你所说的情况。我们所指的是那些随访患者，因为在中国，病人来到门诊，第一次看了李医生，他作了分析，制定了治疗方案，让病人回家。而他们一个月之后又来了，同样的问题，继续原来的治疗，李教授可能只是回答一些简单的问题。Ok，继续原来的治疗，因为李医生评估患者后，发现情况好转，可以维持治疗方案不变。但是患者排了半天队，才看到了李医生，结果只要五分钟时间咨询。

Mr. Zou: You think this is not necessary?

邹悦：你认为这没有必要吗？

Mr. Xiao:This is not necessary, and so we, the platform technology can set up, all we tried is to set up a platform, after doctor made the diagnosis, made these treatment, regimen, let them go, and then they can link through internet,mobile phone and the patients, do self evaluation, entry the life test and medication and then data synchronization.

肖飞：没这个必要，所以可以建立技术平台。我们想做的就是搭建一个平台。医生作了诊断、制定了治疗方案，让病人回家，然后，他们可以通过互联网、手机保持联系，患者作自我评估，录入检查结果和用药，然后数据同步。

Mr. Zou: But, let’s push this a litter further, if this is the case, can doctor do this in a remote way? Like we just discussed, they don’t have to travel at all, even for the first diagnosis, can people wear a device and look at doctors, see and diagnose a patient from a distance?

邹悦：但是，让我们再深入一点。如果是这样的话，医生可以远程做所有的事吗？正如我们刚刚说过的，医生根本不需要出门，哪怕是对于初诊的患者，能否让患者戴上设备，看着医生，（医生）远程看病，作出诊断？

Mr. Xiao: Some diseases, like dermatology, (rash,) and doctor can send pictures over, and eye doctor, they gave this picture for the fundus of the eye.

肖飞：有些疾病，如皮肤病、皮疹，医生可以（要求）发照片；还有眼科医生，可以根据眼底照片给予建议。

Mr. Zou: So still different diseases of different requirement for information.

邹悦：所以不同的疾病还是需要不同的信息。

Mr. Li: Yeah, for the internal medicine, for my specialty rheumatology, and the very important thing is the history. So we can remotely

李梦涛：是的，对内科来说、对我的专业风湿病学来说，病史就非常重要。

Mr. Zou: So that’s why data are important things.

邹悦：所以那也是为什么数据很重要的原因。

Mr. Li: Yeah, we can remotely, to, not face to face to a patient, but we also can collect the valuable information for the diagnosis.

李梦涛：对，我们能远程地，不用面对面地看病人，但是我们还是能收集到对诊断有价值的信息。

Mr. Zou: The Chinese medicine has a huge challenge in how to modernize their practice, because their practice basically is based on patient-doctor contact. The doctor has to see the patient, feel the patient, touch the patient, and ask a lot of questions. Do you think Chinese medicine can be modernized in a modern world with technologies like we are talking about?

邹悦：中医在诊治现代化的进程中面临着巨大挑战，因为他们看病基本上是以患者和医生的接触为基础。医生必须望闻问切，问许多问题。您认为有了我们谈论的技术，中医能在现代社会中被现代化吗？

Mr. Xiao: Actually, I can give you an example. They have started properly, yes, they start to develop a special, you know, camera, because traditional Chinese medicine, need to read this tongue, So they can take pictures, and match different conditions and give diagnosis follow Chinese medicine systems, you know, to give some advice. so that’s possible and also like palpation, like listening, like observation, these all can be solved through this, you know, technology device, but the whole theoretic that, you know, these theories system, you know, the system, they’re different from modern western medicine, and if we observe this history of traditional medicine development——Actually 2000 years ago, they all originate from the same source observation from our forefather, but the western medicine goes to evidence based and the life test based whereas our traditional Chinese medicine is inherited from family education, and inherited from this, use of natural herbal stuff, So we have to integrate some theory, like Chinese traditional medicine theory, reason, actually the lead work ，like our traditional Chinese doctor educated me, that’s, see same disease in different way. That means very match modern concept, like precision medicine, we have to reclassify disease.

肖飞：实际上，我能给您举个例子。有人已经开始开发一种特殊的照相机，因为中医需要看舌象，所以这种相机能照相、还能匹配到不同的病证，然后按照中医体系来作出诊断、给一些建议。所以这是可能的。像望、闻、问、触，这些都可以通过类似的技术设备来解决。但是中医的整个理论体系和现代西方医学不同，如果我们纵观传统医学的发展史——实际上两千年前，中西医都起源于我们祖先的观察，不同的是西医走了循证和检查化验的道路，但中医却通过师傅带徒弟、中草药的使用传承了下来，所以我们必须整合某些理论，比如中医理论中的杰出理念——如我的中医老师教导我的，同病异治，这非常契合现代理念，是精准医学的精髓——必须对疾病重新分类。

Mr.Zou: So it seems you are suggesting the advancement of technology has also changed the profession of medical professionals as well.

邹悦：所以看起来您认为技术进步也会改变医学职业。

Mr.Xiao:Sure, sure.

肖飞：当然，当然。

Mr. Zou : As a medical professional, where do you think  the health care industry is developing in ten years and twenty years time? What is the major breakthrough that will happen that will be a game changer of  your profession?

邹悦：作为医学专家，您认为在未来十年、二十年的时间里，医疗行业将如何发展？可能给您职业带来转折的重大突破会是什么？

Mr. Xiao: Actually, I think there is no any one technology revolution can make health care system revolution happen, but that’s  incremental. Yeah, in the past, we have the experience, like antibiotics, you know this infectious diseases’ gun, and chemical therapy, chemotherapy, will kill cancer. MRI can make all the tissue observed.

肖飞：其实我认为没有任何一项技术进步能引发医疗卫生系统的革命，是一个渐进过程。我们有这方面的体验，如抗生素的发明——治疗感染性疾病的“武器”、还有化疗——治疗癌症、MRI能看到所有的组织，是医学突破，但没对医疗体系产生革命性变化。

Mr. Zou:We can see the emphasis of a human body. These kinds of technology are  game changers.

邹悦：我们能看到身体内部我们想看的地方。这些技术改变了医疗行业。

Mr. Xiao: Yeah, game changer. And for the diagnosis, however, like human genome, and everybody expects too much, however this incremental develop. So I am sure we should get a paradigm shift from the old one to the new one, like, right now, we should change our paradigm from volume driven to outcome driven, and also we should change our paradigm from just treating the disease… treating disease or heal the patients? we should use our care. Go back to the ancient time, you know, doctors should not only depends on the machine and use their care. I have a lot of stories to talk about that, like, if patients, get good advice from doctor. doctor said okay that’s a new medicine effective on your disease, very confident , that’s we call the positive placebo effect. That’s, even you take a sugar pill, you can get 25% of the effect. But if doctor neglected the patient, and said okay, that is the drug, you can try, maybe get 25% less effect. Go back to the original, you know, we have to recover this medical professionalism， that is the one part, the other part, we should change our paradigm from treating the disease, find the nature of the disease, like we treat tumor, in old days we use chemotherapy, we use antibody, monoclonal antibody, nowadays, you see this in the world. They change the paradigm, build up patient self-immune ability, this anti-PD1, anti-CTLA, in this kind of the costimulators that releases the break of our immune ability to antitumor, this matches our traditional Chinese medicine concept, this is the “fu zheng qu xie”, build up the positive energy against enemy. so you see… this paradigm shift,.. maybe lead to the future revolution and combine this new technology, IT.

肖飞：对，带来了转折。然而在诊断上，比如说人类基因组，每个人都寄望过高，但这是一个逐渐发展的过程。

所以我认为我们应该转变观念，好比现在，我们应该从就诊量驱动转向疗效驱动，我们还要转变仅仅治疗疾病的理念，你是要治愈病人，我们应该关怀病人。回到古时候，医生不仅要治病，而且要关怀病人。

我可以讲出很多这样的故事。比如说，病人去看医生，医生非常自信地说，这有一个新药，对你的病很有效，这就是我们说的积极的安慰剂效应。这样即使你吃的是糖丸，你也能得到25%的疗效。但如果医生忽略病人，说这有一个药，你试试看吧，那可能效果还降低25%。

回到最初，我们需要借鉴先贤的一些工作方法。另一方面，我们应该转变观念，从治疗疾病变成认识疾病本质。好比治疗肿瘤，以前我们用化疗、抗体、单克隆抗体来杀伤肿瘤，今天，你能看到世界上对肿瘤的治疗已经改变了理念——变为增强患者的免疫力，目前最热门的抗PD-1，抗CTLA疗法，抑制这两种因子，从而放开机体肿瘤免疫的“闸”，通过加强机体免疫力而消灭肿瘤。这和我们的中医理念是一致的，就是“扶正祛邪”，扶持正气，祛除邪气。

所以，理念的转变再加上新的IT技术才可能导致未来医疗行业的变革。

Mr. Zou: These paradigm shifts come from the changes of mindset.

邹悦：这些理念转变都来自观念的改变。

Mr. Xiao: Mindset, mindset. That’s why we see the whole world as different, so we have to change the mindset, that may lead to the next revolution of healthcare, and how to see the patient, how to see the disease, how to see the health……

肖飞：对，观念。这也就是为什么我们看世界都是不一样的，所以我们必须改变观念，这才可能引领医疗界的下一次革命。比如如何看待病人、如何看待疾病、如何看待健康……

Mr. Zou: All right, thank you very much, Dr. Li, and thank you, Mr. Xiao for takin sound of this question. You are watching Dialogue on CCTV News, thanks for joining us, goodbye.

邹悦:非常感谢，李医生，谢谢您，肖先生。感谢关注这个话题。您正在收看的是CCTV新闻频道对话节目。感谢您的收看，再见。