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HEALTHY CHINAWhat’s Next for Healthcare and Cities
健康中国医疗和城市的下一步是什么
A salon on the future of Chinese healthcareLangham Hotel, Shanghai
15 September 2014
关于中国医疗未来的沙龙上海朗廷酒店
2014年9月15日
H
WHAT’S NEXT FOR HEALTHCARE AND CITIES IN CHINA? 中国医疗和城市的下一步是什么？HOW CAN PATIENT-CENTERED CARE ENABLE A BETTER LIFE IN CHINA? 以病人为中心的护理如何使中国有更美好的生活？
WHAT IS DRIVING MISTRUST BETWEEN PATIENTS AND PHYSICIANS? 什么导致病人和医生之间的不信任？
CAN THE PROFIT ORIENTATION BE SOLVED FROM THE BOTTOM-UP?
以利润为导向能够自下而上解决吗？
HOW CAN CHINA USE ITS OWN INDIGENOUS TRADITIONS TO TRANSFORM HEALTHCARE?
中国如何利用它的本地传统来做医疗转型？
WILL INNOVATION COME FROM THE GOVERNMENT SIDE OR THE PRIVATE SECTOR? 创新将来自于政府方还是个体方？
CAN WE TAKE THIS CONVERSATION ABOUT HEALTH TO THE OFFICE? THE HOME?
我们可以把关于健康的讨论带到办公室吗？ 家里？
HOW CAN TECHNOLOGY IMPROVE THE HOSPITAL EXPERIENCE? 科技如何改善医院体验？
WHY ARE THERE SO MANY PATIENTS? 为什么有这么多病人？
WHAT CAN HOSPITALS CURRENTLY DO TO REDESIGN THE PATIENT-DOCTOR
INTERACTION? 医院现在能做什么来重新设计医患互动？
HOW CAN WE EDUCATE PEOPLE ABOUT GENERAL HEALTH AND NUTRITION? 我们如何教育人们关于一般健康和营养？ CAN YOU IMAGINE NO WAITING ROOMS IN A HOSPITAL IN
CHINA? 您能想象在中国医院里没有候诊室吗？
AS CHINA HAS BECOME MORE urbanized and more prosperous, its health profile has changed accordingly. From 1990 to 2010, the country enjoyed an increase in life expectancy and a reduction in infectious disease rates, even while it suffered from an increase in non-communicable diseases such as smoking and high blood pressure. Risk factors such as reduced physical activity, longer lifespans, job stress and dietary changes are concerns that China now shares with other leading economies, including the United States and United Kingdom.
These population and health trends place increasing pressure on the Chinese healthcare system. The number of patients is growing. Many wait hours to see their doctors for only a few minutes, and those doctors are frequently overworked. Yet despite these challenges, China faces an opportunity to transform the experience of healthcare.
FIRST, a great opportunity exists for those healthcare providers who are willing to change their approach to a patient-centered experience. Where choices are available, many patients will pay for higher-quality care that is state-of-the-art not only in terms of technology and clinical practice, but also in terms of experience. Healthcare environments must adapt and address new, foundational questions: How can patient rooms become more like classrooms, where patients and their families learn about their health and about how to ensure well-being long after leaving the hospital? How can families integrate into the healing journey? How can we ensure that hospitals are healthy workplaces for staff?
SECOND, we spend nearly 99 percent of our time in built environments. Given this level of influence over our lives, architects, policymakers and planners will play a critical role in creating places that enhance, nurture and develop human well-being. They can answer questions such as: Can good city design act as effective preventive medicine? How can architects create places that enhance, nurture and develop human well-being? How can city planning and policy shape how much we walk, exercise, socialize, smile and relax?
FINALLY, when we think of health, all too often we think of disease treatment; in actuality, “health” encompasses far more than just healthcare. Well-being must be considered as a network of factors — among them social connections, nutrition, economic security and the built environment — which have historically been strong in Chinese culture. China can take advantage of these cultural traditions, blending them with state-of-the-art technology and clinical practices, to leapfrog a Western tradition of medicine that has long focused only on intervention.
We already know that “you are what you eat,” but recent research also proves that “you are what you build.” We can build hospitals, cities, offices and a culture that make us overweight, unfit and depressed — or we can build environments that help us to be the healthiest versions of ourselves, and of our society.
HEALTHY CHINA: WHAT’S NEXT FOR HEALTHCARE AND CITIES
中国已经变得越来越城市化和繁荣，它的医疗状况也随之改变。从1990年到2010年，国家的人均寿命增长，传染性疾病发病率下降，与此同时它甚至还在遭受非传染性疾病如抽烟和高血压的高增长。减少的体育活动、老龄化、工作压力和饮食结构变化等风险因素是中国目前和其他包括美国和英国在内领先经济体所共有的担忧问题。
这些人口和健康的趋势为中国的医疗系统带来与日俱增的压力。病人数目正在增加。很多人等候几个小时但看医生的时间只有几分钟，而那些医生也经常工作过度。然而尽管有这些挑战，中国仍面临一次转型医疗体验的机遇。
首先，这为那些愿意改变方法来提供以病人为中心的体验式服务的供应商们带来一次契机。当有机会选择时，很多病人愿意为更高质量的护理买单，他们需要不仅仅在科技和临床实践方面，同时在体验方面都是最佳的。医疗环境必须适应和解决医疗体验的新基本问题：病房如何更像教室， 病人和他们的家属可以在这里了解他们的健康状况并学习如何确保离开医院后继续长久保持健康？家庭如何参与到治疗的过程中？我们如何确保医院对员工而言是健康的工作环境？
其次， 我们在建造的环境中几乎度过我们99%的时间。鉴于对我们生命的影响之大，建筑师、政策决策师、和规划师将在打造提升、培育和促进人类幸福感的场所方面起到至关重要的作用。他们能够回答这样的问题：好的城市设计能否扮演有效的预防医学的角色？建筑师如何能打造提升、培育和促进人类幸福感的场所？城市规划和政策如何来影响我们走路、运动、社交、微笑和放松的量？
最后，每当我们想到健康，我们时常想到疾病治疗。事实上，“健康”远不仅仅包括医疗。幸福必须考虑各因素—其中包括社会关系、营养、经济安全和建造环境—而这些在中国文化历史上曾经很强。中国能够利用这些文化传统，把它们与先进的科技和医疗实践相结合，从而超越长久以来仅注重于干预手段的西方医学传统。
我们已经知道“人如其饮食”，但目前的研究也证明“人如其居所”。我们能够建造使我们负担加重、不适合和沮丧的城市、办公室和医院—我们也能建造对我们自己和我们的社区最为健康的环境。
健康中国:医疗和城市的下一步是什么
DR.
JOSEPH TUCKER约瑟夫 · 塔克 博士Assistant Professor of Medicine and DirectorUNC Project-China副教授和主任UNC 中国项目
PROFESSOR
JOHN CAI蔡江南 教授
DirectorChina Europe International Business School (CEIBS) 主任 中欧国际工商学院(CEIBS)
DR.
QIANG ZHANG张强医生
JOAN SABA琼 · 萨巴
“Dr. Smile,” Vascular Surgeon“微笑医生” 心血管外科
THE SALONLangham Hotel, Shanghai15 September, 2014
China’s citizens are growing increasingly aware of the value of good health; more and more they will begin to play a more active role in their own well-being, both in and out of the hospital. To enable this fundamental shift, we convened a panel of healthcare experts in design, policy and clinical practice for a salon event in the Grand Ballroom of Shanghai’s Langham Hotel. Before a standing-room audience of healthcare and design professionals, we discussed the challenges China faces, as well as its opportunities for a healthier future.
PROFESSOR
HONGYANG WANG 王红扬 教授School of Architecture & Urban PlanningNanjing University南京大学建筑与城市规划学院
Editor-in-ChiefForbes (China)总编 《福布斯》(中文版)
Healthcare Design Partner NBBJ医疗设计合伙人NBBJ
中国公众正逐渐意识到健康的价值；他们在自己的身心健康方面越来越扮演更积极的角色，不仅在医院里，也在医院外。为了产生这个根本的变化，我们召集医疗设计、政策和临床实践方面的专家小组在上海朗廷酒店的大会议厅举办了一次沙龙活动。我们讨论了中国面临的挑战，以及一个更健康未来的机遇。
MODERATOR
JIANGONG ZHOU周健工
沙龙活动朗廷酒店，上海2014年9月15日
URBANIZATION AND HEALTH:HOW GROWTH WILL AFFECT CHINA
城市化和健康：增长如何影响中国
China has urbanized at an astounding rate: by some measures, twice as fast as the United States, and three times faster than the United Kingdom. Although the pace has slowed, Chinese cities will continue to grow; as they do, their citizens will face new and increased health challenges.
Source: The Economist
中国已经以一个令人震惊的速度进行城市化：一些衡量标准显示比美国快2倍，比英国快3倍。尽管节奏已经放慢，中国城市将继续增长; 在它们增长的时候，它们的居民将面临新增长的健康挑战。
来源： 经济学者
中国人口老龄化 以年龄层区分
每五个人中就有一个中国人患慢性疾病 肥胖是每个年龄层的问题
呼吸道疾病 肥胖 糖尿病
预测
罹患糖尿病数字正在增加 世界上超过四分之一的糖尿病患者案例在中国。
全球糖尿病患者
世界其他人口
PROFESSOR
JOHN CAI教授
蔡江南Director China Europe International Business School (CEIBS)
主任中欧国际工商学院(CEIBS)
ON PERSONAL EXPERIENCE:
You study healthcare for so many years, but you might not have a personal experience of it. Only pain can really teach you. That’s the first lesson I learned.
ON THE PATIENT EXPERIENCE:
You need a very comfortable, peaceful environment. In China, you see many, many hospitals that don’t have privacy for patients. When you see the doctor, there can be many people surrounding you. That’s a problem: there is no space.
ON PRIORITIES:
We see a lot of empty space in shopping malls, a lot of empty residential developments with nobody in them. Why is that? There is a lot of misallocation of resources to the wrong things. The hospital should be the most important place.
关于个人经验：
您或许研究医疗许多年，但您可能没有个人体验。也就只有疼痛能真正教导您。这是我学到的第一课。
关于病人体验：
您需要一个非常舒适、宁静的环境。在中国，您看到许许多多的医院没有病人隐私。 当您在看病时， 可能有很多人围在您身边。那是一个问题：没有空间。
关于优先顺序：
我们看到购物商场里有很多闲置的空间，有很多空置的住宅开发项目无人入住。为什么会那样？有很多资源的错配。医院应该是最重要的空间。
ON THE MOST IMPORTANT ISSUES FOR HEALTHCARE:
First, you need to have the right pricing mechanisms. The incentive has to be right.
Second, you need to have the human resources. You need to have physician experts, but right now you see a shortage of physicians.
Third, you need to have clear, right, open, transparent, implementable regulation policies. Right now we have a lot of policies, but they aren’t clear. Also, people don’t have the power of enforcement to implement them. So everybody interprets the policies in different ways. It causes a lot of confusion.
ON THE LESSONS OF CHINESE CULTURE:
Chinese tradition always thought of food and medicine as just one thing — it emphasized how to eat well. I hope this good tradition could be carried over, instead of falling into American fast food. Our children need to learn these healthy things from their early years.
That’s why education is so important. Right now, education focuses on how to get into good schools, good colleges. But in Shanghai the government has issued regulations that require students to get one hour of exercise per day. At least the government is starting to pay attention to that.
关于医疗最重要的问题：
首先，您需要有正确的定价机制。激励措施要合适。
其次， 您需要有人力资源。 您需要有医生专家，但现在您看到医生短缺。
第三，您需要有清晰、正确、开放、透明、可以执行的规章制度。现在我们有很多政策，但是它们不清晰。同时，人们没有执行权利来实施它们。所以每个人以不同的方式诠释政策。它导致了许多混乱。
关于中国文化的教训：
中国传统通常把食补和药补看成一回事—它强调如何很讲究地吃。我希望这个好传统可以延续，而不是沉浸于美式快餐食品。我们的儿童需要从他们幼年时候起学会这些健康观念。
这是为什么教育是如此重要。现在教育重点是如何进入好的学校、好的大学。 但是在上海，政府经颁布规定要求学生每天增加一小时运动。至少政府开始关注这个问题。
DR.
JOSEPH TUCKERAssistant Professor of Medicine and Director UNC Project-China
ON THE RELATIONSHIP BETWEEN PATIENTS AND PHYSICIANS:
There are perceptions of inequity. Patients come to clinics with a suspicion that doctors are getting kickbacks from pharmaceutical companies. And on the physician side, there are extremely long work hours and very short intervals of seeing patients. And if you look at how physicians are reimbursed in China, the amount that a typical hospital gets from the state is very small compared to many other states and nations.
If you look at health reform more generally, all over China there’s been a real push toward primary care, towards building up general practitioners and family doctors. From a health systems perspective, that’s a really important step towards reform. I see places that can implement this model, and I think that’s the future of a more trusting doctor-patient relationship.
ON THE POWER OF DESIGN:
We need to reimagine healthcare, and why not start with construction, the building, the physical space of what healthcare is?
For one, as you walk into almost any hospital in China, the first thing you see after you go in the door is the bank of ATMs, right? You laugh, but this is serious. The values and the core mission of the institution are part of this environment. So if the first thing you see after you walk in the door is “Open your wallet!” what does that say? In terms of design, hospitals can do some simple things to make sure that their mission is more clear.
ON CULTURAL PRACTICES AND HEALTHY LIVING:
How China can use its own indigenous traditions, the things that are already shining examples? Just look at the park. Go to a park at six a.m. tomorrow morning. What are you going to see? Lao tou and lao tai tai doing tai chi, walking, taking the dog for a walk. This is wonderful physical activity, getting people close to the natural environment. Parks are not so well-used in the United States.
I think the integration of traditional Chinese medicine and Western medicine in China is certainly a strength. It provides a culturally appropriate way of preventive care that, in many cases, can be really powerful.
博士
约瑟夫 · 塔克医学副教授和主任UNC 中国项目
关于医患关系：
有一些不平等的认知存在。病人来到诊所怀疑医生从制药公司拿回扣。而在医生方面，工作时间超长，看病间隔极短。并且如果您看一下医生在中国的回报，在一家典型的医院从国家拿到的数目和其他国家地区相比是非常小的。
如果您更广泛地看待医疗改革，中国各处已经在切实推进基层医疗，普及普通执业医师和家庭医生。从一个医疗系统角度，这是朝向改革的非常重要的一步。我看到可以实施这个模型的地方，我相信这是更互相信任的医患关系的未来。
关于设计力量：
我们需要重新想象医疗，这为何不是从施工、建筑、医疗的物理空间开始？
例如，当一个人走进中国的几乎任何一家医院，您进门首先看到的是银行的提款机，是吗？ 您笑了，但是这是严重的问题。机构的价值和核心使命是这个环境的一部分。所以如果您走进门首先看到的是“打开您的钱包”，这说明什么？从设计方面，医院可以做一些简单的事来确保它们的使命更清晰。
关于文化实践和健康生活：
中国如何利用它自己的本土传统、一些耀眼的现有例子？只要看一下公园就可以了。明天早上６点钟到公园去，您将看到什么？老先生和老太太在打太极、散步、遛狗。这是极好的身体活动，让人们与自然环境亲近。公园在美国不是那样被充分利用。
我相信在中国的中西医结合一定是一个优势。它提供了一条适合文化的预防保健之路，在很多情况下，可以非常强大。
THE COMING HOSPITAL BOOM:CONSTRUCTION IS ON THE RISE
即将到来的医院激增：施工正在增加
Already, Chinese leaders are preparing a major expansion to healthcare infrastructure. One commonly cited target is the construction of 20,000 new hospitals over the next five years (FTI Consulting), which could create 400,000 new hospital beds per year (Businessweek). At this scale, it is imperative to invest correctly.
中国领导已经准备进行医疗基础设施的大规模扩建。一个常被引用的目标是在未来的5年中有超过20,000所医院的建设(FTI 咨询）， 这将创造每年400,000张新的医院床位（商业周刊）。在这样的规模下，正确投资至关重要。
据估计，中国75%的医院正在规划中或已在施工中，这些多数是政府经费推动。
中国花费在医疗的费用比其他发达国
家还少 人均医疗开支
中国比其他发达国家人均医生数量还少。
百万位 医生
每千人医生数 中国 美国 欧盟
年
新医院
每年新床位
新医院新增床位
中国 英国 美国
PROFESSOR
HONGYANG WANGSchool of Architecture & Urban PlanningNanjing University
ON THE CAUSES OF AND SOLUTION TO THE HEALTH CRISIS:
Why are there so many patients? We all know the reasons: we eat too much, we exercise too little, and we pollute too much. So as an outside observer, if I were to ask the question, “What would make the most important contribution to healthcare?” I would say it’s a good city, a good society.
ON SOCIAL MEDIA STARS:
Of course the Internet, the digital era, has innovated a new space, with new opportunities for medical care and the patient-doctor relationship. But it still comes down to people’s trust of the whole society. In the end, if we only rely on a limited number of trusted people, the whole society is not improved that much.
ON THE VALUE OF DESIGN:
Firstly, a health-friendly city or community, able to foster healthy working, life and behavior, is the most significant value of planning and design. Then, it doesn’t matter if the hospital building is really noble or decorated beautifully, as long as it’s functioning well. It could be designed in a Chinese way with some cultural elements, and it might not cost so much money. A quality building is not expensive. I think this is maybe something designers try to sway people to believe, but actually it’s not. It could be a very friendly environment; it could let doctors cherish their value as doctors.
ON THE OPPORTUNITIES OF DESIGN:
We have a lot of public space, but mainly for monumental functions, or transportation hubs, or retailing centers. We don’t have much “daily life” public space. We always try to create some sort of landmark something, like a landmark hospital of 80,000 beds. But I don’t think we should advocate for this kind of landmark. We should try to create a landmark community, really a landmark society.
ON PUBLIC HEALTH VERSUS PRIVATE HEALTH:
Obviously medical care in China is primarily the public sector. I personally am confident in that. Also I’m quite confident that the current governmental reform is quite clear, and the government should focus on the public side. But of course, some private enterprise will work, and we shouldn’t forbid them to come in.
ON COLLABORATING ACROSS DISCIPLINES:
In my career as an urban planner, I haven’t really collaborated with doctors. I will make it a point in the future to involve medical experts to bring notions of health and activity back home, back to the office — everywhere in the city. If we involve medical experts in our designing and planning process, I think this will help us a lot.
教授
王红扬建筑与城市规划学院 南京大学
关于医疗危机的成因和解决方法：
为什么有这么多病人？我们都知道原因：我们吃太多，我们运动太少，我们污染太多。所以作为一个局外观察者，如果我被要求回答，“什么能对医疗保健做最重要的贡献？”我将说它是一个好的城市、一个好的社会。
关于社会媒体之星：
当然互联网、数码时代，已经创新出新空间，为医疗护理和医患关系带来新机遇。但它归根到底是整个社会人与人之间的信任问题。最终，我们仅仅依赖于有限数量可信赖的人，整个社会不会有大幅度的改进。
关于设计的价值：
首先，一个健康友好的城市或社区，能够培育和促进健康的工作、生活、行为模式， 是规划、设计对健康的最大价值所在。 然后，医院建筑是否很高贵或者装修华丽是没有关系的，只要它运作良好。它可以以中国的方式被设计并带有文化元素，并且它可能不会花费很多钱。一幢高品质的建筑不是昂贵的。我认为这也许是设计师试图说服人们相信的重要的事，但事实上它不是。它可以是一个非常友善的环境；它可以让医生珍惜他们作为医生的价值。
关于设计的机遇：
我们有很多公共空间，但主要是纪念的作用，或者交通枢纽，或者商业中心。我们没有很多“日常生活” 的公共空间。我们总是试图打造一些地标，比如一家有80,000张床位的地标性医院。但我不认为我们应该热衷于此类地标。我们应该试图打造一个地标性社区，一个真正的地标性社会。
关于公共医疗和民营医疗相比：
显然在中国的医疗护理主要是公共机构。我个人认同这一点。同时我也很有信心目前的政府改革是非常清晰的，政府应该着重关注公共部分。而当然，一些民营企业将会运作，我们不应该阻止他们进入。
关于跨专业合作：
在我城市规划师的职业生涯中，我还没有真正和医生合作过。我认为邀请医疗专家把保健和活动的概念带回家，带到办公室—带到城市里的任何地方在未来是很有意义的。如果我们邀请专家参与我们的设计和规划流程，我想这将让我们受益匪浅。
DR.
QIANG ZHANG“Dr. Smile,” Vascular Surgeon
ON PHYSICIANS’ WORKLOADS:
Experts like me — I am a senior surgeon with almost 20 years’ experience in surgery — have to see almost 80 patients in one day. That means for each patient, I only have five minutes to finish the diagnosis and examination. You cannot imagine that within five minutes you can know much about the patient. You cannot know their feelings. And sometimes we can perform over 10 procedures in one day! Some doctors don’t even know what their patients look like: they just see the patients in the operating room. That’s a terrible thing.
ON THE DISTRIBUTION OF RESOURCES:
We have an 80,000-bed hospital in Zhengzhou I think this is the largest in the world. A professor in Shanghai asked the question, “Why not build 10 hospitals with 1,000 beds in different areas?” Why do we build such big hospitals instead? They absorb patients and resources from all over China, so doctors in rural areas have nothing to do.
ON MEDICAL EDUCATION IN CHINA:
The general practitioner in China is often not qualified, because we do not have a standardized education system for those doctors. That’s why, when the government pushes patients to see the general practitioner first, the patients don’t trust them. They still trust the big hospital.
ON THE IMPACT OF DESIGN:
There’s no doubt that environment influences the patients’ recovery time. For example, if a patient receives spine surgery, and if after surgery you put the patient in a closed room with no window, you can imagine that after several days the patient will get depressed. But if you move the patient to another room with sunshine, I think you can imagine the patient will feel healthier and recover more quickly. There’s no doubt.
ON THE BENEFITS AND LIMITATIONS OF TECHNOLOGY IN HEALTHCARE:
For establishing the patient-physician relationship, the Internet helps a lot. For example, the patients who see me, even for the first time, know everything about me. They say, “Oh, Dr. Smile, you have been to Suzhou city and had dinner there!” It’s just like a friend: they relate to me because of Weibo and WeChat. So they choose you, they trust you. That changes the relationship greatly. And it allows doctors to help not only patients in their own cities, but patients all over China. Every day I help at least ten patients, some far from Shanghai, to resolve their problems. But I have a policy that doctors are not allowed to make a diagnosis or give treatment online. Disease can be so complicated, and for most diseases we cannot make the diagnosis with only a description. We have to see the patient, we have to touch the patient, we have to check the patient and perform tests. One dream of mine is to set up a remote medical consultation system that can help patients after discharge from the hospital. In the past, Chinese doctors did not want to do the follow-up, because it can cost a lot of time and energy. But now we can use the Internet to follow-up on all our patients with remote medicine.
医生
张强“微笑医生” 血管外科
关于医生的工作量：
我是一名在外科有近20年经验的资深外科医生—像我这样的专家不得不一天看近80位病人。 这意味着对于每位病人，我仅仅有五分钟来完成诊断和检查。 您不能想象在五分钟里能了解多少关于病人的事。您不能知道他们的感受。有时我们可以在一天内进行十几道手术。一些医生甚至不知道他们的病人的长相：他们仅仅在手术室看到病人。那是一件可怕的事。
关于资源分配：
我们在郑州有一家有80,000张床位的医院，我想这是全球最大的医院。一位上海的教授问了一个问题：”为什么不在不同的区域建造10家有1,000张床位的医院？” 为什么我们却要建造如此大的医院？他们吸收中国各地的病人和资源，所以在乡村的医生没有事情做。
关于在中国的医疗教育：
在中国普通执业医生通常不合格，因为我们没有一套标准的教育系统给那些医生。这就是为什么政府鼓励病人首先去看普通执业医生，而病人不相信他们。他们仍然相信大医院。
关于设计的影响：
毫无疑问环境影响病人的康复时间。比如，如果病人接受脊柱手术，并且如果在手术后，您把病人放到一个没有窗户的封闭房间，您可以想象在几天后病人将变得沮丧。但是如果您把病人移到另一间有阳光的房间，我想您能够想象病人将感到更健康，并且恢复更快。这是毫无疑问的。
关于医疗中科技的益处和局限：
为了建立医患关系，互联网帮了很多忙。比如，见我的病人，甚至是第一次，对我已经完全了解。他们说，＂哦，微笑医生，您已经去过苏州，在那里吃过饭！＂就像一位朋友：由于微博和微信他们和我有关联。所以他们选择您， 他们相信您。这极大地改变了关系。并且它允许医生不仅帮助他们自己城市里的病人，还有中国各地的病人。每天，我至少帮助10位病人解决他们的问题，有些人还从距离上海很远的地方远道而来。我有一个规定是医生不能在网路上做诊断和治疗。疾病可能是非常复杂的，对于大多数疾病，我们不能仅凭描述作出诊断。我们不得不见病人，我们不得不接触病人，我们不得不检查病人和做检验。我的梦想之一是建立一套远程医疗咨询系统，帮助出院的病人。在过去，中国医生不想做跟进工作，因为它花费很多时间和精力。但是现在我们可以利用互联网，利用远程医疗来跟进所有我们的病人。
“
”
We can’t design health systems that focus solely on the problems of today. New technology, changing clinical paradigms, disruptive discoveries in genetic research or personalized medicine will change the way that we think about delivering healthcare.
我们不能设计仅仅关注当今问题的医疗系统。新科技、改变的临床范例、基因研究或个体化医学的颠覆性发现，都将会改变我们关于提交医疗服务的思考方法。
JOAN SABAHealthcare Design PartnerNBBJ
琼·萨巴 医疗设计合伙人NBBJ
·
ON INTEGRATING NATURE INTO HEALTHCARE:
The environment matters a great deal in terms of how well and how quickly a patient can heal. We have found that, when patients have access to nature and natural light, they use less pain medication and their length-of-stay decreases. We can actually measure that impact.
ON FLEXIBILITY AND PREPARING FOR CHANGE:
We can’t design hospitals or health systems that focus solely on the problems of today. New technology, changing clinical paradigms, disruptive discoveries in, say, genetic research or personalized medicine may — indeed, will — change the way that we think about delivering healthcare. Designing flexible facilities that can accommodate those changes is a top priority for us.
ON CULTURAL SENSITIVITY:
We’ve learned that successful healthcare innovation comes from a partnership between the owner, the clinicians and the designers. One can’t simply import the best hospital from somewhere else and expect it to work. To design innovations in how care is delivered, a partnership has to exist, to ensure the solution is culturally appropriate.
My vision of a next-generation hospital in China is centered on the human experience. It upholds all the positive aspects of healthy living, incorporating the best traditions of Chinese culture. It features many, many small moves that together have a big impact. When we bring those things together in the clinical environment? That’s when we’ll build a healthy China.
JOAN SABAHealthcare Design PartnerNBBJ
ON THE PATIENT EXPERIENCE:
The healthcare experience is really a design problem. But that experience is twofold: it depends on designing for one’s personal experience — for both patients and physicians — and on designing environments to support that experience. These aren’t separate concerns; they have to be considered together. And we know that positive interactions between people — between patients and their physicians, between clinical colleagues working in teams — lead to better care, to reduced recovery times and increased patient and staff satisfaction.
ON EFFICIENCY:
We have a real opportunity to design for efficiency, to allow physicians to have more of the one-on-one time that improves outcomes and increases the trust between patients and physicians. This can be achieved through Lean design, changes to clinical operations, even simply focusing resources on what will return the highest value. And people are willing to pay more for the things that bring value to their care.
琼·萨巴医疗设计合伙人NBBJ
关于病人体验：
医疗体验其实是一个设计问题。但是体验是两层面的：它来自为人们的个人体验而设计—对于病人和医生而言—以及来自支持这种体验的环境设计。这些不是独立的问题；它们不得不被放在一起考虑。 并且我们知道人之间的积极的互动—在病人和他们的医生之间，在工作团队的临床医生同事之间—会产生更好的护理、减少康复时间和增加病人和工作人员的满意度。
关于效率：
我们有真正的机会来为效率做设计，以使医生有更多一对一的时间提升结果并增加病人和医生之间的信任。这可以通过精益设计、对临床手术的改变、甚至简单地关注产生最高价值的资源来实现。而且人们愿意为那些为他们的护理带来价值的东西支付更多。
关于把大自然融合到医疗中：
环境对于如何很好很快地治愈病人是至关重要的。我们已经发现当我们的病人能接触到大自然和自然光线时，他们使用更少止痛剂并且他们留院时间减少。我们其实能够测量这种影响。
关于灵活性和为改变而做的准备：
我们不能设计仅仅关注当今问题的医院或医疗系统。新科技、改变的临床范例、颠覆性的发现，比如基因研究或个体化医学可以—事实上，将会改变我们关于交付医疗服务的思考方法。设计可以顺应这些变化的灵活的设施是我们的首要任务。
关于文化敏感：
我们已经知道成功的医疗创新来源于业主、医生和设计师的合作关系。不能简单地把其他一些地方的最佳医院搬来并期望它可以运作。为了设计在如何交付护理方面的创新，必须有一种合作关系存在，以保证解决方案在文化上是合适的。
我对中国下一代医院的愿景是以人为本的体验。它支持健康生活的所有积极面，并融合了中国文化的最佳传统。它包含许许多多小的举措并在一起形成大的影响力。当我们把这些东西一起带入医疗环境中，那就是我们建造了一个健康中国的时候。
EXPERIENCE Patients pass through several significant steps along their healthcare journeys: identifying the facility at a distance, parking the car, finding the information desk, checking in, riding elevators, receiving care and beyond. For one project, a team of researchers spent 18 months investigating these “21 Critical Experiences,” key moments at which improvements could be made to simplify the journey and elevate the patient experience.
病人沿着医疗路线经过几个重要步骤：从远处辨识出设施、停车、找到信息咨询处、登记、乘电梯、接受护理和其他。为了一个项目，一个调研团队花了18个月调研“２１个重要体验”， 这些可以进行改进的关键节点，以简化过程并提升病人的体验。
KAISER PERMANENTETOTAL HEALTH EXPERIENCEMultiple Locations
凯萨永久医疗集团全方位健康体验多个地点
EFFICIENCY
SEATTLE CHILDREN’S BELLEVUE CLINIC AND SURGERY CENTERBellevue, Washington
西雅图儿童医院 贝尔维尤医疗和手术中心 华盛顿州贝尔维尤
To lessen patient load at central hospitals, many providers now offer ambulatory surgery at regional centers. Here, efficiency is paramount. When operating rooms are connected to induction rooms – two, to double capacity – procedures can be performed not only more efficiently, but also more safely, because patients travel only a few feet from anesthesia to surgery. And parents remain with their children longer, for greater peace of mind.
为了减轻中央医院的就诊压力，很多医疗服务现在提供地区中心的门诊手术。在这里，效率是至关重要的。当手术室与麻醉室—两间连接，使容量翻倍—不仅流程更有效， 也更安全， 因为病人从麻醉室到手术间只有几英尺。而且父母和孩子有更多时间待在一起，可以使他们内心更平静。
Recovery 康复 Surgery 手术
OPERATINGROOM
INDUCTIONROOMS
InductionRooms 麻醉室
Surgery Suite Entrance手术房入口
Patient Lobby 病人大厅
PATIENT (CHILD) JOURNEY 病人（儿童）路线
PARENT JOURNEY 父母路线
OR AND PACU AREAS 手术室和麻醉后监测治疗室区域
EXAMPLES OF BEST PRACTICES
最佳实践案例
麻醉室
手术室
体验
效率
MIAMI VALLEY HOSPITAL HEART AND ORTHOPEDIC CENTERDayton, Ohio
迈阿密河谷医院心脏和骨科中心俄亥俄州代顿
Environments need to change as care models evolve. One method: a flexible open core with extra-wide hallways and patient rooms on both sides that turn the entire corridor into a caregiver workspace (1). “Corporate” systems furniture can be easily reconfigured as staff needs evolve.
Overhead mechanical racks – including ductwork, dampers, sprinkler piping, medical gasses and offshoots to patient rooms – can be prefabricated to exact specifications (2). In the future, maintenance personnel know exactly where to work on them, and clear areas in each rack can accommodate future expansion of utilities.
随着护理模式的演变，环境需要改变。有一套方法：一个灵活的开放性核心筒，超宽走道两侧为病房，可以把整个走道转变成照护工作空间（1）。“办公”系统的家具可以在员工需要变化时，容易被重新配置。
顶置式机电桥架—包括管道、风门、喷淋管道、医学气体和到病房的分管—可以被预制成特定规格（2）。在未来， 维护人员确切地知道在哪里进行工作，和每个桥架中空的区域可以顺应设施未来的扩建。
FLEXIBILITY
1. 2.
NATURE Exposure to nature and daylight is proven to help patients heal faster. For instance, ICU rooms designed with abundant sunlight and views of a rooftop bamboo garden (1) or planted atrium (2) have been shown to help patients recover more quickly from surgery, using less pain medication and returning home sooner than they would in similar facilities.
接触大自然和天然光被证明可以使病人更快治愈。比如，设计有充沛阳光和一个屋顶竹园景观的重症监护室（1)或有植物的中庭（2）已经显示有助于病人更快从手术后恢复，使用更少止痛剂并且比他们应该在相似设施中能够更快回家。
MASSACHUSETTS GENERAL HOSPITAL, LUNDER BUILDINGBoston, Massachusetts
马萨诸塞州综合医院, 隆德大楼马萨诸塞州波士顿
CHIEF ANDREW ISAAC HEALTH CENTERFairbanks, Alaska
安德鲁·艾萨克健康中心阿拉斯加州费尔班克斯
A successful healthcare environment is relevant to the culture of its patients. The design of one Fairbanks-based clinic — which serves Alaskan Native people from 42 remote villages within a 235,000 square-mile region — drew on an immersive 18-month study of Alaska-Native tribal cultures, including a visit to Koyukuk, a village accessible only by boat or plane. This effort resulted in a large, circular gathering area that encourages social interaction and accommodates patients’ close-knit, community-oriented culture (1). The facility also incorporates forms familiar to Native people, including curved, flowing walls that mimic the course of Alaskan rivers, seasonal colors, floral motifs and art by local artists (2).
一个成功的医疗环境和其病人的文化传统相关。为设计一个位于费尔班克斯的诊所—服务方圆235,000平方英里内42个偏远村庄的阿拉斯加原住民—投入18个月深入研究阿拉斯加原住民部落文化，包括对可优库可，一个仅坐船或飞机才能到达的村庄的拜访研究。 这部分工作创造了一个大型的、圆的聚集空间，鼓励社交并满足病人紧密连接的、以社区为导向的文化需求（1）。该设施也融入了原住民熟悉的造型，包括弯曲的、流动的墙体效仿阿拉斯加河道、四季颜色、花的图案和当地艺术家的艺术品（2）。
CULTURE
1. 2.
1.
1.
2.
2.
自然
灵活性
文化
ABOUT THE PANELISTS 关于专家小组成员
PROFESSOR
JOHN CAI
蔡江南 教授 王红扬 教授
张强 医生
JOAN SABA
琼 · 萨巴
DR.
JOSEPH TUCKER
Director China Europe International Business School (CEIBS), Center for Healthcare Management and Policy
主任中欧国际工商学院 (CEIBS) 医疗管理与政策研究中心
Healthcare Design PartnerNBBJ
医疗设计合伙人NBBJ
Assistant Professor of Medicine and DirectorUNC Project-China
医学副教授和主任中国UNC项目
Dr. John Cai leads the Center for Healthcare Management and Policy at China Europe International Business School (CEIBS), a leading business school in China and Asia. He participated in the design, implementation and evaluation of the United States’ first comprehensive healthcare reform plan (in Massachusetts) and was also actively involved in the design of China’s new healthcare reform plan.
蔡教授领导中欧国际工商学院 (CEIBS) 医疗管理与政策研究中心，这是一个在中国和亚洲领先的商学院。 他参与美国首个全面医疗改革计划（在马瑟诸塞州）的设计、施和评估，并且积极参与中国新医疗改革计划的设计。
A specialist in healthcare architecture and planning, Joan has more than 25 years of expertise in strategic visioning for academic medical centers, pediatric hospitals and teaching hospitals such as NYU Langone Medical Center and Massachusetts General Hospital. She has been named to Healthcare Design’s list of “Twenty Who Are Making a Difference” and as 2013 Architect of the Year.
作为一名医疗建筑和规划领域的专家，琼在策略性愿景规划方面有超过25年的经验，包括为学术医疗中心、儿科医院和教学医院，如纽约大学兰贡医疗中心和马瑟诸塞州综合医院。她被《医疗设计》杂志列入“20位有影响力的人”名单，并且成为2013年度建筑师。
Joseph D. Tucker, MD, PhD (@JosephTucker) is an infectious diseases physician and health systems researcher. A term member of the Council on Foreign Relations and Chair of SESH (Social Entrepreneurship for Sexual Health) Global, he was a contributor to the 2013 WHO HIV Guidelines and a member of the International AIDS Society’s Towards a Cure Global Executive Committee.
约瑟夫 · 塔克，医学博士，(@JosephTucker)是一名传染病医生和医疗系统研究员。作为外国关系理事会会籍会员和全球ＳＥＳＨ（性健康社会企业）的主席，他参与制定2013年世界卫生组织艾滋病病毒的导则，并且是国际艾滋病协会的面向治愈的全球执行委员会成员。
PROFESSOR
HONGYANG WANG
DR.
QIANG ZHANG
MODERATOR
JIANGONG ZHOU
School of Architecture & Urban PlanningNanjing University
建筑与城市规划学院南京大学
“Dr. Smile” Vascular Surgeon
“微笑医生” 血管外科医生
Editor-in-ChiefForbes (China)
总编辑《 福布斯 》 （中文版）
Professor Hongyang Wang researches and teaches planning philosophy and methodology, comprehensive planning, urbanization and urban-rural integration. He has chaired more than 40 plans throughout eastern, middle and western China, and he is currently a member of the UN-Habitat Ad-Hoc Expert Group for International Guidelines on Urban and Territorial Planning.
王红扬教授研究并主讲规划原理和方法、总体规划、城市化和城乡结合的课程。他已经主持中国东部、中部和西部的40多个规划方案，目前他是联合国人类居住署关于城市及国土规划之国际指导方针特设专家组成员。
Dr. Zhang Qiang, a renowned vascular surgeon and social-media personality popularly known as Dr. Smile, specializes in minimally invasive surgery and treatment of peripheral vascular disease (PVD). In January 2013, he joined with the Shanghai World Path International Clinic as chief vascular surgeon, and in October 2013, Dr. Zhang signed with Beijing United Family Hospital and Clinics.
张强医生，知名的血管外科医生和被社会媒体广泛认知的“微笑医生”，擅长微创手术和外周血管病的治疗（PVD)。在２０１３年１月，他加入了上海沃德国际医疗中心作为血管外科主任，并且在２０１３年１０月，张医生与北京和睦家医院和诊所签约。
Jiangong Zhou is the editor-in-chief of Forbes (China) and is based in Shanghai. He was one of the founders and managing editors of China Business News, a national daily headquartered in Shanghai, and has also worked as a consultant with the Center for Strategic and International Studies (CSIS), based in Washington, DC.
周健工是 《 福布斯 》 (中文版) 杂志的总编辑，目前驻于上海。他曾是 《 第一财经日报 》 的创办人之一并担任编委，这是一家总部位于上海的全国日报。并且他曾担任位于华盛顿特区的智库战略与国际研究中心 （CSIS)的顾问。
约瑟夫 · 塔克 博士 主持人 周健工
NBBJ creates innovative places and experiences for organizations worldwide, and designs environments, communities and buildings that enhance people’s lives. Founded in 1943, NBBJ is an industry leader in healthcare and corporate facilities and has a strong presence in the commercial, civic, science, education and sports markets. The firm has won numerous awards and has been recognized as one of the “Top Ten Most Innovative Architecture Firms” by Fast Company, as “Firm of the Year” by Healthcare Design and “Most Admired” healthcare design firm by Interior Design. One of the world’s largest healthcare design practices, NBBJ has more than 750 employees in ten offices worldwide, including Beijing, Boston, Columbus, London, Los Angeles, New York, Pune, San Francisco, Seattle and Shanghai. Clients include Alibaba, Amazon, the Bill & Melinda Gates Foundation, Boeing, Cambridge University, Cleveland Clinic, GlaxoSmithKline, Google, Kaiser Permanente, Massachusetts General Hospital, Microsoft, Reebok, Salk Institute, Samsung, Stanford University, Starbucks, Telenor, Tencent and the Wellcome Trust.
CONTACT
Shanghai OfficeSuite 2201. No. 1717 West Nanjing Road, Shanghai
www.nbbj.com
NBBJ为全球各地机构打造创意空间和体验，设计提升人们生活质量的环境、社区和建筑。成立于1943年，NBBJ是医疗和企业办公设施领域的行业领导，并且在商业、市政、科学、教育和体育市场方面有很强的影响力。公司已经荣获无数奖项并且被《快公司》杂志评选为”十家最有创意的建筑公司”之一，被《医疗设计》杂志评选为”年度公司”，以及被《室内设计》杂志评选为“最受尊敬的”医疗设计公司。作为全球最大的医疗设计事务所之一，NBBJ在全球十个办公室包括北京、波士顿、哥伦布斯、伦敦、洛杉矶、纽约、普纳、旧金山、西雅图和上海，总共有超过750名员工。客户包括阿里巴巴、亚马逊、比尔盖茨梅琳达基金会、波音、剑桥大学、克利夫兰医疗中心、葛兰素史克、谷歌、凯萨永久、马瑟诸塞州综合医院、微软、锐步、索尔克研究所、三星、斯坦福大学、星巴克、挪威电信、腾讯和惠康信托。
联系信息
上海办公室上海市南京西路1717号2201室
www.nbbj.cn
