[Annotated] A revolution in health care is coming

Welcome to Doctor You

No wonder they are called "patients". When people enter the health-care systems of rich countries today, they know what they will get: prodding doctors^[각주:1], endless tests, baffling^[각주:2] jargon^[각주:3], rising costs and, above all^[각주:4], long waits. Some stoicism^[각주:5] will always be needed, because health care is complex and diligence matters^[각주:6]. But frustration is boiling over^[각주:7]. This week three of the biggest names in American business - Amazon, Berkshire Hathaway and JPMorgan Chase - announced a new venture to^[각주:8] provide better, cheaper health care for their employees. A fundamental problem with today's system is that patients lack knowledge and control. Access to data can bestow both^[각주:9]. 

The internet already enables patients to seek online consultations when and where it suits them. You can take over-the-counter tests to^[각주:10] analyse your blood, sequence your genome^[각주:11] and check on the bacteria in^[각주:12] your gut. Yet radical change demands a shift in emphasis^[각주:13], from providers to patients and from doctors to data. That shift is happening. Technologies such as the smartphone allow people to monitor their own health. The possibilities multiply when you add the crucial missing ingredients^[각주:14] - access to your own medical records^[각주:15] and the ability easily to share information with those you trust. That allows you to reduce inefficiencies in your own treatment and also to provide data to help train medical algorithms. You can enhance your own care and everyone else's, too.

The doctor will be you now 

Medical data may not seem like the type of kindling to^[각주:16] spark a revolution^[각주:17]. But the flow of information is likely to bear fruit^[각주:18] in several ways^[각주:19]. One is better diagnosis^[각주:20]. Someone worried about their heart can now buy a watch strap^[각주:21] containing^[각주:22] a medical-grade monitor that^[각주:23] will detect^[각주:24] arrhythmias^[각주:25]. Apps are vying to see if^[각주:26] they can diagnose everything from skin cancer and concussion to^[각주:27] Parkinson's disease^[각주:28]. Research is under way to see whether^[각주:29] sweat^[각주:30] can be analysed for molecular^[각주:31] biomarkers^[각주:32] without the need for an invasive blood test^[각주:33]. Some think that changes in how quickly a person swipes a phone's touchscreen^[각주:34] might signal the onset of^[각주:35] cognitive problems^[각주:36]. 

A second benefit lies in^[각주:37] the management of complex diseases^[각주:38]. Diabetes^[각주:39] apps can change the way patients cope^[각주:40], by monitoring blood-glucose levels^[각주:41] and food intake^[각주:42], potentially reducing long-run harm such as blindness and gangrene^[각주:43]. Akili Interactive, a startup, plans to seek regulatory approval for^[각주:44] a video game designed to stimulate an area of^[각주:45] the brain implicated in^[각주:46] attention-deficit hyperactivity disorder^[각주:47]. 

Patients can also improve the efficiency of their care. Although health records are increasingly electronic^[각주:48], they are often still trapped in silos^[각주:49]. Many contain data that machines cannot read. This can lead to delays in treatment^[각주:50], or worse. Many of the 250,000 deaths in America attributable to^[각주:51] medical error^[각주:52] each year can be traced to^[각주:53] poorly co-ordinated care^[각주:54]. With data at their fingertips, common standards to enable sharing and a strong incentive to get things right^[각주:55], patients are more likely to spot errors^[각주:56]. On January 24th Apple laid out its plans to^[각주:57] ask organizations to let patients use their smartphones to download their own medical records. 

A final benefit of putting patients in charge^[각주:58] stems from^[각주:59] the generation and aggregation of their data^[각주:60]. Artificial intelligence (AI) is already being trained by a unit of Alphabet, Google's parent company, to identify cancerous tissues^[각주:61] and retinal damage^[각주:62]. As patients' data stream from smartphones and "wearables^[각주:63]", they will teach AIs to do ever more. Future AIs could, for instance, provide automated medical diagnosis from a description of your symptoms, spot behavioral^[각주:64] traits that^[각주:65] suggest you are depressed or identify if you are at special risk of cardiac disease^[각주:66]. The aggregation of data will also make it easier for you to find other people with similar diseases and to see how they responded to various treatments. 

An Apple a day

As with^[각주:67] all new technologies, pitfalls^[각주:68] accompany the promise^[각주:69]. Hucksters^[각주:70] will launch apps that do not work. But with regulators demanding oversight of^[각주:71] apps that present risks to patients, users will harm only their wallets. Not everyone will want to take active control of^[각주:72] their own health care; plenty will want the professionals to manage everything. Fine. Data can be pored over by those who^[각주:73] are interested, while those who are not can opt to share^[각주:74] data automatically with trusted providers. 

The benefits of new technologies often flow disproportionately^[각주:75] to the rich. Those fears are mitigated by^[각주:76] the incentives that^[각주:77] employers, governments and insurers^[각주:78] have to invest in cost-efficient^[각주:79] preventive care for all^[각주:80]. Alphabet has recently launched a firm called Cityblock Health, for example, which plans to trawl through^[각주:81] patients' data to provide better care for low-income city dwellers^[각주:82], many of them covered by Medicaid^[각주:83], an insurance programme for poorer Americans. 

Other risks are harder to deal with. Greater transparency^[각주:84] may encourage the hale^[각주:85] and hearty^[각주:86] not to take out health insurance^[각주:87]. They may even make it harder for the unwell to^[각주:88] find cover^[각주:89]. Regulations^[각주:90] can slow that process - by requiring insurers to ignore genetic data^[각주:91], for example - but not stop it. Security is another worry. The more patient data are analysed in the cloud or shared with different firms, the greater the potential threat of hacking or misuse^[각주:92]. Almost a quarter of^[각주:93] all data breaches in America happen in health care. Health firms should face stringent penalties if they are slapdash about^[각주:94] security, but it is naive to expect that breaches will never happen. 

Will the benefits of making data more widely available outweigh such risks^[각주:95]? The signs are that they will. Plenty of countries are now opening up their medical records, but few have gone as far as Sweden. It aims to give all its citizens electronic access to their medical records by 2020; over a third of Swedes have already set up accounts. Studies show that patients with such access have a better understanding of their illnesses, and that their treatment is more successful. Trials in America and Canada have produced not just happier patients but lower costs, as clinicians^[각주:96] fielded fewer inquiries^[각주:97]. That should be no surprise^[각주:98]. No one has a greater interest in your health than you do. Trust in Doctor You. 

1. prod ; (~·ded; ~·ding) 1. 찌르다 ((with)) ;; 2. 자극하다(incite), 괴롭히다(irritate); <기억을> 불러일으키다 [본문으로]
2. baffling ; [형용사] 저해하는; 당황하게 하는; 이해할 수 없는 [본문으로]
3. jargon ;[U] (흔히 못마땅함) (특정 분야의 전문・특수) 용어 [본문으로]
4. above all ; [명사] 특히, 그 중에서도, 무엇보다도(most important of all, principally). [본문으로]
5. stoicism ; [U] (격식) 극기(심), 금욕 [본문으로]
6. diligence ; [U] 근면, 부지런함; [법] 주의, 안전 배려 ;; 미국∙영국 [|dɪlɪdƷəns] [본문으로]
7. boil over ; 1. 액체가 끓어 넘치다 ;; 2. (비격식) 화가 끓어오르다 ;; 3. 상황·감정 등이 폭발하다 ;; [VERB] to overflow or cause to overflow while boiling [본문으로]
8. venture ; (pl. ventures[-z]) 1. [U]모험(성); [C]모험적 시도[행위]. ;; 2. (투기적) 기업[사업]; (위험이 따르는) 신규 개발 사업. [본문으로]
9. bestow ; 1. 주다, 수여[증여]하다(confer, grant)(on, upon). ;; 2. 놓다(place, put), 간수해두다(deposit). [본문으로]
10. over-the-counter ; [명사 앞에만 씀] 1. (약이) 처방전 없이 살 수 있는 ;; 2. (美 상업) (주식이) 비상장(非上場)의 [본문으로]
11. sequence ; [vn] 1. (전문 용어) 차례로 배열하다 ;; 2. (생물) (유전자・분자의) 배열 순서를 밝히다 [본문으로]
12. check on ; (이상이 없는지를) 확인하다[살펴보다] ;; …을 확인하다(=verify). [본문으로]
13. a shift in emphasis (to) ; ~를 강조하는 방향으로의 변화 [본문으로]
14. missing ; [형용사] 2. (원래 있던 것이) 빠진[분실된/폐기된] ;; 3. (사람이) 행방불명된 ;; 4. (흔히 있어야 할 것이) 빠진[누락된] [본문으로]
15. medical record ; [명사] 진료 기록, 카르테(Karte ; [의학] a (clinical) chart; a patient's chart.) [본문으로]
16. kindling ; [명사] 불쏘시개 ;; 흐름상 "결정적 계기, 원인, 시발점" 정도의 의미 [본문으로]
17. spark ; 1. [타동사][VN] ~ sth (off) 촉발시키다, 유발하다 [본문으로]
18. bear fruit ; 결실을 보다[맺다] [본문으로]
19. in several ways ; 여러가지 이유로, 방법으로, 여러 점으로 [본문으로]
20. diagnosis ; ((pl. -ses[-siːz])) [CU] [의학] 진단(법); [생물] (특징을 기술하는) 정확한 분류; 식별; (문제의 원인이나 성질의) 판단 분석; (문제의) 해답, 해결 ((of)) [본문으로]
21. watch strap ; [명사] (손목시계의) 시계줄 [본문으로]
22. contain ; 2. (조직안에) 함유[포함]하다(include). [본문으로]
23. medical grade ; 의료용(의) [본문으로]
24. detect ; 3. (…이 있는 것을) 탐지하다(perceive the existence of). [본문으로]
25. arrhythmia ; [명사] (병리) 부정맥(不整脈) ;; 미국·영국 [əríðmiə,ei-] [본문으로]
26. vie ; (vying / 'vaIIN / vied , vied) ~ (with sb) (for sth) (격식) (어떤 것을 차지하기 위해) 다투다[경쟁하다] ;; 미국∙영국 [vaɪ] ;; ORIGIN ;; Latin 「(시합에) 초대하다」의 뜻에서 [본문으로]
27. from ~ and ~ to ~ 형태로 활용한 것을 확인 [본문으로]
28. Parkinson's disease ; [U] (의학) 파킨슨 병, 진전(振顫) 마비(shaking palsy). [본문으로]
29. be under way ; have started and be now progressing or taking place [본문으로]
30. sweat ; 1. LIQUID ON SKIN | [U] 땀, 식은땀, 진땀 ;; 참고 ; sweaty [본문으로]
31. molecular ; [형용사] 분자의, 분자로 된, 분자에 의한 ;; 미국·영국 [məlékjulər] [본문으로]
32. biomarker ; (의학) 생물표시자, 생물표지다 ;; 발암, 유전질환, 노화 등이 진행되는 단계 중 특징적으로 나타나는 형태학적·생화학적·분자생물학적 변화. 생체지표를 검색함으로써 물질의 위해성을 판단할 수 있다. [본문으로]
33. invasive ; (격식), (참고: invade) 2. (의학적 치료가) 몸에 칼을 대는, 외과적인 [본문으로]
34. swipe ; 1. ~ (at) sb/sth 후려치다, 후려치려고 하다 ;; 2. [타동사][VN] (비격식) 훔치다, 슬쩍하다 ;; 3. [타동사][VN] (신용 카드 같은 전자 카드를 인식기에) 대다[읽히다] ;; 흐름상 "폰의 스크린을 손으로 문지르다" 정도의 의미 [본문으로]
35. onset ; 습격, 공격(attack); (질병 따위의) 시초; 착수, 개시 [본문으로]
36. cognitive ; 1. 인식의; 인식에 의한; 경험적 지식에 바탕을 둔. ;; 2. 인지(認知)되는; 지각력[인식력] 있는. cognitive·ly 부사‒̀tív·i·ty 명사 [본문으로]
37. lie ; 6. [자동사][V] ~ (in sth) (생각・특질・문제 등이) 있다, 발견되다 [본문으로]
38. complex disease ; [명사] (생명과학) 복합병(複合病) [본문으로]
39. diabetes ; [U] [단수취급] (병리) 당뇨병. ;; 미국·영국 [|daɪə|bi:ti:z] [본문으로]
40. cope ; [자동사][V] ~ (with sth) 대처[대응]하다 [본문으로]
41. blood glucose level ; [명사] (영양학) 혈당치 (血糖値 ) [본문으로]
42. food intake ; [명사] (영양학) 식품 섭취(食品攝取) [본문으로]
43. gangrene ; 1. (병리) 괴저(壞疽)(질병으로 인한 신체 일부 조직의 파괴), 탈저(脫疽)(cf. necrosis). ;; 2. (도덕적) 부패 ; 타락(의근원). ;; 미국∙영국 [|gӕŋgri:n] [본문으로]
44. regulatory approval ; 규제 승인 [본문으로]
45. stimulate ; 1. [타동사][VN] 자극[격려]하다, 활발하게 하다 [본문으로]
46. implicate ; 2. ~ sth (in/as sth) (나쁜 것의) 원인임을 보여주다[시사하다] [본문으로]
47. attention deficit hyperactivity disorder ; 주의력 결핍 과잉 활동 장애 ((略 ADHD)) [본문으로]
48. electronic ; 2. 전자 장비와 관련된 [본문으로]
49. silo ; 1. 사일로(곡식·목초 따위를 저장하기 위한 탑모양의 건축물; cf. ENSILAGE); (지하의) 저장굴 ;; 2. 사일로(언제든지 발사할 수 있도록 준비된 유도탄 지하 격납고) 미국식 [|saɪloʊ] 영국식 [|saɪləʊ] [본문으로]
50. lead to delays in ~ ; ~을 지연시키다, ~이 지연되다 [본문으로]
51. attributable ; [명사 앞에는 안 씀] ~ to sb/sth …가 원인인, …에 기인하는 [본문으로]
52. medical error ; 의료 과실 , 의료오류 [본문으로]
53. trace ; 2. ~ sth (back) (to sth) (기원・원인을) 추적하다[(추적하여) 밝혀내다] ;; 3. (진행・발달 과정을 따라가며) 기술하다 [본문으로]
54. coordinated ; [형용사] ; 조직화된, 조율이 잘 이루어진, 조정된, 조직적인 [본문으로]
55. get st right/straight ; understand something clearly and correctly [본문으로]
56. spot ; 3. (구어) 발견하다, 찾아내다, 알아내다(detect), (사람을) 알아보다(recognize), 수상한 놈이라고 주목하다(note as suspicious). [본문으로]
57. lay out ; [동사] 펼치다; 투자하다; 질책하다; 때려 눕히다; 설계[계획]하다. ;; 동의어 ; extend at length; spend, contribute; reprimand; knock down; arrange, plan, [본문으로]
58. put sb in charge (of sth) ; …에게 …에 대한 책임을 맡기다, 담당하게 하다 [본문으로]
59. stem from ; (진행형으로는 쓰이지 않음) ~에서 생겨나다[기인하다] ;; [동사] …에 기인하다, …에 유래하다. ;; 동의어 ; originate in, emanate from. [본문으로]
60. aggregation ; [UC] 집합, 집성; 집합체, 집단 [본문으로]
61. cancerous tissue ; 암 조직 [본문으로]
62. retinal damage ; [명사] (실험심리학) 망막 손상 [본문으로]
63. wearable ; [Noun] 1. an item that can be worn. [본문으로]
64. behavioral ; 행동[거동]의[에 관한] ;; 미국∙영국 [bihéivjərəl] [본문으로]
65. trait ; [명사] (성격상의) 특성 [본문으로]
66. cardiac disease ; 심장병 [본문으로]
67. as with ; ~와 같이, 마찬가지로, ~이 그러하듯, ~처럼, ~하는 것에 있어서 [본문으로]
68. pitfall ; 1. (짐승을 잡는) 함정. ;; 2. (숨겨진) 덫, 책략; 도사리고 있는 위험. ;; 동의어 ; TRAP [본문으로]
69. accompany ; 2. (일・현상 등이) 동반되다[딸리다] [본문으로]
70. huckster ; (fem. -stress[-stris]) 1. 행상꾼, (야채·과일 등의) 행상인( costermonger) ;; 2. (라디오·텔레비전의) 광고업자(adman), 광고 작가 ;; 3. 돈이라면 무엇이든지 하는 사람 ;; 4. 강매하는 영업 사원 [본문으로]
71. oversight ; 2. [U] (격식) 관리, 감독 [본문으로]
72. take control of ; ~을 장악, 지배하다, 관리하다, 제어하다 [본문으로]
73. pore over ; 세세히 보다[읽다] ;; …을 자세히 조사하다[보다](=examine). [본문으로]
74. opt to ; ~하기로 선택하다 [본문으로]
75. disproportionately ; [부사] 불균형하게, 어울리지 않게. [본문으로]
76. mitigate ; [타동사][VN] (격식) 완화[경감]시키다 [본문으로]
77. incentive ; [C , U] ~ (for/to sb/sth) (to do sth) (어떤 행동을 장려하기 위한) 장려[우대]책 [본문으로]
78. insurer ; 1. (보험) 보험업자(underwriter). ;; 2. (드물게) 보증인, 인수인. [본문으로]
79. cost-efficient ; 동의어 ; COST-EFFECTIVE ;; 비용 효율[효과]이 높은 [본문으로]
80. preventive ; (또한 pre・venta・tive / prɪ|ventətɪv /) [명사 앞에만 씀] 예방[방지]을 위한 ;; 참고 ; curative [본문으로]
81. trawl ; 1. ~ (through sth) (for sth/sb) | ~ sth (for sth/sb) 대대적으로 조사하다, 샅샅이 훑다 ;; 2. [자동사][V] ~ (for sth) 저인망 어업을 하다 ;; 미국∙영국 [trɔ:l] [본문으로]
82. dweller ; 1. 거주자(inhabitant), 주민. ;; 2. [복합어로] (…에) 사는 사람[동물]. ;; 3. (장애물 목책 따위 앞에서) 망설이는 말. [본문으로]
83. Medicaid ; [U] (때로 m-) 《美》 (정부의) 저소득층 의료 보험 (제도), 메디케이드. ;; 어원 ; medical+aid [본문으로]
84. transparency ; 3. [U] (변명・거짓말 따위가) 속이 빤히 들여다보임[명백함] ;; 4. [U] (상황・주장 따위의) 명료성 [본문으로]
85. hale ; [형용사] (노인이) 기운찬, 튼튼한, 정정한. [본문으로]
86. hearty ; [형용사] 2. 원기 왕성한; 스스럼없는; 열렬한; 힘센, 강력한; 건강한, 튼튼한; [영·구어] (때로는 소란스러울 정도로) 쾌활한, 떠들어대는; 기분이 매우 좋은 ;; [명사] 정력가; 친구; (英대학)(지성·감성이 그다지 느껴지지 않는) 기운찬 학생, 스포츠맨(↔aesthete) [본문으로]
87. take out ; (비격식) ~을 죽이다[없애다] ;; to remove something from somewhere [본문으로]
88. unwell ; [형용사] 《서술용법》 편찮은, 기분[건강]이 좋지 않은; 《구어》 월경중인. ;; [명사 앞에는 안 씀] (비교적 격식) 몸이 편치 않은, 아픈 [본문으로]
89. cover ; 4. INSURANCE | [U] (美 cov・er・age) ~ (against sth) (英) (보험의) 보장 [본문으로]
90. regulation ; 1. [C] [주로 복수로] 규정 [본문으로]
91. genetic data ; [명사] 유전자 데이터[정보]. [본문으로]
92. misuse ; [U , C] [주로 단수로] 남용, 오용, 악용 [본문으로]
93. a quarter of ; ~의 4분의 1 [본문으로]
94. slapdash ; 성급하게[되는대로] 한[하는] ;; 물불을 가리지 않고, 무턱대고, 함부로; 바로, 정통으로 [본문으로]
95. outweigh ; [타동사][VN] …보다 더 크다[대단하다] [본문으로]
96. clinician ; 임상의(직접 환자를 상대하는 의사) [본문으로]
97. field ; 4. QUESTIONS | [타동사][VN] (질문・논평을) 받아넘기다[처리하다] [본문으로]
98. be no surprise ; 놀라운 일이 아니다 [본문으로]