Name: 為什麼美國農村需要遠程醫療 (Why rural America needs telehealth)
Uploaded: 2025-09-16T22:58:54.000Z
Duration: 7 min 53 s

This is a phrase physicians use when talking about a stroke.

這是醫生在談論中風時使用的一句話。

基礎被動語態

Because for every minute that passes, an estimated 14 billion synapses, the building blocks that are responsible for brain functions like learning, memory, and behavior, are lost.

因為每過一分鐘，估計就會有 140 億個突觸丟失，而這些突觸正是負責學習、記憶和行為等大腦功能的構件。

It means the longer it takes for a person to access care, the worse the outcome can be.

這意味著一個人獲得醫療服務的時間越長，結果可能就越糟糕。

In rural America, local hospitals are less likely to have specialists on staff.

在美國農村地區，當地醫院不太可能配備專科醫生。

And because of that, stroke patients in rural areas are more likely to die than stroke patients in urban settings.

正因為如此，農村地區的中風病人比城市地區的中風病人更容易死亡。

But we have the technology to change these outcomes.

但我們擁有改變這些結果的技術。

It's called Telestroke, a form of telehealth that allows a stroke specialist from anywhere to dial in, assess a patient, read brain scans and quickly prescribe life-saving drugs, or recommend a transfer.

它被稱為遠程中風（Telestroke），是遠程醫療的一種形式，可以讓任何地方的中風專家撥通電話，對病人進行評估，讀取腦部掃描結果，迅速開出救命藥方，或建議轉院。

Studies have found that it's effective at reducing mortality in rural stroke patients.

研究發現，它能有效降低農村中風患者的死亡率。

The trouble is telehealth services like this are frequently underfunded, undervalued, and underutilized.

問題是，像這樣的遠程保健服務往往資金不足、價值低估、利用率不高。

But when telehealth is used correctly, proponents say it stands a chance at radically altering mobile healthcare for the better.

但支持者認為，如果遠程醫療使用得當，將有機會從根本上改善移動醫療。

But how effective can virtual care really be?

但是，虛擬醫療的效果究竟如何呢？

This is another video we're doing about how emergency help gets to remote places.

這是我們正在製作的另一個視頻，介紹如何將緊急救援物資送往偏遠地區。

Rural areas in the U.S. often struggle to get the same services as more populated regions and we wanted to explore what some of those challenges look like and what might be done to make things better.

美國的農村地區往往難以獲得與人口較多地區相同的服務，我們希望探討其中的一些挑戰是什麼樣子的，以及如何才能讓情況變得更好。

And thanks to our sponsor, T-Mobile, for supporting this video.

感謝我們的贊助商 T-Mobile 對本視頻的支持。

T-Mobile is now the best mobile network in the U.S. according to the Ookla speed test and continues to be committed to supporting first responders and their families with exclusive savings.

根據 Ookla 速度測試，T-Mobile 現在是美國最好的移動網絡，並將繼續致力於以獨家優惠支持急救人員及其家屬。

您可以通過下面的鏈接瞭解更多資訊。

T-Mobile didn't dictate the content of this video, but their support did make our recording possible.

T-Mobile 沒有決定本視頻的內容，但他們的支持使我們的錄製成為可能。

Telehealth is less of a singular thing and more of a toolkit.

遠程保健與其說是一個單一的事物，不如說是一個工具包。

Most people think it looks like this with a doctor.

大多數人都認為醫生是這樣的。

It includes the obvious things like phone calls or video calls.

其中包括電話或視頻通話等顯而易見的內容。

But there are two other versions of telehealth that have been in use for decades.

但還有另外兩種遠程保健方式已經使用了幾十年。

Remote monitoring allows physicians to monitor patients in their everyday lives using a medical device.

遠程監控允許醫生使用醫療設備對病人的日常生活進行監控。

It was actually first developed by NASA during the space race to monitor the health of astronauts.

實際上，它最早是由美國國家航空航天局（NASA）在太空競賽期間開發的，用於監測太空人的健康狀況。

Today, this can be as simple as a blood pressure cuff equipped with Bluetooth to send real-time information to a physician.

如今，它可以像配備藍牙的血壓袖帶一樣簡單，向醫生髮送實時資訊。

There's also store and forward telemedicine.

This is when a patient might be evaluated by a nurse or doctor in one location, and then that information is sent off to a specialist in another location.

這是指病人可能在一個地方由護士或醫生進行評估，然後將資訊發送給另一個地方的專家。

This first came about in the 40s with the development of teleradiology.

這種情況最早出現在上世紀 40 年代遠程放射學的發展過程中。

The tech was extremely limited at the time.

Radiographic images were sent via telephone lines.

你可以想象，這需要一段時間。

Today, it's as simple as uploading a file like an x-ray, CT scan, or MRI.

如今，只需上傳 X 光片、CT 掃描或核磁共振成像等文件即可。

So many different models of telemedicine, but all with the same goal, connecting providers and patients when they're not in the same room.

遠程醫療有許多不同的模式，但目標都是一致的，即在醫療服務提供者和患者不在同一病房時，將他們聯繫起來。

The desire, or really need, for this kind of care spans decades.

對這種護理的渴望，或者說真正的需求，跨越了幾十年。

This article from The Lancet recounts a story from 1879.

這篇摘自《柳葉刀》的文章講述了 1879 年的一個故事。

A concerned mother phoned her family doctor in the middle of the night, convinced that her baby had croup, a respiratory infection with a distinct cough.

一位憂心忡忡的母親半夜給家庭醫生打電話，確信她的孩子得了咳嗽，這是一種伴有明顯咳嗽的呼吸道感染。

The doctor was able to listen to the phone and declare that wasn't the case.

醫生聽了電話後宣佈情況並非如此。

But more recently, we saw a massive uptick in the widespread use of telehealth, starting here, March 2020.

但最近，從 2020 年 3 月這裡開始，我們看到遠程醫療的廣泛應用有了大幅提升。

At the start of the COVID-19 pandemic, policymakers loosened restrictions on telehealth.

在 COVID-19 大流行之初，政策制定者放寬了對遠程保健的限制。

Before the pandemic, physicians had to get licensure in different states in order to treat patients, even through telemedicine, and that was lifted during the pandemic.

在大流行之前，醫生必須在不同的州獲得執照才能治療病人，即使是通過遠程醫療，而在大流行期間，這一規定被取消了。

Medicare would not cover telemedicine for a patient other than in a facility in a rural area.

除農村地區的醫療機構外，醫療保險將不支付病人的遠程醫療費用。

But by opening it up to urban facilities, to the home, we were able to scale massively.

但是，通過向城市設施和家庭開放，我們得以大規模擴展。

The pandemic is over, but there's still a healthcare crisis in rural America, and telehealth could play a huge role in closing those gaps.

大流行病已經過去，但美國農村地區仍然存在醫療危機，而遠程醫療可以在縮小這些差距方面發揮巨大作用。

There are a few key challenges for rural healthcare in the United States.

美國農村醫療面臨著一些主要挑戰。

One is the distance a patient has to travel for care.

其一是病人接受治療的路途遙遠。

Analysis from the Pew Research Center found that on average, rural Americans have to travel about twice as far to a hospital compared to those in urban or suburban areas.

皮尤研究中心（Pew Research Center）的分析發現，與城市或郊區的美國人相比，農村地區的美國人到醫院看病的平均路程要遠一倍左右。

These hospitals are serving several thousand square miles, and so, you know, people might have to drive a good amount in order to get there, and that's just not always possible.

這些醫院的服務範圍達數千平方英里，是以，你知道，人們可能需要開很長時間的車才能到達那裡，而這並不總是可能的。

Now, hospitals in rural areas are often the only healthcare, so when we're talking about distance to a hospital, we're not just talking about emergency services.

現在，農村地區的醫院往往是唯一的醫療機構，是以，當我們談論到醫院的距離時，我們談論的不僅僅是急診服務。

It's often primary care, and lab services, and even pharmaceuticals.

通常是初級保健、實驗室服務，甚至是藥品。

People tend to avoid care, they tend to not go when they need to, and that just exacerbates the issues.

人們傾向於迴避護理，在需要的時候不去護理，這隻會使問題更加嚴重。

Telehealth could mitigate this, especially in non-emergency situations.

遠程醫療可以緩解這一問題，尤其是在非緊急情況下。

For example, if a patient needs an operation, they would typically have to make multiple trips.

例如，如果病人需要做手術，通常需要多次往返。

Prior to telemedicine, they would have to drive to the pre-op center to get their screenings before anesthesia, and then go back home and then come back for their surgical procedure.

在使用遠程醫療之前，他們必須在麻醉前開車到術前中心接受檢查，然後回家，再回來進行手術。

現在，我們可以通過虛擬方式實現這一目標。

A lot of post-op physical therapy could also be handled virtually to save the patient time and money.

許多術後物理治療也可以通過虛擬方式進行，以節省患者的時間和金錢。

The second problem for rural healthcare is workforce shortages.

農村醫療保健面臨的第二個問題是勞動力短缺。

It's harder for rural areas to recruit doctors, nurses, and especially full-time specialists.

農村地區更難招聘到醫生、護士，尤其是全職專家。

We can mitigate some of those workforce shortages by using video visits, connecting the hospital with the tertiary or quaternary care hospital.

我們可以通過視頻訪問，將醫院與三級或四級護理醫院連接起來，從而緩解部分勞動力短缺問題。

Some rural areas have specialists that come in as little as twice a month.

有些農村地區的專家每月只來兩次。

Their patients can still have access to that specialist and have that relationship with that specialist.

他們的病人仍然可以看專科醫生，並與專科醫生保持聯繫。

Finally, the third main problem for rural healthcare is money.

最後，農村醫療的第三個主要問題是資金。

Small-town hospitals have very thin margins.

Many of them operate just above or even in the red.

其中許多公司的經營狀況剛剛超過甚至處於虧損狀態。

Telehealth helps keep patients in local facilities, which keeps the money there.

遠程醫療有助於將病人留在當地醫療機構，從而使資金留在當地。

Telestroke, for example, has been found to reduce hospital transfers up to 50 or even 60% in some areas.

例如，在某些地區，遠程中風可使轉院次數減少 50%，甚至 60%。

A specialist provides a treatment plan from another location, and the on-site staff can carry that out.

專家從另一個地方提供治療方案，現場工作人員可以執行。

Basically, it gives those local facilities more options to keep revenue in-house, which of course is good for the patient as well.

從根本上說，這為當地醫療機構提供了更多的選擇，使其能夠保持內部收入，當然這對病人也有好處。

As time goes on, telehealth devices are getting better and less expensive, making it more accessible for lower-income communities.

隨著時間的推移，遠程醫療設備的性能越來越好，價格越來越低，使低收入社區更容易獲得遠程醫療服務。

The ability to do telehealth has really brought healthcare to a ton more people, has helped them really identify issues earlier and treat them earlier, so they're finding healthier communities as well.

遠程醫療的能力確實為更多人帶來了醫療保健服務，幫助他們更早地發現問題，更早地進行治療，是以他們也發現了更健康的社區。

但這裡有一些重要的注意事項。

We need to do a better job of educating because not everyone in rural America understands technology.

我們需要更好地開展教育工作，因為在美國農村地區，並不是每個人都懂技術。

Which means setting up things like digital navigation training for patients.

這意味著要為患者提供數字導航培訓等服務。

Rubin and her team are also working with communities to set up private telehealth centers within community centers and libraries.

魯賓和她的團隊還與社區合作，在社區中心和圖書館內建立私人遠程保健中心。

另一個非常重要的問題是連接性。

Broadband access in rural areas is still extremely limited compared to urban areas.

與城市地區相比，農村地區的寬帶接入仍然極為有限。

Even having all the devices, even having the specialists there and ready for them 24-7 could not mean much if they can't get connectivity.

如果他們無法獲得連接，即使擁有所有設備，即使有專家全天候為他們提供服務，也沒有多大意義。

And finally, those pandemic-era bills that led to this huge leap in telehealth services are set to expire at the end of September 2025.

最後，促使遠程醫療服務實現巨大飛躍的那些大流行病時期的法案將於 2025 年 9 月底到期。

Luckily, it looks like there's bipartisan support to extend those bills.

幸運的是，兩黨似乎都支持延長這些法案的有效期。

So the goal here isn't to have telehealth replace in-person visits with a doctor.

是以，我們的目標並不是讓遠程醫療取代醫生的親診。

It's to supplement and enhance care whenever possible.

這是為了儘可能地補充和加強護理。

What I believe, quite frankly, is telemedicine isn't going to be telemedicine.

坦率地說，我認為遠程醫療將不再是遠程醫療。

It's just healthcare in the 21st century and going forward.

這只是 21 世紀和未來的醫療保健問題。

Most of the public policies are in place, not all, but we're hopeful that that will happen.

大部分公共政策已經到位，但不是全部，但我們希望能做到這一點。

It's a tool that's available to patients.

這是一個可供患者使用的工具。