Section B: Information Matching
Directions: In this section, you are going to read a passage with ten statements attached to it. Each statement contains information given in one of the paragraphs. Identify the paragraph from which the information is derived. You may choose a paragraph more than once. Each paragraph is marked with a letter. Answer the questions by marking the corresponding letter on Answer Sheet 2.
Telemedicine is transforming healthcare
[A] After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous(无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it's dramatically changing the delivery of healthcare.
[B] Doctors are linking up with patients by phone, email and webcam(网络摄像头). They're also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
[C] As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.
[D] None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy(精通技术的) consumers found that 39% hadn't heard of telemedicine, and of those who haven't used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed(补偿).
[E] What's more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
[F] Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there's the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine's future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here's a closer look at some of these issues:
[G] Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they've never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor's office, $160 at an urgent-care clinic or $750 and up at an emergency room.
[H] Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
[I] But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory(上呼吸道的) infections can't be thoroughly evaluated by a doctor who can't listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians' credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. "Telemedicine holds enormous promise, but these sites are just not ready for prime time," says Jack Resneck, the study's lead author.
[J] The American Telemedicine Association and other organizations have started accreditation(鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
[K] Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. "It's very hard to get paid unless you physically see the patient," says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed "parity"(等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor's office or clinic.
[L] Bills to expand Medicare coverage of telemedicine have bipartisan(两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
[M] Experts say more hospitals are likely to invest in telemedicine systems as they move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
[N] Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of "medical practice" makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles(麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. "If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it," says Steve Ommen, who runs Mayo's Connected Care program.
[O] To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another's licenses, as they do with drivers' licenses. But states aren't likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. "A lot of states are still trying to define telemedicine," says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
36. An overwhelming majority of family physicians are willing to use telemedicine if they are duly paid.
37. Many employers are eager to provide telemedicine service as a benefit to their employees because of its convenience.
38. Different states have markedly different regulations for telemedicine.
39. With telemedicine, patients in regions short of professional medical service are able to receive better medical care.
40. Unlike employers and health plans, insurers have been rather reluctant to pay for some telemedicine services.
41. Some supporters of telemedicine hope states will accept each other's medical practice licenses as valid.
42. The fastest growing area for telemedicine services is for lesser health problems.
43. As telemedicine spreads quickly, some of its opponents doubt whether its service quality can be guaranteed.
44. The results obtained by researchers who pretended to be patients seeking help from telemedicine providers are disturbing.
45. Some people argue that the fact that different states have different regulations concerning medical services hinders the development of telemedicine.
Answers & Explanations
36. D。解析：题干中的 An overwhelming majority of family physicians are willing to use telemedicine if they are duly paid 对应 [D] 段的 Only 15% of family physicians used it, but 90% said they would if it were appropriately reimbursed。90%（90%的医生）对应 overwhelming majority（绝大多数）；appropriately reimbursed（得到适当报销/补偿）对应 duly paid（得到应有的报酬）。
37. H。解析：题干中的 Many employers are eager to provide telemedicine service as a benefit to their employees because of its convenience 对应 [H] 段的 Employers promote them as a convenient way to get care... offer virtual doctor visits as a benefit。convenience（便利）对应 convenient way；as a benefit（作为一项福利）在文中原词重现。
38. E。解析：题干中的 Different states have markedly different regulations for telemedicine 对应 [E] 段的 Rules defining and regulating telemedicine differ widely from state to state。markedly different regulations（截然不同的规定）对应 differ widely from state to state（各州差异很大）。
39. B。解析：题干中的 patients in regions short of professional medical service are able to receive better medical care 对应 [B] 段的 Telemedicine allows for better care in places where medical expertise is hard to come by。short of professional medical service（缺乏专业医疗服务的地区）对应 medical expertise is hard to come by（很难获得医疗专业知识的地方）。
40. K。解析：题干中的 insurers have been rather reluctant to pay for some telemedicine services 对应 [K] 段的 Insurers have been far less willing to pay for telemedicine for existing patients。reluctant to pay（不情愿支付）对应 far less willing to pay（不太愿意支付）。
41. O。解析：题干中的 Some supporters of telemedicine hope states will accept each other's medical practice licenses as valid 对应 [O] 段的 Some advocates prefer states to automatically honor licenses like driver's licenses。supporters（支持者）对应 advocates（倡导者）；accept each other's medical practice licenses as valid（承认彼此的医疗执照有效）对应 automatically honor licenses（自动承认执照）。
42. G。解析：题干中的 The fastest growing area for telemedicine services is for lesser health problems 对应 [G] 段的 Fastest-growing services connect consumers with clinicians for nonemergency issues like colds, flu and rashes。lesser health problems（较轻的健康问题）对应 nonemergency issues like colds, flu and rashes（非紧急问题，如感冒、流感和皮疹）。
43. F。解析：题干中的 some of its opponents doubt whether its service quality can be guaranteed 对应 [F] 段的 Some critics question if quality of care is keeping up with rapid expansion。opponents doubt（反对者怀疑）对应 critics question（批评者质疑）；service quality can be guaranteed（服务质量得到保证）对应 quality of care is keeping up（护理质量是否跟上）。
44. I。解析：题干中的 researchers who pretended to be patients... are disturbing 对应 [I] 段的 A study with researchers posing as patients found unsettling results。pretended to be patients（假装是病人）对应 posing as patients（冒充病人）；disturbing（令人不安的）对应 unsettling results（令人不安的结果）。
45. N。解析：题干中的 different states have different regulations concerning medical services hinders the development 对应 [N] 段的 The state-by-state regulatory system is outdated. 50 different sets of rules and licensing fees is hampering growth。hinders the development（阻碍了发展）对应 hampering growth（阻碍了增长）；different regulations（不同的规定）对应 50 different sets of rules（50套不同的规则）。
全文翻译
医生通过电话和网络摄像头与患者联系。他们在一瞬间做出诊断决策，为患者开具药物、安排化验，所有这一切都无需任何身体接触。这就是远程医疗的未来图景。远程医疗——也就是通过电子通信远距离提供医疗服务和信息——自发明电话以来就以某种形式存在。但以数字技术为依托的远程医疗的兴起，正在改变医疗保健，尤其是在远程诊断和监测方面。它使医生和护士能够监控患者，比以往任何时候都更密切、更具成本效益。事实上，在美国，一些医院的系统已经在利用这些工具的潜力，并从中获益。他们看到患者满意度大增，再入院率大幅下降。在密苏里州的"Mercy虚拟医疗中心"，一个由330名医疗专业人员组成的团队通过音频、视频和聊天远程监控着数千名患者。他们能够看到最新的病例笔记、测试结果和药物清单，然后给出建议。传统上，患者可能因为没有人在他们身边而感到担忧。但在这里，人们发现，实际上由于这种连续远程监测，他们感到比以往更安全。他们有一种被持续照顾的感觉，这种感觉反而增强了他们的信任。远程医疗无疑为改善医疗服务和改革现有流程提供了机会。例如，在患者出院后的第一个月，再入院率往往很高。通过远程医疗进行适当随访，可以将这个数字降低。数字化解决方案还可以通过早期干预降低对昂贵的面对面咨询和住院治疗的需求。最大的潜在市场可能在中国，那里拥有庞大的人口和相对不足的初级医疗基础设施。当然，远程医疗也有其挑战。一些医生担心，远程医疗可能难以发现那些需要面对面检查才能发现的细微线索。但是，随着传感器和成像技术的进步，这些问题也许可以通过更好的技术来解决。人们已经呼吁当局提供足够的资金，以便在所有医疗机构推广这些创新。如果处理得当，远程医疗有可能让医疗保健变得更好、更快、更便宜。
核心搭配与高分句型
【核心搭配与高频短语】
● live up to its potential：不辜负其潜力（Telemedicine is finally living up to its potential）
● hard to come by：难以获得，难得（medical expertise is hard to come by）
● differ widely from：与...大相径庭，差异很大（Rules... differ widely from state to state）
● keep up with：跟上...的步伐（quality of care is keeping up with rapid expansion）
● pose as：冒充，假装成（researchers posing as patients）
● lag behind：落后，滞后（Medicare lags behind）
● hamper growth：阻碍增长（50 different sets of rules... is hampering growth）
【亮点句型解析】
虚拟语气 (if it were...)：
"...90% said they would if it were appropriately reimbursed."
（...90%的人表示如果能得到适当的报销，他们会使用的。）主句使用 `would`，条件句使用 `were`，表示对现在或未来的假设（当前实际报销情况并不理想）。
"...90% said they would if it were appropriately reimbursed."
（...90%的人表示如果能得到适当的报销，他们会使用的。）主句使用 `would`，条件句使用 `were`，表示对现在或未来的假设（当前实际报销情况并不理想）。
How 引导的宾语从句：
"Telemedicine's future depends on how regulators, payers and patients address these challenges."
（远程医疗的未来取决于监管机构、支付方和患者如何应对这些挑战。）`how` 引导的宾语从句作介词 `on` 的宾语，清晰地阐述了决定事物未来发展的三个主体和动作，结构紧凑且逻辑严密。
"Telemedicine's future depends on how regulators, payers and patients address these challenges."
（远程医疗的未来取决于监管机构、支付方和患者如何应对这些挑战。）`how` 引导的宾语从句作介词 `on` 的宾语，清晰地阐述了决定事物未来发展的三个主体和动作，结构紧凑且逻辑严密。