英语六级模拟及答案详解9套汇总.docx
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英语六级模拟及答案详解9套汇总.docx
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英语六级模拟及答案详解9套汇总
2011年12月预测模拟题
第一套
PartⅡReadingComprehension(SkimmingandScanning)(15minutes)
WillElectronicMedicalRecordsImproveHealthCare?
Electronichealthrecords(EHRs)havereceivedalotofattentionsincetheObamaadministrationcommitted$19billioninstimulusfundsearlierthisyeartoencouragehospitalsandhealthcarefacilitiestodigitizepatientdataandmakebetteruseofinformationtechnology.Thehealthcareindustryasawhole,however,hasbeenslowtoadoptinformationtechnologyandintegratecomputersystems,raisingthequestionofwhetherthepushtodigitizewillresultininformationthatempowersdoctorstomakebetter-informeddecisionsoramorassofdisconnecteddata.
TheUniversityofPittsburghMedicalCenter(UPMC)knowsfirsthandhowdifficultitistoachievetheformer,andhoweasilyanEHRplancanfallintothelatter.UPMChasspentfiveyearsandmorethan$1billiononinformationtechnologysystemstogetaheadoftheEHRissue.Whilethatismorethanfivetimesasmuchasrecentestimatessayitshouldcostahospitalsystem,UPMCisamammothnetworkconsistingof20hospitalsaswellas400doctors'offices,outpatientsitesandlong-termcarefacilitiesemployingabout50,000people.
UPMC'searlyattemptstocreateauniversalEHRsystem,suchasitsambulatoryelectronicmedicalrecordsrolledoutbetween2000and2005,weremetwithresistanceasdoctors,staffandotheruserseitheravoidedusingthenewtechnologyaltogetherorclungtoindividual,disconnectedsoftwareandsystemsthatUPMC'sITdepartmenthadimplementedovertheyears.
Onthemend
AlthoughUPMCbegandigitizingsomeofitsrecordsin1996,theturningpointinitseffortscamein2004withtherolloutofitseRecordsystemacrosstheentirehealthcarenetwork.eRecordnowcontainsmorethan3.6millionelectronicpatientrecords,includingimagesandCTscans,clinicallaboratoryinformation,radiologydata,andapicturearchivalandcommunicationsystemthatdigitizesimagesandmakesthemavailableonPCs.TheEHRsystemhas29,000users,includingmorethan5,000physiciansemployedbyoraffiliatedwithUPMC.
IfUPMCmakesEHRsystemslookeasy,don'tbefooled,cautionsUPMCchiefmedicalinformationofficerDanMartich,whosaysthehealthcarenetwork'sITsystemsrequirea"huge,ongoingeffort"toensurethatthosesystemscancommunicatewithoneanother.OneofthemainreasonsisthatUPMC,likemanyotherhealthcareorganizations,usesanumberofdifferentvendorsforitsmedicalandITsystems,leavingtheintegrationlargelyuptotheITstaff.
Sincedoctorstypicallydonotwanttochangethewaytheyworkforthesakeofacomputersystem,thesuccessofanEHRprogramisdictatednotonlybythepresenceofthetechnologybutalsobyhowwellthedoctorsaretrainedon,anduse,thetechnology.PhysiciansneedtoseethebenefitsofusingEHRsystemsbothpersistentlyandconsistently,saysLouisBaverso,chiefinformationofficeratUPMC'sMagee-Women'sHospital.Butthesebenefitsmightnotbeobviousatfirst,hesays,adding,"Whatdoctorsseeinthebeginningisthatthey'relosingtheirabilitytoworkwithpaperdocuments,whichhasbeensovaluabletothemupuntilnow."
Opportunitiesandcosts
GiventhelackofEHRadoptionthroughoutthehealthcareworld,therearealotofopportunitiestogetthisright(orwrong).Lessthan10percentofU.S.hospitalshaveadoptedelectronicmedicalrecordseveninthemostbasicway,accordingtoastudyauthoredbyAshishJha,associateprofessorofhealthpolicyandmanagementatHarvardSchoolofPublicHealth.Only1.5percenthaveadoptedacomprehensivesystemofelectronicrecordsthatincludesphysicians'notesandordersanddecisionsupportsystemsthatalertdoctorsofpotentialdruginteractionsorotherproblemsthatmightresultfromtheirintendedorders.
CostistheprimaryfactorstallingEHRsystems,followedbyresistancefromphysiciansunwillingtoadoptnewtechnologiesandalackofstaffwithadequateITexpertise,accordingtoJha.Heindicatedthatahospitalcouldspendfrom$20millionto$200milliontoimplementanelectronicrecordsystemoverseveralyears,dependingonthesizeofthehospital.Atypicaldoctor'sofficewouldcostanestimated$50,000tooutfitwithanEHRsystem.
TheupsideofEHRsystemsismoredifficulttoquantify.Althoughsomeestimatessaythathospitalsanddoctor'sofficescouldsaveasmuchas$100millionannuallybymovingtoEHRs,themereactofimplementingthetechnologyguaranteesneithercostsavingsnorimprovementsincare,JhasaidduringaHarvardSchoolofPublicHealthcommunityforumonSeptember17.AnotherHarvardstudyofhospitalcomputerizationlikewisedeterminedthatcuttingcostsandimprovingcarethroughhealthITasitexiststodayis"wishfulthinking".ThisstudywasledbyDavidHimmelstein,associateprofessoratHarvardMedicalSchool.
Thecostofgettingitwrong
ThedifferencebetweentheprojectedcostsavingsandtherealityofthesituationstemsfromthefactthattheEHRtechnologiesimplementedtodatehavenotbeendesignedtosavemoneyorimprovepatientcare,saysLeonardD'Avolio,associatecenterdirectorofBiomedicalInformaticsattheMassachusettsVeteransEpidemiologyResearchandInformationCenter(MAVERIC).Instead,EHRsareusedtodocumentindividualpatients'conditions,passthisinformationamongclinicianstreatingthosepatients,justifyfinancialreimbursementandserveasthelegalrecordsofevents.
Thisisbecause,ifahealthcarefacilityhas$1milliontospend,itsmanagersaremorelikelytospenditonanexpensivepieceoflabequipmentthanoninformationtechnology,D'Avoliosays,addingthattheinvestmentonlabequipmentcanbemadeupbychargingpatientsaccesstoitasabillableservice.ThisisnotthecaseforIT.Also,computersandnetworksusedthroughouthospitalsandhealthcarefacilitiesaredisconnectedandoftenmanufacturedbydifferentvendorswithoutastandardizedwayofcommunicating."Medicaldataisdifficulttostandardizebecausecaringforpatientsisacomplexprocess,"hesays."Weneedtofindsomewayofreachingacrossnotjustdepartmentsbutentirehospitals.Ifyoucan'tmeasuresomething,youcan'timproveit,andwithoutaccesstothisdata,youcan'tmeasureit."
Toqualifyforapieceofthe$19billionbeingofferedthroughtheAmericanRecoveryandReinvestmentAct(ARRA),healthcarefacilitieswillhavetojustifythesignificanceoftheirITinvestmentstoensuretheyare"meaningfulusers"ofEHRs.TheDepartmentofHealthandHumanServiceshasyettodefinewhatitconsidersmeaningfuluse
Aggregatinginfotocreateknowledge
Ideally,inadditiontoprovidingdoctorswithbasicinformationabouttheirpatients,databasesofvitalsigns,images,laboratoryvalues,medications,diseases,interventions,andpatientdemographicinformationcouldbeminedfornewknowledge,D'Avoliosays."Withjustafewofthesedatabasesnetworkedtogether,thepowertoimprovehealthcareincreasesexponentially,"D'Avoliosuggested."Allthatismissingisthecollectiverealizationthatbetterhealthcarerequiresaccesstobetterinformation—notautomationofthestatusquo."Downtheroad,theadditionofgenomicinformation,environmentalfactorsandfamilyhistorytothesedatabaseswillenableclinicianstobegintorealizethepotentialofpersonalizedmedicine,headded.
1.InAmerica,itisslowtoadoptinformationtechnologybecause—————.
A)thefundsinvestedbythegovernmentisnotenoughinthepast
B)EHRshavereceivedlessattentionofthepublicinthepast
C)whetheritwillbeusefultodoctorsornotisdoubtful
D)UPMCknowshowdifficultitistodigitizethehospital
2.TheUniversityofPittsburghMedicalCenter(UPMC)—————.
A)isthefirstmedicalcentertoadoptinformationtechnology
B)satisfytherequirementofthegovernmentoninformationtechnology
C)spentlessmoneyoninformationtechnologythanitwasestimated
D)attemptedtocreatedauniversalEHRsystem,butmetsomedifficulties
3.Thehealthcarenetwork’sITsystemsrequirealotofefforttoensureitcancommunicatewithoneanothermainlybecause—————..
A)theintegrationamongdifferentsystemislargelyuptotheITstaff
B)UPMCislikemanyotherhealthcareorganizationsintheUnitedStates
C)UPMCmakesEHRsystemslookeasy
D)UMPCbegandigitizingsomeofitsrecordsin1996
4.ThesuccessoftheEHRprogramisdecidedby—————..
A)thefactwhethertheinformationtechnologyisavailableornot
B)thefacthowwellthedoctorsaretrainedtousetheinformationtechnology
C)notonlythepresenceofthetechnologybutthedoctor’strainingontechnology
D)thefactwhetherphysicianscanseethebenefitsofusingEHRsystems
5.ThemostimportantreasonofmosthospitalsbeingreluctanttoadoptEHRsystemisthat—————.
A)thecostistoohighforthehospitaltoafford
B)physiciansareunwillingtoadoptit
C)thereisalackofstaffwithadequateITexpertise
D)doctorworryaboutitsnegativeinfluenceonpatients
6.AccordingtothestudyledbyDavidHimmelsteinthroughhealthIT—————.
A)itispossibletocutthecostsofthehospital
B)itispossibletoimprovethehealthcare
C)itensureneithercostsavingnorimprovementincare
D)itcouldsaveasmuchas$100millionannually
7.Thehospital’smanagerspreferto—————.
A)spendmoneyonanexpensivepieceofequipmentthanoninformationtechnology
B)chargepatientsaccesstotheinformationtechnologyasabillableservice
C)purchasetheinformationtechnologytoimprovethehealthcareofthehospital
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