Part ⅡReading Comprehension (Skimming and Scanning) (15 minutes)

　　Directions: In this part, you will have 15 minutes to go over the passage quickly and answer the questions on Answer Sheet 1. For questions 1-7, choose the best answer from the four choices marked A), B), C) and D). For questions 8-10, complete the sentences with the information given in the passage.

　　Will Electronic Medical Records Improve Health Care?

　　Electronic health records (EHRs) have received a lot of attention since the Obama administration committed $19 billion in stimulus funds earlier this year to encourage hospitals and health care facilities to digitize patient data and make better use of information technology. The healthcare industry as a whole, however, has been slow to adopt information technology and integrate computer systems, raising the question of whether the push to digitize will result in information that empowers doctors to make better-informed decisions or a morass of disconnected data.

　　The University of Pittsburgh Medical Center (UPMC) knows firsthand how difficult it is to achieve the former, and how easily an EHR plan can fall into the latter. UPMC has spent five years and more than $1 billion on information technology systems to get ahead of the EHR issue. While that is more than five times as much as recent estimates say it should cost a hospital system, UPMC is a mammoth network consisting of 20 hospitals as well as 400 doctors' offices, outpatient sites and long-term care facilities employing about 50,000 people.

　　UPMC's early attempts to create a universal EHR system, such as its ambulatory electronic medical records rolled out between 2000 and 2005, were met with resistance as doctors, staff and other users either avoided using the new technology altogether or clung to individual, disconnected software and systems that UPMC's IT department had implemented over the years.

　　On the mend

　　Although UPMC began digitizing some of its records in 1996, the turning point in its efforts came in 2004 with the rollout of its eRecord system across the entire health care network. eRecord now contains more than 3.6 million electronic patient records, including images and CT scans, clinical laboratory information, radiology data, and a picture archival and communication system that digitizes images and makes them available on PCs. The EHR system has 29,000 users, including more than 5,000 physicians employed by or affiliated with UPMC.

　　If UPMC makes EHR systems look easy, don't be fooled, cautions UPMC chief medical information officer Dan Martich, who says the health care network's IT systems require a "huge, ongoing effort" to ensure that those systems can communicate with one another. One of the main reasons is that UPMC, like many other health care organizations, uses a number of different vendors for its medical and IT systems, leaving the integration largely up to the IT staff.

　　Since doctors typically do not want to change the way they work for the sake of a computer system, the success of an EHR program is dictated not only by the presence of the technology but also by how well the doctors are trained on, and use, the technology. Physicians need to see the benefits of using EHR systems both persistently and consistently, says Louis Baverso, chief information officer at UPMC's Magee-Women's Hospital. But these benefits might not be obvious at first, he says, adding, "What doctors see in the beginning is that they're losing their ability to work with paper documents, which has been so valuable to them up until now."

　　Opportunities and costs

　　Given the lack of EHR adoption throughout the health care world, there are a lot of opportunities to get this right (or wrong). Less than 10 percent of U.S. hospitals have adopted electronic medical records even in the most basic way, according to a study authored by Ashish Jha, associate professor of health policy and management at Harvard School of Public Health. Only 1.5 percent have adopted a comprehensive system of electronic records that includes physicians' notes and orders and decision support systems that alert doctors of potential drug interactions or other problems that might result from their intended orders.

　　Cost is the primary factor stalling EHR systems, followed by resistance from physicians unwilling to adopt new technologies and a lack of staff with adequate IT expertise, according to Jha. He indicated that a hospital could spend from $20 million to $200 million to implement an electronic record system over several years, depending on the size of the hospital. A typical doctor's office would cost an estimated $50,000 to outfit with an EHR system.

　　The upside of EHR systems is more difficult to quantify. Although some estimates say that hospitals and doctor's offices could save as much as $100 million annually by moving to EHRs, the mere act of implementing the technology guarantees neither cost savings nor improvements in care, Jha said during a Harvard School of Public Health community forum on September 17. Another Harvard study of hospital computerization likewise determined that cutting costs and improving care through health IT as it exists today is "wishful thinking". This study was led by David Himmelstein, associate professor at Harvard Medical School.

　　The cost of getting it wrong

　　The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D'Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients' conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.

　　This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D'Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can't measure something, you can't improve it, and without access to this data, you can't measure it."

　　To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use

　　Aggregating info to create knowledge

　　Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D'Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D'Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.

　　1. In America, it is slow to adopt information technology because —————.

　　A) the funds invested by the government is not enough in the past

　　B) EHRs have received less attention of the public in the past

　　C) whether it will be useful to doctors or not is doubtful

　　D) UPMC knows how difficult it is to digitize the hospital

　　2. The University of Pittsburgh Medical Center (UPMC) —————.

　　A) is the first medical center to adopt information technology

　　B) satisfy the requirement of the government on information technology

　　C) spent less money on information technology than it was estimated

　　D) attempted to created a universal EHR system, but met some difficulties

　　3. The health care network’s IT systems require a lot of effort to ensure it can communicate with one another mainly because —————..

　　A) the integration among different system is largely up to the IT staff

　　B) UPMC is like many other health care organizations in the United States

　　C) UPMC makes EHR systems look easy

　　D) UMPC began digitizing some of its records in 1996

　　4. The success of the EHR program is decided by —————..

　　A) the fact whether the information technology is available or not

　　B) the fact how well the doctors are trained to use the information technology

　　C) not only the presence of the technology but the doctor’s training on technology

　　D) the fact whether physicians can see the benefits of using EHR systems

　　5. The most important reason of most hospitals being reluctant to adopt EHR system is that —————.

　　A) the cost is too high for the hospital to afford

　　B) physicians are unwilling to adopt it

　　C) there is a lack of staff with adequate IT expertise

　　D) doctor worry about its negative influence on patients

　　6. According to the study led by David Himmelstein through health IT —————.

　　A) it is possible to cut the costs of the hospital

　　B) it is possible to improve the health care

　　C) it ensure neither cost saving nor improvement in care

　　D) it could save as much as $100 million annually

　　7. The hospital’s managers prefer to —————.

　　A) spend money on an expensive piece of equipment than on information technology

　　B) charge patients access to the information technology as a billable service

　　C) purchase the information technology to improve the health care of the hospital

　　D) invest more money on the training of the physicians to charge patients more money

　　8. Jha said the mere act of implementing the technology guarantees ______________________.

　　9. D'Avolio says the investment on lab equipment can be made up by_____________________.

　　10. Databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be ____________________.

　　Part II Reading Comprehension (Skimming and Scanning)

　　原文精譯

　　【1】給自己的事業(yè)買最好的保險

　　消防隊無意之中淹沒了Mad Gab's的總部，Mad Gab's是Gabrielle Melchionda二十多年前建立的美容公司。盡管Melchionda知道，保險公司會替她換掉損壞的桌椅、電腦以及唇膏架子，但她仍淚流滿面。然而，讓她吃驚的是，隨后幾個月，才是真正的痛苦，她一直虧欠工資和租金，銷售額慢的像涓涓細流。

　　【2】Melchionda女士說，“沒有投保最重要的企業(yè)停頓保險”。她已經投保了財產險和責任險，卻從沒有想到多買一張保單，以承擔事故之后的收入損失。

　　企業(yè)主們有很多類似Melchionda女士的經歷。他們的很多保單要么不足以涵蓋所有損失，要么投保了錯誤的風險。關于保險的怨言，有些可以歸咎于吝嗇的保險公司或信息有誤的代理人，更多卻是因為企業(yè)家自己的保險決策不夠全面。

　　獨立的保險代理人Steven Spiro說，“一般來講，干小生意的人并不太清楚他們擁有或需要的保險范圍”。他解釋，這些人買保險只是為了遵守辦公室租賃條約的要求。

　　選擇代理人

　　【3】買保險可能讓人膽怯，很難知道哪些人是想利用你，哪些人是給你忠告。所以你應該咨詢同行的企業(yè)家們，他們購買了何種保險以及是向誰購買的。有三類人可以幫你選擇保險：獨立代理人，專屬代理人，風險咨詢師。

　　獨立代理人，別稱“經紀人”，因為他們代表很多家保險公司，所以可以提供很好的選擇。保險公司付他們傭金，一般是一張保單每年保險費的10%到20%。注意：由于某些保險公司付給更多傭金，這些經紀人可能受到誘惑，會有私心和偏愛。

　　專屬代理人代表某一家保險公司，從該保險公司領取薪水，并對其絕對忠誠。一些諸如Allstate的公司只和自己的代理人打交道;也就是說，你只能通過該家保險公司的代理人來購買此公司的保險。

　　每年年末，按照賣出去的保險和賠償損失之間的比率，獨立代理人和專屬代理人都可拿到獎金。這意味著，賣給你盡可能多的保險，而最小化你的索賠，是符合他們利益的。

　　也要理解，大部分代理人只注意保險。美國保險研究所主要從事小本生意研究的專家Arthur Flitner說，“有時候，沒有保險，你的問題反而可能處理的更好�！北热缯f，建立基金以備不時之需，自己為自己投保來應對某些財產風險;或執(zhí)行嚴格的雇傭政策，減少訴訟風險，從經濟角度來看，這些更有意義。

　　這時就需要風險咨詢師的幫助了。他們收費很高，一個簡單的項目就要花費幾千美元�！�4】如果你的運作有很大風險，如果你的公司一年收入2500萬美元，如果你的公司有100多名員工，這時候雇傭風險專家，才有意義。

　　找到了可信的代理人，接下來就要買保險了。你想去找多少個代理人都可以，但是需要記住：同樣的保險項目，保險公司不會尋找不同的代理人。

　　選擇保單

　　如果公司總值低于300萬美元，你很有可能需要被稱為B.O.P.的業(yè)主保單，它把業(yè)務保單集中在一起，還讓你增添必要的保單。每個保險公司的B.O.P.都不一樣，購買的時候，要確保自己進行了精確的比較。

　　如果公司總值高于300萬美元，你可能必須分開購買保險。如果公司有幾十名員工，做生意不得不買的保單有四個：

　　【5】員工賠償保險是州法律要求的，它涵蓋員工的醫(yī)療費用、殘疾人士福利金和死亡賠償，【6】保險比率因行業(yè)和職業(yè)不同相差甚遠。秘書的保險費可能是，每100美元工資給付22美分，而蓋頂工可能是，每100美元給付20多美元。確保你的生意分類正確，不要把玩具廠(制造業(yè)被認為是高風險的)誤歸為設計公司(低風險)。雇員填寫索賠表格時，保險公司會認為，你的公司是一個風險系數比較高的設計公司，從而提高保險費。

　　【8】財產保險包括房產和辦公室里的設備。所在建筑的年齡大小，距離消防隊的遠近，建筑材料是鋼鐵還是木材，都會使保險比率大有不同。

　　要注意共同保險條款，如果保險公司認為投保金額不足，這個條款允許保險公司只賠償部分損失。讓代理人加上“協定保險價額 ”，你和保險公司認同一個合適的保險價值。這可能讓保險費提高15%，卻減少了隨后的爭端。

　　一般責任保險涵蓋公司對他人健康、財產或名譽帶來的傷害損失。一般來說，保險費的比率要考慮以下因素：收入，辦公室規(guī)模，客戶數量。大多數的基本成套保險，是每次危險保100萬美元;而傘狀保單以相對低的價格涵蓋更大范圍。

　　【9】如果可能，一定買比較貴的“發(fā)生”保單，它在事故發(fā)生當時就給你賠償，哪怕你已停業(yè)或保單已過期�！八髻r”保單與此相反，它只有在你受保期間索賠才有效。

　　【10】企業(yè)停頓保險——Melchionda女士本該買的保險，它不僅賠償事故之后房子重建期間的銷售損失、房租、工資損失;還出錢幫你租賃臨時辦公室或設備，這樣你可以盡快的回到軌道上去。

　　這些保單僅僅是投保的開始。根據你經營的生意種類，還可增加其他幾十個保單。像醫(yī)生、醫(yī)院的醫(yī)療過失保險，這些非常重要;而另一些純粹是浪費。想要決定你需要哪些保險，可以先問自己兩個問題：你承受損失的可能性有多大，你自己可以賠償所有損失嗎?正如專家指出的那樣，保險旨在賠償大災難，而不是日常維護。

　　【7】公共調解員George Von York說，“這是場賭博”。他幫助業(yè)主和保險公司談判，以期獲得更多賠償。“大部分人一輩子也沒有得到實在的賠償。但是，孩子，在你需要時，最好還是有保險。”

　　1. 答案 A

　　解析：本題考查考生對整篇文章大意的掌握。本篇快速閱讀的標題為“為自己的公司買最好的保險”，暗示文章內容圍繞著如何買保險而展開的。選項A是標題的同義表述，而B、C、D僅僅涉及了買保險過程中的某一個因素。

　　2. 答案D

　　解析：題干中的人名Gabrielle Melchionda出現在文章一開始。文章開頭講述Melchionda女士的遭遇。因為沒有�！捌髽I(yè)停頓保險”，Melchionda女士蒙受了損失，感到痛苦。答案D是正確選項。

　　3. 答案B

　　解析：題干中in that相當于連詞because，表示原因�？碱}考查買保險為什么讓人感到害怕�？忌�可定位在文章的第五段，文章提及有些是忠告，有些卻是在利用投保人，而這之間很難分辨。選項B是對此句話的總結。

　　4. 答案C

　　解析：考題考查在特定的情況下，投保人應該如何做。考生可根據題干中“如果你的運作有很大風險”，將答案定位在第一個小標題picking an agent的最后兩段，文章講到，此時你需要雇風險咨詢師，所以選項C是正確答案。

　　5. 答案A

　　解析：考題問到，州法律要求的保險是什么?第二個小標題picking a policy下面的第三段中講“員工賠償保險是州法律要求”，所以選項A是正確答案。

　　6. 答案D

　　解析：根據題干中的“worker's compensation”，考生可繼續(xù)鎖定第二個小標題下的第三段，原文中講“Rates vary widely by industry and occupation”，其中vary意為“不同，變動”，和選項D中的be different同義。

　　7. 答案B

　　解析：根據題干中的人名George Von York，考生可鎖定文章的最后一段，George Von York認為保險就是一場賭博，一輩子可能用不到，可是又不能沒有，如果有可能，你還是需要買保險。從中可以看出George Von York的態(tài)度，他是建議人們買保險的，而選項C是個干擾項，他并不是向投保人收費很高，而是幫助投保人獲得更高的索賠。

　　8. 答案equipment in your office

　　解析：根據題干，考生可找到第二個小標題picking a policy下面的第四段，它講到財產保險涵蓋的方面。

　　9. 答案available

　　解析：根據題干，考生可鎖定第二個小標題picking a policy下面的第七段，原文講到買這種保險的條件。

　　10. 答案a temporary office or equipment

　　解析：根據題干中的business interruption insurance，考生可鎖定第二個小標題picking a policy下面的第八段，文中提及“企業(yè)停頓保險”的承保內容。

　　Part II Reading Comprehension (Skimming and Scanning)

　　原文精譯

　　【1】給自己的事業(yè)買最好的保險

　　消防隊無意之中淹沒了Mad Gab's的總部，Mad Gab's是Gabrielle Melchionda二十多年前建立的美容公司。盡管Melchionda知道，保險公司會替她換掉損壞的桌椅、電腦以及唇膏架子，但她仍淚流滿面。然而，讓她吃驚的是，隨后幾個月，才是真正的痛苦，她一直虧欠工資和租金，銷售額慢的像涓涓細流。

　　【2】Melchionda女士說，“沒有投保最重要的企業(yè)停頓保險”。她已經投保了財產險和責任險，卻從沒有想到多買一張保單，以承擔事故之后的收入損失。

　　企業(yè)主們有很多類似Melchionda女士的經歷。他們的很多保單要么不足以涵蓋所有損失，要么投保了錯誤的風險。關于保險的怨言，有些可以歸咎于吝嗇的保險公司或信息有誤的代理人，更多卻是因為企業(yè)家自己的保險決策不夠全面。

　　獨立的保險代理人Steven Spiro說，“一般來講，干小生意的人并不太清楚他們擁有或需要的保險范圍”。他解釋，這些人買保險只是為了遵守辦公室租賃條約的要求。

　　選擇代理人

　　【3】買保險可能讓人膽怯，很難知道哪些人是想利用你，哪些人是給你忠告。所以你應該咨詢同行的企業(yè)家們，他們購買了何種保險以及是向誰購買的。有三類人可以幫你選擇保險：獨立代理人，專屬代理人，風險咨詢師。

　　獨立代理人，別稱“經紀人”，因為他們代表很多家保險公司，所以可以提供很好的選擇。保險公司付他們傭金，一般是一張保單每年保險費的10%到20%。注意：由于某些保險公司付給更多傭金，這些經紀人可能受到誘惑，會有私心和偏愛。

　　專屬代理人代表某一家保險公司，從該保險公司領取薪水，并對其絕對忠誠。一些諸如Allstate的公司只和自己的代理人打交道;也就是說，你只能通過該家保險公司的代理人來購買此公司的保險。

　　每年年末，按照賣出去的保險和賠償損失之間的比率，獨立代理人和專屬代理人都可拿到獎金。這意味著，賣給你盡可能多的保險，而最小化你的索賠，是符合他們利益的。

　　也要理解，大部分代理人只注意保險。美國保險研究所主要從事小本生意研究的專家Arthur Flitner說，“有時候，沒有保險，你的問題反而可能處理的更好�！北热缯f，建立基金以備不時之需，自己為自己投保來應對某些財產風險;或執(zhí)行嚴格的雇傭政策，減少訴訟風險，從經濟角度來看，這些更有意義。

　　這時就需要風險咨詢師的幫助了。他們收費很高，一個簡單的項目就要花費幾千美元�！�4】如果你的運作有很大風險，如果你的公司一年收入2500萬美元，如果你的公司有100多名員工，這時候雇傭風險專家，才有意義。

　　找到了可信的代理人，接下來就要買保險了。你想去找多少個代理人都可以，但是需要記�。和瑯拥谋ｋU項目，保險公司不會尋找不同的代理人。

　　選擇保單

　　如果公司總值低于300萬美元，你很有可能需要被稱為B.O.P.的業(yè)主保單，它把業(yè)務保單集中在一起，還讓你增添必要的保單。每個保險公司的B.O.P.都不一樣，購買的時候，要確保自己進行了精確的比較。

　　如果公司總值高于300萬美元，你可能必須分開購買保險。如果公司有幾十名員工，做生意不得不買的保單有四個：

　　【5】員工賠償保險是州法律要求的，它涵蓋員工的醫(yī)療費用、殘疾人士福利金和死亡賠償，【6】保險比率因行業(yè)和職業(yè)不同相差甚遠。秘書的保險費可能是，每100美元工資給付22美分，而蓋頂工可能是，每100美元給付20多美元。確保你的生意分類正確，不要把玩具廠(制造業(yè)被認為是高風險的)誤歸為設計公司(低風險)。雇員填寫索賠表格時，保險公司會認為，你的公司是一個風險系數比較高的設計公司，從而提高保險費。

　　【8】財產保險包括房產和辦公室里的設備。所在建筑的年齡大小，距離消防隊的遠近，建筑材料是鋼鐵還是木材，都會使保險比率大有不同。

　　要注意共同保險條款，如果保險公司認為投保金額不足，這個條款允許保險公司只賠償部分損失。讓代理人加上“協定保險價額 ”，你和保險公司認同一個合適的保險價值。這可能讓保險費提高15%，卻減少了隨后的爭端。

　　一般責任保險涵蓋公司對他人健康、財產或名譽帶來的傷害損失。一般來說，保險費的比率要考慮以下因素：收入，辦公室規(guī)模，客戶數量。大多數的基本成套保險，是每次危險保100萬美元;而傘狀保單以相對低的價格涵蓋更大范圍。

　　【9】如果可能，一定買比較貴的“發(fā)生”保單，它在事故發(fā)生當時就給你賠償，哪怕你已停業(yè)或保單已過期。“索賠”保單與此相反，它只有在你受保期間索賠才有效。

　　【10】企業(yè)停頓保險——Melchionda女士本該買的保險，它不僅賠償事故之后房子重建期間的銷售損失、房租、工資損失;還出錢幫你租賃臨時辦公室或設備，這樣你可以盡快的回到軌道上去。

　　這些保單僅僅是投保的開始。根據你經營的生意種類，還可增加其他幾十個保單。像醫(yī)生、醫(yī)院的醫(yī)療過失保險，這些非常重要;而另一些純粹是浪費。想要決定你需要哪些保險，可以先問自己兩個問題：你承受損失的可能性有多大，你自己可以賠償所有損失嗎?正如專家指出的那樣，保險旨在賠償大災難，而不是日常維護。

　　【7】公共調解員George Von York說，“這是場賭博”。他幫助業(yè)主和保險公司談判，以期獲得更多賠償�！按蟛糠秩艘惠呑右矝]有得到實在的賠償。但是，孩子，在你需要時，最好還是有保險�！�

關注"566四六級"微信，獲取作文預測、真題、內部資料等信息！

英語四六級題庫【手機題庫下載】 | 微信搜索"566四六級"

　　相關推薦：

　　2015年大學英語四六級考試流程及新題型

　　歷年大學英語六級作文真題及參考范文匯總

　　2000-2015年6月英語六級聽力下載(原文+MP3)

　　2011-2015英語六級真題及答案|解析|估分|下載

　　考試吧考后首發(fā)2015年12月英語四六級真題及答案