IBM's Watson Could Be Healthcare Game Changer - InformationWeek
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IBM's Watson Could Be Healthcare Game Changer

IBM's cognitive computing technology moves past Jeopardy and into serious healthcare challenges, including cancer treatment. IBM's rivals seem stuck on more prosaic problems.

On the payer side of health care, IBM partnered with WellPoint, one of the largest U.S. health insurance networks, operating in 14 states and covering one in nine Americans. This collaboration yielded the other two apps, WellPoint Interactive Care Guide and Interactive Care Reviewer, which are designed to help payers and providers, respectively, to quickly review claims and pre-authorizations and either approve or flag treatments as either appropriate or out-of-step with the latest, evidence-based treatment options.

WellPoint has trained the apps on 25,000 test-case scenarios and 1,500 live cases as part of a pilot project, and they are now in a learning mode. The Interactive Care Reviewer is being used by a handful of selected providers in the Midwest, and WellPoint expects 1,600 to be up and running on the application by year end. The key benefit is expected to be faster review times for pre-authorizations, moving away from faxes and phone calls to evidence-based decisions.

Of course other vendors, including business rules and analytics vendors, have been working on better, faster and more reliable healthcare utilization and adjudication apps, but Watson stands apart from systems that rely on rules and decision trees, according to IBM. "Those systems tend to be brittle and static, so it's hard to constantly learn from new clinical trials and research," said Stephen Gold, worldwide director of marketing for IBM Watson, in an interview with InformationWeek. "Those tools also tend to be deterministic, which means they try to get to 'yes' or 'no,' whereas Watson is probabilistic, so it gives you a degree of confidence in various choices based on the specific circumstances of the patient."

It remains to be seen whether the Watson-based apps have an edge over analytics-based applications, from vendors such as SAS, or blended rules-and-analytics systems, such as those from Pegasystems. Healthcare is a $2 trillion industry worldwide, so it has attracted plenty of vendors to work on tough problems.

Watson stands on the shoulders of earlier achievements, including search technologies like Google and language-processing technologies such as Apple's Siri. "But you can't ask Google, 'What is the appropriate initial dosage of antibiotic for a 7-year-old child with a history of asthma?'" said Saxena. At least you can't and expect something more concise than a jumble of thousands of hits. The top search results might be on the right track, but the Watson applications are designed to deliver concise, evidence-based advice, such as, "two teaspoons, 80% confidence; one-and-half teaspoons, 45% confidence" accompanied by citations and links to supporting research. "It's a deep, semantic question that has to be supported not just by keywords, but by actual medical evidence," Saxena said.

To apply Watson to an industry-specific problem, IBM has over the last two years streamlined the code and focused the body of knowledge the technology has to work with. To play Jeopardy, Watson had to train on a smorgasbord of information ranging from history, literature and science to politics, the arts and pop culture. Instead of learning a broad range of idioms, slang and regional dialects, the technology had to target domain-specific jargon such as that used in the medical profession. As a result, the conference-room sized Watson that played Jeopardy has been shrunk down to a single server that can be scaled out on racks, according to IBM. The applications can be delivered as a cloud-based service, which is how The Maine Center for Cancer Medicine & Blood Disorders plans to use the Interactive Care Insights for Oncology app.

"Our state has real problems with access to care, particularly in its rural areas," said Tracey Weisberg, medical oncology president at the center. "This will enable us to provide comprehensive, evidence-based treatment we could have only dreamed of in the past, yet our patients won't have to leave the state and travel to a big-city hospital."

The release of three Watson applications doesn't guarantee success, but WellPoint executives said its nurses reviewing patient-care cases are already seeing 90% accuracy rates on the treatments advised by the Interactive Care Guide and Interactive Care Reviewer apps. Given the increasing number of new medical treatments and technologies, the complexity of managing multiple chronic diseases and the growing personalization of treatments and diagnostics, the challenge is to soak all that information in, retain it and "deliver practical evidence that clinicians and patients can follow," said Dr. Samuel Nussbaum, WellPoint's Chief Medical Officer. "That's something Watson can address, and it will revolutionize the quality of care."

IBM has its problems like many tech companies, including high-profile legal battles, low-margin businesses needing restructuring, and mature businesses facing long-term decline. But when it comes to efforts such as Watson, which is now the IBM Software Group's single largest investment, you have to acknowledge that the company is operating on a higher level, setting more audacious goals than any company in IT.

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D. Henschen
D. Henschen,
User Rank: Author
2/11/2013 | 7:48:14 PM
re: IBM's Watson Could Be Healthcare Game Changer
The subtext here is that IBM's top exec thought ahead and made tough calls like selling off the printer business, the hard drive business and the PC business back when those were much tougher calls to make. Investments in Watson began in 2006, and there was no promise of an imminent payoff. In fact, they still have a long way to go, but this is about laying the groundwork for the IT business of 2020 and beyond. That took vision and courage.
J. Nicholas Hoover
J. Nicholas Hoover,
User Rank: Apprentice
2/11/2013 | 8:48:44 PM
re: IBM's Watson Could Be Healthcare Game Changer
I'm also impressed by the dedication IBM has shown in placing Watson technologies onto commercial servers. This type of technology has application far beyond the healthcare arena, and we're on pace to see the impacts in a short time period.
User Rank: Strategist
2/11/2013 | 10:25:33 PM
re: IBM's Watson Could Be Healthcare Game Changer
Health care is one of the places where a rules-based engine in many cases can sift through well defined patient symptons and come up with a well-defined answer. This is a great place to use computing power to make a preliminary or first diagnosis. In cancer cases, Watson is moving beyond that level to a deeper diagnostic capability. Obviously doctors will have to review its conclusions as a safety check and amend them or intervene in cases where Watson is struggling -- cases that do not fit into known patterns. But humans around the globe share a great similarity of symptons to known diseases and Dr. Watson will be right in many, many cases, given his relentless, machine-command of medical information sources. Charlie Babcock, InformationWeek
David Berlind
David Berlind,
User Rank: Apprentice
2/13/2013 | 6:36:18 PM
re: IBM's Watson Could Be Healthcare Game Changer
The healthcare and pharmaceutical industries have a history of weighing efficacy against cost. Based on what I'm reading in this article, it seems like the efficacy of having a Watson-like interlocutor involved in better healthcare outcomes is undeniable. But the question is, at what cost? Consider the process that a pharmaceutical company uses in considering a new drug for the market. The efficacy of the drug could be undeniable. Testing may have already proven how a significant # of lives could be saved if the company develops the drug and brings it to market. However, if the company foresees significant barriers in bringing the drug to market (barriers that amount to predictable and unpredictable costs), it may back away. Those costs could be development costs, costs to protect the IP (if the IP is even protectable), etc. The company backs away, the drug never makes it to market, and some number of lives that could have been saved are lost.

I for one would be interested to know what sort of cost a hospital or doctor's practice would be expected to bear in order to have access to Watson technology. I saw from the related story ( that Watson's functionality will be available through the cloud. We have to assume that customers like an oncology clinic will get the benefits of "cloud-enomics" (multi-tenancy, etc) that drive down the cost for customers, thus increasing the likelihood of adoption. But can we know more about those costs to better understand the balance of efficacy v. cost?
User Rank: Author
2/13/2013 | 9:51:08 PM
re: IBM's Watson Could Be Healthcare Game Changer
Don't underestimate the cultural change needed to put such techniques to work in the day to day practice of healthcare. very practically, what's the right step in the patient interaction to bring in the machine? how do you share the results, and debate the machine when your diagnosis goes against it? or instill confidence if you're just agreeing with a machine? Much left to learn.
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