Monday, June 22, 2015

Uncertain Health in an Insecure World – 46

“What is… Elementary?”

Jeopardy is a TV game show that requires contestants to answer in the form of a question. IBM Watson, named after former IBM president Thomas J. Watson Jr., won the show in 2011 over two humanoid champions.

Since early 2014, the IBM Watson Group has rolled out a campaign for U.S. and world market domination in the cognitive computing domain.  While its global networking has largely focused on financial services at CaixaBank in Spain and ANZ Global Wealth in Australia, the game show winning supercomputer has also been deployed to Bumrungrad International Hospital in Thailand to enhance cancer care, and to Metropolitan Health system in South Africa to tackle personalized medicine.

Overall, Watson is becoming literate in >25 countries around the world.

As I saw last week at the IBM Watson client experience center in New York’s fashionable lower Manhattan ‘Silicon Alley’ (above), the machine’s capacity to master the content of 23,000 Medline bio-medical journals gives Watson all the answers to any reasonable question that doctors and scientists might pose. Its natural language processing (NLP) skills allow it to pull in structured data and textual electronic medical record (EMR) entries, and connect these to increasingly common genomic testing data in the charts of patients receiving care in hospitals & clinics, often as part of clinical trials.

While capturing information from the medical literature and iterating it with the contents of the clinical record, Watson learns from its mistakes by using scoring agent algorithms to compute the strength of published evidence against the clinical outcomes of patients. In this way, Watson’s machine learning capabilities as a clinical decision support tool can rapidly generate high confidence diagnoses that could, in theory, save lives and improve care efficiency.

Such artificial computer “expertise” doesn’t replace the hard won clinical acumen of skilled consultants, but it can be a big boost to busy doctors caring for complex cases, working under the growing pressures of contracting resources and health system penalties for poor outcomes and long hospital stays. The chief medical information officer at Bumrungrad Hospital, Dr. James Miser, says “Watson is like having a capable and knowledgeable colleague who can review the current information that relates to my patient.
Cancer care and research are very hard to separate these days; >90% of patients entering clinical trials have genomic &/or proteomic data as key qualifying criteria. Much of Watson’s current cancer capabilities were learned from the best practices and research files of New York’s Memorial Sloan Kettering Cancer Center. Lest our four-legged friends be left out, Watson has engaged the ag-vet expertise of Guelph University and LifeLearn in Canada to develop a mobile app for animal doctors to weigh treatment options on the fly, a process of veterinary care now being tested at New York’s Animal Medical Center (not yet subject to the U.S. Obamacare regulations!).

Question: Poor and less developed countries.
Answer: What is… Watson’s brave new world?

If IBM CEO Ginni Rometty (above) has something to say about, “He” definitely will be there. At the intersection of human soft intelligence and big data, poor and less developed countries can more cheaply use the cloud to interface with Watson, without the cost and risk of local site investments. The relative absence of legacy computing systems and big data platforms makes Africa a high tech desert, but bodes well for rapid Watson adoption.

As part of IBM’s Project Lucy in Africa, Rometty points to the Digital Aquifer project that will provide “… analytics on 100 million points of water across the African continent… It’s going to reinvent drought management.”

Statistics South Africa called the state of data collection on the continent, “Africa’s statistical tragedy”. Other Project Lucy initiatives include analyzing the impact of food price patterns on nutrition, and the relationship between poverty and endemic diseases. A well deployed Watson healthcare strategy could empower beleaguered health workers dealing with HIV-AIDS and drug-resistant tuberculosis in sub-Saharan Africa.

IF, and I still say IF, Watson can speed patient care and reduce deadly medical mistakes, then it will “do no harm”, and probably provide a lot of real good. While the whole Watson platform has the sniff of high tech marketing hyperbole, its mad cognitive computing skills combined with true medical care expertise and constantly refreshed cutting-edge research sourcing is hard to deny, at least out of hand.

So, as the complexity of it all continues to escalate, we in the Square will join the IBM Watson team, and give the new Big Blue a chance to bring practice changing research to global health systems that have become sloppy, expensive and frankly dangerous. 

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