Supercomputer could improve health care

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IBMโ€™s latest challenge project, Watson, astounded millions of Jeopardy! game show fans earlier this year when it defeated two of the showโ€™s most successful players. Now, one of the nationโ€™s largest health benefits companies, Indianapolis-based Wellpoint Inc., has licensed the technology from IBM for its first commercial applications within the countryโ€™s health care system.

Wellpoint operates Anthem Blue Cross and Blue Shield plans in 14 states, including Wisconsin.

โ€œWhen you think about the growth of knowledge, particularly in the area of medical literature, more studies and reports are written than any doctor would ever be able to read,โ€ said Scott Larrivee, spokesman for Anthem Blue Cross and Blue Shield in Wisconsin. โ€œThis information gap between best practices in medical literature and how health care is being administered has to be narrowed if we are going to reduce health care costs and improve the quality of care patients receive. Our hope is that by applying the Watson technology to health care we can help make health care safer and more affordable.โ€

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Watson, named after IBM founder Thomas J. Watson, is a computing system built by a team of IBM scientists designed to replicate a humanโ€™s ability to answer questions posed in natural language with speed, accuracy and confidence.

Watson will be outfitted with very specific information from medical journals, protocols and the most up-to-date evidence-based medicine that is known today, said Larry Schreiber, president of Anthem Blue Cross and Blue Shield in Wisconsin.

โ€œThe unique characteristics of Watson are that it doesnโ€™t have to be programmed going forward,โ€ Schreiber said. โ€œIt can learn and understand by reading text and turning that into decision-making skills. We see Watson having the ability to help us improve the quality of health care in the communities that we work in.โ€

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No single physician can even come close to knowing all of the potential diagnoses and treatments for any given patient, Schreiber said.

Watson has the ability to sift through an equivalent of 1 million books or 200 million pages of data, analyze the information and provide precise answers in less than three seconds.

โ€œThis capability is expected to enable physicians to engage Watson to easily coordinate medical data with specific patient factors to help identify treatment options in complex cases,โ€ Schreiber said. โ€œWatson will primarily be used as a front end tool to aid physicians in coming up with the right potential diagnosis faster in order to optimize good health outcome for the patient. Itโ€™s not meant to replace the physician by any means.โ€

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Larrivee likened Watson to the use of search engines to make better use of the information available on the internet.

As a corporation, Wellpoint Inc., plans to launch Watson pilot programs in specific oncology groups around the country near the second quarter of 2012. While Wellpoint expects to identify all groups in the first quarter of 2012, it is unlikely that any of the pilots will take place here in Wisconsin, Schreiber said.

โ€œAfter the initial pilots the company will evaluate how and when to expand the use of Watson into other areas,โ€ he said. โ€œThere are clearly applications in partnering with physicians in the community.โ€

Hector Joseph, the chief technology officer at Froedtert Hospital in Wauwatosa, has been following the technology behind supercomputers ever since computers were programmed to play chess.

โ€œItโ€™s fascinating technology,โ€ Joseph said. โ€œThe health care space is all about doing more with less and I look at Watson as a tool to help clinicians provide better care to patients. It would eliminate some of the need for facilities to spend valuable resources and time on endless amounts of research and interrogation of data sources. If you knew what you want to look for, Watson can help put that information at a physicianโ€™s fingertips almost instantly.โ€

Joseph has received both positive and negative reactions from people about supercomputer use.

โ€œThere will certainly be some physician acceptance issues if this technology were implemented,โ€ he said. โ€œBut I think it has a lot of applications in health care. If you look at Watson, not as a decision maker, but as a tool that helps physicians enhance their own decision making it becomes a situation similar to robotic surgery. The robot isnโ€™t actually doing the surgery in those instances. The surgeon is using the robot as an extension in order to be more precise and accurate for the benefit of the patient.โ€

Wellpoint is using the Watson technology to improve the quality of care patients receive, not to change medical policies, executives say. Wellpoint will not be using the Watson technology to process claim information.

โ€œThere are many opportunities for us to improve health care in the United States. Medical errors and drug safety events result in up to 2.4 million additional hospital days per year, 32,000 annual deaths and $9 billion in health care costs,โ€ Larrivee said. โ€œRedundant or inappropriate care makes up 30 percent of medical spending.โ€

The Watson technology could help narrow the scope of what physicians have to do to diagnose and treat a patient, Schreiber said.

โ€œWith all the possible diagnoses out there for every patient symptom and history, Watson could help reduce the amount of research the physician has to do on their own and could also help reduce the amount of treatment options they have to try,โ€ Schreiber said.

Dr. Rick Gillis, director of the office of Clinical Informatics and associate dean of Clinical Informatics at the Medical College of Wisconsin, is excited about the future implications of Watson.

โ€œWe see more and more data becoming available for use as it comes out of paper records and into more electronic tools,โ€ he said. โ€œThe idea of building data warehouses and using business intelligence to share and perform more analytics on large groups of data is becoming more and more a part of medicine today. Tools like Watson add the possibility of being able to pass information in natural language, process in a real time scenario and apply analytics from a large number of databases very quickly.โ€

At the rate that information is being published, physicians and scientists need these types of tools to make progress in the field, Gillis said.

โ€œItโ€™s impossible for any one person to keep track of it all. Watson will give us the technology to ask it questions to get help determining what the best treatment or diagnosis is for a specific patient based on their own individual symptoms and history. That type of deep analytical information will be extremely helpful to clinicians.โ€

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