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IBM’s Watson Addresses Errors of Diagnosis

Posted on June 2, 2011 I Written By

I’m beginning to see a pattern here. Two weeks ago, I wrote about clinical decision support in context of Dr. Larry Weed’s new book. Two weeks before that, I commented about physicians worrying that patients would perceive them as being incompetent if they relied on CDS. Today, I’m back to the same topic.

Deny the obvious all you want, physicians, but clinical decision support is coming, and once it’s here, it’s not going away.

I just got back back from the new IBM Healthcare Innovation Lab in downtown Chicago, the company’s third such center in the U.S. and eighth worldwide. While kickoff included a “healthcare leadership exchange” with such thought leaders as HIMSS CEO Steve Lieber and Allscripts Healthcare Solutions Chief Innovation Officer Stanley Crane, the real star was not a person, but a computer. IBM’s Watson, to be specific.

People stayed after lunch mostly to see a demo of Watson processing healthcare data—and IBM Chief Medical Scientist Dr. Marty Kohn said this was the first audience to see this demo. Make no mistake, IBM is positioning Watson as a clinical decision support tool, particularly for the much-ignored area of diagnostic decision support.

Saying that perhaps 25 percent of all healthcare errors are errors of diagnosis, Kohn noted how getting the diagnosis right can prevent all kinds of unnecessary complications and spending. “Of course, if you’ve made the wrong diagnosis, picking the right course of treatment becomes a challenge,” Kohn said.

And after the diagnosis, Watson can prevent treatment errors by, say, scanning EMR data for patient allergies to recommend against a drug that might cause a harmful interaction, then suggest alternative therapies. Kohn presented the case of a 29-year-old pregnant woman who was diagnosed with Lyme disease. A common treatment is the antibiotic doxycyline, but Kohn noted that it’s contraindicated during pregnancy.

Watson, according to Kohn, draws preliminary conclusions according to presenting symptoms, then scans multiple sources of information to present recommendations. Watson does look at the notoriously incomplete and inaccurate Wikipedia, Kohn said, mostly because that user-edited site covers so many topics, but then verifies information from other sources.

Watson then displays reasons why it believes the diagnosis may be correct so the doctor can make an informed decision. “It won’t let you ignore all the possible diagnoses,” Kohn said. But it won’t actually make the final call. “Watson is going to be in a supportive role rather than actually making decisions.” Kohn added.

What the supercomputer does is process vast amounts of data in a short amount of time., something that even the sharpest human mind could never do. And that’s what clinical decision support is supposed to be all about.

One More Reason to Implement an EMR – Genomics

Posted on May 17, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Katherine Rourke, on my sister site EMR and EHR, wrote an interesting piece on Adding Genomic Info to the EMR. Here’s a short excerpt from the post. You should go and read the rest of the post as well.

As the author notes, some specialties have already begun to tailor drug treatments to individual patients based on their genomic profile. For example, DNA sequencing of tumors in non-Hodgkin’s and Mantle Cell lymphoma can lead to personalized cancer vaccines that can produce great results, notes writer Gerry Higgins of the NIH.

Such data can also be used for a growing number of clinical situations, such as tailoring Coumadin doses to specific patients and providing psychiatric patients with the appropriate drug.

I’d been meaning to write about genomics and EMR for a while and so I’m glad that Katherine did. In one of my more interesting discussions at HIMSS with CMO of Nuance, Dr Nick (sorry, his last name is too hard to spell), we talked about the future of EMR and the possible benefits it could provide to patient care, diagnosing, etc. Nuance had partnered with IBM’s Watson project (the famous Jeopardy Watson) to apply the Watson technology to healthcare. At its core is using technology to crunch a lot of data and provide some meaningful (sorry I had to use the word) results or information.

As this discussion progressed, I casually suggested that one day we’ll need the same sort of processing across things like a person’s genome. The genome project isn’t quite a consumer commodity, but it’s getting there. One day, it won’t be at all surprising for us to bring our PHR info along with our personal genome to the doctor’s office. The lady at the front desk will ask you for a copy of your genome. Pretty crazy to consider, but probably much closer to happening than we realize.

Imagine trying to somehow process the information found in a genome in a paper based world. Exactly! The thought is so unreasonable you have to just laugh. I don’t follow the science of using the genome in healthcare that closely, but the examples in the above article by Katherine are quite interesting.

Plus, I think we’re still in an old world mentality where the world is still flat when it comes to understanding the data that’s available in the human genome. One day some remarkable humane genome Christopher Columbus is going to discover a new world that nobody knew about before. EMR software will be the tool used by most doctors to tap into that new world of healthcare based on the human genome.

This is why I’ve argued for so long about the possible long term benefits of having an EMR. The integration of a patient’s genome into their healthcare is just one of those potential long term benefits of having an EMR in your office.