I was told that my posts might be a bit more interesting with a robot involved. So this post is about IBM’s Watson (really a computer and not a robot, but will have to do for now).
Watson is the world’s most advanced “question answering” machine, able to understand a question posed in everyday human elocution — “natural language,” as computer scientists call it — and respond with a precise, factual answer. In other words, it does more than what search engines like Google and Bing do, which is merely point to a document where you might find the answer. It has to pluck out the correct answer itself.
Watson uses more than a hundred algorithms at the same time to analyze a question in different ways, generating hundreds of possible solutions. Another set of algorithms ranks these answers according to plausibility; for example, if dozens of algorithms working in different directions all arrive at the same answer, it’s more likely to be the right one. In essence, Watson thinks in probabilities. It produces not one single “right” answer, but an enormous number of possibilities, then ranks them by assessing how likely each one is to answer the question.
And it does all of this before you can even say the first word in “It’s elementary, my dear Watson.”
What does Watson have to do with Health Care? Well the creators and other computer scientists are looking a “medical” version of the machine. The hope is that this technology can be transferred to assist in decision making for doctors. By storing amazing amount of information, it could fill in where there’s a gap in knowledge. Though I haven’t read this anywhere, and am wary to say what this technology can and can’t do, I imagine it could potentially update as new information becomes available such that doctors are in on the latest research and resources as soon as possible. A “medical Watson” could personalize medicine by taking into account a patient’s medical histories, could catch medication errors in the patient’s Electronic Medical Records, suggest tests or therapies all while interacting in real time with a physician while they are seeing the patient. And it would give doctors options – while it wouldn’t give every possible diagnosis, it could narrow it down to the top 5 most likely so the doctor can investigate from there.
This is incredible! The idea of such advanced technology is astounding on it’s own. But the possibilities are endless and impact health as a human right. With the help of decision making tools, a doctor’s visit could be more efficient, and thus more patients could be seen and correctly diagnosed. For rural areas with a shortage of doctors (particularly primary care physicians) this technology could be used by nurse practitioners (who may practice on their own or under the supervision of a doctor) to diagnose and treat patients. In resource-limited countries, this technology could help care providers, who are often not doctors, by providing information and clinical decision making. Already some of those countries with access to technology find the quality of care is already improving (see this article on electronic medical records used in Kenya). So imagine what a Watson could do!
Still, the cost of such technology will be steep – most likely prohibitively so for most of us. Who will pick of the tab to use one of these machines – will doctors’ offices pay for these machines when they already say implementing basic health information technology is too expensive? If they purchase them, will they charge higher rates and will the costs be passed on to patients through increased insurance rates? And then what is the liability for relying on the information given? Who will pay the costs if the machine has some glitches?
Of course, everyone wants to know if Watson or his progeny will replace doctors. I don’t think so. Computers aren’t people, they still cannot read emotions or take into account subtleties of human behaviour. And we know that a doctor’s empathy can improve health outcomes (more on this later) – as far as I know, technology cannot empathize either.
Ultimately, with doctors and technology working together, we may be able to use our resources more efficiently to reach a greater population and ensure the highest quality of health. The possibilities are limitless.