Two years ago, "Watson" beat all-time Jeopardy! champions. Dr. Larry Norton, Deputy Physician-in-Chief for Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center had wondered then whether the IBM Watson system might be harnessed to improve cancer care and research. Mark Kris, MD, Chief, Thoracic Oncology Service at Sloan-Kettering, heard Dr. Norton's comment and became interested too.
The two doctors felt that combining Watson's ability to process huge amounts of data and use natural language processing might accomplish much more than winning Jeopardy! "Might it not also revolutionize cancer care and research and speed up progress for patients?" they wondered.
A year ago, a team at Memorial Sloan-Kettering started working with an IBM and a WellPoint team to train Watson to help doctors choose therapies for breast and lung cancer patients. They continue to share their knowledge and expertise in oncology and information technology, beginning with hundreds of lung cancers, the aim being to help Watson learn as much as possible about cancer care and how oncologists use medical data, as well as their experiences in personalized cancer therapies.
During this period, doctors and technology experts have spent thousands of hours helping Watson learn how to process, analyze and interpret the meaning of sophisticated clinical data using natural language processing; the aim being to achieve better health care quality and efficiency.
An opportunity to improve how medicine is taught, practiced and paid forAccording to the American cancer Society, approximately 1.6 million new cancers will be diagnosed in the United States in 2013 alone. The studies have shown that about 20% of patients have received either an incomplete or wrong diagnosis.
In a communiqué, IBM wrote "These statistics, coupled with a data explosion of medical information that is doubling every five years, represents an unprecedented opportunity for the health care industry and next generation cognitive computing systems, to combine forces in new ways to improve how medicine is taught, practiced and paid for."
Manoj Saxena, IBM General Manager, Watson Solutions, said:
"IBM's work with WellPoint and Memorial Sloan-Kettering Cancer Center represents a landmark collaboration in how technology and evidence based medicine can transform the way in which health care is practiced. breakthrough capabilities bring forward the first in a series of Watson-based technologies, which exemplifies the value of applying big data and analytics and cognitive computing to tackle the industry's most pressing challenges."
Using evidence-based medicine to advance oncologySo far, Watson has ingested:
- Over 600,000 pieces of medical evidence
- 2,000,000 pages of text from 42 academic journals and human studies (clinical trials) based on oncology research
- A huge number of patients' records spanning decades of cancer treatment history, including medical records and patient outcomes. Watson can sift through 1.5 million pieces of such records and provide doctors with evidence-based treatment options within seconds
Watson has started off learning about 1,500 cancer cases. Memorial Sloan-Kettering doctors and analysts are training Watson to retrieve and interpret laboratory results, clinical research and physician notes, and using data on hundreds of thousands of cancer patients to put forward treatment suggestions and possible diagnostic observations.
Craig B.Thompson, M.D., President of Memorial Sloan-Kettering Cancer Center, said:
"It can take years for the latest developments in oncology to reach all practice settings. The combination of transformational technologies found in Watson with our cancer analytics and decision-making process has the potential to revolutionize the accessibility of information for the treatment of cancer in communities across the country and around the world. Ultimately, we expect this comprehensive, evidence-based approach will profoundly enhance cancer care by accelerating the dissemination of practice-changing research at an unprecedented pace."
The first adopters of this capability include the Maine Center for Cancer Medicine and WESTMED Medical Group. Their cancer specialists will start testing the product and providing valuable feedback to IBM, WellPoint and Memorial Sloan-Kettering.
Improving patient care by speeding utilization managementAccording to WellPoint Inc., during its utilization management pilot, Watson ingested over 25,000 test case scenarios and 1,500 real life cases "and gained the ability to interpret the meaning and analyze queries in the context of complex medical data and human and natural language, including doctors' notes, patient records, medical annotations and clinical feedback. In addition, more than 14,700 hours of hands-on training were spent by nurses who meticulously trained Watson."
Even now, while on the job Watson continues to learn as if it were a medical resident, while working side-by-side with the WellPoint nurses.
In December, Watson started processing common, medical procedure requests by providers for members in WellPoint affiliated health plans; this was later expanded to include another five provider offices in the Midwest.
Watson will help speed up the review process between the patient's doctor and their health plan.
Lori Beer, WellPoint's executive vice president of Specialty Businesses and Information Technology, said:
"The health care industry must drive transformation through innovation, including harnessing the latest technology that will ultimately benefit the health care consumer. We believe that WellPoint's data, knowledge and extensive provider network, combined with the IBM Watson technology and Memorial Sloan-Kettering's oncological expertise can drive this transformation."
IBM, Memorial Sloan-Kettering and WellPoint are now introducing the first viable products based on Watson. The three teams say that these innovations represent a breakthrough in how doctors may apply advances in analytics and natural language processing to "big data", together with the clinical knowledge base, including genomic data, so that evidence-based decision support systems are created.
The creators of the Watson system have not disclosed the price. Hospitals and health care networks that sign up can buy or rent Watson's advice either from their own server or from cloud.
Two years ago, Watson occupied the area of a master bedroom, now it fits into a server the size of a pizza carton.
Over the past 24 months, Watson's processing speed has increased by over 240%. What was once a bit of IT fun, has become a real business for WellPoint and IBM. WellPoint is currently the exclusive seller of the technology.
What does Watson do?Watson does not tell the physician what to do. Rather, the system provides a number of options for each case, backed up with supporting evidence, which the doctor can use to come to a faster and hopefully more beneficial decision for the patient.
The physician can write something into an iPad in simple speech, for example "my patient has blood in her urine". Within 30 seconds Watson comes back with a series of well considered treatment options.
According to IBM, over 90% of the nurses who have worked with Watson follow the guidance the system gives to them.