Clinical Decision Support: Is Watson up to it?

Are you a Jeopardy fan? If you are, I am sure you know that in January of 2011, IBM’s supercomputer, Watson beat two of Jeopardy’s all time money winners, Brad Rutter and Ken Jennings. Watson is an Artificial Intelligence that can understand questions posed to it in natural ‘human’ language.

WellPoint, a BlueCross collaboration, is the largest provider of health benefits in the country. Their plan is to utilize Watson to sift through their patient databases to make diagnosis and treatment recommendations to WellPoint physicians.

This idea is not at all far-fetched and certainly a reasonable way for IBM to make some money off their huge research and development investment in Watson. They have also purchased some other companies that position them well for movement into the medical sphere.

Over the last four years, IBM has spent more than $7.8 billion to acquire database analytics specialists Cognos and SPSS, both formerly public, as well as data warehouse company Netezza, along with other private companies. In the first half of 2011, IBM spending on research and development exceeded $3.15 billion.
—International Business Times, 9/19/2011

What WellPoint is proposing to do is a starting point for a task all EMR’s will ultimately need access to and participation in. In order to meet the requirements for ARRA stimulus funds, eligible providers will need to utilize their EMR’s to help them make clinical decisions.

Clinical Decision Support (CDS) is a process whereby the physician gets notices and alerts from their software to assist them in making clinical choices that are based on data and evidence rather than memory and intuition. The Centers for Disease Control and Prevention (CDC) hopes to see public health organizations utilizing population data and statistics to guide their choices. They believe this will be one of the most impactful effects EMRs can offer the public health. The Office of the National Coordinator for Healthcare IT (ONC) wants to see individual physicians using Clinical Decision Support to advise their patients. Clearly, WellPoint plans for this level of intervention: physicians will have access to the data Watson can provide to assist them in making diagnoses and recommending treatments.

We talked in this blog about some of the potential benefits of CDS back in 2009. Since then, research on the benefits of supported clinical decision making has continued. A Google Scholar search of ‘decision support emr’ results in 16,800 hits. There have also been noted some shortcomings, most notably a phenomenon called ‘alert fatigue‘, wherein a provider gets so many alerts and notices that they stop attending to them or turn them off altogether. Obviously, we have lots to learn about how to present information to healthcare providers so they can use it most effectively for the benefit of their patients. WellPoint has decided to dive right in!

What do you think about being diagnosed by a computer? Will it be more effective or less so? What is the relevance of CDS for behavioral health?

Please share your thoughts below.


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