By Joe Clabby, President, Clabby Analytics

Watson can help drive down the escalating cost of healthcare

If you were to reduce the problems with the American health care system down to just two issues, they would be “cost” and “coverage”.  The Patient Protection and Affordable Care Act (PPAC — also referred to disparagingly by some as “Obamacare”) is an attempt to address both of these issues.

As a technology researcher and writer, I don’t usually get involved in political discussions — but in this case, I’ll make an exception because the PPAC act directly affects me as an American taxpayer and as an “older” American.  I don’t think this act provides a remedy to address escalating medical costs.  I know this act will drive my insurance costs up.  And finally, I don’t like the federal government forcing compulsory insurance on me (I think it is unconstitutional — and I really, really, really don’t like the government telling me how I am to spend my own money).   Of these three issues, I’d like to focus on the first point: reducing medical costs.

The Patient Protection and Affordable Care Act introduced a concept called pay for performance (or P4P for short).  P4P focuses on paying hospitals and doctors based on the quality, not just the quantity, of health care that they provide.  This is an excellent and laudable concept — but it is fraught with pitfalls (such as how do you fairly reward a hospital for taking on patients who are very, very sick, as opposed to taking on only mildly challenging cases).  Further, it rewards hospitals on how well they adhere to government standards — which could work out extremely well for large hospitals with the personnel to ensure standards compliance, but may not work out as well for rural hospitals with a very thin margin of profitability and far less staff.  In the end, P4P may help improve the quality of medical care, but it does little to nothing to reduce the cost of administering health care.

Now, consider how a new technology might be brought to bear on this situation that could address the P4P goal of awarding achievement, while also lowering healthcare costs.  Last year, IBM introduced a new “workload optimized” computing environment known as Watson (the computer that beat two human game show contestants on a show called Jeopardy!).  This environment performs a workload (a function, a job) known as analytics.  Further, it has access to a very large database that it can sort through almost instantaneously.  By using a computer such as this, hundreds of thousands of patient records can be examined — and a composite picture of potential illnesses can be immediately constructed.  A doctor would also be given several choices of what the problem could be — along with data that indicates the probability of the answer the computer provided being right.  Doctors could work with Watson in real time, prodding the patient for other symptoms while the patient is still in the office.  Watson could even suggest the battery of tests that should be run to determine if an illness is one affliction or another.  And, ultimately, a fix for the problem could be delivered more quickly than using a trial-and-error testing method to guess at the cause of a given illness.

I see Watson driving down medical costs in several ways:

1)      Fewer super-highly-skilled doctors would be needed to diagnose and solve medical problems.  Doctor fees could be reduced accordingly.  (This same concept applies to the management of information systems in data centers.  Some systems can be difficult to manage and require highly-skilled specialists to manage them.  But vendors are constantly introducing intuitive management tools that greatly simplify systems management.  And, guess what — enterprises that use these tools don’t have to pay the lower-skilled systems managers who use these tools as much money as they were formerly paying highly-skilled management professionals).

2)      The time it would take to isolate a problem and fix it would be greatly shortened using Watson.  This means doctors can see more patients, and each additional patient generates additional revenue for the hospital — while the doctor is paid a set fee (a more or less fixed cost).  This improves profitability in the healthcare system — and could potentially forestall the need to constantly raise costs.  (Additionally, this addresses point number two — it broadens the number of patients a hospital can cover, thus increasing healthcare coverage).

3)      Watson could help direct more accurate testing/data gathering.  If you don’t know what you’re looking for, then a battery of tests needs to be conducted to zero-in on a problem.  Watson can indicate the data that it needs, narrowing the number of tests that need to be run.  Fewer tests, less cost.

4)      Better diagnosis and better treatment leads to fewer return trips to the doctor/hospital — again lightening the load on the healthcare system.  Watson can help achieve better diagnoses and direct appropriate treatments.

I’ve only just touched the surface on what this technology can do for the healthcare system.  What I really want is for the government to commission a panel to investigate how this technology can be used to remedy the problems that are endemic to our healthcare system.  I’m sure experienced healthcare providers could lengthen my list considerably.   Please feel free to contribute your cost saving ideas to this discussion.

By Jane Clabby

Discover how Watson will help physicians in diagnosis and treatment

One of the first applications for Watson will be the result of an agreement IBM signed with Wellpoint (one of the nation’s largest health benefits companies in terms of membership numbers) on September 12, 2011.  According to IBM, Wellpoint will develop and launch Watson-based solutions that will assist in a physician’s decision process. Watson can review millions of pages of clinical knowledge contained in medical journals, quickly analyze and then correlate that information with population health data, specific patient history and patient symptoms to suggest both diagnoses and treatment options. IBM and Wellpoint believe that this kind of analysis will be particularly helpful in the treatment of complex diseases including cancer, diabetes, chronic heart and kidney disease.

It is anticipated that Watson can assist in narrowing treatment options by taking into account various drug interactions and other factors so that treatment will be more effective. Watson can potentially help with identifying specialists in a very specific treatment approach and facilitate patient, physician and health provider communication – all driving down costs and improving efficiency and care.

Wellpoint believes that solutions based on Watson will be available through select physicians in clinical pilots early this year.

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Clabby Analytics and Wintergreen Research believe that Watson can revolutionize Health Care, leading to more accurate and quicker diagnoses, and more targeted treatment plans—-potentially saving billions of dollars in unnecessary tests, drugs and doctor and nurse time. Patients will be treated quicker and with more accuracy, leading to more positive outcomes.

The purpose in creating this blog is to start a dialog around Watson and healthcare decision support systems.  As we generate blogs, we will post hhose that our editors deem most relevant,  We also seek feedback and comments from the medical community.  What do you think? Will Watson bring a revolution in healthcare delivery?  Will people begin to take more responsibility for their own diagnoses?  What do we do about the fact that many people generally tend to make such bad decisions about their own healthcare?  What do we do? Will Watson help doctors do their job?