Monthly Archives: February 2012

IBM Forms Watson Healthcare Advisory Board.

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by Susan Eustis

IBM has formed a Watson Healthcare Advisory Board.  The board members include medical leaders with expertise in primary care, oncology, biomedical informatics and medical innovation.  The advisory board is positioned to provide IBM with insight about healthcare issues that could be impacted by Watson technology adoption.   Medical industry trends, clinical imperatives, regulatory considerations, privacy concerns, and patient and clinician expectations are topics that will be addressed by the advisory board.    Watson technology will address automation of clinician workflows. The initial eight-member board has the following members:

Charles Barnett, Ascension Health, President, Healthcare Operations and Chief Operating Officer. Since 1993, Charles J. Barnett FACHE, has led the Seton Healthcare Family, an Ascension Health ministry, in serving the healthcare needs of 1.9 million Central Texas residents in 11 counties. Barnett now oversees Ascension Health operations nationwide.

Dr. Michael Barr, American College of Physicians ACP, Senior Vice President is responsible for promoting best practices according to the principles of patient-centered care and professionalism through the development of innovative products and services, quality improvement programs and educational initiatives for internists and other healthcare professionals.

Dr. Herbert Chase, Columbia University Faculty, Professor of Clinical Medicine (in Biomedical Informatics) has collaborated with IBM Research on the Watson technology and related use cases in healthcare. Dr. Chase’s research interests include decision support tools for diagnosis and management of chronic kidney disease. He continues to develop new medical educational programs and is implementing a four-year curriculum in medical decision-making.

Dr. Lynda Chin, The University of Texas MD Anderson Cancer Center, Professor and Chair, Department of Genomic Medicine.  Actively involved in the Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium (ICGC), Dr. Chin is a recognized leader in the translation of the cancer genome.  She is interested in using cutting-edged information technology and computational biology to accelerate the conversion of cancer genomic insights into tangible endpoints at clinics for patients.

Chris Coburn, Cleveland Clinic, Executive Director of Innovation,has built a high performing team of nearly three dozen professionals in collaboration with some of the nation’s top venture capitalists.

Dr. Douglas Henley, American Academy of Family Physicians (AAFP), Executive Vice President and Chief Executive Officer. Dr. Henley works with the AAFP Board of Directors on the mission, strategy and vision of the organization and provides representation to others from the medical, public, and private sectors.

Dr. Michael K Magill, The Department of Family and Preventive Medicine, University of Utah School of Medicine, Past President, Association of Departments of Family Medicine. For 13 years he has held leadership roles in the University’s Community Clinics, in which he leads transformation of primary care delivery under a model of Patient Centered Medical Homes known as Care by DesignTM.

Dr. Steven Shapiro, University of Pittsburgh School of Medicine, Chief Medical & Scientific Officer. Dr. Shapiro’s primary focus is working with his colleagues across UPMC and the School of Medicine to develop improved models of clinical care based upon “good science” and “smart technology.”

IBM Watson analytical solutions provide decision support systems.  They use deep content analysis and evidence-based reasoning.  The systems are built on a natural language processing framework.  The aim is to accurately extracting medical facts and quickly understand relationships buried in large volumes of data.  The systems are anticipated to be used to make electronic medical records, family medical history, and the latest clinical research available in a usable form to clinicians.  The technology can help accelerate and improve clinical decisions, reduce operational waste, and enhance patient outcomes.

According to the IBM press release, “Watson represents a technology breakthrough that can help physicians improve patient outcomes,” said Dr. Herbert Chase, a professor of clinical medicine at Columbia University. “As IBM focuses its efforts on key areas including oncology, cardiology and other chronic diseases, the advisory board will be integral to helping align the business strategy to the specific needs of the industry.”

“The depth of leadership, talent and experience represented on the Watson Healthcare Advisory Board will be instrumental to advancing how IBM Watson technology is put to work in the healthcare industry,“ said Manoj Saxena, General Manager of IBM Watson Solutions. “IBM’s Watson technology has the potential to profoundly impact the quality patient care by fundamentally transforming how medicine is taught, paid for and practiced.”

The recommendations of the Watson Healthcare Advisory Board are expected to be valuable to IBM clients.  IBM has a global team of health care industry professionals.   This group has 4,000 professionals and 60 medical doctors working with clients to create smarter healthcare systems, focused on the patient, aimed at reducing medical errors, achieving better patient safety and quality outcomes, and saving lives.  IBM has undertaken more than 3,000 healthcare transformation projects around the world from small hospitals to national healthcare systems.

For more information about IBM Watson Solutions visit www.ibm.com/watson and IBM Smarter Healthcare http://www.ibm.com/smarterplanet/us/en/healthcare_solutions/ideas/index.html.


GE Healthcare and Microsoft Create Joint Venture “Caradigm” to Provide Healthcare Solutions

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By Jane Clabby

In December 2011, Microsoft and General Electric announced a joint venture focused on providing an open, interoperable platform for healthcare providers and ISVs to develop next-generation clinical solutions. The goal is to improve healthcare quality, patient experience, and efficiency — by integrating patient care processes across silos of delivery. Supporting a global trend away from “episodic” single patient care to population-based healthcare management, merging and integrating all forms of patient data with healthcare data about the general population will provide an integrated patient-centric approach to healthcare.

According to the two companies, the 50-50 joint venture will result in a new company called “Caradigm” that will combine Microsoft’s expertise in building platforms and ecosystems, with GE Healthcare’s background in clinical and administrative workflow solutions.

Intellectual property contributed by each company will include:

  • Microsoft Amalga, an enterprise health platform
  • Microsoft Vergence, a single sign-on and context management solution
  • Microsoft expreSSO, and enterprise single sign-on solution
  • GE Healthcare eHealth, a Health Information Exchange
  • GE Healthcare Qualibria, a clinical knowledge application environment being developed in cooperation with Intermountain Healthcare and Mayo Clinic

With this foundation, a healthcare performance management suite will be created. The companies will also continue to work together in the healthcare IT industry to “improve the quality of healthcare through innovative collaboration”.

Two of the critical problems in healthcare that the joint venture intends to address are: (1) healthcare associated infections (2) chronic disease management.

Caradigm will be headquartered near the Microsoft campus in Redmond,Wash., and is expected to launch (pending regulatory approvals) in the first half of 2012. Executive management of the new company will draw from both Microsoft and GE Healthcare, as will the Board of Directors.

MD Anderson Has Data Access Among Keys to Personalized Cancer Therapies

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by Susan Eustis

MD Anderson sees data access as key to achieving personalized cancer therapy care delivery.
MD Anderson is the leading cancer diagnostic and treatment center worldwide, rivaled by Sloan Kettering and others, but clearly better than any by several measures.  MD Anderson has research on pediatric brain cancers regarding genomic sequencing, hedgehog pathways, p53 degradation and EGFR signaling.  The results of the research have been published in a variety of respected scientific publications.

Translating those research advances to clinically proven therapies is daunting.  MD Anderson and IBM’s Watson supercomputer are collaborating to seek to learn how to be able to apply pattern recognition to the analysis of questions and to sort patterns into key data components for the purpose of delivery of personalized medicine. The collaboration between the research specialists and the computer specialists is in a manner that is designed to let clinicians interrogate multiple large databases to select the most likely answer to a question relating to the delivery of personalized cancer treatment.

As IBM Watson is trained by the MD Anderson experts, much as a medical student would be trained by the leading medical practitioners, Watson is learning how to process data in a manner that supports rendering a diagnosis.  The aim is to keep Watson up to date with the latest research findings so that it can support clinicians quickly and effectively.  Watson is different from the best medical student,  it remembers more, and it remembers better.

At a special public seminar at Rice University with the explicit purpose of discussing the potential real-life applications of Watson, it was explained that the computer can help physicians interrogate large sets of diagnostic or outcomes data as they pertain to the questions the clinician has about a given patient.  This could then be used to train Watson as a clinician support tool.

This goes far beyond data mining. It applies pattern-recognition technology to very large data sets to determine the diagnosis that best fits the patient data.  Based on its analysis, Watson could potentially determine a treatment plan that best fits unique disease characteristics.  Watson can take a list of symptoms and organize those as key data components.  A Watson query of data is conducted.  Watson selects a diagnosis.  Watson then selects and prioritizes likely treatments.

Specialists at MD Anderson are working to use Watson to facilitate the critical leap needed to achieve truly personalized medicine. The success of Watson as a system, depends on what data hospital organizations are willing to release to the database.  More data is one aspect of the issue, quality of data is a far more significant issue, MD Anderson can provide data that can be trusted.  There is enough of the trusted data to be significant, and there is enough data to permit comparisons.

This is what is needed so that the clinicians can be sure of the trustworthiness of an answer provided by Watson.  Physicians can base decisions on years of patient data — the data in mind about their own patients. That is a valuable combination of data and experience.  But physicians can not know all the research, sometimes their data is outdated, sometimes they just have not heard of the latest advances.  Thus enters Watson to compliment what the physician or group practice knows.

MD Anderson is leading the way in developing personalized therapies for cancer.  The data available to Watson can be in a format that hides the personal medical information of a patient.  Training Watson is like training a medical student, you want the computer to make decisions based on the most up to date, accurate research available.

Oracle Announces Enhancements to Healthcare Analytics Platform

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Improvements to scheduling and comparative research capabilities and new support for mobile devices

By Jane Clabby

On February 21, at the Healthcare Information and Management Systems Society (HIMMS) Conference and Exhibition in Las Vegas, Oracle announced enhancements to Oracle Enterprise Healthcare Analytics, a business intelligence and performance management solution for healthcare.

One new feature is Healthcare Analytics Data Integration which, according to Oracle, consolidates, integrates, validates and loads source data from clinical, financial, administrative and research systems into Oracle’s comprehensive healthcare data model.  The new feature will be applied to map staffing requirements to patient scheduling, as well as look at optimizing the scheduling of other resources such as operating rooms. These activities are very complex and time-consuming; the new software has the potential to improve efficiency and drive down costs associated with scheduling doctors, nurses and hospital equipment and resources.

Also included are features that support comparative effectiveness research, enabling physicians to collect evidence from clinical research and medical journals and compare various treatment options (drugs, surgery etc.) for a particular patient and condition, as well as formulary modeling.

Out-of- the –box support for mobile devices such as the iPhone and iPad has also been added.

Oracle Enterprise Healthcare Analytics includes a range of products: Oracle Healthcare Data Warehouse Foundation, Oracle Healthcare Analytics Data Integration, Oracle Health Sciences Cohort Explorer, Oracle Healthcare Operating Room Analytics, and Oracle Healthcare Provider Supply Chain Analytics enabled by core Oracle technology, including Oracle Database, Oracle Fusion Middleware and Oracle Business Intelligence Enterprise Edition. This suite of products is designed to help physicians gain better clinical and business insight by integrating clinical, financial, administrative, and research information in a common data warehouse, and providing a set of pre-built analytics applications from Oracle and Oracle partners.

Chandar Pattabhiram IBM Vice President, Cloud Product Strategy Talks About CLoud

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by Susan Eustis

Following is a conversation we at WinterGreen Research had with Chandar Pattabhiram IBM Vice President, Cloud Product Strategy where he talks about cloud positioning and integration in this context.  As cloud computing becomes the new mantra for improving business productivity and efficiency, we look to our leaders in the channel to provide new business models.  Chandar is surely one of our best.

What difference does integration make in a cloud environment? 

  • Integration has become the ‘productivity application’ for Cloud computing. Without integration, Cloud users don’t get access to critical backoffice information locked away in other on-premise applications. For example, a salesforce.com users needs access to critical customer information – orders, invoices, credit history, payment history, etc. – that is locked away in an ERP application like salesforce.com. Without integration, Cloud users are doing one of two things: a) ‘swivel-chairing’ to multiple apps to access the information  b) manually calling people or accessing offline spreadsheets, etc. With integration, they get all the information they need in one place – in the Cloud. As a result, they are able to maximize their productivity and the company is able to maximize the economic value of their Cloud investment.

 

So, you suggest that integration is the very base of cloud computing, that we used to have siloes that represented different aspects of a line of business, and now we are finding that it is more efficient to use one set of information for ordering and billing and shipping rather than having separate customer lists.

Why would an IT manager want to integrate between cloud environments within the data center?

  • Most companies operate in a hybrid Cloud environment. They consume some public Cloud services like salesforce.com, create some private Cloud services and house within their data center and also house traditional on premise applications. In such an environment, they may have the need to: a) integrate public cloud apps with each other (e.g. salesforce.com and netsuite), b) public cloud and private cloud apps (e.g. salesforce and a private cloud commissions applications they have developed), or c) integrate Cloud and on premise applications (e.g. salesforce, private cloud commissions application and SAP). The business value is as mentioned above – increased end-user productivity and lower IT costs.

Why would an IT manager want to integrate within cloud environments within the data center?

  • A company may have a combination of Private Cloud services within a data center. For example,a private cloud service for patient tracking and another private cloud service for patient billing. In this example, they will have the need to integrate these private Cloud services with each other within the data center.

Does this make any difference to the line of business?

  • As mentioned above, Integration has become the productivity application for Cloud Computing. With integration, line-of-business users get a 360* view of business information in one place – directly in that Cloud application rather than having to log into multiple places. As a result, they are able to maximize productivity and deliver a superior customer experience. As SaaS applications are being rapidly adopted by line-of-business user (salesforce.com, taleo, Success Factors, etc.), integration has become one of the most critical factors for the continued adoption and success of these applications over time in each company.


Dr. Mostafa el Sayed Works on Gold as a Cure for Cancer

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by Susan Eustis

Dr. Mostafa el Sayed has an invention that uses gold nano-particles and nanorods in medicine.  These nanomaterials are applied as a cure for cancer:  From cancer diagnostics to photothermal therapy, gold nano-particules appear to be useful.. Gold particles are provided by using nanotechnology in a manner that is useful in medicine because it can be heated once it is inside the body sticking to the tumors and the tumors then melt. The procedures elaborated by Dr Mostafa el Sayed and his students show how to manipulate atoms, molecules, and materials to form structures on the scale of nanometer, one billionth of a meter.  Animal trials are underway and human trials believed to be not far behind.

IBM Watson Positioned to Leverage a Knowledge Base at Memorial Sloan-Kettering Cancer Center

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by Susan Eustis

IBM Watson has been positioned to leverage a known knowledge base to assist in cancer diagnosis.  Facilities that are leading in their field provide direction for the automated process computer.  Computer-assisted surveillance will play an increasingly important role the in helping clinicians diagnose cancer conditions.

Melanoma is treated at Memorial Sloan-Kettering Cancer Center in New York City.  Clinicians there are interested in how Watson can be used to provide a more consistent approach to care delivery across the entire medical spectrum.  Watson technology has the potential to help clinicians identify suspicious lesions in a more consistent manner, and act as an aid to achieving diagnosis of an individual concerning lesions.  Melanoma and cutaneous malignancies are matters of interest.

Watson, an IBM computer represents a change in computer evolution. It can understand natural language.  Based on this understanding, it can query a huge database to come up with a clinical diagnosis.

IBM is developing the ability of Watson to interpret radiological images.  The system is learning how to diagnose melanoma images.  It needs to be taught in the same manner that medical students need to be taught.  There are other systems that can assist in identifying and diagnosing lesions and these support the clinician and the decision support computer systems.

The value of Watson is that once it learns how to achieve a diagnosis, it will be able to be updated once and used millions of times.  It is impossible for clinicians to keep up with every possible piece of information in the medical literature.  Diagnostic tools like Watson can scan known conditions and can point out differential diagnoses that a clinician might not have considered.  Using computers to assist in diagnosing melanoma and other cancers depends on having the computer trained at a leading medical center.  .

In terms of identifying images and following changing lesions, a computer would need pictures from every patient visit.  The aim is to create a system in which a patient walks through the door and gets a  picture taken as part of the visit to the clinician.

Over time, one problem with using multiple images is registering the images in a manner that permits comparisons.  The difficulty occurs because patients’ bodies change.  Curved surfaces and 2D images, make registration and comparison difficult.  3D images solve this problem, making registration easier.  In this manner computers are being trained in much the same manner that medical students are being trained.

Cleveland Clinic and IBM Watson Innovation

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by Susan Eustis

Cleveland Clinic supports emerging cardiovascular technologies that implement automated process, including IBM Watson.  IBM Watson is learning from a hospital system widely regarded as having one of the best heart care programs in the world.   Watson is being introduced to the clinicians as way to implement automated process in the diagnosis and treatment of patients.  The aim is to potentially improve health care delivery with the use of technology, including Watson.

To leverage technology to deliver what the best hospitals and best clinicians know is a fundamental opportunity in the healthcare delivery industry.  Clinicians who are leading know the most about care delivery.  The aim is to get out what they know to all the facilities that need to provide care delivery.

Cleveland Clinic is an acknowledged leader in diagnosis and care delivery.  The Cleveland Clinic has been able to attract leading clinicians, and they are encouraged to work with leaders of major industry associations that represent pharmaceutical research companies, biotechnology and the medical technology industry.  The aim is to articulate directions in research..

IBM Watson is being tasked with looking at cardiovascular innovation from a patient’s perspective.  The technology in cardiology has exploded in the last few years, illustrating the impact of innovation.  Cleveland Clinic cardiologists and surgeons are representative of how leaders in the care delivery system can evolve a role to work to shape technology.

Technology is only as good as the experts that shape it.  Technology does not evolve from a survey or looking at many patients, it is a result of having input from the most knowledgeable people who practice medicine.

IBM Watson is positioned as providing an innovation, a medical breakthrough.  Cleveland Clinic doctors are intensely interested in how Watson will reshape health care in the coming years.  Watson from IBM promises to be a game-changing technology that will have high impact.

 

 

50 Years of IBM Healthcare Automation

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by Susan Eustis

IBM is marking the 50th Anniversary of the first electronic medical record EMR.     February 18, 50 years ago the first electronic medical record system was installed at a children’s hospital in Akron, Ohio. Akron Children’s Hospital in 1962, worked with IBM to build the first computer-based patient information system to centralize patient records, allow sharing of patient information, eliminating of paperwork, and alerting of nurses when patients needed their medications.

Progress in major electronic medical records systems by Kaiser and Mayo have carried early implementations ideas forward. Now IBM is taking a quantum leap forward by implementation of Watson for healthcare.

Fifty years after Akron Children’s made history, only 1% of hospitals are really using them to their full potential. Watson is positioned to facilitate the physician diagnostics process through sophisticated automation. More about Watson at

http://www-03.ibm.com/industries/ca/en/healthcare/files/smarter_healthcare_brochure.pdf

http://www-01.ibm.com/software/data/infosphere/smart-analytics-system/industry/healthcare-provider.html

and
www.wintergreenresearch.com/blog

IBM has smart analytics system healthcare provider solutions as well.  The IBM Smart analytics system gives healthcare provider’s workload optimized predictive analytic solutions.  The aim is to uncover patient insight, to reduce member risk, and to increase plan effectiveness.

An integrated platform provides healthcare providers broad analytics capabilities.   This is a significant automated process platform that provides a foundation for solutions that make a difference in people’s lives.

Watson’s One-Year Jeopardy Anniversary – What Next?

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What does the future hold for IBM Watson?

By Jane Clabby

This week marks the one-year anniversary of Watson’s Jeopardy appearance. IBM’s Dave Ferrucci, Lead Researcher for Watson, had some interesting data to share as well as some thoughts about the Watson technology and the kinds of things that Watson could do in the future. In his Smarter Planet blog, Ferrucci shared the following “one year later” statistics.

  • 15 million viewers watched the Jeopardy rerun
  • 5 Congress members competed against Watson
  • 386 Universities are collaborating with IBM on Watson and Analytics
  • 34 million people potentially benefitting from Watson through WellPoint Health Plans

Ferrucci believes that we are entering a new era of computing where machines will be increasingly capable of learning.  He goes on to say that these intelligent machines will be capable of ingesting huge volumes of knowledge captured in human language and then, by interacting directly with humans, will be able to predict the impact of certain decisions.  By doing so, nations, cities or states (for example) would be able to determine the best course of action in a given situation or what policy decision would be best — without personal or political bias. Ferrucci outlines several steps which are required to get Watson to this point: 1) extend the information Watson understands from answering specific questions to problem-solving (2) expand Watson’s abilities to include rich conversations with humans 3) enhance Watson’s ability to explain results and (4) change how Watson learns so that he can continuously gather information in specific areas.

As part of the first anniversary milestone, IBM also poses a question via twitter, #WhatShouldWatsonDoNext? I checked it out and there are some interesting responses. Here are several examples (1) “participate in presidential debates”, (2)“identify content of images and photos” (3) “support interactive triggered oral response for apps, so translate an oral question in an application command” (4)  ” advise government on how to spend tax money in a fair way” (5) “cure cancer”. But my personal favorite has to be “make up its own mind”, and perhaps someday Watson will be able to do just that.