It is one of the great dreams of science fiction -- a computer that can speak, a computer that can simulate human thinking. Sometimes in our imaginings, it is friendly like the talking computer on Star Trek, and sometimes it is not like the Terminators from the movies. In any case, for good or evil, they now seem to be here, in the real world. We have Siri on the iPhone and, more notably, an IBM supercomputer that not only speaks, but also, performs advanced medical diagnosis and suggests treatment plans.1
The computer, named ‘Watson,' burst onto the scene in 2011 as a contestant in the game show Jeopardy, where it beat the pants off two of the best human contestants in the history of the show. Watson made a huge splash in part because it processes inquiries spoken to it in normal language and answers in a pleasant voice. The computer takes its name from IBM founder Thomas Watson -- not from Sherlock Holmes' sidekick. Watson looks something like a normal laptop (at least the part you see) but has a larger screen. All of the massive memory and processing power are stored elsewhere -- out of sight. And it's definitely the fast kid on the block, able to process 200 million pages of data in three seconds flat. In other words, it can perform extremely complex analyses and functions way faster than humans can.
Watson can potentially be used in many ways, but the first industry to seize on its capabilities for commercial application has been the medical field. Wellpoint Insurance has paired up with Memorial Sloan-Kettering Hospital in New York to use the computer to help physicians working with cancer patients. The computer is being fed enormous amounts of data regarding cancer diagnosis and treatment, including obscure literature that might otherwise have eluded physicians, practitioner experiences worldwide, individual medical records of millions of patients (sans all identifying information), and anecdotal, plain language information about patient reactions to various courses of treatment. It will take about a year to finish gathering and programming all the data.
Watson is expected to function as a bedside tool, allowing physicians to diagnose and treat cancer more quickly and effectively. Eventually, its database will be stored in the cloud so that physicians everywhere will be able to access it.
Experts say that it typically takes up to 15 years for medical breakthroughs to become known throughout the medical community. According to IBM's chief medical science officer, Dr. Martin Cohn, "What Watson can do is read and understand huge volumes of information. There is so much information being developed in health care in general, and oncology in particular, that the ability to understand all the information out there is becoming progressively more challenging. What Watson does is bring information to the doctor."2
Watson will work by allowing physicians to enter all the quirky information relevant to a particular patient, including information about a patient's psychological and social circumstances as well as that patient's individual treatment preferences. For instance, if a patient doesn't want a treatment that would result in hair loss, that would go into the system, as would the fact that a patient has little support from others and so can't undertake risky at-home treatments. Then Watson would go to work, crunching the patient symptoms, personal preferences, and history against its vast storehouse of information, and in a matter of seconds, suggests a diagnosis and a first-choice treatment plan, with several back-up options ranked in order of preference. Ostensibly, the physician and patient can then choose whether to honor or disregard the recommendations. Then again, insurance companies might have something to say about that -- especially if cost factors are programmed in. Remember: Wellpoint Insurance is one of the partners in this project.
According to Lori Beer, WellPoint's executive vice president of Enterprise Business Services, "The implications for healthcare are extraordinary. We believe new solutions built on the IBM Watson technology will be valuable for our provider partners, and more importantly, give us new tools to help ensure our members are receiving the best possible care."
Certainly, that's the hope, but some fear that insurers will use the technology to impose medical solutions on patients and to justify refusing to pay for less conventional treatment. If the medical establishment views a diagnosis and prescription from Watson as inviolable, then very soon the poor patient will have even less voice in determining what type of treatment he or she prefers than now. What Watson says will go. And the scary thing is that Watson can make mistakes, and in fact did make mistakes on Jeopardy. Plus, Watson relies on numbers, facts, and probabilities -- in other words, "evidence-based medicine," discounting the possibility of the rare exception to the rule that some who opt for alternative medicine might hope for. Keep in mind: "unexplained," spontaneous remissions do happen! Plus, it isn't clear just how much information about alternative courses of treatment Watson will be fed. Will the computer consider treatments based on nutraceuticals, acupuncture, energy healing, and so on? Watson can only make recommendations according the data in its information banks. If its programmers decided not to include information about a promising new experimental therapy, Watson can't evaluate it -- or respond to it. Given that insurers don't often reimburse for these sorts of treatment, the outlook is cloudy.
On the other hand, at least we can count on Watson to be sober as it dispenses treatment plans, unlike so many real-life doctors. That, combined with its huge storehouse of data, may actually work to improve the current state of medicine. Watson can never forget or let slip an important treatment option…as long as the option was fed to it in the first place.
1 "Supercomputer Watson Takes on Cancer Care with Memorial Sloan Kettering." 23 March 2012. CBS Health Pop. 1 April 2012. < http://www.cbsnews.com/8301-504763_162-57403164-10391704/supercomputer-watson-takes-on-cancer-care-with-memorial-sloan-kettering/>
2 Stern, Joanna. "IBM's Watson Supercomputer Gets Job as Oncologist at Memorial Sloan-Kettering Cancer Center." 22 March 2012. ABC News. 1 April 2012. < http://abcnews.go.com/Technology/ibms-watson-supercomputer-job-memorial-sloan-kettering-cancer/story?id=15979580#.T3j2dtm8GSq>