A while back I wrote about Watson, IBM’s computer that trounced the competition on the Jeopardy! game show. I mentioned then that IBM was thinking of applying the technology to medical purposes, rendering us doctors irrelevant to health care. I flippantly suggested that we would soon be out of a job.
The joke’s on me. Today IBM and the insurance giant WellPoint announced a collaboration that would allow the insurer to make use of Watson’s natural language processing abilities. Though the press release is all sweetness and light, other reports suggest that the initial use will be by WellPoint nurses evaluating whether physicians should be paid. In a year or so, according to a report by Slate’s Josh Voorhees, “the insurer will expand its use to a small number of oncology practices, ‘which would likely allow doctors to access it through their own computer systems or tablets.’”
I’ve talked in the past about ASCO’s Rapid Learning System, which has become a major project for our Society. Some of the folks I have spoken to about this project believe that this is some far-off fantasy, but today’s Watson story suggests otherwise. The digital revolution is headed our way, and at high speed. If we as a profession do not jump on this particular bus and try to at least help direct where it is going, it may run us over.
Where WellPoint goes, other insurers are sure to follow, each with their own complex algorithm determining how patients should be cared for. I am all in favor of systemization of health care, because every bit of data we have suggests that a checklist approach improves care.
But at the same time, systematizing oncology is not easy. NCCN guidelines, widely used by insurance companies, are not (as a recent JCO publication showed) generally based on Level 1 evidence. Health care is full of value judgments, and those value judgments can easily be turned into source code. And if you believe that Watson is necessarily your friend, just ask Ken Jennings. He’s still groggy from the beating he took on Jeopardy!.