Watson, Your New Health Insurer

[MountainLaurel]

Watson, the IBM supercomputer that crushed the human competition on “Jeopardy!” has been hired by one of the country’s largest health insurers.

WellPoint Inc., which operates Blue Cross Blue Shield plans in 14 states, will use Watson’s vast health care database and quick calculating power to guide treatment decisions for its 34.2 million members.

“With medical information doubling every five years and health care costs increasing, Watson has tremendous potential for applications that improve the efficiency of care and reduce wait times for diagnosis and treatment by enabling clinicians with access to the best clinical data the moment they need it,” Manoj Saxena, general manager of an IBM division behind Watson’s marketing, said in a statement. “WellPoint’s commitment to innovation and their work to improve how care is delivered and benefits administered make them an ideal partner for IBM’s software and services to pioneer new efficiencies in health care.”

In its new job, Watson will swiftly compare patients’ electronic records to a mammoth library of textbooks and medical journals, and WellPoint’s history of treatments to generate a list of options and the rationale behind them.

http://abcnews.go.com/blogs/health/2011/09/12/your-new-health-insurer-who-is-watson/

[ScreamingMeemie]

1. If you qualify, that is.

[msongs]

2. great combo, they can deny services and cut staff at the same time n raise profits nt

[yella_dawg]

3. Weird.

Possibly good. Maybe good. But weird.

[RKP5637]

4. Oh great, I can't wait. Just what I need, "Hal" dictating my health care.

:scared:

[justabob]

8. right?

HAL was the first thing I thought of. <shudder>

[RUMMYisFROSTED]

5. Pin this to the top, mods!

Please!

[FLAprogressive]

6. "guide treatment options", hey it's ok for a computer to come between you and your doctor but keep

the goddamn gubmint out of it!

[Safetykitten]

7. "I'm sorry sir, the computer says your doctor is wrong."

[Liberal_in_LA]

9. uh oh. Is this a joke?

[MountainLaurel]

11. Apparently not

Here's a WSJ article with a little more detail.

http://online.wsj.com/article/SB10001424053111903532804576564600781798420.html?mod=googlenews_wsj

[JoePhilly]

15. There is less detail in that article than there was in the first.

[kenny blankenship]

10. He knows you're faking it.

It's elementary- just like reduced payouts and expanded layoffs equal greater profits.

Computer says: Time to die.

[JoePhilly]

12. I'd like to add some LIGHT to the darkness found in this thread.

I avoided the word ignorance.

First, I actually know some of the folks who work on IBM's Watson project and I've been following it through them. Ironically, I spoke to one of them earlier today and he is actually involved in the Wellpoint effort described in this rather vague article. What they are doing is very cool.

But Before I describe what Watson is, or what it does, or what it could do in the medical field, I want to tell a related story.

A few years ago, I was playing basketball and I dislocated both knees at the same time. In doing so, I also snapped both patella tendons. I was taken to the hospital ER by ambulance. And as I lay there, in the ER, the doctors were using GOOGLE, searching for the phrase "BILATERAL PATELLAR DISRUPTION".

Why?

First ... none of them had every seen it before. It is incredibly rare, particularly in a person in their earlier 40s. It has happened in the NFL once, but only a month AFTER it happened to me.

And so, I had ER doctors searching GOOGLE trying to find out what the first steps are to treating "BILATERAL PATELLAR DISRUPTION".

My surgeon had never seen it.

No physical therapist I've ever met since has seen it. They have protocols for single knee dislocation, but not BILATERAL.

There are a handful of people who know about this injury. And what they know, few others know.

Now back to Watson ...

Watson is GOOGLE on HORSE STEROIDS.

Its basic architecture is a natural language front end (making the query process easier), an array of "research algorithms" (kind of like the way your brain has specialized regions for speech, spacial location, etc), with a powerful probability logic engine, and then the ability to present a set of potential "choices" based on those probabilities. In the Jeopardy game, Watson had to PICK ... in most real life applications PEOPLE will examine the choice set from any Watson implementation and then decide (a) does one of these make sense, or (b) should we ask the question in a different way.

In the end ... Google helps YOU find things that are KNOWN, that YOU do not yet KNOW.

Watson is even better at finding that which is known, even if its known by only a very small number of experts.

And that is where the value, and the cost savings will be. Once something is known, everyone else does not need to rediscover it.

Or, we can panic.

[RKP5637]

13. Interesting! n/t

[JoePhilly]

14. The screaming about this reminds me of how the right wing screams about

computerized meters for home energy usage.

They see it as a huge global warming conspiracy.

In reality, such meters help to collect data on usage patterns so you can design more efficient energy transfer mechanisms.

[RKP5637]

16. Yep, I can see how that could lead to optimized mechanisms! I was reading

about the screaming about computerized meters for home energy usage yesterday, and I was wondering WTF. It seems to me an ideal way to design for optimization and to load balance based on usage patterns.

[JoePhilly]

18. I think the Watson thing is the same ...

The ability to parse large amounts of data and find meaning in it is very useful.

Could be energy consumption, could be medical treatment models, could be traffic patterns, could be the study of pollution and its effects.

The ability to parse huge amounts of data and synthesize it for people is powerful.

I think back to when I got my PhD (the 80s) ... I spent 100s of hours in the library copying articles. Hours hunting through the stacks, just to find what was already known. So I could build on that.

The Internet and GOOGLE makes that process look silly. Finding what is KNOWN is getting easier.

And Watson (its component technologies really) will improve on that ... researching a problem will get even easier, because the computer will search the stacks, and organize what it finds ...

Where once a doctor made reference to an old book, or tribal knowledge handed down from the last DOC, they will have an "assistant" who can find any reference to any instance of the condition at hand.

[RKP5637]

21. Somewhat analogous to my slide ruler days decades ago, sitting in physics classes

calculating quantum shifts on my slide rule. And then later the awesome power of a Wang calculator with trig functions. And then when TI came out with exponential functions in a hand held calculator.

Yep, research today is certainly more pleasant than combing the stacks for information, endless notes and cross-correlating the hits and the driving to several libraries. I have a headache thinking about those days! LOL

Yes, I think the use of Watson is quite innovative and a good thing!

[Trekologer]

28. The technology will allow researchers to spend more time discovering what is UNKNOWN

Instead of spending time (re)compiling what is already known.

And in providing medicine that can be very powerful. Even specialist doctors are not likely to have seen every type of ailment. What if you come into the emergency room with something that the staff hasn't seen before? Would you rather they guess at the treatment? Or be able to look up what treatments have been performed on patients and which ones work and which ones don't work. A computer such as Watson can direct the medical staff toward treatments that are statistically more effective.

[Shagbark Hickory]

17. We regret to inform you that your claim has been denied.

Sincerely,
Watson
Chief Decider
Wellpoint Inc.

[JoePhilly]

19. Do you think your doc doesn't use internet content?

This is an important question.

[Shagbark Hickory]

20. The difference between Doc and Watson (try to ignore that pun) is that...

Doc wants to sell me services and give me care, as much of it as Watson/Wellpoint will pay for.
Watson otoh, it's his job to find an excuse for Wellpoint not to pay for it.

[JoePhilly]

22. Read my post # 12 ... the intent of Watson is no such thing.

The actual goal is to find treatments that work.

Today, insurers use the DUMBEST of rules to accept and deny coverage.

The use of a Watson model, rather than help them deny coverage, would also force them to show what alternatives a system like Watson suggested as potential. Alternative treatments will be found MUCH faster.

Its a good thing.

[Shagbark Hickory]

23. I'm sure that's not Watson's intent. But if you think it isn't Wellpoint's intent to ..

assess risk and write policies accordingly, then I think you're being naive.

I'd trust Watson to find a treatment. But Wellpoint obviously has other plans.

[JoePhilly]

24. Again, read my earlier posts ... I know an IBM guy working on this

directly with Wellpoint. I spoke to him earlier today (by total coincidence).

There is nothing in any legislation which allows a company to use Watson, or any other computerized means, or even human means, to DENY coverage.

You might as well claim that Wellpoint can use GOOGLE to deny claims.

In reality, Watson should scare insurers because it will find those cases in which a person who statistically can't survive does.

My niece might be an example. When she was 2, she was diagnosed with a nerve cancer. Its usually 90% fatal. My sister's ensurer did not want to treat her ... after all, she was going to die anyway. My sister fought. Was able to get a children's hospital to treat my niece and save her life.

The insurer was working on their limited data. My sister has expanded the data. The reasons my niece survived are what Watson can find.

Sure ... all insurance companies are evil ... I get that ... but I think Watson lifts the knowledge base up so that more can see it.

You can be sure that IBM is not just working with Wellpoint.

[Shagbark Hickory]

25. So what if you know a guy?!?!? What does that have to do with anything?

You think he knows what Wellpoint is really doing this for? And if he did, do you think he's going to tell you about it?

Total naivete.

I'll have you know I was at the doctor this past friday. He made a decision on my treatment based on what my "insurance" policy will cover. I was like :wtf: you're telling me what treatment I will be getting because you already know what my "insurance" will cover?

WEllpoint isn't paying big bucks for the Watson because they really give a shit about treatment. They only give a shit about the bottom line.

[JoePhilly]

26. yes yes ... wellpoint is evil ... I get that ...

The do not need Watson to be evil.

In fact, Watson works against them because it will have access to a much broader spectrum of information then any single insurance company does today ... not knowing things helps them deny claims today.

Your experience this past week did not need a Watson.

The Watson technology will not stop with insurers. It will go well past there. Your doctor will have access to the same knowledge.

Wellpoint wants to be able to deal with the over 35,000 authorization requests that they get each day faster. That is the actual focus of this effort. See, most of those 35,000 pre-authorization requests should be approved, but the sheer volume slows them ALL down. A technology like Watson can quickly help expedite those that should clearly be approved.

[Shagbark Hickory]

27. It sure would be nice if Wellpoint really wanted to approve those requests faster.

Something tells me that's not what they're interested in doing.