Thursday, February 17, 2011

Dr. Watson treats a patient with back pain!

The "amazing" performance of the IBM Watson in the Jeopardy contest vs. 2 of the best past performers has lead to headlines like

  • Machine stomps on humanoids
  • Watson is creaming the humans
  • Ken Jennings himself wrote "I for one welcome our new computer overlords"

Yesterday we saw the news of IBM partnering with Nuance (the makers of Dragon) to develop a physician assistant.  The concept being this would be way to rapidly consider all the related texts, reference materials, prior cases, and latest knowledge in journals and medical literature to gain evidence from many more potential sources than previously possible.  

One can imagine a day in the future where patients will give their history over a phone to a computer that triages them to appropriate care.  So here is what might happen when some one with back pain calls in:

Kidding aside, here are some examples where a supercomputer could be useful as a physician assistant:
  1. Have all the EHR data for an individual be fed into the computer.  Then when a physician wants to know something like:
    1. Is there a relationship between the rise in creatinine and any medication or procedure? Or
    2. What could be the cause of the hyperkalemia?You could get an answer like creatinine increased 3 days after starting Lisinopril for example OR the pt developed non-gap acidosis and hyperkalemia and this is probably from a type IV RTA due to his diabetes.
  2. Have all the EHRs from major hospitals in a city be connected to the Computer.  Then the computer would know the prevalence and incidence of various conditions or the resistance patterns of microbes to antibiotics in that area.  You could then ask the computer to consider the pretest and posttest probabilities and likelihood ratios of various conditions and tests and spit out the odds.  This would help us in appropriate test ordering and medication prescriptions.
  3. Record my conversation with the patient, a video of my examination of the patient and list all my queries (that I ask the computer to do on the EHR) and create a note! 

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