Watson in the examining room?

University of Maryland and IBM working on computerized physician's assistant

February 17, 2011|By Frank D. Roylance, The Baltimore Sun

Are you ready for Watson to join you and your doctor in the examining room?

That could be the outcome of a collaboration under way between Watson's creators at IBM and experts at the University of Maryland's School of Medicine.

They have begun work on merging the speech recognition and question-answering skills of Watson — the computer that beat two humans on "Jeopardy!" this week — with the vast stores of clinical knowledge and analytical skills in the medical profession.

If it all works out, the end product could be a "Dr. Watson" in hospitals and physicians' offices.

"In the future, I see the software sitting with the physician as he is interviewing the patient, and processing information in real time, and correlating that with the patient's medical record and other records," said Dr. Eliot Siegel, director of the Maryland Imaging Research Technologies Lab at the University of Maryland School of Medicine in Baltimore.

Watson, he said, "has incredible potential to revolutionize how we interact with medical records; to be a really valuable assistant to me; to read all the literature pertinent to my practice … to always be at my side and help suggest problems, things in the medical records I need to know about; to suggest diagnoses and treatment options I may not have considered," he said.

For example, Siegel said, if a patient comes to him with a brain tumor, with a Dr. Watson "we have the capability of not just looking at the latest article on a new drug approach that worked with 50 percent of patients, but being able to look at genomic and clinical data … so I can personalize my treatment for that patient, because I have a database of patients with similar laboratory and imaging findings."

Robotic artificial intelligence is not entirely new in medical applications, said Dr. Mark Krasna, director of the Cancer Institute at St. Joseph Medical Center in Towson (and an "avid" "Jeopardy!" fan).

The Catholic Health Initiative uses remote telemedicine technologies to link doctors in rural hospitals with experts elsewhere in the system.

"What you're talking about is expanding that to the next level, and having a physician's assistant at the bedside," he said. "Assuming that is done with the appropriate [federal, medical privacy] regulations so that the information that's being shared electronically is appropriately firewalled, I think it's a wonderful way to bring a massive amount of information to the physician's fingertips faster than they can do alone."

Even so, Krasna added, "especially in the area of hands-on physical examination, and some of the interpersonal, psychosocial and ethical issues that come up every day in a practice, I don't see Watson ever replacing physicians."

Siegel is a professor and vice chairman of the radiology department at Maryland's medical school. He's also at the Veterans Affairs Hospital in Baltimore and has worked for years to develop computer applications and digital imagery systems in that hospital's radiology department.

His work with IBM brought him into contact with the team in Armonk, N.Y., that was developing the Watson software for the "Jeopardy!" challenge.

"I suggested to them it would be an amazing next project, after 'Jeopardy!' to look at real-world applications for the technology, and apply it to medicine," Siegel said.

That led to a grant from IBM to develop a version of Watson that could serve as a doctor's assistant. The project would combine IBM's Deep Question Answering, Natural Language Processing and Machine Learning software, with Nuance Communications Inc. speech recognition and Clinical Language Understanding software.

"Combining our analytics expertise with the experience and technology of Nuance, we can transform the way that health care professionals accomplish everyday tasks by enabling them to work smarter and more efficiently," said IBM's director of research, John E. Kelly III.

Siegel's team at Maryland is looking at how Watson can best interact with medical practitioners, while partners at Columbia University Medical Center are contributing further medical expertise and research.

IBM and Nuance believe the first commercial applications could be available in as little as 18 months. Siegel says a fully integrated Dr. Watson system is probably still years off.

"In three, five, seven years or so, we will start to see software beginning to look at patterns [in medical records] and suggest different diagnoses of patients, and begin to look at safety issues," he said.

But even high-speed IBM computers make mistakes, and Siegel acknowledged that Watson's performance on TV was not perfect.

In fact, Watson offered an answer that had just been ruled incorrect when spoken by a human competitor. It also answered "Toronto" to a question that called for the name of a U.S. city.

But "physicians make mistakes, as well," Siegel argued. So do their assistants.

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