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The Biggest Lesson Learned from IBM Watson

Posted on August 13, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

There’s no sexier marketing story than IBM Watson. When IBM Watson beat Ken Jennings on Jeopardy, there was an explosion of coverage. The most promising area for IBM Watson was healthcare. However, as the Wall Street Journal recently reported, IBM Watson has fallen short of expectations in healthcare.

More than a dozen IBM partners and clients have halted or shrunk Watson’s oncology-related projects. Watson cancer applications have had limited impact on patients, according to dozens of interviews with medical centers, companies, and doctors who have used it, as well as documents reviewed by The Wall Street Journal.

In many cases, the tools didn’t add much value. In some cases, Watson wasn’t accurate. Watson can be tripped up by a lack of data in rare or recurring cancers, and treatments are evolving faster than Watson’s human trainers can update the system. Dr. Chase of Columbia said he withdrew as an adviser after he grew disappointed in IBM’s direction for marketing the technology.

No published research shows Watson improving patient outcomes.

No doubt, part of the problem is that IBM Watson could never live up to the hype. The hype was too big. However, it seems that IBM Watson has really fallen short from even the most conservative hopes for it. That’s a big problem.

One thing that’s interesting about IBM Watson is that they spent no marketing on it. Especially in healthcare. At the IBM Think events the past couple years they didn’t have any healthcare press or influencers at their event. Their marketing team’s response was that they didn’t have any budget to market to healthcare because they got so much coverage for IBM Watson already.

Fair enough. IBM Watson has gotten a ton of exposure in healthcare, but maybe if they’d invited the press they could have had some real conversations about whether IBM Watson was real or was it memorex (Sorry for those that don’t know this old reference). While not always the case, the healthcare IT press and influencers are a different breed that asks deeper questions about a product and what it can do to impact healthcare. It feels like IBM Watson had so much hype that not enough people held them accountable for actually delivering results to healthcare organizations.

From the same WSJ article linked above is this great quote:

“The discomfort that I have—and that others have had with using it—has been the sense that you never know what you’re really going to get…and how much faith you can put in those results,” said Lukas Wartman of the McDonnell Genome Institute at the Washington University School of Medicine in St. Louis. Dr. Wartman said he rarely uses the system, despite having complimentary access.

The concepts of AI and machine learning that IBM Watson represent are incredible and I believe will impact healthcare for good. However, it’s still not there yet. The trust isn’t there.

The core lesson I take from IBM Watson is that things like Jeopardy can create hype for a certain product, but in healthcare we need more than hype. We need trust. If a healthcare provider can’t trust the result, then your product won’t go anywhere and won’t be used. Unfortunately for IBM Watson, beating Ken Jennings on Jeopardy creates a lot of awareness, but does nothing to build trust.

The jury is still out on IBM Watson on healthcare. They’ve spent billions on it and so it’s not like it’s going to just disappear. Hopefully, it does turn the corner and becomes a trusted tool for many in healthcare. Trust just takes consistency over time. That’s an important lesson for many healthcare IT products.

The Truth about AI in Healthcare

Posted on June 18, 2018 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.

Those who watched the television show, “The Good Doctor,” in its first season got to see how a young autistic surgeon who has savant syndrome faced challenges in his everyday life as he learns to connect with people in his world. His extraordinary medical skill and intuition not only saves patients’ lives but also creates bridges with co-workers.

During each show, there is at least one scene in which the young doctor “visualizes” the inner workings of the patient’s body – evaluating and analyzing the cause of the medical condition.

Although all physicians can describe what happens to cause illness, the speed, detail and clarity of the young surgeon’s ability to gather information, predict reactions to treatments and identify the protocol that will produce the best outcome greatly surpasses his colleagues’ abilities.

Yes, this is a television show, but artificial intelligence promises the same capabilities that will disrupt all of our preconceived notions about healthcare on both the clinical and the operational sides of the industry.

Doctors rely on their medical training as well as their personal experience with hundreds of patients, but AI can allow clinicians to tap into the experience of hundreds of doctors’ experiences with thousands of patients. Even if physicians had personal experience with thousands of patients, the human mind can’t process all of the data effectively.

How can AI improve patient outcomes as well as the bottom line?

We’re already seeing the initial benefits of AI in many areas of the hospital. A report by Accenture identifies the top three uses of AI in healthcare as robot-assisted surgery, virtual nursing assistants and administrative workflow assistance. These three AI applications alone represent a potential estimated annual benefit of $78 billion for the healthcare industry by 2026.

The benefits of AI include improved precision in surgery, decreased length of stay, reduction in unnecessary hospital visits through remote assessment of patient conditions, and time-saving capabilities such as voice-to-text transcription. According to Accenture, these improvements represent a work time savings of 17 percent for physicians and 51 percent for registered nurses – at a critical time when there is no end in sight for the shortages of both nurses and doctors.

In a recent webinar discussing the role of AI in healthcare, John Lynn, founder of HealthcareScene.com, described other ways that AI can improve diagnosis, treatment and patient safety. These areas include dosage error detection, treatment plan design, determination of medication adherence, medical imaging, tailored prescription medicine and automated documentation.

One of the challenges to fully leveraging the insights and capabilities of AI is the volume of information accumulated in electronic medical records that is unstructured data. Translating this information into a format that can be used by clinical providers as well as financial and administrative staff to optimize treatment plans as well as workflows is possible with natural language processing – a branch of AI that enables technology to interpret speech and text and determine which information is critical.

The most often cited fear about a reliance on AI in healthcare is the opportunity to make mistakes. Of course, humans make mistakes as well. We must remember that AI’s ability to tap into a much wider pool of information to make decisions or recommend options will result in a more deeply-informed decision – if the data is good.

The proliferation of legacy systems, continually added applications and multiple EMRs in a health system increases the risk of data that cannot be accessed or cannot be shared in real-time to aid clinicians or an AI-supported program. Ensuring that data is aggregated into a central location, harmonized, transformed into a usable format and cleaned to provide high quality data is necessary to support reliable AI performance.

While AI might be able to handle the data aggregation and harmonization tasks in the future, we are not there yet. This is not, however, a reason to delay the use of AI in hospitals and other organizations across the healthcare spectrum.

Healthcare organizations can partner with companies that specialize in the aggregation of data from disparate sources to make the information available to all users. Increasing access to data throughout the organization is beneficial to health systems – even before they implement AI tools.

Although making data available to all of the organization’s providers, staff and vendors as needed may seem onerous, it is possible to do so without adding to the hospital’s IT staff burden or the capital improvement budget. The complexities of translating structured and unstructured data, multiple formats and a myriad of data sources can be balanced with data security concerns with the use of a team that focuses on these issues each day.

While most AI capabilities in use today are algorithms that reflect current best practices or research that are programmed by healthcare providers or researchers, this will change. In the future, AI will expand beyond algorithms, and the technology will be able to learn and make new connections among a wider set of data points than today’s more narrowly focused algorithms.

Whether or not your organization is implementing AI, considering AI or just watching its development, I encourage everyone to start by evaluating the data that will be used to “run” AI tools. Taking steps now to ensure clean, easy-to-access data will not only benefit clinical and operational tasks now but will also position the organization to more quickly adopt AI.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies, a proud sponsor of Healthcare Scene. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.

Health Leaders Say Automating Patient Engagement Efforts Will Have Major Impact

Posted on March 12, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the last few years, many vendors have rolled out products designed to engage patients further in their care. According to a new study, these solutions may be just the tip of the iceberg. In fact, many healthcare executives see patient-facing, engagement-enhancing technology as critical to the future of healthcare, according to a new study.

The study, by the World Business Group, focuses on technology that can link patients with care in between visits to their primary care center. Patient engagement technologies, which they call “automated care,” have the potential to bridge such gaps by providing AI-based assistance to consumers.

The survey, which was also backed by Conversa Health, drew on direct interviews and survey responses from 134 health execs. The researchers looked at how those execs viewed automated healthcare technologies, how these technologies might be used and whether respondents plan to adopt them.

Respondents were clearly very enthusiastic about these tools. Nearly all (98%) said they believed automated healthcare will be important in creating a continuous, collaborative relationship with providers. The survey also found that 87% of respondents felt that automated healthcare will be helpful in getting patients to engage with their own care.

The next step, of course, is throwing resources at the problem — and it’s happening. Seventy-nine percent of survey respondents said they expected to work on integrating automated healthcare in their organization within the next two years. Also, 44% said that they had a chief patient experience officer or other executive with an equivalent title on board within their organization. This development is fairly new, however, as 40% of these organizations said that the role has existed for two years or less.

Meanwhile, several respondents felt that automating patient healthcare could generate a positive feedback loop. Forty-nine percent of those surveyed reported that they were either integrating or have already integrated patient-generated health data, which they expect, in turn, to integrate into the patient experience efforts.

Among organizations working with patient-generated health data, 73% were gathering patient health histories, 64% treatment histories, 59% lifestyle or social data, 52% symptoms data, and 32% biometric data.

Thirty percent said they were beginning to integrate such data and collect it work effectively, 28% said they could collect some PGHD but had trouble integrating with their systems, 14% said they were just beginning to collect such data and 9% said they were not able to collect this data at all. Just 19% reported they were fully able to collect integrate PGHD and use it to improve patient experiences.

All told, it appears we’re on the cusp of a major change in the role patient services play in provider outreach. It will probably be a few more years before we have a good idea of where all this is headed, but my guess is that it’s heading somewhere useful.

UPMC Plans $2B Investment To Build “Digitally-Based” Specialty Hospitals

Posted on November 20, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The University of Pittsburgh Medical Center has announced plans to spend $2 billion to build three new specialty hospitals with a digital focus. Its plans include building the UPMC Heart and Transplant Hospital, UPMC Hillman Cancer Hospital and UPMC Vision and Rehabilitation Hospital. UPMC already runs the existing specialty hospitals, Magee-Womens Hospital, Western in Psychiatric Institute and Clinic and Children’s Hospital of Pittsburgh.

UPMC is already one of the largest integrated health delivery networks in the United States. It’s $13 billion system includes more than 25 hospitals, a 3-million-member health plan and 3,600 physicians. If its new specialty centers actually represent a new breed of digital-first hospital, and help it further dominate its region, this could only add to its already-outsized clout.

So what is a “digitally-based” hospital, and what makes it different than, say, other hospitals well along the EMR adoption curve? After all, virtually every hospital today relies on a backbone of health IT applications, manages patient clinical data in an EMR and stores and stores and shares imagines in digital form.   Some are still struggling to integrate or replace legacy technologies, while others are adopting cutting-edge platforms, but going digital is mission-critical for everyone these days.

What’s interesting about UPMC’s plans, however, is that the new hospitals will be designed as digitally-based facilities from day one. UPMC is working with Microsoft to design these “digital hospitals of the future,” building on the two entities’ existing research collaboration with Microsoft and its Azure cloud platform.

The Azure relationship dates back to February of this year, when UPMC struck a deal with Microsoft to do some joint technology research. The agreement builds on both UPMC’s fairly impressive record of tech innovation and Microsoft’s healthcare AI capabilities, genomics and machine learning capabilities. For example, in working with Microsoft, UPMC gets access to Microsoft’s health chat bot technology, which is being deployed elsewhere to help patient self-triage before they interact with the doctor for a video visit.

I’d love to offer you specific information on how these new digitally-oriented will be designed, and more importantly how the functioning will differ from otherwise-wired hospitals that didn’t start out that way, but I don’t think the two partners are ready to spill the beans. Clearly, they’re going to tell you all of this is the new hotness, but nobody’s provided me with any examples of how this will truly improve on existing models of digital hospital technology. I just don’t think they’re that far along with the project yet.

Obviously, UPMC isn’t spending $2 billion lightly, so its leadership must believe the new digital model will offer a big payoff. I hope they know something we don’t about the ROI potential for this effort. It seems likely that if nothing else, that technology investment alone won’t drive that big a rate of return. Clearly, other major factors are in play here.

E-Patient Update: Hospitals Need Virtual Clinicians

Posted on July 20, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Hospitals have a lot to lose if patients are readmitted not long after discharge. But in most cases, their follow-up care coordination efforts post-discharge are perfunctory at best.

My husband’s experience seems to be typical: a few weeks after his discharge, a nurse called and asked perhaps five or six very broad questions about his status. I doubt such as superficial intervention has ever done much prevent a patient from deteriorating. But this dynamic can be changed. As an active, involved e-patient, I think it’s time to bring artificial intelligence technology into the mix.

In recent times, AI platforms have emerged that may offer a big improvement on the, well, largely nothing hospitals do to prevent patients from deteriorating after they leave the facility. In fact, artificial intelligence technology has evolved to the point where it’s possible to provide a “virtual clinician” which serves as a resource for patients.

One example of this emerging technology comes from AI startup Sense.ly, which has developed a virtual nurse named Molly. According to the company, Molly is designed to offer customized patient monitoring and follow-up care, particularly for patients with chronic diseases. Its customers include the UK’s National Health Service, Kaiser Permanente, San Mateo Medical Center, University of California San Francisco, Microsoft and Allscripts.

Molly, an avatar-based system which was designed to mimic the bedside manner patients crave, can access data to assist with real-time care decisions. It also monitors vital signs – though I imagine this works better with a remote connected device — and tracks patient compliance with meds. Molly even creates custom questionnaires on the fly to assess patients, analyzes those responses for risk, and connects patients directly to real- life clinicians if need be.

While this is admittedly a groundbreaking approach, some independent research already exists to suggest that it works. Back in 2011, Northeastern University researchers found that patients who interacted with virtual nurse Elizabeth were more likely to know their diagnoses and make follow-up appointments with their doctor, ZDNet reports.

And if you’re afraid that using such a tool exposes your facility to big legal risks, well, that’s not necessarily the case, according to veteran healthcare attorney David Harlow.

“The issue is always in the terms of use, and if you frame that properly – and build the logic properly – you should be OK,” Harlow told me. He concedes that if hospitals can be sued for patient care problems generated by EMR failures — which happens now and then — a cause of action could arise from use of virtual clinician. But my sense from talking with him was that there’s nothing inherently more dangerous about deploying an AI nurse than using any other technology as part of care.

Speaking for myself, I can’t wait until hospitals and medical practices deploy a tool like Molly, particularly if the alternative is no support at all. Like those who tested Elizabeth at Northeastern University, I’d find it much easier to exchange information with an infinitely patient, focused and nonjudgmental software entity than a rushed nurse with dozens or hundreds of other patients on their mind.

I realize that I’m probably ahead of the market in my comfort with AI technology. (My mother would have a stroke if you asked her to interact with a virtual human.) But I’d argue that patients like me are in the vanguard, and you want to keep us happy. Besides, you might be pleasantly surprised by the clinical impact such interventions can have. Seems like a win-win.

The Amazon Echo – Bringing Sci Fi Reality to Healthcare

Posted on February 16, 2016 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children's hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children's hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David's latest CXO Scene posts here and follow me at Twitter Facebook.

My initial impression of the Amazon Echo was that this is simply a Bluetooth speaker that looks like a portable humidifier with a little bit of artificial intelligence. The next thing I discovered is that the Echo always needs to be plugged in for it to work. But then, after playing around with it, I realized that the Amazon Echo is actually quite impressive.

The Echo introduces the handy Alexa function. The initial conversations with Alexa are very simple. You can ask about the weather, the time, sports results, or the latest news. But with time, I learned that Alexa could even read an audio book; tell me about the local businesses; and where to go for a Thai dinner.

The other benefit of Echo its accessibility and quality. It comes with a remote control or you may control it via your mobile device after downloading the Amazon echo app. The bottom part of the Echo has a 360-degree speaker that surprisingly fills the entire room with sound. Even at a distance of 9-10 feet Alexa can pick up commands.

Because of the sophisticated voice activated system, the Echo has great potential for use by patients in a healthcare setting. The main use case that I see is in the hospital’s patient room. Let’s think of a scenario where we have a 50-year-old patient in the hospital that had just gone through a surgery procedure and is expected to be in the hospital for two days. Echo can be a great device to allow personalization such as: integration to the patient’s Spotify music, control of the room temperature and blinds, the ability to order an Uber for the patient’s family, as well as many other features of a smart home. The goal will be to bring the technology of a smart home into a patient’s room to enhance the patient’s experience away from home.

From a clinical perspective, the Echo can assist the medical provider by reciting the medical education transcribed by the doctor to the patient, such as: the side effects of a prescription drug that the patient should expect for the next month after surgery. If we go back to the example of the patient who is recovering from surgery and has been prescribed drugs, the Echo can either be a replacement or an integrated device for the nurse call system where the patient can ask for pain medication through Echo. In addition, patients can also order their meals through the device if it is integrated with the dietary system in the hospital. As such, the voice-activated system would clearly be a great two-way communication tool for the patient who may not be able to move from their bed with ease.

As healthcare is moving towards the goal of creating the best patient experience possible, we have to start integrating consumer products with the strategy of providing a hotel-like experience in an inpatient room. The integration of smart room technology and voice activation communication has become an invaluable part of luxury hotels, and likewise, we must attempt to replicate that same kind of technology and convenience in hospitals.   I have personally witnessed a lot of success by international hospitals incorporating the hotel experience into their culture to improve patient experience. Similarly, I believe that hospitals in the US must start to adjust our strategy in order to meet the expectation of today’s consumer-patients.

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