Post CES reflection on role of technology and Alzheimer's.
Boston, mid-May, 2016
Watson: that Jeopardy win was a good beginning -- real win is ahead. In a computer science building at Carnegie Mellon University last week, it was cute to watch the students file into a room to watch the last Jeopardy round on TV. So by now you know that IBM's super computerized multi-year Jeopardy effort paid off and Watson handily beat the two best human Jeopardy players. So what's Watson's next act? Soon, say IBM folk, Watson's tech will be commercialized within healthcare apps: "We're going to look at creating a product offering in the next 24 months that will help empower doctors to do higher quality decision making and diagnoses." Interesting -- and even more so while thinking about Andy Kessler's WSJ analysis of the types of jobs threatened by technology, including the roles of today's doctors.
The New York Times diagnosis 'triumph' -- not so fast. Perhaps you read the Sunday New York Times Magazine article about a difficult and successful diagnosis of a rare rash. The first doctor visited by the patient could not figure it out and brought in a partner who recognized the rash and commented that diagnosing it was 'really just luck' and based on the coincidence of having read a recent article: "That's what's so great about working in a group." But if he hadn't read the article, the patient would have gone to doctor after doctor until she found someone else who had read the article or seen the rash. Given that imaging is already enabling remote dermatological diagnosis, even on iPhones (!), it is just a matter of time before doctors have access to a Watson-like database visual search engine that could match the patient's rash in seconds, offering the doctor several likely diagnostic choices and treatments. That's a far-cry beyond the benefits of 'working in a group'.
So what has this to do with baby boomers? We can scarcely go a day or two without reading an article about future shortages of doctors, whether it is in rural areas, due to changes in Medicaid mandates, or the lure in urban settings that enables a doctor to make more money outside of direct care. Or all of the above. Baby boomers will be seniors with multiple chronic conditions when this shortage becomes chronic, waits for appointments become intolerable, and complications result from delayed examinations. But by then, as with every industry in recent history, fewer doctors per population will be shored up with more information. The healthcare industry will finally tire of the Electronic Medical Record money pit and give up on automating its transactional systems that will never connect properly to other systems. (I heard one hospital executive say recently: "After 10 years and $1 billion of investment, barely 1% of our enterprise has reached full EMR use.") Instead, the real opportunity for making the doctor more efficient is in their access to drug and diagnostic knowledge that could reduce the likelihood of a not-infrequent incorrect diagnosis. Not to mention the time and money wasted by patients traveling long distances to meet with the wrong specialists who simply refer to the next specialist or bring in a partner from the group who may have read an article and recognizes relevance.
And what's to say boomers-now-seniors won't more accurately diagnose themselves? Watson is really a search engine on steroids that translated phrasing variations (with the help of Nuance) into accurate results, assigning a degree of confidence to its proposed answers. That's exactly what we want to do for ourselves, before we visit a doctor, using a search engine so that our care can be correctly calibrated to our need, keeping us out of emergency rooms if we don't need to be there, reserving our time with our doctor to discuss possible treatments of an accurately pinpointed diagnosis, verified by a system that does not rely on luck.