Whats the Big Data

Presiding over the ceremonial opening of the new IBM Watson Health global headquarters in Cambridge, Mass., IBM’s senior vice president Mike Rhodin highlighted the sometime-neglected focus of the effort to mine the ever-increasing quantities of health data. “We know that technology alone isn’t the answer,” said Rhodin. “At its core, Watson Health provides the means to orient the entire system around us.”

In a telephone conversation before the event, Dr. Lynda Chin, associate vice chancellor for health transformation at the University of Texas system, voiced a similar perspective: “Technology and innovation are the instigators for change, but they alone won’t do it. We have to think about implementation, about translating the technology into desired outcomes. Implementation is never just a technology play.”

Before assuming her current position in April, Dr. Chin was the founding chair of Genomic Medicine and scientific director of the Institute for Applied Cancer Science at The University of Texas MD Anderson Cancer Center. Two years ago, IBM and MD Anderson announced the Oncology Expert Advisor (OEA), based on IBM’s Watson data analytics engine, an expert system enabling clinicians to “uncover valuable insights from the cancer center’s rich patient and research databases.”

Dr. Chin reports that MD Anderson has by now developed two “apps,” each dealing with a different type of cancer, and is in the process of developing a third one, with each successive cancer-specific solution taking less time to develop. The ultimate goal is to make these solutions available to MD Anderson’s national and international network, so general oncologists in remote hospitals and clinics could tap into its accumulated and evolving expertise.  “To show that the OEA is a knowledge democratization tool, we have to build a network cloud infrastructure to support it. The OEA will not be useful if it doesn’t fit into the everyday life of the general oncologist.”

To achieve that goal, MD Anderson has also partnered with PwC for the development of the cloud information interchange and with AT&T for a secure, dedicated network. It is now piloting its first network link, to one of its network partners in New Jersey.

The integration with the general oncologist’s workflow is moving the expert system from a research reference resource and clinical decision support tool to helping manage the care of specific patients. “The OEA is trained to simulate the exchange between a physician and an expert,” says Dr. Chin. “So for the OEA to work, it has to be connected to the EHR system so we can learn about the patient. The OEA is trained not only to understand the profile of the patient in terms of what is the appropriate evidence-based treatment options but also sharing the experience in managing patients on that type of therapy and helping the general oncologist manage it. It’s as if the oncologist has the ability to call up the expert 24/7 to ask for advice.”

Still, one of the lessons learned so far is that “there will always be a question the OEA was not trained on,” so a teleconferencing component has been built into the system.  Other lessons include the need to provide mobile-device-based solutions, the challenge of teaching the OEA the relative value of each piece of information, and that the expert system “is very valuable from a learning perspective,” as a teaching tool for doctors in training. It also turned out that the OEA is useful in helping research nurses screen patients for clinical trials. Before, the nurses were often considering only the trials they knew about. Now they have at their disposal a clinical trial recommendation engine that screens through all the available trials and an expert system that helps with monitoring the patients participating in the clinical trial.

The development of the OEA is a never-ending journey. Healthcare is a complex and constantly changing endeavor involving research and practice, experiments and established procedures, professionals, institutions, and providers of all sorts, and most important of all, the people they serve—both patients and everybody else trying to keep themselves healthy.  Over the last decade healthcare has gone, at long last, through rapid digitization, transforming mounds of paper into electronic records and introducing computers to many aspects of the physician’s work.

As in other fields, the introduction of computer technology provides opportunities for reducing costs and increasing quality and effectiveness, while at the same time increasing the potential for errors caused by over-reliance on technology and automation. Similarly, while digitization facilitates the collection and sharing of practical knowledge and research expertise, it also produces mountains of data that threaten to impede rather than accelerate progress.

IBM Watson helps in processing and analyzing this data and presenting it as confidence-level-ranked suggestions and recommendations.  At the IBM event on September 10, Dr. Jeff Burns described how OPENPediatrics doesn’t tell the physician “do this,” but rather “tells the doctor what to think about.” OPENPediatrics is a Boston Children’s Hospital-led initiative bringing medical knowledge to pediatric caregivers worldwide (currently reaching 900 hospitals in 127 countries). IBM and Boston Children’s Hospital plan to develop “solutions for commercialization, initially pursuing applications in personalized medicine, heart health and critical care,” leveraging Watson’s genomic, image, and streaming analytics capabilities.

At the new Watson Health headquarters in Cambridge, Mass., Dr. Watson—and 700 other IBM employees—will be joining more than 600 Massachusetts-based life sciences companies and research organizations employing about 60,000 people. IBM plans to open there an interactive Watson Health Experience Center (a demonstration center for IBM customers) and establish a dedicated Health Research lab.

“We have to do it as a community,” Mike Rohdin declared at the event. Other participants, executives from Yale University, Sage Bionetworks, Medtronic, CVS Health, Modernizing Medicine and Teva Pharmaceuticals, echoed the sentiment. And Like Rhodin, they stressed putting people at the center of their efforts to improve healthcare, highlighting the specific goal of helping patients manage their disease.

Digitization—and smart analysis of the data it generates—helps in building a community around shared knowledge. The competition for profits and prestige among healthcare providers, however, while driving the innovation that may lead to better healthcare, also could stand in the way of cooperation and knowledge sharing. It may also lead to hasty development of technology-based solutions without a careful evaluation of the actual benefits and potential risks. Let’s hope that IBM and its partners will do everything they can to uphold the medical community’s tradition of controlled experiments and contributing to the ever-growing public repository of knowledge of what works and what doesn’t work in healthcare.

Originally published on Forbes.com