IBM Watson and the Future of HealthcareeHealth-päivä OYS 29.3.2016

Jouko Poutanen, IBM Finlandjouko.poutanen@fi.ibm.com

Agenda

► Healthcare Industry Trends

► What and Why of Cognitive Computing?

► Watson in Healthcare

2

Healthcare Vision 2020

3

https://youtu.be/bVY7OmYqBSY

The healthcare industry is experiencing unprecedented level of disruption…

Source[1]: http://www.mckinsey.com/insights/health_systems_and_services/how_us_healthcare_companies_can_thrive_amid_disruption

For more than half a century, healthcare expenditures have risen considerably faster than GDP growth

0

100

200

300

400

500

600

700

800

900

1960 1970 1980 1990 2000 2010

Cumulative real per capita growth in national health expenditures vs. GDP, % growth since 19601

GDP National health expenditure

5x

There’s a gap in the accuracy of treatment decisions.

As many as 44% of all initial cancer treatments are modified on the second course of treatment. 1

Less than 50% of medicine is evidence based.2

An epidemiologist would have to read 167 hours a week to keep up with new professional insight. 3

Aging populations can’t be served.

25% of Japan's population is over 65, growing to 40% by 2060. 4

1. Journal of Clinical Oncology, Talk about Health Blog, Sept 2011 2. www.washingtonmonthly.com/features/2007/0710.brownlee.html 3. http://www.economist.com/blogs/babbage/2013/02/computer-aided-medicine4. "Population Statistics of Japan 2012". National Institute of Population and Social Security Research. January 2012.

Data: must be harnessed and harvested

2010

Volu

me

in E

xaby

tes

9000

8000

7000

6000

5000

4000

3000

2020

Percentage of uncertain data

Percent of uncertain data

100

80

60

40

20

0

Sensors & Devices

VoIP

Enterprise Data

Social Media

Source: IBM Global Technology Outlook - 2012

We are here

6

Unable to use the new natural resource of data to fullest extent, organizations experience a performance gap…

4V of Data(Volume, Variety, Velocity, Veracity)

Cha

nge Performance Gap

Opportunity…new ways of working, operating, thinking

Achievement…but riding by the constraints of limited capabilities, organization achievements would be at slower pace

By 2010 Health Information Will Double Every 73 Days

1100 TerabytesGenerated per lifetime

25%Medical Care

5%Genetic

75%Social Context, Behaviors

Impact on population health status

SOURCE: Barbara J. Sowada, A Call to Be Whole: The Fundamentals of Health Care Reform, July 30, 2003, Praeger.

Consumer-contributed data from non-medical sources: wearables, social media activity, public records

6 TerabytesEMR, EHR, claim systems

0.4 TerabytesGenetic research, personalized medicine, clinical trials

Traditional technology can’t fully utilise 2/3 of health data!Huge opportunity for improvement

9

Healthcare is moving to a system focused on value, coordinated around the individual and integrated into our communities

9

Emphasis is on proactive care to meet health needs

Payment is based uponvalue and outcomes

Care is standardized according to evidence-based guidelines

We measure quality and make rapid changes to improve it

Knowledge is translated into practice quickly

Data and Information

Understand and

influencetheir

populations

Evidence-based andstandardized care planning

Coordinationacross

boundaries-- share care,

accountabilityand risk

Individualengagement

andempower-

ment

Quality measurement

andperformance

reporting

Social Worker

BehaviouralHealth

Family

Community

Pallative Care/Hospice

Rehabilitation

Home Care

Specialists Intensivist

Physical Therapist

Dietician

Case Manager

Caregivers

Transportation

Housing

Medications

Funding and Payment

PrimaryCare

Why cognitive? Humans as observers…

What do you see?

“..you see one or the other, never both. And the way we perceive is strongly connected to how we think about more abstract issues, even politics”- Dr. Nick Chater, Warwick Business School, Behavioral Science Lab

Why cognitive? Humans as Decision Makers…The cognitive process of human decision making

Observe

InterpretDecide

Evaluate

Cognitive systems reduce the bias from our decision making

Social proof

Group think

Outliar, Halo Effect

Sunk cost

Availability bias

Pattern recognition

Examples of human cognitive biases

We Need a New Way of Computing …

Tabulation

1900 - 1950 - 2011 -

Programmatic Era Cognitive Era

Traditional IT• Structured data (local)• Deterministic Applications• Machine Language• Systems of records

• Structured & unstructured (global)• Probabilistic Applications• Discovery Oriented• Natural Language• Systems of engagement

Industry Solutions

BusinessAnalytics

Big Data

Watson

Learn by example

Learn by programming

CloudComputing

LearnsDecisions made by leading experts feed the engine. Watson learns & improves over time.

Understands Natural LanguageWatson can read and understandmillions of documents:• Medical Texts• Evidence-Based Guidelines• Peer-reviewed Articles• Clinical and Case Records

ReasonsWatson searches & analyzes data, returning evidence-based recommendations.

Watson: A Cognitive System

14

How Cognitive Systems Drive Value?

Scale AccelerateEnhance

Human Expertise

RBV, Capabilities Theory, Tacit Knowledge…

Published Knowledge

Knowledge-Driven Method Data-Driven Method

ObservationalData

• Longitudinal records• Claims, Rx, Labs• Patient reported data

• Scientific papers• Books• Guidelines

Closing the translational knowledge gap Personalized Insights from institutional data

From population averages … To insights for individual patient!

Hypothesis with confidence measurement which is backed up by personalized measurements and insights

Watson as a decision support system

DataStandards based.

Massively scalable.Open repository of data on all

dimensions of health for research.

Insights as a Service Knowledge and

actionable information,through advanced analyticsand cognitive capabilities

Watson Health Cloud

Data - Insight - Solutions

SolutionsFrom IBM &

an ecosystem of partners.Improves the overall

experience and increases the quality of outcomes.

Individual

Social Programs

EducationGovernments

Home Health Agencies

Practitioners

Hospitals

Therapists

Health Plans

Family

Public Health

Medical Devicesand DiagnosticsBio-Pharma

Employers

Driving Engagement Across Communities of Care

Payers

IBM Watson // ©2015 IBM Corporation

Population Health

Management

Identify care gaps and deliver

timely, coordinated care

Social Programs

Address individuals' social context for better

outcomes

Real WorldEvidence

Uncover health interventions to

inform care approaches

ConditionSpecific Care

Apply best care protocols to

manage chronic conditions

Healthand Wellness

Empower individuals to live healthier, more productive lives

DiscoverySolutions

Accelerate research and

improve treatments

Solutions for the health industry

Life Sciences, Care Providers, Payers, Employers, Wellness, and Health And Human Services

SolutionsPopulation Health

Management

ConditionSpecific Care

Healthand Wellness

Social Programs

DiscoverySolutions

Real WorldEvidence

EcosystemPopulation Health

Management

ConditionSpecific Care

Healthand Wellness

Social Programs

DiscoverySolutions

Real WorldEvidence

Individual

Social Programs

Education

Governments

Home HealthAgencies

Practitioners

Hospitals

Therapists

Health Plans

Family

Public Health

Medical Devicesand Diagnostics

Bio-Pharma

Employers

Payers

DataInsight

IBM Watson // ©2015 IBM Corporation

Solutions

Population HealthManagement

ConditionSpecific Care

Healthand Wellness

Social Programs

DiscoverySolutions

Real WorldEvidence`

Watson Analytics

eHealthSolutions

Solutions

DataStructured & Unstructured

InsightsCognitive &

Advanced Analytics

Watson Discovery & Genomic Advisor to aid in drug research

Testing new drugs with Clinical Trial

Matching

Protocol development/ Clinical trial design with

Explorys

WH eHealth: Data collection from devices, cloud data integration

predictive analytics

WH Phytel: Patient Engagement and Care

Coordination

Data and Knowledge Ingested by Watson Health Platform

Insights as a service delivered by Watson Health platform

21

Private HIPAA, GXP Cloud

COGNITIVE USE CASES

Improve Engagement R&D Productivity Improve Outcomesexamples provided

© 2014 International Business Machines Corporation 23

Watson Uncovers Cancer Clues – Baylor College of Medicine

The Result:1.I n the past 35 years, an average of one P53 kinase per year has been discovered

2. Analyzing articles through 2003, Watson identified 9 kinases that could phosphorylate P53

3. In 2013, Watson identified 2 additional kinases likely to phosphorylate p53. Early experiments have yielded confirmatory evidence.

The Question:• Are there novel kinases that could activate the

P53 protein? The Goal:• Accelerate the discovery of novel ways to

activate P53 through phosphorylation of related proteins.

The Challenge:• Effectively discovering insights from:

‒ More than 70,000 papers exist on P53‒ 240,000 papers exist on human kinases

• This year 2 million women will be diagnosed with breast cancer worldwide

• Therapies available for treatment : more than 800

• To keep up, it would take a physician 160 hours of reading per week!

• 15,000 hours of training by MSK, Watson ingested more than 600,000 pieces of medical evidence, 2 million pages of text, 1.5 million patient records and 26,000 clinical cases

• Watch the video in the next slide

26

https://youtu.be/338CIHlVi7A

IBM Watson for Oncology Demo

Quality&Regulatory

GlobalCloudInfrastructureSecurity&Privacy

Operational Subsystem AnalyticsSubsystem

Watson Health Offers an eHealth Journey

27

Analyticaltoolsandcapabilitiesthatsupportevidence-basedclinicaldecisionmakingresultinginenhancedefficiencyandeffectivenessin

caredeliveryandpopulationmanagement

Toolsandcapabilitiesthatenablepersonalizedcaredelivery,includingcareassessment,careplanning,providercollaboration,andaccessto

outcomesdataacrossthespectrumofcaresettings

Fundamentalcapabilitiesthatlinkinformationsystemsanddatasetsforthesamepatientallowingforaholistic,longitudinalviewof

patient’sinformationacrosscaresettings

Analytics

Foundation

Data-driv

eninsig

hts

Expe

rientialinsights

WellBeing

CareCoordination

Socialdeterminantshavedirectimpactonoverallhealthand

wellbeing

Lifestylechoiceshave

directimpactonmentalandphysicalwellness

Clinicalfactorssuchasmedicalsymptoms,history,medications,etc.are

indicatorsofanindividual’shealth

Respiratory Diabetes

for

Oncology

CentralNervousSystem CHF