How Watson Could Change Health Care and Nursing

By Rose O. Sherman

“The first thing that we realized about Watson is that this thing could be applied anywhere. We have tried to choose a field where Watson can have notable social impact while proving its ability to master a complex body of knowledge.” John Kelly, IBM Chief of Research

Some of you might remember in 2011 when IBM pitted Watson, their newly developed artificial intelligence computer, against two all time champions in a televised game of Jeopardy. Watson had access in its computer database to 200 million pages of structured and unstructured content from a wide variety of sources on the worldwide web, but was not connected to the Internet during the game. In a two-game, combined-point match, broadcast in three Jeopardy! episodes February 14–16, Watson beat the biggest all-time money winner on Jeopardy! (>$3.4 million), and the record holder for the longest championship streak (74 wins). IBM is now hoping to change both medicine and health care delivery with Watson. The potential is very exciting and could have significant impact on some aspects of nursing practice.

What is Watson and how does it work?

Watson is a computer invented by IBM that uses artificial intelligence to grasp the intricacies of human language and answer exceedingly difficult questions. The Siri application for apple products is a much less sophisticated example of the same technology. To train Watson to assist with diagnoses, technicians feed Watson medical texts, journal articles, best practice protocols and patient histories. Watson is also able to analyze unstructured information such as clinician notes and product or treatment reviews on websites. When asked questions, Watson scans its very significant knowledge bank to make recommendations. Watson has the capability to ingest more data in one day than a human being could in a lifetime. In health care, it is believed that Watson could be invaluable in helping health care providers to make diagnoses and select appropriate treatments based on the patient’s personalized information.

Current Health Care Testing

Memorial Sloan-Kettering Cancer Center in New York and the Wellpoint Insurance Company are early adopters testing how Watson can be used to improve care and care delivery. Oncologists at Sloan Kettering are testing an IPAD application that allows them to enter from the point of care queries about how to best treat a lung or breast cancer patient given the patient’s unique health problems, medications, test results and genomic variant of their tumor. Watson then reviews millions of pages of text in journals, research studies and treatment guidelines within seconds and then explores all aspects of the patient’s electronic medical record. Watson then provides potential options for treatment including confidence levels. The oncologist weighs the options and makes the call. The early testing has been extremely promising.

At Wellpoint, Watson is being tested to expedite the authorization process for medical procedures. Nurses and doctors there use Watson to evaluate the patient’s record and latest medical literature. Watson makes a recommendation based on all the data whether or not to authorize the procedure. Eventually it is thought that Watson could provide any doctor in the world with a second opinion about treatment.

Possible Uses in Nursing

When we discuss evidence-based practice in nursing today, we rely on nurses to evaluate the evidence. In the future, we may see a Watson on every unit to assist nurses in making decisions about individualized patient care based on a review of best evidence available. We could see a Watson in the ER being used by triage nurses to assess the urgency of care needs. With the volume of information available both in the literature and in the patient’s record, it is not humanly possible for any professional to have all the information they need at their finger tips as they make decisions.

Watson will not replace health professionals but it does have the potential to significantly help us to make better decisions. The engineers at IBM believe that in the future, Watson will be a handheld device and health care professionals will not be able to work without it. They understand that it will take time to permeate but Watson will play an important future role in health care delivery.

Read to Lead

Ford, M. (9/14/2011 New York Times Blog) Dr. Watson: How IBM’s supercomputer could improve health care. http://www.washingtonpost.com/opinions/dr-watson-how-ibms-supercomputer-could-improve-health-care/2011/09/14/gIQAOZQzXK_story.html

Gertner, J. (November 2012). Call Dr. Watson. Fast Company. p. 126-129, 140-141.