Computer Assisted Healthcare, The Surmountable Insurmountable Challenge
Speech Recognition, Language Processing, and Reasoning Facilitation are Essential to Provide Adequate Baseline Care

For many years, the information overload challenge has been clear to us all.  With the advent of Meaningful Use requirements, like maintaining and evolving a useful codified problem list, we're finding that we don't have the time, much less the adequate definitions to keep up.  As I travel around the country to talk with physician executives, all of them see the challenge of moving to ICD-10 and related documentation improvements as an insurmountable challenge.  That is, insurmountable to do manually or with currently available technologies.

Last February, an AI-enabled computer system named “Watson” competed against two human Jeopardy! masters in the game and won.  To do so, it had to use natural language processing and reason over four terabytes of disk storage, including the full text of Wikipedia.  There's a nice summary of the hardware and software issues here: http://en.wikipedia.org/wiki/IBM_Watson.

Will it take a computer capable of reading a million books per second to help physicians review a patient's complete chart, the relevant medical literature, the quality and coding requirements, and assemble a note and orders with adequate reasoning to address our triple aim goal: better healthcare, better health, lower costs?  It might.

For a presentation that elaborates on the background and paints issues in detail, watch the video ("Jeopardy! Understanding, Questioning and Answering in Healthcare").

Jeopardy! Understanding, Questioning and Answering in Healthcare from Healthcare Informatics on Vimeo.

We have developed systems with the capacity to store and retrieve all the information we need to provide not just adequate, but quality baseline patient care.  My team, working in conjunction with users, and many others in our industry are now striving to evolve our systems to near the level of Watson, but without the astronomical cost associated with owning it.  Impossible?  I don’t think so.  After all, 20 years ago, the Internet as we know it today was considered by most a pipedream.

What do you think?


Joe Bormel, M.D., MPH
CMO & VP, QuadraMed

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