Supercomputing coming to the point of care

Doctors will soon be able to access the power of IBM Watson's cognitive computing intelligence to get answers to medical questions at the point of care.

Modernizing Medicine is one of three new IBM partners leveraging Watson technology via the cloud with apps slated to hit the market later this year.

Modernizing Medicine's Electronic Medical Assistant (EMA) — a specialty EMR system with a built-in library of medical content and coding expertise — will be enhanced into schEMA, a powered-by-Watson app that will comprehend peer-reviewed medical journals and provide near-instantaneous answers to physicians' questions about conditions, treatments and outcomes.

The purpose of the app is to strengthen physicians' recommendations and enable them to efficiently practice evidence-based medicine.

"Doctors are looking at diseases, operating on patients, prescribing medications. There is no way we can remember all of the information and all of the textbooks we've ever read, as well as all the published literature that comes out on a weekly basis and synthesize that at the point of care for the 40 to 50 patients we see every day,” said Michael Sherling, MD, a practicing dermatologist and co-founder of
Modernizing Medicine. “That's what schEMA is for. It helps us get that level of evidence in a contextual way in a split-second."

But Watson doesn't jostle the doctor out of the driver's seat, emphasized co-founder and CEO Dan Cane. "There are certainly people out there who think computers should help with differential diagnosis or hypothesis generation," he said. "That is not how we are using this type of cognitive supercomputer. We are using it to help doctors cite evidence in their note or answer questions, but the doctor is not the passive one and the computer is not making active recommendations. It's the other way around."

In a real-world scenario, a dermatologist might be deciding between treatment options for a psoriasis patient. First, the doctor would ask schEMA, "What is the head-to-head benefit of methotrexate vs. cyclosporine?" Studies show that methotrexate has some long-term benefits, but there may be side effects, so the next question would be, "What are the side effects of methotrexate?" Finally, the doctor would ask, "What are the guidelines for surveillance liver biopsies for patients on methotrexate?"

"When I trained 10 years ago, the biopsy guideline was after 1.5 grams of methotrexate," Sherling said. "But the National Psoriasis Foundation released guidelines a year or two ago that said it's after 4 grams of methotrexate. Here's where evidence helps. I could read article after article and not know that — or I could just ask the question and get the most up-to-date answer."

Aside from dermatology, Modernizing Medicine provides EMA for the specialties of ophthalmology, plastic surgery, orthopedics and otolaryngology and is expanding into gastroenterology, urology and rheumatology. Its next step in moving schEMA along to actual use in physician practices is finalizing deals with content providers, the peer-reviewed journals that will be "ingested" into Watson's corpus of information.

IBM's other newly announced Watson app partners work outside of healthcare. Reflexis Systems is developing an app that will alert retailers when the timing is right to more prominently display certain products to increase sales. Modulus Financial's app will help investors make on-the-go decisions based on insights uncovered from trading floor data.

In the past 18 months, nearly 2,000 individuals and organizations have contacted IBM to share ideas for building cognitive-computing apps.