The Impact of Cognitive Computing on Healthcare in Southeast Asia

Bumrungrad International Hospital is the world’s first hospital to implement IBM Watson, the world’s first cognitive computer. This is a computer that can rapidly analyse the collective research and recommendations of leading professionals, in order to advise healthcare professionals and improve patient outcomes. To find out more, we speak with Dr James Miser, Chief Medical Information Officer at Bumrungrad International Hospital, who describes the implementation process so far and how the technology is likely to transform healthcare.

Key facts about IBM Watson:

• To date, Watson for Oncology has compiled nearly 15 million pages of medical content, including more than 200 medical textbooks and 300 medical journals.
• Watson can assemble and assess patient information along with relevant medical information from its entire database in less than a minute.
• Watson provides medical professionals with instant access to information from leading research institutions from around the world.
• At Bumrungrad International Hospital, staff will be using Watson to make their data organization more efficient and ultimately the system will help them decide on the best course of treatment for patients.

How is cognitive computing changing the way medicine is being practised?

Dr James Miser: “Medicine is changing dramatically, in large part due to our genetic and molecular understanding of ourselves and the diseases that we can contract. In essence, we’re getting more complicated to medically understand. This leads to greater quantities of patient information and the necessity for more organisation of said information, along with more disease and treatment information.”

“Within the next 5-10 years, this mass of accumulated patient, disease and treatment information is going to become dramatically more complex. In order to give patients the best treatment  options, all of that data needs to be available immediately. This represents an immense challenge for physicians all over the world. Fortunately, a cognitive computing solution is able to absorb thousands of medical journals, textbooks, papers and guidelines from leading institutions in order to piece together the most appropriate data and outline the best course of action for the patient.”

Why is this of particular importance in Southeast Asia?

Dr James Miser: “The challenges in Southeast Asia are magnified because of the uneven distribution of  healthcare throughout the region, for example, the differences between major medical centres and more rural areas. If we can address this balance with cloud based cognitive computing solutions then I think we can have more of an impact here than anywhere else.”

How does Watson function?

Dr James Miser: “It’s a cloud-based system meaning that primary, secondary and tertiary care centres would all have access to it. So even if a primary care centre was unable to properly diagnose a patient or provide the suggested treatment (many cancers require molecular diagnosis with advanced technological processes), its staff would be able to accurately determine where the patient needs to be referred to, with a clear idea of what tests and potential treatments may be  necessary.”

What benefits does using Watson give your colleagues in the oncology department at present?

Dr James Miser:  “We’re just about to start actively using Watson, which means we’re piloting it after numerous test cases. So to be honest, initially the results will be modest but over time it will become more and more important as it is used in connection with a wider variety of cancers and cancer patients, especially in complex cases where the cancer regresses and then reappears often.

“Currently, it will help doctors using the system become more efficient as it helps organise the data, combine the relevant healthcare literature, provide roadmaps and so on. All of these processes will quickly become standardised too, which will allow healthcare professionals to practise in a more efficient and timely manner.”

So it’s accurate to say that the benefits delivered by Watson haven’t been fully realised yet and are going to increase significantly as more healthcare professionals become used to utilising it?

Dr James Miser
:  “Certainly. It’s also going to deliver increased benefits for patients too in terms of helping to design more effective treatment plans. By March we’re hoping to be able to present more concrete data regarding this area. The key issue is ensuring the information is available across the entire healthcare network, so that each medical professional involved is properly informed and can subsequently keep the patient properly informed at every step. In this way,

everybody benefits: the hospitals and healthcare professionals benefit financially and get a boost to their reputation, but more importantly, the patients will benefit. Instead of feeling cut off from the care that they need, they can go to their local healthcare facility and receive a diagnosis and treatment plan supported by the entire hospital network’s expertise based on effective dissemination of information.”

Can you give a ballpark estimate regarding how much of an impact the system will have on oncology department efficiency rates?

Dr James Miser: “Cancer diagnosis requires the completion and analysis of multiple tests which Watson can carry out for the doctor. It can gather all of the patient’s data, organise it and ensure it is complete before consulting its databank of medical literature and then making a suggestion on what the best treatment might be, based on its findings. All of this can be done in perhaps less than a minute – it’s more to do with the speed of the internet than anything else. Moreover, it doesn’t give just the best treatment option, it also suggests the next best option, and the next, with more options available if necessary. In some cases this is more for the patient to decide, because what’s best for one patient may not be best for another, like whether or not to receive chemotherapy, for example. Essentially, Watson puts all of those options, all of the relevant data, literature and several other information tools right at the doctor’s fingertips. It’s really going to help them make efficient, informed decisions in a much more timely manner.”

We’ve been talking primarily about Watson’s impact on oncology. What other applications and impacts do you see this technology having?

Dr James Miser:  “I think that Watson has wider applications to health in general. It can be applied to all types of cancer but it also has applications to the treatment of any serious or chronic disease because it can keep medical professionals updated on the latest practices, treatments and therapies as they are developed”

Will the costs of implementing Watson keep it prohibitively expensive for other less well-funded medical institutions?

Dr James Miser:  “Watson was certainly expensive to develop but like any technology the costs of implementing it will decrease over time. For example, initially it cost hundreds of thousands of dollars to map the human genome but now it only costs around $1000. In the same way, once Watson is applied more broadly, I imagine that the costs will decrease dramatically. There’s even a case to be made by governments that its implementation will eventually save money as it improves healthcare efficiency. Ultimately, Watson can and should be implemented outside of the wealthiest institutions, because they already have the expertise, so they have less of a need for Watson’s capabilities. It’s in more remote and less specialised healthcare facilities in regions like South-East Asia that Watson will have the greatest impact on improving the overall health of the population and I believe that IBM and the other developers of Watson have that vision for their creation.”

What advice would you give any other healthcare organisation that is looking to integrate Watson into their existing processes?

Dr James Miser: “It’s essential that you are able to link Watson to your medical staff effectively. Creating the right user interface and the right IT platform takes time, care, diligence and ICT expertise in order to create a scenario where your employees have a seamless connection to the expertise provided by Watson. So it’s vital that you create a team of both ICT technicians and healthcare professionals to design that integration effectively. It’s also very important to ensure that the right training in the use of Watson is carried out, so that everyone is up to speed with what it can do and how best to utilise its information tools.

“Due to its cloud-based nature, Watson isn’t a simple “straight out of the box” tool; it does need some time and thought to go into its implementation. However, it is a fantastically user-friendly system and can be effectively integrated with any healthcare ICT systems.”

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