Surveillance – e.g. Los Alamos Labs

Bioterrorism

Drug

 Infectious Disease
 Review for patient safety issues

 Computerized patient problem list

 IBM team and I found patient problem list typically 

poorly maintained and updated

 Problems not deleted when they are no longer 

important

 Contradictions in patient problem list

 Patient on medications not corresponding to problems 

on the list 
 Dr. Watson software can utilize genomic and 

proteomic information in addition to patient signs and 

symptoms to provide personalized diagnostic and 

treatment information

 Will be able to utilize an increasing number of 

genomic and proteomic databases such as The Cancer 

Genome Atlas and The Million Veteran Program
January 

2000 May 2001 March 2002

Brain 

mass

Chest 

nodule

normal

normal

No 

history

Mass 

decreased

Chest 

nodule 

remains 

same

normal

normal

normal

No mass

Nodule 

remains 

same

Had 

MI

normal

Gave 

birth 6 

weeks 

back

Synthesis/Display of Complex Information in EMR
Image

Image 

Annotation and 

Lab Annotation 

Data 

Genomic &

Clinical Analytic 

Results
 Need to understand to listen and human 

speech including accents

 Needs to have improved ability to 

understand abbreviations and medical 

jargon

 Needs mechanism to obtain feedback 

(learn) from physicians using it

 Continue to refine and improve user interface to 

allow feedback and refinement of algorithms
 Emergency Department Scenario

 Requires “real-time” decision making

 Cannot use same model with all 

information entered into the chart 

before Watson makes its assessment and 

recommendations

 Need better systems to capture 

information at point of care

 Vital signs and lab and signal monitoring 

 Do we need additional methods of 

inputting data?

 Do we need to capture live conversations 

with providers and patients?

9
 Could use more personality

 Female voice chosen for Siri after much research 

and feedback

 Needs to understand nuances of 

communication such as patients questions 

expressing emotions such as fear etc.

 Potential for Watson to be bridge to allow 

connectivity and interoperability since so 

many islands currently being set up with 

health information exchanges at city and 

state and other levels

 Watson or Watson like technology may 

provide test bed for standards in medicine 

and may improve interoperability
 According to a study done by the Mayo Clinic in 2006, the 

most important characteristics patients feel a good doctor 

must possess are entirely human

 According to the study, the ideal physician is confident, 

empathetic, humane, personal, forthright, 

respectful, and thorough

 Watson may have proved his cognitive superiority, but can 

a computer ever be taught these human attributes needed 

to negotiate through patient fear, anxiety, and confusion? 

Could such a computer ever come across as sincere?

13
Introduced by Alan Turing in his 1950 paper 

“Computing Machinery and Intelligence”

Opens with the words “I propose to consider 

the question, ‘Can machines think?”

Asks whether a computer could fool a human 

being in another room into thinking it was a 

human being

Modified Dr. Watson Turing Test might ask: 

Can a computer fool a human being into 

thinking it was a doctor?


 No, in order to achieve their full 

potential we will need to make our 

medical records more structured and 

standardized, and rethink how we can 

make our clinical trial and other 

research databases more readily 

discoverable and reusable

 These changes will also accelerate 

interoperability and information 

exchange which will improve 

healthcare