Search This Blog

Tuesday, September 13, 2011

“Dr. Watson will see you now” – an opportunity for payers, a question mark for providers and patients, and potentially a big headache for pharma

by Torsten Bernewitz

Yesterday Wellpoint, with 34 million members one of the largest health insurers in the US, and IBM announced that they are teaming up to test Watson, the supercomputer of Jeopardy fame, in clinical trials.
The hope is that using Watson, doctors will improve diagnostic accuracy and make better-informed treatment decisions. Watson will scan large amounts of electronic health records and medical research data to provide doctors and nurses with treatment recommendations. Providers will access Watson trough the web from a conventional personal computer or handheld device.
Pilots will begin early next year, initially in academic medical centers and oncology centers and practices. The choice to focus on oncology first makes perfect sense given that in this area treatment and care cost are growing significantly faster than elsewhere.

But it is also a pointer to one of the motivations to use this technology: not just to provide patients with the most effective treatment, but also managing cost-benefits.

Although Wellpoint says that it will not base a claim decision on the supercomputer - well, at least not solely – the stated goal is to make the clinical decision process more evidence based, with Watson contributing the evidence.

A diagnostic test or therapeutic intervention that is consistent with Watson’s assessment will get faster (possibly automatic) approval and create less paperwork. That’s great, but on the flipside, going outside or even against Watson’s recommendation will be more work for the treatment team, and therefore probably happen less frequently. Off-label use and experimental treatments are big question marks already that can only get bigger.

Payers will certainly watch with interest how this experiment will play out. Providers and patients may need to overcome some emotional hurdles before they let a machine guide therapeutic choices.

But another healthcare stakeholder should become really worried, and that is the pharmaceutical industry.

In a future world where treatment decisions are significantly determined by evidence based algorithms, what can be the role of sales and marketing? Sales and marketing’s primary task is to influence attitudes and behaviors of decision makers, and is most effective if it can exploit on ambiguity of information or knowledge gaps. A lot of that may be going away soon…


Torsten Bernewitz is a healthcare industry analyst and management consultant.
He is Managing Principal, Healthcare Insurers and Payers at
ZS Associates.

This post is the author’s own and does not necessarily represent ZS Associates’ positions, strategies or opinions.

No comments:

Post a Comment