Memorial Sloan-Kettering’s Newest Medical Student: IBM Watson
While there is nothing elementary about cancer care, IBM’s famous Watson will be in training as an oncologist at NYC’s Memorial Sloan-Kettering Cancer Center. The IBM-Sloan-Kettering team hopes that Watson technology, capable of processing large datasets in response to natural language questions, will ideally help clinicians apply evidence-based principles to diagnostics and treatment.
Together, IBM and Sloan-Kettering will “feed” Watson information from medical textbooks, the most recent publications in cancer research, the hospital’s clinical data, and with patients’ permission, individual medical records. As Watson processes more information, the team will test the super computer on increasingly challenging cancer cases. Watson is expected to reduce the growing scientific literature to relevant, actionable information for the treatment of individual patients.
Dr. Larry Norton, the deputy chief for breast cancer programs at Sloan-Kettering, quipped to the Boston Globe, “The capabilities are enormous… and unlike my medical students, Watson doesn't forget anything.” Most impressive to Dr. Norton is Watson’s ability to process natural language in plain text form (physician notes); with this, Watson will contextualize the data to provide better recommendations to physicians.
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A new article from the International Journal of Medical Informatics highlights the fact that people and processes, not technology, are the keys to successful EMR implementation. The article describes the experiences of two public hospitals in Australia that deployed the same radiation oncology information system (OIS) in 2003 but achieved very different results.
By 2007, the "successful" hospital was using the OIS for to record all patient histories, examination results, diagnoses, prescribing and approving radiation therapy, tracking disease outcomes, side effects and acute late toxicities. In contrast, the OIS at the other hospital was never fully adopted and was poorly utilizaed by clinicians.
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A few weeks ago President Obama signed into law the Continuing Extension Act of 2010. It includes a revision to the HITECH Act that will enable physicians practicing in hospital outpatient clinics to collect federal payments for meaningful use of health IT. My colleague Protima Advani, who heads up the Advisory Board's IT Insights practice, wrote the following analysis, which I though you might find of interest:
"This change marked a huge victory for many Washington lobbyists and may have set a precedent for additional amendments to the HITECH Act. In fact, right on the heels of this amendment, several congressional representatives introduced legislation to expand this definition--for the purposes of meaningful use incentives for EHR adoption--to include behavioral health, mental health, and substance abuse treatment professionals and facilities.
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We unfortunately did not have time during our March 30 web conference, "Realizing the Potential of Oncology Clinical IT," to address all of the questions we had received on the topic. However, our expert panelist Matt Sherer very kindly helped me to draft answers to the most frequently asked questions. Here they are:
1. Is there an oncology-specific system that is "certified" under the meaningful use requirements?
Not yet. The Office of the National Coordinator for Health Information Technology (ONC) will be responsible for certifying health information technologies, but they have not certified any systems to date. They have indicated that the electronic health records that have been certified by the Certification Commission for Health Information Technology (CCHIT) will likely meet the meaningful use certification criteria or will require only minimal upgrades to do so.
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