• Paging Dr. Expert-system

    Ken Jennings reacts to being outsmarted on Jeopardy! by IBM’s computer “Watson” (h/t Ezra Klein):

    IBM has bragged to the media that Watson’s question-answering skills are good for more than annoying Alex Trebek. The company sees a future in which fields like medical diagnosis, business analytics, and tech support are automated by question-answering software like Watson. Just as factory jobs were eliminated in the 20th century by new assembly-line robots, Brad and I were the first knowledge-industry workers put out of work by the new generation of “thinking” machines. “Quiz show contestant” may be the first job made redundant by Watson, but I’m sure it won’t be the last. [Bold mine.]

    How long until the triage nurse has another option, Dr. Expert-system? It may sound like a joke today, but it could be a health care game changer tomorrow. IBM wants a piece of the action. Will Medicare reimburse?

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    • I don’t think this is crazy at all. Already, “clinical decision support” is part of meaningful use criteria for electronic health record reimbursement. Epocrates is very popular. I don’t think the skill biased technological change literature has too much to say about what to expect.

    • What the use of a “Dr. Watson” application will do is drive up health care costs. The reason is that all of these expert systems rely on matching the presenting situation across a huge database of previous situations. In chess and Jeopardy the presenting situation is quite constrained (a board position or a short series of words) and is easy to describe digitally. Patients, on the other hand, present in analog form. To ‘convert’ the analog patient into a digital representation requires doing tests that produce digital output. And for optimum reproducibility, the panel of tests needs to be done in every case.

      Physicians in training are well known to order tons of tests, often without knowing exactly why or what they will do with the answers. This will be writ large with Dr. Watson.