A Closer Look at How IBM’s Watson Could Transform Veteran Health Care

In December, the Department of Veterans Affairs announced a pilot project with arguably the most famous "Jeopardy" champion of all – IBM’s Watson.

The announcement merited some positive press: VA provides health care for more than 8 million veterans annually, but unless you’ve been living in a cave for the past year and a half – or you prefer “Keeping up with the Kardashians” to the evening news – you know VA has received about as much positive press as the Washington football team.

VA has been under fire for an assortment of issues, ranging from an outright scandal over delays in treating veterans that even has its own Wikipedia page, to blowing millions of taxpayer dollars in a futile effort to share health care information with the Defense Department.

Yet, its Watson pilot represents a chance for some groundbreaking efforts in health care, especially if Watson’s cognitive computing capabilities prove to enhance veteran care.

IBM’s Watson will be deployed in one of VA’s Austin, Texas, data centers and will according to various press reports and official statements “ingest hundreds of thousands of Veterans Health Administration documents, medical records and research papers.”

On the surface, the goal appears to have Watson serve as an information-gathering tool to help clinicians and physicians gather data in near-real time. Yet, there’s more to the $6.8 million pilot than collecting a bit of data.

For starters, Watson ingests actual health records “in a safe-harbor environment,” according to a VA official, and Watson will “make extensive use of natural-language processing.”

How natural?

“The ability for the system to decipher [doctors’] notes and act on that understanding is something we are very interested in,” the official said in an email to me.

Some health care data fits nicely in machine-readable structures, such as vital signs or lab test results. That data can be ingested easily by computers. 

But unstructured data can comprise as much as 85 percent of a patient’s health care record. Doctors’ notes detailing a veteran’s symptoms, for example, are often unruly and a huge challenge for computing systems. Yet, put together, they could tell the veteran’s nearly complete health history.

Watson ability to decipher doctors’ notes will be a “key part of the assessment” that VA will oversee in the pilot. The assessment will not include speech-to-text or text-to-speech capabilities, but it will be able to ingest text notes included in a patient’s health care record.

Text notes and the insight within them will be used to improve Watson’s primary efforts, which are the retrieval of “relevant information from the medical record” and permitting clinicians to “rapidly search clinical literature through natural language questions,” the VA official said.

Clearly, VA has larger plans in mind for its pilot with Watson, but it will be thorough in assessing the technology’s capabilities.

VA is creating an assessment team of practicing physicians and informatics specialists to evaluate the technology based on factors such as efficiency, effectiveness and accuracy. VA will also evaluate aspects regarding the training of a reasoning system across a wide variety of diseases and disorders.

It is important to note that Watson will not simulate actually diagnoses – so veterans shouldn’t expect a computer to replace their human doctors anytime soon.  

But depending on the success of VA’s pilot, perhaps the "Jeopardy" champion will soon be famous for something a little more virtuous: improving millions of veterans’ health care.