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Comment by nostromo | Hacker News Reader

I think this is backwards. (After thoroughly testing of course) I'd rather see Watson be the first-tier of diagnosis, backed up by a doctor when Watson isn't so sure of an answer, as opposed to Watson just helping befuddled doctors. This could really bring down medical costs at scale.

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And also possibly make it harder for doctors to, say, recommend a more expensive procedure because their hospital gets paid more.

Actually, this seems like the perfect opportunity for pharma companies to "help" in creating the database.

That's actually what they are already doing when pitching new drugs to doctors. Now they only have to convince the system designers and not thousands of practicing doctors.

In the end, the power is going to be with the payors, who are plenty savvy themselves, not the pharma companies.

Drugs are a relatively small part (10-15%) of the overall cost of healthcare.

Most new drugs today win on marketing, rather than efficacy. Once you have a system like watson, it's rather trivial to do the expected value calculation of "This treatment has an X% chance of working, and costs Y. The competing treatment has X'%, and costs Y'."

As long as that data is available to patients (and it should be), I'm with the parent poster, this will make it harder to pad treatments.

The customers for the software are the hospitals that people go to, not the insurance companies or the patients. I guarantee you that the hospitals will prefer whatever option results in the best possible financial outcomes for themselves.

Well then who is going to do the clinical observation, coding, and data entry? That work doesn't get done for free and in most cases it would actually take the healthcare providers more time to do.

There's (going to be) an app for that! Input data -> output diagnoses!

Ha ha. Seriously, clinical data entry is not quick or easy (outside a few limited special cases) regardless of how well you design that mythical app. Even perfect speech recognition would only get you part of the way there, and we aren't likely to get that any time soon.

I really don't think perfect speech recognition is that far away. 10 years and we're gonna have something that can work. 10 years and we'll have an advanced Google Goggles that can help with diagnosis. Ask the question "What are the limits of human input?" Nothing besides touch, taste, hear, see and smell, and we're getting closer and closer to being able to input that data and process it as humans would.

"Even perfect speech recognition would only get you part of the way there, and we aren't likely to get that any time soon."

We're working on it, though.

http://www.mmodal.com

Most of the time, there is still a transcriptionist in the loop. Or the doctor has to make his own edits.

I know, we use your service. :-) It works well for increasing the productivity of our human transcriptionists but it doesn't really solve the automated diagnosis data entry problem that others were asking about.

and a Mobile Diagnostics X-Prize to incentivise you to get there: http://www.technologyreview.com/biomedicine/37596/?p1=A4

Do you need to spend 7 or 8 years training someone to do that? If I'm not mistaken, that's already largely done by nurses and patient care technicians.

You are mistaken. In most cases that's not done at all by anyone. Most of the data entry done by medical coders (not programmers, the other kind of coders) is for billing and insurance claims purposes. That claims data isn't detailed enough to be useful for diagnosis. And in most cases it is done hours or days later, not immediately at the point of care where the doctor is expected to make a diagnosis and decide on the course of treatment.

> And in most cases it is done hours or days later, not immediately at the point of care where the doctor is expected to make a diagnosis and decide on the course of treatment.

So does that mean it's not important to the doctor's job? Or would having this information right away allow doctors to do their jobs better? If so, why isn't it done that way right now?

Here is a list of the most common diagnoses from a few years ago. http://www.hcup-us.ahrq.gov/reports/natstats/commdx/table2a.... Doctors already do quite well diagnosing those in almost all cases so there isn't much room to improve on the diagnostic side. Once the doctor takes the patient history, observes the symptoms, and reviews the lab results then the diagnosis is usually fairly obvious (to an experienced professional). If the doctor had to enter all her detailed observations into a computer it would just slow the process down and increase costs.

> If the doctor had to enter all her detailed observations into a computer it would just slow the process down and increase costs.

On the other hand, paying someone working for/requiring much less money/training than the doctor (say, a BS & $20 or $30/hour) to enter the data would lower the overall costs, would it not?

No that really wouldn't lower overall costs because it wouldn't immediately add much value in most cases. There would be some long term value later since that additional coded clinical data could be mined for clinical research to determine which treatments are most effective. But no one is willing to pay an additional $10 (or whatever) per patient encounter to get that data.

If there wasn't so much bureaucratic red tape surrounding the healthcare industry, that would be a great opportunity for an enterpreneur. Correcting the smallest inefficiencies can dramatically increase profit.

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