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would interact with physicians at the point of documentation to ensure each medical record contains the level of specifi city required to achieve ICD-10 reimbursement. This technology, computer-assisted physician documentation, is in develop- ment now. This solution will make documentation more productive for the physician, eliminate redundant queries from coding teams and drive the creation of more detailed patient records.

Clinical decision support Patients’ medical records are extremely complex, with varying treatments, medica- tions and outcomes. The way Watson could be applied to handle these complexities is by creating data repositories of patient informa- tion, which could then be mined for valuable information that ultimately could be leveraged as knowledge for use in treating patients with similar symptoms and care scenarios. Watson can be meaningfully applied anyplace in healthcare where there is an intersection between structured and unstructured data and/or where a sophisticated question is being asked. By leveraging data repositories (big knowledge bases), Watson is extremely good at extracting knowledge from mass amounts of structured and unstructured data that otherwise would be near impossible to break down and assess. Additionally, through natural language processing (NLP) capabilities, Wat- son is purpose-built to understand highly complex questions and process them in a way that delivers back highly relevant, evidence-based information and answers. In order for Watson to be utilized in healthcare, however,

Watson, powered by IBM POWER7, is a work-load optimized system that can answer questions posed in natural language over a nearly unlimited range of knowledge.

there is enormous work that must be done on the annotation front, which involves educating Watson on what’s important (see sidebar). For example, Watson needs to be guided on how to identify medications, details about treatment protocols, patient outcomes and more. Once Watson comes to know what is important and critical, it will be positioned well to make evidence-based clinical recommendations with high levels of confi dence. Specifi c areas where Watson will likely be applied in healthcare include oncology, where it can be lever- aged as an aid to fi gure out the treatment plan for a patient, as well as in multiple areas for clinical decision support and for differential diagnosis. In general, Watson will be used to support physicians’ decisions by providing real-time evidence that backs up their approach moving toward.

The partnership

There are a number of joint development agreements between Nuance and IBM that have been announced over the years. One of the areas that we’re working with them on is the general advancement of the state-of-the-art voice recognition and voice technologies – the way a consumer would use it, making advancements in things like noise fi lter- ing, etc. Basically, together, we’re working to tackle some of the long-standing problems that have impacted the quality and utility of voice-driven solutions across various markets and use cases. With IBM, we’re also advancing retrieving information from structured information sources; this is being accomplished through various forms of advanced NLP projects. And thirdly, we’re collaborating with IBM on Wat- son where Nuance is contributing development and research resources to advance our own set of Watson-appropriate use models within healthcare, as well as to advance use models in healthcare that IBM is exploring. Our shared work involves a superset of technologies, including speech, NLP and reason- ing solutions that we’re working to advance and ultimately bring to market.

IBM’s Watson computer system, powered by IBM POWER7, competes against two of the most successful and celebrated “Jeopardy!” contestants, Ken Jennings and Brad Rutter. “What’s that you say?” One of the hurdles that must be overcome in order to make HEALTH MANAGEMENT TECHNOLOGY March 2012 9

Photo courtesy IBM

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