Back in August, 2015 IBM announced their bid to acquire Merge Healthcare for $1B dollars. (Forbes article here) Merge is a product that helps to manage, store, report, and bill for the medical images of patients as read by Radiologists. (More here) Today between the 7500 Merge customers they have access to roughly 30 billion images.
The promise for Watson Health is to learn how to “see” through machine learning from the vast amount of medical images that Merge Healthcare manages. Currently, Watson reads 66 million pages a second. It is predicted by IBM researchers that 90% of all “Big Data” stored by healthcare systems is related to medical imaging.
The offer to hospitals, healthcare systems, Radiologists, and ultimately patients is that Watson will be able to have information, including medical images, uploaded to the cloud for analysis. Based on the symptoms and a cross referencing of medical images against images of previously diagnosed medical conditions and diseases, Watson would be able to provide an initial recommendation. (supporting article)
Let’s call out the “elephant” in the room: The Radiologist
Today it takes 5 years beyond medical school to become a Radiologist. Making a few assumptions the average graduate is around 31-32 years of age. Let’s assume a Radiologist works for 30 years. The Radiologists “value” (Labor theory of value) or potential for reading images peaks out at 30 years.
In comparison, Watson Health has infinite potential. Remember Watson is now reading 66 million pages per second, which is far more pages than a Radiologist will be able to read during the course of their career.
As an increasing number of Radiologists around the world contribute their expertise on patient images and clinical findings, Watson will continue to gain in expertise.
I have to ask, will Watson cause us to reach a singularity in the world of Radiology?
Will Watson replace Radiologists?
This is my plea to Radiologists:
Step out of the dark and into the light. Own your narrative, your story, and connect.
Do the one thing that Watson can’t do no matter the number of pages or images it views……connect with another human being.
Demonstrate your value to the entire care team. Primary care physicians, Internists, OB/GYN, Medical Oncologists, Cardiologists, Surgeons, Radiation Oncologists, Pulmonologists, Pathologists, Technicians, Nurses, and administrators.
Join multidisciplinary teams, lead process improvement projects, help educate internal teams, participate in radiation safety committees, and be part of the M&M reviews. Make yourself known.
I encourage Radiologists to connect with patients.
For far too long have other physicians used your images and reports to convey your story to the patient. This doesn’t always mean sharing the results before the referring physician. (somehow taboo) You can connect with patients before the imaging study. Introducing yourself, explaining the rationale and intention for the exam, and shaking a hand can go a long way. Holding community education sessions can be helpful. Highlight the importance of Image Wisely at a community event. Conduct a lecture or a Q&A session during an awareness month on the importance of a specific imaging modality.
As Metcalfe’s Law states:
The value of a network is proportional to the square of the number of connected users of the system.
As a Radiologist, you are the key decision point to making a diagnosis for patients and the referring physician.
Without you, there is no outcome.
The more relationships, bonds, and connections you make to people inside of the healthcare system and the people (patients) within the community, the more valuable you become to the network.
What makes us human is our ability to connect with another individual.
Watson will meet production metrics beyond the reach of Radiologists.
Watson will never meet and connect with another human.
Radiologists can choose to connect with others.
The choice is simple: connect or be replaced.
Andy DeLaO, aka Cancergeek, is a healthcare professional with 15 years of experience leading and developing healthcare service lines, marketing, and challenging the status quo of healthcare delivery to improve connecting patients and the world of healthcare.
Categories: Uncategorized
Imaging is not a “test” like ordering a serum calcium. Obtaining an imaging study on a patient is a consultation. It is only useful if the physician ordering the test has honed the clinical question to be addressed with the study and the physician analyzing the image is speaking to that question. I am a rheumatologist who is quite “expert” in reading bone and joint images myself, unless the clinical utility remains elusive. Furthermore, it often does since my practice is enriched in unusual presentations. Then I and my patient is advantaged by several radiologists specializing in bone and joint diseases at my hospital. These are experienced physicians committed to helping me help my patients. So, I go down to the “reading room”, present the clinical conundrum, review the images together, and engage in discourse. The result is often reassuring and sometimes illuminating. Watson can never satisfy my need for collegiality at the bedside. Nor will it ever be a match for the variability of the patient-doctor relationship. Trying to digitize this humanity is a fool’s errand.
Nortin M Hadler MD MACP MACR FACOEM