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2010 2020 Sensors & Devices Natural Language Enterprise Data Medical Images Images/ Multimedia You are here 44 zettabytes Growing data volume and complexity demands a new approach... Th

IT as an Enabler for Translating Quality Research to Optimized Healthcare Delivery

Luu Danh Anh Vu (Vu Luu)

Country Manager for Technology Solutions

IBM Vietnam

( vuluu@vn.ibm.com )

2010 2020

Sensors

& Devices

Natural Language

Enterprise Data

Medical Images

Images/

Multimedia You are here

44 zettabytes

Growing data volume and complexity demands a new approach

Tabulating

Systems Era

1900 – 1940s

Programmable Systems Era

1950s – Present

Cognitive Computing Era

2011 –

3

Cognitive systems expand the problems we can address

Cognitive Systems

• Leverage traditional data sources

• Follow pre-defined rules (programs)

• Provide the same output to all users

• Are taught, not programmed

• Learn and improve based on experience

• Interpret sensory and non-traditional data

• Relate to each of us as individuals

• Allow us to expand and scale our own thinking

Programmatic Systems

Generation and Delivery of Evidence and Insights

Published Knowledge

Learns

Decisions made by leading experts feed the engine Watson learns & improves over time

Understands

Watson can read & understand

documents & data – both structured &

unstructured – at a massive scale

Reasons

Watson searches & analyzes data, returning evidence-based recommendations

WATSON: A COGNITIVE SYSTEM

Why Now? The Healthcare Disruption

Percentage of patients expected

to use digital health services in the future5

Sources: McKinsey&Company, Centers for Medicare and Medicaid Services, Centers for Disease Control and Prevention

© 2016 International Business Machines Corporation 7

Rethinking Oncology

By 2025, overall demand

for medical oncology

The number of oncologists

© 2016 International Business Machines Corporation 10

WATSON ONCOLOGY HELPS MEDICAL ONCOLOGISTS AND THEIR CARE TEAMS

ADDRESS THESE CHALLENGES

61 y/o woman s/p mastectomy is here to discuss treatment options for a recently diagnosed 4.2 cm grade 2 infiltrating ductal carcinoma…

Prioritized Treatment Options + Evidence Profile

Patient Case • Inclusion / exclusion

• Other guidelines

• Published literature - studies, reports, opinions from Text Books, Journals, Manuals, etc

Evidence

Watson Oncology

Key Case Attributes

Candidate Treatment Options

Supportin

g Evidence

Extract key attributes from a patient’s case

1

Use those attributes to find candidate treatment options as determined by consulting NCCN Guidelines

2

Use Watson’s analytic algorithms to prioritize treatment options based on best evidence

4

Guidelines Search a corpus of

evidence data to find supporting evidence for each option

3

Medications

Symptoms Diseases

Modifiers

Natural Language Processing

We use Natural Language Processing and UMLS (Unified Medical Language

System) CUIs (Concept Unique IDs) to recognize medical concepts

Rethinking Genomic Medicine

Ensembl.org NCI PID Clinvar Genenames.org (HUGO) Drugs@FDA dbNSNP

TCGA NCI Thesaurus NCI Drug Info NCI Drug Dictionary Elsevier Gold Standards Select whole text journal articles

Rethinking Clinical Trial Matching

30% of sites for clinical

trials fail in enrolling even

a single patient

cancer patients participate in

clinical trials

16

IBM Watson Health // ©2015 International Business Machines Corporation #Watson Health

Watson Health - Vision

WATSON DISCOVERY ADVISOR

Watson solution:

Making linkages that unlock insights

Which accelerate breakthroughs

11,000+ drugs

20,000+ genes

12M+ chemical structures

Watson Corpus

Over 1TB of data Over 40m documents Over 100m entities and relationships

Available External Data

17

Business challenge:

• Researchers can’t innovate fast enough to create truly breakthrough

therapies

• They struggle to anticipate the safety profile of new treatments and design

trials that demonstrate efficacy and safety

WATSON DISCOVERY ADVISOR:

ACCELERATING BREAKTHROUGH INSIGHTS ACROSS LIFE SCIENCE FUNCTIONS

• What new ways could we target this

disease pathway?

Let’s look at all the genes identified in

every disease that are activated by this

protein

Lead & Drug Discovery

• How can we quickly identify if this

compound has a toxicity issue?

Signals from internal toxicology reports and published studies suggest this compound may cause serious AEs

Safety & Toxicity Assessment

• Are there reasons for the early safety

signals that we can quickly identify?

AE reports suggest that our drug is often being taken with dairy foods when this side effect is being reported

Pharmacovigilance

• Does this drug have an effect on the

pathway of another disease?

There are several diseases where the

same receptors that this compound

binds to exist

Drug Repurposing

• What populations are likely to benefit

most from this intervention?

Looking at all known studies of similar compounds, this is how this treatment might perform in these populations

Comparative Effectiveness / Clinical Trial Design

• What do early studies of competitors

reveal about their efficacy and safety? Animal models revealed early

effectiveness and faster onset, differentiating from current products

Competitive Intelligence

Reducing CHF readmission to improve care

Seton Healthcare strives to reduce the occurrence

of high cost Congestive Heart Failure (CHF)

readmissions by proactively identifying patients

likely to be readmitted on an emergency basis

How?

Utilizing natural language processing to extract key

elements from unstructured History and Physical,

Discharge Summaries, Echocardiogram Reports, and

Consult Notes

Featured on

2 Paid by Medicaid Indicator

3 Immunity Disorder Disease Indicator

4 Cardiac Rehab Admit Diagnosis with CHF Indicator

5 Lack of Emotional Support Indicator

6 Self COPD Moderate Limit Health History Indicator

7 With Genitourinary System and Endocrine Disorders

8 Heart Failure History

9 High BNP Indicator

10 Low Hemoglobin Indicator

11 Low Sodium Level Indicator

Phase 1

Stream computing provides real time analytical insights and notifications to nurses for critical trends

- Physiologic monitor data

- Laboratory results

- Radiology results

-

Patient in ICU

EMR will be pulled

in using natural language processing and content analytics

Watson will be able to identify risks along with streaming data to predict extended set of conditions

Phase 2

Treatment option based

on ingested intensive care corpus and best practice guidelines Treatment decision support and exposure

of data to research and look at patient similarities

Phase 3 The Mt Elizabeth Novena ICU real time cognitive solution can proactively

alert and prevent life threatening complications

© 2016 International Business Machines Corporation https://www-03.ibm.com/press/us/en/pressrelease/48764.wss 24

Developing an image-guided informatic system

to provide holistic summaries of patient

conditions and evidence-based clinical decision

support to radiologists

The system

• integrates clinical and imaging data

• filters out irrelevant images using multimodal

analytics

• highlights disease depicting regions

(anomalies)

• flags coincidental diagnosis

• offers clinical decision support

MEDICAL SIEVE - RESEARCH