CVS Health and IBM recently announced that they are joining forces to apply predictive analytics and Watson cognitive computing to care management services for patients with chronic diseases. With their partnership still in its infancy, CVS Health and IBM have not yet determined exactly how they will use Watson to enhance patient care services.
“While the partnership is just beginning, the ultimate goal is to identify subtle signals of disease progression that allow us to intervene in a more timely fashion and prevent poor outcomes—thereby improving the patient’s health and reducing health care costs,” said a spokesperson for CVS Health.
Regardless of the form the technology takes, an exponentially greater volume of information at the fingertips of the community pharmacist could have implications for pharmacy practice and patient care. “The more information that pharmacists have, the better informed decisions they can make,” said James A. Owen, PharmD, BCPS, APhA Vice President for Practice and Science Affairs.
Watson is a cloud-based cognitive computing system that can understand and interpret natural language and unstructured data, such as text messages and progress notes. Computing systems typically require structured data, such as the type of information one enters into a field in an online form. That Watson understands unstructured data means that it can interpret the type of information created by humans for humans—from scientific papers to tweets and virtually everything in between. The system can be trained to infer meaning as it is shaped by nuances in grammar, culture, context, and intent.
Watson can process a large body of information and identify patterns in that data set faster than humans can. Coupling Watson with IBM’s predictive analytics capabilities would offer pharmacists decision-making support and evidence-based predictions of patient outcomes.
Giving pharmacists access to electronic health records is a sign of progress by any measure, but Watson could offer pharmacists more. “This takes us to the next level by sorting through the information and providing analytics and clinical decision support versus making pharmacists manually go through it themselves,” said Owen.
Watson, however, has the potential to process far more than electronic health records. It could work with data from wearable health and fitness devices, purchasing information from retail loyalty cards, social media posts, prescription history, and countless other information sources. Watson has the capability to identify patterns in population data and individual patient data to predict outcomes and support clinical decision making.
“We already know that this patient’s combination of diabetes medications, for example, indicates that the next step is insulin. Maybe we need to encourage health and fitness based on their weight and how much they are moving, based on the data the patient allowed us to collect from their smartphone or wearable device,” says Timothy Dy Aungst, PharmD, Assistant Professor of Pharmacy Practice at Massachusetts College of Pharmacy and Health Sciences University.
Watson’s ability to aggregate and interpret unstructured information from diverse sources raises questions. While the Watson Health Cloud is HIPAA-enabled and offers secure access to information, questions remain about patient privacy. Will CVS Health customers’ purchasing patterns, for example, automatically upload to Watson? If a patient shares his or her purchase history and fitness tracker data with CVS Health, can health insurance companies use that information to raise insurance premiums on patients who buy high-calorie foods and avoid exercise?
“Having technology available to help pharmacists make informed decisions is good when patients can opt in and understand what they are agreeing and submitting to. If they’re not comfortable with that, then they should obviously be able to opt out,” said Owen.
Could Watson replace the health care provider? “This technology still has to be combined with the health care provider. It doesn’t replace the decision making of the pharmacist,” added Owen.
Aungst believes the technology will expand the role of pharmacists and raise their profile as health care providers. “Engaging technology allows us to give patients more information and help before they leave the pharmacy and after,” Aungst said. “It may actually make patients want to ask questions and take pharmacists more seriously.”