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IBM Watson Health slashes workforce

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Re: IBM Watson Health slashes workforce

#61

Post by sergers »

xoail wrote: post #27
phren0logy wrote: post #22

Earlier quoted context omitted.

Probably. The following applies to the US: It seems to me that some of the biggest barriers involve getting access to enough data to make a good training set. Some of this is related to HIPAA and related privacy laws, which are in place for a good reason but are still a major barrier. The other big factor is the fragmentation of the data across different, non-interoperable, non-standard formats from different vendors…

I am working on a medical dictation app and the lack of any interoperability between 1000s of EHRs is mind boggling to me. There is absolutely no standards and like you mentioned its completely deliberate. Working through these platforms over the years has made me less and less optimistic about having a better health care system in the future.

Well FHIR is making its way, that looks positive, but no mainstream EHR has adopted it really.

May I ask what your target users are? I sell alot of nuance PS360, and fluency

Re: IBM Watson Health slashes workforce

#62

Post by sergers »

criley2 wrote: post #34
phren0logy wrote: post #10

I'm an MD, and I dabble in programming and AI/DL. While I don't really care much about Watson in particular, the pervasiveness of the "enter healthcare = death" equation is worrisome to me. And it should worry you, too. There's a lot of potential for good applications of this type of tech in healthcare, but the barriers to actually getting it off the ground strangle it in the crib.

I work for a medical software company which evaluated Watson for use in our diagnostic product. It should be seen as a Good Thing that medical is a Serious Field where Non-Serious Ideas get run through the ringer and fail. And that's what happened with Watson. The word from our engineers was that Watson was designed to sell commercials, not be a useful tool in a problem space like differential diagnosis or drug react…

I had posted this previously in a different thread, but it's all smoke and mirrors.

I work in the diagnostic imaging space, we are working on integrating AI for assisted diagnosis or screening. It's a several-year road map for some base function.

We had a top sales executive leave for IBM Watson Healthcare division about a year ago, was very proud to be part of what Watson was going to bring to healthcare

He's been working back at my company, couldn't stand selling lies (and wasn't making much commission with canceled contracts).

From a named company more impressed with what Google deepmind has done with NHS

Re: IBM Watson Health slashes workforce

#63

Post by sergers »

Thriptic wrote: post #40
criley2 wrote: post #37

Earlier quoted context omitted.

The FDA is not the primary source of regulation in medical software, it's CMS. And while CMS regulations do not apply theoretically to private insurance and private practice, Medicare and Medicaid represent such a large segment of the healthcare economy that private insurers tend to use similar expectations as CMS regs. Also, software which cannot meet CMS reg and cannot be used for Medicare/Medicaid patients is a no…

> The FDA is not the primary source of regulation in medical software, it's CMS It's totally dependent on what you are doing. Sure, HIPAA / PHI concerns are the primary issues for people who generally make software for the medical space, but by "medical software" I mean software that FDA might classify as "software as a medical device" AKA FDA regulated software. If your software falls under this designation, as most…

My company software is considered a Class 2 medical device.

We have to go through so many crippling hurdles with FDA it's almost not worth it.

You are spot on.

To add though, In atleast the diagnostic imaging space, radiologist reading groups/practices are selecting their own systems more and more nowadays.

Individual doctors? Likely not.

Re: IBM Watson Health slashes workforce

#64

Post by aaavl2821 »

phren0logy wrote: post #22
ISL wrote: post #18

Earlier quoted context omitted.

Many of those barriers have historical reasons for existing -- which do you think could be lowered without risking patient health (or yielding sufficient benefit to be worth some added risk)?

Probably. The following applies to the US: It seems to me that some of the biggest barriers involve getting access to enough data to make a good training set. Some of this is related to HIPAA and related privacy laws, which are in place for a good reason but are still a major barrier. The other big factor is the fragmentation of the data across different, non-interoperable, non-standard formats from different vendors…

Unfortunately, from my experience the biggest barriers to sharing data are very deeply embedded incentives.

I was at a talk recently by an executive in charge of managing data for a massive health system. Think tens of millions of patients. He said they dont share data because if people learn their real quality metrics it would give payers, the public, anyone with an interest that isnt aligned w the hospital system ammunition against them. Have heard this sentiment echoed by many. Open data is their enemy because then patients could choose based on outcomes, not on market power or how nice the lobbies are

The EMRs designed a closed garden into their systems DNA. If data is shared freely then it's easy to switch systems, and they will have to compete based on cost and quality and couldn't charge hundreds of millions for installations and maintenance contracts

Call me cynical but this is all based on conversations with people well placed in the industry

Re: IBM Watson Health slashes workforce

#65

Post by 616c »

sergers wrote: post #63
Thriptic wrote: post #40

Earlier quoted context omitted.

> The FDA is not the primary source of regulation in medical software, it's CMS It's totally dependent on what you are doing. Sure, HIPAA / PHI concerns are the primary issues for people who generally make software for the medical space, but by "medical software" I mean software that FDA might classify as "software as a medical device" AKA FDA regulated software. If your software falls under this designation, as most…

My company software is considered a Class 2 medical device. We have to go through so many crippling hurdles with FDA it's almost not worth it. You are spot on. To add though, In atleast the diagnostic imaging space, radiologist reading groups/practices are selecting their own systems more and more nowadays. Individual doctors? Likely not.

So why do you need FDA regulation in your situation? I know people handling security regulation in the defense industry and I'm curious how you know the FDA has to approve you as opposes to CMS and what it entails.

Re: IBM Watson Health slashes workforce

#66

Post by sergers »

616c wrote: post #65
sergers wrote: post #63

Earlier quoted context omitted.

My company software is considered a Class 2 medical device. We have to go through so many crippling hurdles with FDA it's almost not worth it. You are spot on. To add though, In atleast the diagnostic imaging space, radiologist reading groups/practices are selecting their own systems more and more nowadays. Individual doctors? Likely not.

So why do you need FDA regulation in your situation? I know people handling security regulation in the defense industry and I'm curious how you know the FDA has to approve you as opposes to CMS and what it entails.

For diagnostic imaging (x-rays, CTs etc) which we make software for, alot of equipment is FDA regulated.

We chose to go for class 2 designation in FDA terms as it shows you comply with uptmost regulations, which is a selling point. Some hospitals depending on state gets rebates for meeting compliance.

It depends on what space you are going into. If it touches a patient, more than likely FDA regulated in the USA.

Other countries have similar orgs ( Canada has... Health Canada).

We also work with DoD/VA... Don't get me started on compliance with them.(the security stuff is a plus though, while initially challenging to meet, it has us pushing the code into commercial space products, everyone benefits from the extra security hardening. )

Re: IBM Watson Health slashes workforce

#67

Post by tjr225 »

yosyp wrote: post #36
criley2 wrote: post #34

Earlier quoted context omitted.

I work for a medical software company which evaluated Watson for use in our diagnostic product. It should be seen as a Good Thing that medical is a Serious Field where Non-Serious Ideas get run through the ringer and fail. And that's what happened with Watson. The word from our engineers was that Watson was designed to sell commercials, not be a useful tool in a problem space like differential diagnosis or drug react…

Tangentially related: how does one get their foot in the door at a medical software company? Is there a big market for such professionals?

I was recruited right out of college to work at Cerner. Its probably still fairly trivial to get a job there, but you have to live in Kansas City.

Re: IBM Watson Health slashes workforce

#68

Post by sk5t »

abakker wrote: post #51
roymurdock wrote: post #43

Earlier quoted context omitted.

Theranos is a counterexample. Probably would have been outed as fraudulent if they tried to enter a more safety-critical space (ventilators, pumps, injectors, etc.), but still a bad sign for medical diagnostic industry that it got so much funding and so far along, inking huge deals before collapsing. Perhaps some good will come if it makes others in the space more cautious in the short run Next industry to keep an ey…

Arguably, the big deals and optimism indicate that there is a lot of pent up demand for successful things, and people are willing to take some risk to get solutions. It’s not all doom and gloom, solutions just have to work.

Conversely, I read Theranos's progress as evidence of cynical bets that the government/military could likely be directed into pumping billions of USD into the company regardless of its merit.

Re: IBM Watson Health slashes workforce

#69

Post by abakker »

sk5t wrote: post #68
abakker wrote: post #51

Earlier quoted context omitted.

Arguably, the big deals and optimism indicate that there is a lot of pent up demand for successful things, and people are willing to take some risk to get solutions. It’s not all doom and gloom, solutions just have to work.

Conversely, I read Theranos's progress as evidence of cynical bets that the government/military could likely be directed into pumping billions of USD into the company regardless of its merit.

You could certainly draw that conclusion from its original board. I did as well. Still, I think the point stands that people want healthcare to work, and will pay for it. It just so happens that it takes a lot of effort to improve the system since what we have is pretty good. (Not to say it doesn’t have problems)

Re: IBM Watson Health slashes workforce

#70

Post by gtmb »

davak wrote: post #60
Spooky23 wrote: post #49

Earlier quoted context omitted.

I worked on a project that did a little Watson work as well. Same result as you described. The shame is decision tree based expert systems can be pretty powerful, but the tools these guys were using were not that great.

I am a nerdy physician desperate to work with somebody on decision tree based expert systems. Are there a bunch of existing projects that I’m just missing?

Well, I just started an open source project to gather the data for such systems. It is starting as a database/graph of symptoms and conditions. But the vision is bigger than that.

https://github.com/gafmgafm/med

There are similar products but they are not open source, such as: http://apimedic.com/ and http://www.diseasesdatabase.com/

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