Cognitive Commerce

Discovering What Really Matters to Health

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Most of us spend time researching the quality of a product or service before we agree to buy it. We want to make sure we’re getting the best product we can for our money. Likewise, producers of those products depend on consumer feedback to make the best products or services consumers could buy.  Yet, when it comes to our most important decisions – those we make about health care – quality information can be hard to come by, for both consumers and providers.

In the U.S. we spend more money on healthcare services than any other industrialized country, yet by comparison, America scores poorly on standard measures of health outcomes [1]. Prompted in large part by health reform, we’re now undergoing a major transformation in the way U.S. health care is paid for and delivered. But what does quality care look like? How do we know how well our health system is working when it comes to the health outcomes that matter most to individuals?

Despite the hundreds of quality measures health care providers are required to document and report, we still struggle to define quality in a meaningful way. And, the measures by which we rate medical services often have little relationship to the actual outcomes they produce. Does it matter what my sugar level is when what I really want to do is walk my daughter down the aisle?

Yes, but my sugars matter to me because I want to see my daughter get married. Does it really matter whether the physician increases the dose of a drug when I can’t afford the drug you prescribed? Not only are personal goals meaningful, non-medical social determinants often have a greater influence on health than clinical interventions [2]. So, knowing the diversity of data we need to analyze probably matters even more than how we analyze clinical data alone.

Fortunately, American healthcare is at a turning point. Thanks to HITECH (a provision of the 2009 “stimulus law”), not only do the vast majority of physicians and hospitals use electronic health record (EHR) systems, we also increasingly have a variety of other data available about our everyday lives and behaviors.

The very definition of health data is evolving from that gathered in a doctor’s office or hospital to include data from wearable technologies (like AppleWatch), social media, and even weather data. Health happens where we live, work, and play. Only by taking a holistic view of what data are relevant to an individual’s health will we truly gain insight into what matters to an individual, how we can help them achieve their goals, and how they can better help themselves.

How do we leverage these newly available data to personalize healthcare to an individual (n=1)? The promise of “big data analytics” and cognitive systems is that we can analyze large sets of aggregate data for learnings that can apply to an individual to help clinicians and individuals make evidence-based decisions that can ultimately improve outcomes.

Disruptive Innovation

I believe we are at a moment in history when simply improving what we currently do won’t get us where we need to go. We cannot change our position as a country with the world’s most expensive healthcare producing such poor outcomes by simply improving upon our current system. It won’t work.

What we need now is disruptive innovation, and it requires collaborations amongst providers, individuals, families, payers, life sciences – and technology companies. IBM established Watson Health to address this opportunity and to serve as a catalyst for and collaborator with health and life sciences entities worldwide.

I see our role at IBM as a partner with the multiple stakeholders in healthcare who directly and indirectly influence the health of individuals and communities, all working collaboratively to improve health and lower costs. I see the potential of Watson Health to help us collectively discover what matters most and see my mission as Chief Health Transformation Officer to make a difference with that insight. I invite others to participate.

[1] World Health Organization, Measuring Overall Health System Performance for 191 Countries:

[2] Barbara J. Sowada, A Call to Action to be Whole: The Fundamentals of Health Care Reform, July 30, 2003, Praeger.

Vice President and Chief Health Transformation Officer, IBM Watson Health

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