Friend or Foe?

Imagining a world operated mostly by computers is not hard. Cell phones have voice controlled assistants. Vehicles come with GPS technology guiding your routes. Robots are increasingly present in hospital operating rooms. And driverless cars will likely be the mainstream in within 20 years.

Now IBM’s supercomputer Watson is taking its place in the insurance industry.

This month, IBM Corp., the health insurer WellPoint Inc. and Memorial Sloan-Kettering Cancer Center announced that two Watson-based applications will be offered commercially to doctors and health insurers.

Both Watson applications – one to help assess treatments for lung cancer and one to help manage health insurance decisions and claims – will utilize artificial intelligence (AI) to increase efficiency and reduce errors. The applications will enable doctors or insurance company employees to quickly compare a patient’s medical records to what Watson has learned and make recommendations in decreasing order of confidence. In the cancer program, Watson will consider what treatment is most likely to succeed. In the insurance program, it will consider what treatment should be authorized for payment.

Watson – named for IBM founder Thomas Watson – has been trained in medicine through pilot programs at Indianapolis-based WellPoint and at Sloan-Kettering in New York. Manoj Saxena, an IBM general manager, told the Associated Press that the supercomputer has ingested 1,500 lung cancer cases from Sloan-Kettering records, plus 2 million pages of text from journals, textbooks and treatment guidelines. It also learned “like a medical student” by being corrected when it was questioned by doctors and came up with wrong answers, Saxena said.

WellPoint itself is already using the insurance application in Indiana, Kentucky, Ohio and Wisconsin. It will be selling both applications – at prices still to be negotiated – and will compensate IBM under a contract between the two companies, an IBM spokeswoman said.

WellPoint said using Watson should not increase insurance premiums thanks to savings from waste and errors.

An IBM insurance industry representative told Claims Journal in 2011 there are several potential assignments in insurance for Watson. Watson might help large insurance companies that are selling multiple products in multiple states or even countries deal with myriad regulations.

Rather than being a threat to the insurance industry and adjusters, an AI wizard like Watson could become their best– and smartest – ally, the IBM executive said.

Fears that AI’s like Watson will replace the human touch and employees are understandable, but appear to be unfounded. “Watson is not making the decisions” on treatment or authorization, Saxena said. “It is essentially reducing the effort for doctors and nurses by going through thousands of pages of information for each case.”