When Apple and IBM announced that they would partner to create a mobile platform, it caught the healthcare marketplace by surprise.
Dan Pelino, the general manager of IBM’s global public sector unit, reveals how the partnership came together, how Apple and IBM executives expect providers to use their technologies, when doctors might be able to query Watson via Siri, and other lesser-known-but-promising aspects of the deal.
Q: What was the catalyst? Some would say it should have happened long ago, others might resurrect that now-infamous picture of Steve Jobs gesticulating in front of an IBM sign …
A: A couple of things. First of all we came together to create value to benefit society - Apple with its engineers saying ‘we can do more from the standpoint of integrating into the enterprise’ and IBM recognizing the importance of getting the right mobile devices into the hands of patients and leaders. It really was a natural fit, and that’s why it progressed so quickly. Regardless of what people thought in the past, it’s a new day. Our chairman is fond of saying how you get a chance to recreate a company, to move forward, and IBM has through the years been successful at transforming itself and the industry. We want to become more essential and continue to challenge ourselves to do that on behalf of our clients, and we found kindred spirits with Apple on this.
[See also: Watson + Siri: new mHealth power couple?.]
Q: How do you envision hospitals using the mobile-first platform to perform functions or tasks they otherwise could not?
A: When you look across the structure it typically starts with the enterprise service bus, then you get into the framework, and then decide which applications to run. So the ability to make that decision across the enterprise in a way that will allow for security and scale to your mobile devices gets at one of the most challenging problems systems face today: BYOD. Bring your own device. And given the fact that there’s HIPAA compliance and other regulatory requirements that need to be addressed, there are challenges of taking consumer-type devices, whether it be Fitbit or others, that have patient information available into the delivery system so it has value at the point of care. And that starts to unlock a tremendous amount of innovation.
Q: Siri and Watson. How far are we really from doctors being able to query Watson via Siri or otherwise and actually receive actionable information back for treatment regimens?
A: We’re piloting that with Memorial Sloan Kettering (and) MD Anderson and have other pilots underway. It is in the upper wide-right quadrant of complexity and value, and we believe that over time it will become part of normal practices followed by the majority of physicians and clinicians. It will also follow with a level of commitment to consistency on practice patterns and best practices and changing processes to be able to get better outcomes sooner.
The idea that ‘you have to know before you can solve’ becomes critical. And the technology is now available, although it’s still with the early adopters, to allow us to know. Once we get into knowing what the condition is, or the disease, we can start building the best practice patterns, the best way to diagnose, to treat — and then as you have that information, to be able to access it at the point of care, such as how to get a patient into the appropriate clinical trial that will have the best outcome. Or to look at whether there’s something out there that can help a patient with a particular issue. In the past that’s been a little bit of trial and error, certainly under the watchful eye of a physician trained in that specific disease or condition, but the potential to put someone in the best clinical trial gives that clinician or physician the opportunity to get that patient well.
Q: Or to literally save someone’s life …
A: It could absolutely save lives. It could extend them or improve a patient’s quality of life. You can change the landscape of care by being able to find and implement best practices.
Q: On the theme of ‘We have to know before we can solve,’ you said the technology exists. But does the data exist? We can look at, say, the National Cancer Institute’s data on the impact that clinical trials have on cancer patients and glean some best practices, for instance, but what about lesser-studied conditions?
A: We have significant work on sequencing the DNA. We believe sequencing of the DNA will continue to evolve and we believe it needs to ride on a consistent platform so it’s available at the point of care. That means you need to have care coordination, understand how to do that sequencing, and that will enable us to look at new discoveries. And therein lies your question: Do we know enough? The answer is absolutely not. So the question then becomes: Do we have a process by which we can try to figure it out? If we’ve sequenced the DNA can we look at these patients ahead of time? If we can, can we then build care provisioning that will allow us to have a better outcome potentially before a mutation actually occurs?
Q: One piece of the partnership was that mobile health apps would be forthcoming. Will IBM or Apple create those, or will you be looking to the developer community?
A: Yes and yes. When we all got together before the announcement an Apple executive said the real value will be how others create applications to fuel levels of innovation that maybe Apple and IBM don’t even think about. This partnership is a catalyst for young and startup companies and provider organizations to be able to do amazing work. I’ll give you an example. Cleveland Clinic has created an ultrasound capability off of an iPhone. So a woman who is with child goes out and has a dinner that causes her some indigestion and she’s worried that an event has taken place. She uses the ultrasound, sends it to someone who can take a look at it and tell her she’s OK, just take some antacid or whatever. Or they find she needs medical attention. So that’s innovation coming from the Cleveland Clinic. I believe this level of innovation will come from providers and from carriers like AT&T that have really smart people looking at devices from Apple and IBM.
It’s interesting to glance back and look at how Apple launched the iPhone. They created an exclusive agreement with AT&T in the initial launch. So if you apply that same thinking, and I’d say it was successful, it’s almost like an ‘a-ha' moment because there is a map here of how to successfully launch into markets and have impact and meaning. We’ve seen Apple do this before with a major company.
A: I’m intrigued by the question because of a meeting I just had with Apple engineers. The amount of energy that was created around the art of the possible was amazing to me. I found that the Apple leaders and the IBM leaders were completing each other’s sentences — yet they were approaching it from two different directions. The Apple healthcare leaders were coming at it from literally consumer first, patient second, in terms of enablement. And the IBM folks were saying ‘OK, let’s talk about how that becomes relevant in the enterprise system of record and what actions can be taken by clinicians and physicians with that information?’ They’re completely complimentary. So to get to your question about what we can imagine that we don’t see coming, I can't answer that other than to tell you that the synergy and the level of cohesive thinking is very exciting.