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The New Era Of Cognitive Collaboration

2013 November 3

General Chuck Yeager is a living legend—a flying ace in World War II, the first man to break the sound barrier and a pioneer of the Space Program.  Yet, to achieve what he did, he needed not just skill and courage, but also to evolve and adapt to a new era.

When Yeager started out pilots were macho “flyboys,” who operated by instinct.  Many couldn’t adapt to the new age of flying-by-wire, in which pilots no longer operate the aircraft, but interface with a computer that flies the plane.  He did and that made all the difference.

Today, as we enter a new age of cognitive computing, we’re all going to have to learn to adapt and, in effect, fly-by-wire.  Much of the skill and expertise that professionals used to spend an entire career earning is now being outsourced to computers and we, like the flyboys, will have to learn to partner with machines—and each other—in order to compete.

An Opportunity To Revolutionize Medicine

Like most professionals, a physician’s work is largely routine.  They see patients with common ailments, prescribe standard treatments and things generally go all right.  Yet when things go off script, it gets dicey.  Doctors need to stop practicing and start researching, referring to old textbooks, online references and specialists in narrow fields.

Dr. Lynda Chin of MD Anderson Cancer Center points out that this is an incredibly inefficient process.  She says: “If you go to Google or PubMed and look for a piece of information on a topic that you’re interested in, you get back too many hits and they’re not right on”.  Doctors can waste hours muddling through what can be a fruitless search.

There is, in effect, a wide gap between scientists generating knowledge and the people who are supposed to put those insights into practice.  So when IBM came and showed her the capabilities of its Watson system, Dr. Chin saw an opportunity to close that gap and put all of the world’s collective knowledge to work in the practice of everyday medicine.

Dr. Chin says that Watson allowed her to “imagine a system that isn’t just to optimize a particular decision making point, but to really change how we think about healthcare.”  In a very real sense she saw that physicians, like pilots, could also learn to fly-by-wire.  That was what led her to develop MD Anderson’s Oncology Expert Advisor with IBM.

The Cautionary Tale Of Ignaz Semmelweis

In the 1840’s, Ignaz Semmelweis, much like Lynda Chin, set out to transform the practice of medicine.  His breakthrough idea, although it seems mundane today, was to get doctors to wash their hands.  He implemented the practice in a Vienna maternity ward and immediately saw fatalities from “childbed fever” reduced from about 10% to under 2%.

Alas, from there things did not go well.  Doctors, like many high status professionals, are often not receptive to changing their habits.  His hand washing idea also did not agree with the belief, largely perpetuated by oral tradition, that an imbalance of humours caused disease, rather than transference of germs.  Semmelweis failed not because he had the wrong idea, but because he failed to convince others to buy into it.

So the challenge at MD Anderson was two-fold.  First, Dr. Chin had to get researchers to change their habits and share data.  Second, she had to convince doctors to outsource their information processing activity—in effect, the same skills which propelled them to top colleges, medical schools and residency programs—to a machine.

In other words, for Watson to fulfill its promise of revolutionizing medicine, Dr. Chin would first have to revolutionize the culture of the medical profession.

A Plan To Disrupt Medicine

In his attempt to introduce hand washing, Semmelweis moved aggressively to get the practice adopted.  He would berate doctors at his own hospital and send scathing letters to prominent physicians elsewhere in which he accused them of heartlessly killing their patients.

Perhaps not surprisingly, his efforts did not have the intended effect.  Semmelweis became an outcast and eventually died in an insane asylum, ironically as a result of an infection that he picked up while under doctors’ care.  Hand washing didn’t become widespread in hospitals until years after Semmelweis’s death and, in fact, still remains a challenge today.

Dr. Chin, on the other hand, immediately recognized that the hardest part of the project would be group dynamics.  Ordinarily, the research and clinical parts of medicine sit on opposite ends of the spectrum.  So instead of trying to convert everybody at once, she picked a clinical group where the leader was already enthusiastic about the idea.

From there, she could start a pilot project and raise funds dedicated to it so that resources weren’t being siphoned off from elsewhere.  As results came in, her case strengthened and she could move on to groups with higher resistance thresholds.  Those converts would then add to the momentum.

We like to think of innovation being solely about great ideas and technology, but social networks are just as important.  As Sandy Pentland, one of the world’s most foremost data scientists puts it,  “We teach people that everything that matters happens between your ears, when in fact it actually happens between people.”

A New World of Possibility

It’s been a year since Dr. Chin began her project and doctors can now use the Oncology Expert Advisor to directly access suggestions for therapy and track progress.  She also hopes that in the future, longitudinal patient data can be fed back into the system to suggest promising new research approaches.

The program seems to be gaining steam.  Manoj Saxena, General Manager of IBM Watson Solutions notes that doctors are saying, “Now I have the power of the world’s 1000 best cancer specialists standing behind me, guiding me through this case that I’m working on… That’s how you drive change.”

He also notes that today we allow jumbo jets with 500 people to land in the middle of the night by computer and no one thinks anything of it, it’s just become the way we do things. He hopes that Watson will be able to achieve the same level of comfort in medicine over the next 7-10 years, rather than the decades it took for hand washing to become standard.

While the Oncology Expert Advisor is still in its early stages, Dr. Chin reports that rather than having to evangelize cognitive computing as a viable approach, she now has doctors coming to her asking to participate.  As more doctors join in, more data will be fed into the system, the algorithms will continue to learn and the system will become more effective.

The Big Shift

Much like Chuck Yeager’s flyboys and the physicians at MD Anderson, in the years to come we will all have to learn to collaborate with machines.  What we have come to regard as expertise is really the ability to recognize the patterns specific to a particular field and pattern recognition is something that computers are beginning to excel at.

Dr. Chin sees technology taking the medical profession in two directions. First, she sees that time researchers now spend on information processing—a task that humans are notoriously bad at— will be spent imagining how they can push the envelope.  Second, clinical physicians will be able to focus more on human interaction with patients.

The upshot is that technology is changing the skills we need to learn.  That’s going to be a hard path because people—especially high status professionals—have a tendency to reject new things that challenge established norms (something known, perhaps not surprisingly, as the Semmelweis reflex).

The New Era Of Cognitive Collaboration

Despite the inevitable challenges—not to mention the blow to our egos—we should be optimistic going forward.  As Chuck Yeager said of his life experience:

But what really strikes me looking back over all those years is how lucky I was.  How lucky, for example, to have been born in 1923 and not 1963, so that I came of age just as aviation itself was entering the modern era.  Being in my early twenties right after the war was key to everything that happened in my life, placing me smack in the Golden Age of aviation research and development, allowing me to participate in the historic leap from prop engines to jets and from jets to rockets and outer space.

And that’s what’s important to remember.  We are all lucky to be able to experience this period of enormous transformation as we see intelligent machines transforming fields as diverse as medicine, legal research and artistic endeavor.  The cognitive energy we save by uploading knowledge to the cloud can be repurposed in exciting new directions.

Of course, no system is perfect.  Although disasters are much more rare than they were fifty years ago, planes flown with the aid of computers still crash.  Now, however, the knowledge learned from that experience no longer dies with the pilot, but becomes part of the collective intelligence of thousands of algorithms that routinely bring us home safely.

And that’s the true value of IBM’s Watson and the other intelligent systems that are emerging—not that computers are gaining the ability to think, but that they are ushering in a new era of cognitive collaboration between humans, computers and other humans.

– Greg

8 Responses leave one →
  1. November 3, 2013


    Another great blog. Particularly like your point about getting the social network to adopt. Accepting new ideas and the change that goes with it seems to always be the key to fully realize the benefits of new ways — technology or process.


  2. November 3, 2013

    Very true. Technology only works when people use it!

    – Greg

  3. Alejandro Segura permalink
    November 3, 2013

    Great comment…so true. I am sure you are aware of Dr. Michio Kaku ´s book “Physics of the Future” where he comments the impact of already current and future technology and the need to adapt. Thanks for your blog and weekly essays. Alejandro

  4. November 3, 2013

    Yes, I’ve even adopted his “Caveman Law” as one of my “4 digital laws”:

    – Greg

  5. November 5, 2013


    Very impressive read.

    I’d like to add that “cognitive” collaboration means that dualism of traditional formal logic is suppllemented by the third component – intangible transcendental element – thinking, knowledge and purposefulness of human. It means that collaboration is provided in new manner – through this third element which is presented by relationships and feedbacks. As a result, we get the “ecosystem” capable of self-development.


  6. November 5, 2013

    Thanks Sergei. I always look forward to your views.

    – Greg

  7. Gregg Gullickson permalink
    January 2, 2015

    Great story. MD Anderson and IBM – two great teams.

  8. January 3, 2015

    Thanks Gregg. Have a great year!

    – Greg

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