by adgrooms on February 13, 2020

We have been looking at how the major technology companies are participating in the healthcare industry. Google, Apple, Microsoft, and Amazon are all making significant investments in developing products and services for healthcare, especially as the fusion of clinical and consumer technology takes place. While most of the media attention focused on those four (sometimes called the "big four"), we also wanted to see what computer pioneer IBM is contributing.

The International Business Machines company has been around for over 100 years. Founded in 1911, it started as a merger of 5 different companies that made tabulators, time recorders, and scales among other business machines. They demonstrated the first example of AI in 1956. Then in 1964, they introduced the first computer system family, the IBM System/360. They have contributed many inventions to what are now standard computing components, including the hard drive, the magnetic stripe, the ATM, and many others. With a century of innovation behind them, it was natural for IBM to enter into healthcare.

IBM has many offerings, but they market two specifically for use in healthcare: cloud computing and an AI question-answering system called Watson, which famously competed against human contestants on the game show Jeopardy! The contestants were champions of the game show, but Watson won the $1 Million prize in the end.

IBM was confident they had the future of healthcare in the AI capabilities of Watson, and they placed a large bet on it. It was the flagship of the IBM healthcare effort, and they recruited heavily for users in the beginning. Watson's first clinical use was in 2012 for lung cancer treatment at Memorial Sloan Kettering Cancer Center to help oncologists synthesize a vast amount of data and treatment guidelines for personalized therapies. Several more institutions, including EHR company EPIC, signed up to use Watson as a clinical decision support tool. Watson was also being used to develop some consumer health guidance apps including diabetes management, personalized athletic coaching, and personalized nutrition advice during pregnancy.

Problems emerged with time, however. The Watson for Oncology platform gave incorrect advice for cancer treatments in multiple instances. The errors happened even as they were promoting the technology. At the time, EPIC and Mayo clinic were jointly working with IBM to develop Watson's decision-making capabilities for EHRs. Still, there is no sign that the project was ever fully implemented. EPIC does offer clinical decision support today, but as a third-party app in their App Orchard. As for the consumer apps that were in development with Watson, none are currently available.

Watson Health did not live up to its ambitious goal to completely change healthcare. IBM acknowledged overpromising and underdelivering, leading to a pullback in the recruitment of new projects. IBM's revised plan for Watson in healthcare is to focus on refining the product that they already have, including AI-based drug discovery. Watson Health got new general manager, Paul Roma, in 2019 who stated "We're going to double down on what's working, and we're going to get super focused on execution".

IBM has been a leader in the traditional on-premises computing model, but today, there is a mass migration to cloud computing. In order to compete with Amazon and Microsoft, they recently bought open-source cloud software provider Red Hat. Red Hat also uses IBM's implementation model, which relies heavily on consulting. IBM software solutions are vast, all-encompassing systems requiring lots of human resources to implement. It is more expensive and less flexible than its competitors like Amazon AWS and Microsoft Azure because an IBM Red Hat implementation is angled to move its customers into a full commitment to IBM products.

IBM offers traditional business enterprise computing options for healthcare systems. The complexity of their products and services may apply to large institutions heavily involved in medical research. Still, clinically focused healthcare institutions are looking for solutions that are more adaptable and of high value. There are smaller, more agile, and just as innovative companies developing healthcare software that fill their needs.

Healthcare is evolving towards a consumer/institutional integrated relationship, and IBM does not have the consumer-facing services or products that any of the big four offers. Will they be a leader in healthcare? Probably not in a consumer-facing capacity. If they can develop Watson further and re-establish trust in the system from healthcare stakeholders, a role in precision medicine may be their best opportunity.