In June I announced in my Twitter column (@hfdigest) the publication of my H&HN Daily column about Watson, the IBM computer that trounced two human champions in three successive rounds of the TV game show "Jeopardy." There ensued some brief Twitter correspondence with a doctor who seemed bemused by my contention that a version of Watson optimized for health care (a "Dr." Watson) would one day replace human doctors. My correspondent clearly did not like my suggestion, but he did not reject it either. His subdued, almost resigned, response was reflected by my audience at a recent health IT conference, to whom I presented the same future — that is to say, a health care landscape dominated by intelligent machines.

It would be nice to suppose that my persuasive powers have increased since the days, not so long ago, when people would respond angrily to my outlandish notions that machines are becoming smarter than doctors, or that people are growing to prefer the machine touch to the human touch. But, the fact is, audiences no longer really need me to tell them that something is, indeed, afoot. They watch "Jeopardy." They buy iPads, whose magic expands with each new version. They immerse themselves in virtual worlds — games, social networks — that rapidly are becoming indistinguishable from the real world. They see corporations shedding employees yet growing in productivity and profitability through automation and increasingly autonomous machines. In short, people can see and feel for themselves the accelerating spiral of change.

If they are subdued, perhaps it is because they are at last starting to worry about where it all will end. I can't be sure where it will all end, but after two decades of study and thought, my recent book, Deus ex Machina Sapiens: The Emergence of Machine Intelligence, at least offers some rational and, I hope, encouraging ideas.

Beyond Watson

Watson's win on "Jeopardy" would have come as no surprise to, and ought not to have worried, someone who had read Deus. Written largely during the 1990s, around the time another IBM supercomputer (Deep Blue) was trouncing world chess grandmaster Garry Kasparov, the book presents the scientific evidence and philosophical argument for a machine that evolves so far beyond mere supremacy at chess, "Jeopardy" and medical diagnosis that it emerges as humanity's rival, if not replacement, for the job of steward of the earth. It seems to me that understanding machine evolution and its implications will make it easier to come to grips with more proximate and parochial issues such as machines taking over much of medical diagnosis and care.

We may be a long way (though that is perhaps as few as 20 years) before we have a machine that rivals Homo sapiens in overall intelligence, but already there are machines that far exceed human intellectual capacity in specific domains, from games to engineering to art. The number of domains is growing exponentially big, exponentially fast, and there is no doubt that medicine is a domain that must succumb to the machine's prowess — and soon. As I point out in my June column, IBM is adapting Watson for the domain of medicine (specifically, for diagnosis) so it is only a matter of months to at most a couple of years away from emergence into the real world of patient care.

There may be some reason for concern about such a development, because there certainly will be impacts, not all of them universally beneficent. But I see no reason for despair. Dr. Watson or its derivatives will deliver better health care to more people at less cost and, if properly encouraged, it could make up for the predicted dire shortage of clinicians in the retirement years. Our concern should, perhaps, be reserved for the reactions of those who might seek to interfere with the future, such as partisan politicians who seem bent on making health care even more expensive, and professional bodies that have shown little interest in the bigger picture and want only to protect the interests of their members from the machine's encroachment into their territory.  

David Ellis is a futurist, author, consultant and publisher of Health Futures Digest, a monthly online discursive digest of news and commentary on long-range, leading-edge technological innovations and their consequences and implications for health care policy and practice. He is also a regular contributor to H&HN Daily and a member of Speakers Express.