From the Top - Nuance Dictaphone Healthcare Solutions

From the Top is a Q&A with key executives in the medcal technology sectors. This interview is with Peter Durlach, Senior Vice President, Marketing and Product Strategy, Dictaphone Healthcare Solutions.

MTJ: What is the current focus of your company's business? 
Durlach: The Nuance Dictaphone Healthcare Solutions division is focused on delivering speech-driven clinical documentation solutions to both acute care and outpatient settings, for use by primary care physicians and specialists. We give physicians freedom of choice in how they dictate. As part of this choice doctors can drive their EMR system using speech, moving through the EMR application much faster than by mouse or keyboard, and freeing more time for patients. Or if they don't use an EMR, our "once and done" speech recognition – in which dictation is recognized in real-time on screen for immediate review and report signing (without transcription) can be used. As a third option, doctors can use "speech-enabled" transcription, where they dictate into a microphone, their speech is recognized and edited by a transcriptionist for review. 

MTJ: How has this focus changed in the last 2 years? 
Durlach: We're changing focus on a number of dimensions. From a coverage standpoint, we're evolving from delivering departmental systems used by a few dozen clinicians to deploying enterprise-wide, integrated speech recognition and transcription services used by hundreds or thousands of clinicians across a health system. We have also repositioned products as complementary to mission-critical systems, actively partnering with all of the major RIS, PACS and EMR vendors who view our technology as essential to improving physician adoption and in many cases are embedding our technology as a standard part of their user workflow. We've also recognized that traditional transcription is still preferred by many physicians, so one of our offerings – iChart – offers speech recognition and traditional transcription all in the same system and workflow. 

MTJ: What are your current initiatives? 
Durlach: Amongst other things, we'll announce a new release of our Enterprise Express Speech product at the AHIMA 2007 event in October; we're working toward our most comprehensive product announcement in the radiology space, which is version 5.0 of PowerScribe and will also expand the functionality of PowerScribe to cater to the Pathology specialty – these initiatives will be announced at RSNA in November. Additionally we are evolving our offerings for an "on demand" world of medicine – ASP-driven solutions available over the web anywhere, anytime, on any intelligent device. We'll be talking more about this initiative in 2008. 

MTJ: How has your market segment changed over the last year? 
Durlach: Computer-based medical records are no longer a "nice to have." Health systems are making system-wide EMR investments in response to "pay for performance", outcomes-related medicine, and various changes in regulations which allow hospitals to purchase IT for physician practices. A number of our customers have aggressively pursued EMR projects and have run into pushback from physicians who feel these systems slow them down. These customers are now looking for a vendor to help accelerate EMR initiatives, and provide a migration path for physicians to move from traditional dictation to EMRs. We're well positioned for this trend. 

MTJ: What are the greatest challenges for your customers in adopting and implementing technology for your customers? 
Durlach: Overcoming skepticism about how effectively speech works today. If doctors haven't investigated speech technology for 2 years or more, they'll be stunned by how powerful and accurate products are. We have 50,000+ clinicians documenting care using our Dragon NaturallySpeaking Medical product, and more than a third of all radiologists are using our PowerScribe for Radiology system. Part of the solution is simply doing a better job of getting the word out on how mainstream speech recognition has become, not only at big teaching hospitals but also across community health centers. 

MTJ: How are you helping your customers address these challenges? 
Durlach: Getting clinician buy-in is crucial. We're asking busy physicians in some cases to change the way they document care. Giving them exposure early on to the system to address misconceptions is important, but it's even more vital that they see their peers successful. We place a lot of importance on on-site, end-user training which can take place even while seeing patients. It also helps that the newest generation of physicians is coming out of residency and internship with the expectation that speech recognition technology is going to be part of how they practice medicine. 

MTJ: Describe your company's position in the industry with regard to the solutions you deliver. 
Durlach: We're the leading provider of speech driven clinical documentation solutions. More than 100,000 clinicians rely on our speech recognition, speech-assisted transcription, or traditional dictation solutions. There are more clinicians using our speech products than clinicians using all EMR systems combined. Of course, many physicians use our solutions in conjunction with an EMR to make them more efficient. We also provide integrated speech recognition and transcription services on a web-based architecture through our Focus Infomatics subsidiary, which has been the top-ranked transcription editing provider over the past 2 years according to one influential industry-watcher. 

MTJ: What advice would you offer to organizations attempting to implement any technology projects? 
Durlach: Get clinician buy-in by having a core group of physicians "prove out" the technology in daily use before rolling it out to your full clinician community. Talk with other institutions or practices that have been successful, particularly using speech in conjunction with an EMR, PACS or RIS system. Make sure the vendor you choose is going to be in business 2, 3, 5 years down the road. Look for a strong commitment to service, particularly strong clinical expertise in deploying speech technology to departments that have similar characteristics to yours. Build a real partnership with your technology providers. Ask a lot of them, but also share with them your direction and objectives. It helps us to deliver solutions to best fit your needs. 

Peter Durlach, Senior Vice President, Marketing and Product Strategy, Dictaphone Healthcare Solutions Peter Durlach has a track record of moving high scaleable, enterprise systems based on speech recognition software from the drawing board into the market. He has worked in various roles focused on marketing and business development within the healthcare industry. In his career, Durlach was a founding member of Unveil Technologies, Inc., was Vice President of Marketing and Business Development for the Healthcare Solutions group at Lernout & Hauspie (L&H), and held management positions at Articulate Systems, Inc. and Audiological Engineering Corporation (AEC). Durlach holds a B.S. in Business Administration from the University of Vermont.