Nuance deal maker explains Commissure acquisition

The users of Dictaphone's speech recognition product PowerScribe now have the means, if they want it, to link radiology orders and findings. Customer demand for more than just speech recognition was a driving force behind the acquisition announced Oct. 2 of the privately held Commissure by Dictaphone's parent Nuance.

Nuance's technicians can integrate Commissure's linking capability into any RIS or IT work list software required, said Peter Durlach, senior vice president of healthcare marketing and product strategy for the Dictaphone division of Nuance. The company will also integrate order entry decision support into installed computerized physician order entry systems that extend beyond radiology.

Ultimately, Nuance plans to blend this function into PowerScribe, along with data mining and analysis tools for trending and forecasting, Durlach said. Along with other senior Nuance executives, he crafted the merger of the two companies and their technologies.

Built into the front end of the Dictaphone reporting package will be key decision support tools that suggest appropriate exams to the referring physician based on guidelines developed by the American College of Radiology. Built into the back end of PowerScribe will be data mining and analysis tools that provide referring physicians with patterns showing the exams ordered for different types of patients and their findings.

"Physicians will have a complete, closed-loop system for documenting why an exam was ordered and the interpretations," Durlach said.

When this integration is completed - in several months time - Nuance will have a product that will satisfy customers' reporting demands, he said.

"They are looking to us to track whether there is a positive finding or not, to be able to document that, and to link it back to the order," he said.

Founded three years ago, Commissure has installed its decision support and analysis tools at more than 70 sites, including the Cleveland Clinic Foundation, the Henry Ford Health System, and New York University Medical Center.

The company offers three products:

• RadPort guides the referring physician in the choice of imaging procedures by generating a utility score based primarily on the ACR Appropriateness Criteria. The higher the score, the stronger would be the support for ordering a particular exam.

• RadWhere creates reports using speech recognition and structured templates established by individual radiologists. It also provides access to reference materials, such as online radiology atlases, and disease details and differentials.

• RadCube analyzes business and clinical data to plot departmental trends addressing service delivery and resource utilization as well as revenues and costs.

Commissure's RadPort and Nuance's PowerScribe both use the same core speech recognition technology, Dragon. Through a series of transactions involving a bankruptcy and corporate merger, the rights to this technology came to rest with Nuance.

Over the last several years, staff at Nuance and Commissure have collaborated on some projects and competed on others, according to Durlach. Now, they are corporate kin.

To cement the relationship, Nuance will offer 217,975 shares of its common stock to 21 individuals. Of those shares, 167,725 will vest over a three-year period; the remaining 50,250 shares will vest over a four-year period.

Deferring to the competitiveness that has come to characterize healthcare IT, Durlach provided no other details of the acquisition, including the price or the exact day the deal was signed. He referred DI SCAN to the 8K filing due soon to the Securities and Exchange Commission for more information.