Voice recognition matures as market prepares to take off

September 26, 2005

Voice recognition has made the jump from emerging to mature technology without raising a hair on the head of radiology. Such a transition is typically accompanied by a sales curve that rockets up, levels off, and then blasts off again, as early adopters pick up on the technology, publish their experiences, and convince the masses to get on board.

Voice recognition has made the jump from emerging to mature technology without raising a hair on the head of radiology. Such a transition is typically accompanied by a sales curve that rockets up, levels off, and then blasts off again, as early adopters pick up on the technology, publish their experiences, and convince the masses to get on board.

In the case of VR, however, there hasn't been much to publish. The only research questions have centered on whether the technology works. In radiology, as well as a few other selected areas of medicine, it clearly does. A decade of experience has proven that, yet vendors have penetrated only about 10% of the potential market.

One of the pioneers of this technology, Dictaphone, estimates that 4200 hospitals and 5000 imaging clinics make up the market for transcription, both manual and VR. The company's VR software is operating at about 500 of them, or about 5% of the overall market. Competitors include Agfa Healthcare and Philips subsidiary MedQuist as well as smaller firms such as ProVox Technologies, ScanSoft, Vianeta, eScription, Dolbey, and Crescendo. Their systems make up the remainder of the installed base - another 5% of the potential market - according to Don Falatti, Dictaphone senior vice president of marketing.

Its several hundred VR systems make Dictaphone the industry leader. More important, its position as the primary source of traditional dictation equipment in the U.S. provides a unique perspective. Falatti noted that the company sells more VR products in a typical month than it does traditional dictation equipment. Moreover, these systems, when implemented, are being broadly applied.

"It isn't just one or two radiologists using it, as you might get with some technologies," he said. "It gets used pretty much across the board."

The maturity of the technology comes from more than a decade of commercial development and the industry's reliance on a relatively few speech engines. Dragon Naturally Speaking, supplied by ScanSoft, is built into its own medical versions of the software, as well as Dictaphone's PowerScribe and Agfa's TalkStation. Philips' SpeechMagic is built into SpeechQ for Radiology. (Until this year, MedQuist resold TalkStation.) IBM's ViaVoice, which is the cornerstone of TalkNotes RAD from Provox, is licensed to ScanSoft for medical applications.

Different packages are distinguished primarily by user interfaces, ease of use considerations, and productivity. Access to software via the Internet has become a necessity, as have tools that assist in dictation, text editing, and data transfer. The latter is accomplished with macros built into VR programs that transfer patient demographics found in RIS/PACS/HIS into VR-driven patient reports.

"Any information that can be pushed to us from a RIS can be echoed back in these fields," said Dave Talton, Agfa solutions manager for reporting.

With technology developed as well as it is, the only remaining question would seem to be productivity, which Fallati and Talton argue is VR's strong suit. Returns on investment among radiology groups can be achieved in less than a year, according to vendor reports. Anecdotal accounts from sites implementing PowerScribe support those claims.

Case histories reported by Dictaphone indicate that its VR software cut turnaround times by two-thirds and costs by $7000 per week at radiology departments in two hospitals run by Mercy Health System of Pennsylvania. It saves $300,000 annually at Sarasota Memorial Healthcare System, an 828-bed regional medical center in Florida.

Armed with these and similar accounts, Dictaphone and other VR vendors are reaching beyond radiology into pathology and cardiology, which, like radiology, have specialized vocabularies. They are also distributing VR packages designed to serve as low-end, voice-driven electronic medical records that digitally chart patient data across a broad swath of departments.

Although there are other opportunities, radiology remains at the top of Dictaphone's list of priorities. Technology is ingrained in this medical specialty, Fallati said, which makes VR relatively easy to sell.

"The interest level is high; the run rate of adoption is high," he said. "I have the very real sense that VR has crossed the bridge of acceptance."