Speech-Driven Documentation and Communication Strategies for Closed-Loop Radiology Workflow Providing Appropriate Imaging Guidance, Radiology Speech Recognition Reporting, Critical Communication, and Data Analysis
With over 1 billion radiology exams performed each year in North America, diagnostic imaging has nudged out pharmaceuticals as the fastest growing component of medical costs. William M. Salganik Boom in medical scans presses health payers The Baltimore Sun May 2007
As a radiologist, harnessing advanced technology to provide superior patient care is what you do. MRI. CT. PACS. RIS. You use them all. You have the latest, most innovative technology to help you identify the faintest anomaly in a matter of minutes. Yet your work relies heavily on the appropriateness of the diagnostic order, how quickly reports are dictated and delivered to the ordering clinicians, the communication of critical patient results, and analytical review of outcomes. You have millions of dollars worth of imaging systems at your command and almost no control over the order-to-results delivery cycle. Until now. What Radiology Chiefs Want You want your ordering clinicians to order the most diagnostically appropriate imaging studies. You want your radiologists to dictate and sign reports at the time they review diagnostic images. You want your reports delivered at the same time as the images not hours or days later. You want to be able to collect quality improvement data and meet industry guidelines. You want to be able to communicate critical test results in a verified, compliant, and efficient manner. You want to better understand the data that your department generates. What Radiology Chiefs Need You need your ordering clinicians to utilize diagnostic imaging appropriately. You need to give your radiologists total control over dictation, review, and signing of reports, but you can t turn them into typists. You need a system that lets them complete diagnostic reports fast and that is fully integrated with your Radiology Information System (RIS), and Picture Archiving and Communication System (PACS), even in a multisite environment. You need to offer radiologists the freedom to choose between speech recognition and speech-assisted transcription all in one system. You need to provide your radiologists with critical communication tools that are integrated directly into the reporting process. You need data visualization tools that allow you to make more educated business decisions. You need a closed-loop radiology solution that s battle-tested by thousands of ordering clinicians and radiologists at teaching hospitals, medical centers, and imaging facilities. solutions for healthcare 3
Clinically appropriate image order guidance Speech-driven reporting and communication Utilization management and outcomes analysis Managing the Order-to-Results Delivery Cycle The practice of radiology is wrestling with optimizing use, spiraling costs, decreasing reimbursements, and its expanded role in improving patient outcomes. To address these challenges, radiology practices must make more effective use of clinical data available today. Improving services to the referring physician, while improving patient safety, allows a radiology practice to set itself apart. Closing the Loop on Radiology Workflow Nuance Healthcare offers an innovative new strategy for managing radiology as a single, end-to-end or closed-loop process. This approach gives radiologists and administrators a continuous view of the order, from diagnosis through results process, which allows for analysis that can drive improvements at each stage. Nuance Healthcare offers the broadest portfolio of imaging documentation and communication software, including RadPort, PowerScribe 360, Veriphy, and RadCube. Improving the Appropriateness of High-Tech Diagnostic Image Ordering Studies have shown a significant percentage of radiology spending may be unwarranted. A renewed focus on utilization has increased administrative overhead for referring physicians and radiologists alike. The benefits of closed-loop radiology are evident: saving time, money, and resources, improving patient safety and care, and better clinical documentation. RadPort Appropriate high-tech imaging utilization and precertification through decision support Decision Support & Precertification Speech Repor ting RadCube Improved decision making through clinical data mining and outcomes analysis Data Mining and Analysis Critical Clinical Communication 4 solutions for healthcare
Manage costs more effectively Improve turnaround time Enhance patient safety RadPort provides clinical decision support for high-tech diagnostic imaging, which means that each and every order entering your department meets clinical care and reimbursement guidelines. RadPort also eliminates the need to spend time with Radiology Benefit Management (RBM) companies to obtain prior authorization. Reducing Turnaround Time and Transcription Costs PowerScribe 360 allows radiologists to create and turn around diagnostic imaging interpretations faster than ever before. By providing more than just dictation and report creation, PowerScribe 360 takes radiology speech recognition reporting to the next level as the new industry standard for report creation, multisite workflow, data capture, and communication. Nuance Healthcare s new radiology speech recognition reporting platform combines speech recognition technology, peer review, data capture, multisite workflow, and structured reporting in a single solution. This next-generation system provides real-time speech recognition and dictation, transcription and correction workflow, printing, faxing, coding, peer review, integrated clinical content, and extensive administrative tools. Customers consider PowerScribe 360 to be a cost-effective investment with payback in six months or less.* PowerScribe 360 Workflow optimization through speech-driven reporting Veriphy Reliable delivery, management, and auditing of urgent patient findings through critical test result management Communicating Critical Test Results In 2006, nearly two-thirds of all hospitals surveyed by the Joint Commission failed to meet National Patient Safety Goal #2 requirements: Improve the effectiveness of communication among caregivers. These hospitals would have met the requirements had they used Veriphy for Critical Test Result Management (CTRM), the preferred solution for radiology, pathology, cardiology, and clinical labs. Veriphy is available seamlessly integrated with PowerScribe 360. Improved Service and Market Competitiveness RadCube s analytic capabilities improve the competitiveness of your practice and strengthen relationships with referring physicians. With RadCube, you can analyze years of departmental data for productivity, quality assurance, utilization management, throughput analysis, and trending and forecasting. * Individual results may vary. solutions for healthcare 5
Our broad range of clinical documentation and communication solutions streamline processes and reduce costs, replacing systems such as traditional transcription, handwriting, or typing with advanced speech recognition technologies and customized workflows to deliver significant results for your healthcare enterprise. Transcription Platforms with EHR Integration use background speech recognition to address the need for cost-saving, enterprisewide dictation and to streamline transcription processes without impacting clinician workflow. escription or Enterprise Speech System Real-Time Speech Recognition in the EHR and voice navigation for the EHR are for organizations looking to accelerate clinician adoption and productivity when compared to typing, keyboard, and mouse navigation within their EHR system. Leading EHR application* 6 solutions for healthcare
provide a complete end-to-end, closed-loop process for the ordering clinician, the radiologist, and imaging administrators covering appropriate exam ordering, precertification, speech recognition reporting, communication, data mining, and outcomes analysis. 360 Critical Test Result Management ensures that time- and care-critical imaging and laboratory test results get to the right clinicians using the right delivery approach, and meet compliance standards and patient safety guidelines. 2010 solutions for healthcare 7
Reduce ordering time Satisfy precertification requirements Manage high-tech utilization RadPort Appropriate High-Tech Imaging Utilization and Precertification Through Clinical Decision Support (CDS) The appropriate ordering of high-tech diagnostic imaging studies is a critical part of good medicine and efficiently running your department. RadPort is a secure, web-based application for appropriate diagnostic image order placement that satisfies precertification requirements and integrates with leading Electronic Medical Record/Computerized Physician Order Entry (EMR/CPOE) platforms, such as the EpicCare EMR system. In these integrated environments, RadPort CDS rules can be accessed through thirdparty CPOE functionality without disrupting clinician workflow, thus allowing your organization to take more control of your high-tech imaging utilization. With American College of Radiology (ACR) Appropriateness Criteria as its foundation, RadPort s scoring methodology is continuously reviewed and enhanced to ensure clinical appropriateness. radport: Reduces ordering time up to 80% by eliminating RBM phone calls and satisfying precertification requirements. Eliminates unnecessary orders and educates referring physicians. Manages high-tech utilization and improves patient care. Healthcare payors are beginning to accept the decision support provided by RadPort as a form of precertification. RadPort in Action: Massachusetts General Hospital Since 2004, Massachusetts General Hospital (MGH), a member of Partners Healthcare, has been working to address the issue of unnecessary high-tech imaging. MGH developed a set of rules with the ACR Appropriateness Criteria as a foundation. The rules are regularly updated to reflect changes in imaging techniques, research developments, quantitative analysis of patient data, and qualitative feedback from referring physicians. The ordering physician enters the patient s information and selects the desired exam. The RadPort system gives the desired exam a utility score that rates the appropriateness of the order. The physician can verify the appropriateness of the exam, receive recommendations from the system for a more appropriate exam, and make the final decision as to which exam is ordered. This process provides accuracy, convenience, and guidance to the ordering physician while ensuring business efficiency. 8 solutions for healthcare
No more interruptions No change in workflow or behavior RIS/PACS/3D PowerScribe 360 The Leader in Speech Reporting PowerScribe 360 is a powerful radiology reporting platform that combines speech recognition technology, data capture, multisite workflow and structured reporting in a single solution. This next-generation system provides real-time speech recognition and dictation, transcription and correction workflow, printing, faxing, coding, peer review, integrated clinical content, and extensive administrative tools. PowerScribe 360 also offers a Web Services API that allows healthcare facilities and third-party solutions providers to integrate applications directly into this extensible platform. By providing more than just dictation and report creation, PowerScribe 360 takes radiology speech recognition reporting to the next level while redefining the industry standard. powerscribe 360: Reduces report turnaround time and associated transcription costs. Improves overall radiologist productivity. Provides integrated critical test results communication. Delivers payback in six months or less.* Through our Partner Program, Nuance Healthcare is integrating PowerScribe 360 with all of the major RIS and PACS vendors. PowerScribe 360 FlexChoice: Dictate the way you want, keep your current workflow, and pay less for the reports you generate! Nuance Healthcare offers PowerScribe 360 FlexChoice, the world s leading radiology speech reporting solution, in a program where radiologists don t have to self-edit or change their workflow. With PowerScribe 360 FlexChoice, your radiology department or imaging practice pays only for the reports you generate, and there s absolutely no capital outlay required. You can choose in-house or outsourced Medical Transcriptionists (MTs). Best of all, PowerScribe 360 FlexChoice ensures that you remain competitive with the latest technology so you can prepare for the future. PowerScribe 360 has a robust set of tools for the radiologist and a very intuitive user interface. The new platform is more than just a speech recognition solution; it serves as a workflow manager and data aggregator to enhance productivity and efficiency by assisting the radiologists with their day-to-day tasks. Matthew J. Bassignani, MD Medical Director, Radiology Department Virginia Radiology Richmond, VA * Individual results may vary. solutions for healthcare 9
Enhance patient safety Automate critical results Comply with industry standards and quality guidelines Veriphy Reliable Delivery, Management, and Auditing of Urgent Patient Findings Through Critical Test Result Management Veriphy is the industry-leading solution for Critical Test Management (CTM) and Critical Test Result Management (CTRM), which automates the delivery, verification of receipt, and documentation of voice communications concerning Critical Test Results (CTRs). For laboratories, Veriphy even automates read-backs by nurses or other caregivers. veriphy: Ensures compliance with Joint Commission, ACR, CAP and HIPAA. Enhances patient safety by verifying the receipt of CTRs. Ensures consistency within the hospital and across the healthcare system with multisite IDN support. We were using a manual process where we would write down what doctor was called, when, and for what patient. I ll go as far as to say that now our organization is meeting Joint Commission requirements because of Veriphy. Chatelain Tom Sadler Digital Imaging/PACS Manager Banner Good Samaritan Medical Center Phoenix, AZ Veriphy offers reporting clinicians one-call-does-it-all simplicity as well as assurance that a CTR has been retrieved by the responsible ordering clinician. A reporting clinician creates a message via phone or computer, and Veriphy does the rest: alerts the ordering clinician of a pending CTR; indicates the urgency of the CTR sends alerts until the message is retrieved; escalates the notification according to preset rules; sends a verification to the reporting clinician when the message has been retrieved all while documenting the entire process to meet audit requirements. Veriphy also provides hospital administrators with tools for real-time performance measurement so they can measure progress of reducing CTR Turnaround Time (TAT) and assess compliance. Veriphy in Action: Memorial Hermann Southeast Hospital An unannounced accreditation survey by a team from the Joint Commission is never a walk in the park, but thanks to Veriphy, Memorial Hermann Southeast Hospital (MHSE) in Houston knows it has one less thing to worry about. In the B.V. (Before Veriphy) era, the 40-45 or so significant and emergent monthly test results were a frequent source of worry to the physicians and to administrators, such as Cynde Chatelain, imaging manager for the hospital. They knew it was their Achilles heel. To fix the problem, the hospital started using Veriphy for critical test result management (CTRM) in July 2006. Now, Chatelain said, there is no finger pointing and no doubt about whether and when a result was communicated, because all the radiologists use the Veriphy system. After he (Joint Commission surveyor) saw how we were using Veriphy for CTRM, he was very impressed, Chatelain said. He said this was a best practice. He said we were doing a great job and were ahead of the pack. 10 solutions for healthcare
Reduce external IT costs Enhance service quality Analyze business operations RadCube Improved Decision Making Through Clinical Data Mining and Outcomes Analysis RadCube is a comprehensive yet flexible data warehouse for multidimensional business analysis and visualization. RadCube allows your department to operate in a data-driven fashion from modality utilization to clinician ordering patterns, through radiologist reporting statistics and outcomes analysis to maximize available data and provide a superior level of customer service. radcube: Allows for analysis of years of clinical records to help make better medical and business decisions. Reduces IT and administrative expenses and helps departments manage costs more effectively. Enhances service quality and customer satisfaction. With RadCube, you can analyze the operational aspects of your business, including business productivity, quality assurance, utilization management, throughput analysis, trending, and forecasting. Our early experience with RadCube has demonstrated that it is an effective and user-friendly tool that can quickly derive valuable performance metrics and business indicators. The combination of graphical presentation of data along with raw numbers provides the ideal means to instantly understand trends and calculate forecasts. This is a tool that practice leadership can use directly, on a daily basis, and will diminish the need for contract services. Dr. David Mendelson Medical Director, Radiology Informatics Mount Sinai Medical Center New York, NY solutions for healthcare 11
Clinically appropriate image order guidance Speech-driven reporting and communication Utilization management and outcomes analysis Nuance Healthcare Your Ideal Partner Let us help you achieve your vision of speech-driven clinical documentation and communication for your radiology department, imaging center, or practice. Best-in-Class Service We re here to support you. Our customer team supports more than 1,300 hospital-based radiology departments and freestanding diagnostic imaging centers. So no matter your size or your setting, we re responsive to your needs. That s why we ve built a world-class service organization to support our customers even before they ve purchased a solution. We develop a solution that fits your organization s needs, integrate it into your IT infrastructure, and support it for the life of ownership. Nuance Healthcare solutions are mission-critical relied on by busy clinicians who expect the highest levels of performance and reliability. Our experience truly speaks for itself. Nuance is now in an excellent position to offer a comprehensive layer of front-end ordering interface enhancements and urgent communication within a unified interface. The integrated strength of the product is greatly improved by Nuance s commitment to enhancing the user experience and supporting good patient outcomes with better IT support. Well done. Edward J. Zaragoza, MD Radiology Clinical Director Santa Monica UCLA Medical Center Santa Monica, CA 12 solutions for healthcare
Manage costs more efficiently Improve turnaround time Enhance patient safety The Proven Leader When you partner with Nuance Healthcare Solutions, you know you re working with the proven leader in speech-driven clinical documentation and communication solutions, backed by the expertise to ensure your success. Widespread Market Acceptance More than 450,000 clinicians in more than 10,000 facilities worldwide use Nuance Healthcare solutions. 100% of Honor Roll hospitals. 1 More than 90% top-ranking cancer hospitals. 2 More than 80% of the top 25 connected healthcare facilities. 3 More than 75% of the top U.S. hospitals. 4 More clinicians use Nuance Healthcare solutions to create electronic patient records than all EHR systems combined. More than 1,100 radiology departments and imaging centers have selected PowerScribe. Unparalleled Cost and Productivity Improvements PowerScribe reduces transcription costs by up to 85%. escription improves MTE productivity by up to 100%. Dragon Medical 10 makes clinicians up to 25% more efficient compared to using a non-voice-enabled EMR. Unmatched Investment in Best-in-Class Solutions $100 million annual investment in R&D. 650+ speech-related patents most in the industry. 500 speech scientists. 600+ services professionals. With PowerScribe 360 we finally have a product that allows the radiologist to concentrate solely on image interpretation and not be distracted by the reporting and communication process. David L. Weiss, MD Physician Coordinator of Imaging Informatics, Carilion Clinic Associate Professor of Radiology Virginia Tech Carilion School of Medicine 1. America s Best Hospitals, the 2010 2011 Honor Roll, U.S. News and World Report 2. Top Ranked Hospitals for Cancer 2010 2011, U.S. News and World Report 3. 2010 Top 25 Connected Healthcare Facilities, HealthImaging.com 4 America s Top Hospitals, 2010, U.S. News and World Report solutions for healthcare 13
Turnaround time in minutes RIS/PACS/3D Improved physician service Nuance Healthcare Solutions Nuance: 2009 Corporate Snapshot FY 2009 Revenues: $1.01 billion Stock symbol: NUAN (NASDAQ) Market capitalization: $4.5 billion* Employees: 3,500 Speech patents: 650+ Speech scientists: 500 Professional services: 600+ *As of October 2010. Nuance is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications, and services make the user experience more compelling by transforming the way people interact with information and how they create, share, and use documents. Every day, millions of users and thousands of businesses experience Nuance s proven applications and professional services. Dictaphone Enterprise Speech System On-site dictation/ transcription platform with background and front-end speech recognition with full controls and advanced workflow flexibility. Dragon Medical A real-time speech recognition program that works with virtually any Windows -based or Citrix EHR system for efficient report completion, and easy navigation and adoption of the EHR system. Dragon Medical Mobile Advanced point-of-care solutions that allow physicians and other caregivers to document patient encounters and access clinical information using their smartphones and other mobile devices. escription On-demand platform for computer aided medical transcription using background speech recognition to turn clinician dictation into formatted draft documents that medical transcriptionists whether in-house or outsourced can quickly review and edit, typically doubling productivity. Nuance Transcription Services powered by escription A full-service, outsourced solution for clinical documentation, including technology and all speech editing, QA, and transcription workflow management. PowerScribe 360 A powerful radiology reporting platform that combines speech recognition technology, peer review, data capture, multisite workflow, and structured reporting in a single solution. RadCube A comprehensive yet flexible data warehouse for multidimensional business analysis and visualization. RadPort A secure web-based decision support application that ensures appropriate high-tech diagnostic image ordering. Veriphy A critical test result management, solution that enhances patient care, increases physician productivity, improves risk management, and automates compliance. 2009 escription 2009 KLAS Enterprise, LLC. All rights reserved. KLAS (www.klasresearch.com) 2009 Top 20 Best in KLAS Awards: Software & Professional Services (December 2009) To learn more about how Nuance Healthcare can partner with you to improve financial performance, support radiologists, and help raise the quality of care, contact us at 800 350 4836 or www.nuance.com/healthcare. 2010 Nuance Communications, Inc. All rights reserved. Nuance, the Nuance logo, Dictaphone, Dragon, escription, PowerScribe, RadCube, RadPort and Veriphy are trademarks and/or registered trademarks of Nuance Communications, Inc., and/or its subsidiaries in the United States and/or other countries. All other trademarks are properties of their respective owners. 14 solutions for healthcare
L-3158-003 11/10 DTM The experience speaks for itself NUANCE COMMUNICATIONS, INC. ONE Wayside Road 800 350 4836 Burlington, MA 01803 www.nuance.com/healthcare