New Nuance Dragon Application Targets Small Health Care Practices

Nuance's Dragon Medical Practice Edition for small practices allows physicians to dictate patient narratives directly into EHRs.

Nuance Communications has unveiled Dragon Medical Practice Edition, a new edition to its speech-recognition software portfolio to allow small practices of 24 or fewer doctors to benefit from the ability to dictate patient conditions into electronic health records.

For Practice Medical Edition, Nuance built the templates and macros to support the workflow of a small practice rather than a hospital, Carina Edwards, Nuance's vice president of health care solutions marketing, told eWEEK.

To accommodate small practices facing financial, legal and technological barriers to EHR adoption, Nuance designed the product to be cost-effective and to help organizations satisfy meaningful-use mandates on EHRs, according to Edwards.

Launched on Aug. 17, the application allows individual doctors to manage the software themselves, while the enterprise version, Dragon Medical Network Edition, runs on Citrix servers and allows IT teams to centrally manage networking settings and user profiles enterprisewide.

Licensed on a per-user basis, Practice Medical Edition costs $1,600 per clinician, while Dragon Medical Network Edition costs around $2,200 per clinician and is geared toward practices of 25 or more doctors.

More than 200,000 physicians use Dragon Medical products to document patient conditions within EHRs, according to Keith Belton, senior director of product marketing at Nuance Healthcare.

In addition to entering information into EHRs, doctors can import spoken data from a CLU (clinical language understanding) engine into a revenue cycle management database, analytics engines and decision-support tools, Edwards said.

Dragon Medical works on top of EHR applications, such as those from eClinicalWorks and NextGen. "Dragon is a toolbar that lays on top of that application and is context-aware of the menus in that application," Edwards explained.

Medical Practice Edition features additional support for multicore hardware, leading to better recognition, faster dictation and quicker turnaround time on documents, Nuance reports.

After some initial 3-minute training sessions to acclimate the software to a doctor's voice, the program can achieve up to 99 percent accuracy, according to Nuance. Dragon Medical Practice Edition brings a 15 percent increase in accuracy over previous versions, the company reports.

In addition, the software can detect poor audio input, such as an out-of-range microphone, and notify the user to correct the problem.

"Dragon Medical is a proven EHR-support solution that helps clinicians to fully and efficiently capture patient data as part of the medical record," Evan Grossman, vice president of product strategy at Athenahealth, said in a statement. Using Nuance's speech recognition software along with Athenahealth's cloud-based EHR service, AthenaClinicals, allows physicians to create high-quality, real-time patient documentation, he added.

Dr. James Nairus, an orthopedic surgeon with Longwood Orthopaedic Associates in Chestnut Hill, Mass., explained how he has difficulty deciphering other doctors' notes in EHRs, but the speech-recognition capabilities of Dragon Medical help alleviate this problem.

With Dragon, you can actually dictate a personalized narrative to each section of an EHR, particularly "History of Present Illness" and "Treatment Plan," Nairus said in a Nuance company video.

Although EHRs create more work for doctors rather than providing notes to a transcriptionist, using speech recognition software can "limit the pain," Nairus added.

By eliminating the role of the transcriptionist, practices save on transcription costs, Edwards noted. In addition, entering patients' narratives by voice could lead doctors to increase adoption of EHR apps, Edwards said.

Meanwhile, on Aug. 10 Nuance announced a 10-year agreement with UPMC, a health system associated with the University of Pittsburgh, to develop new tools physicians can use to dictate patient data and convert it into a discrete, structured format in EHRs. Nuance is also working to integrate CLU capabilities with IBM's Watson supercomputer.