Navigating Healthcare – Patient Safety and Personal Healthcare Management

Nuance eScription Receives 7th Consecutive Best IN KLAS award

Posted in eScription, KLAS, Nuance by drnic on December 21, 2010

Nuance’s eScription Platform Honored with Seventh Consecutive Best-in-KLAS Award

Seven Consecutive Best in KLAS Awards, Market Growth and Continued Delivery of Innovation Reinforces eScription as Leading Solution for Hosted, Background Speech Recognition

BURLINGTON, Mass., – December 20, 2010Nuance Communications, Inc. (NASDAQ: NUAN) today announced that its eScription platform has received a Best in KLAS award for the seventh consecutive year. With a score of 89.8, the eScription platform ranked the highest in the speech recognition category, surpassing its score from 2009 even as the platform’s usage has dramatically grown with both new and existing customers. Today, the number of active dictating clinicians who use eScription is up by 24 percent since one year ago.

The Best in KLAS Award is driven solely from customer feedback, a testament to the demonstrated benefits of the eScription platform and the service and support provided to eScription customers. According to Nuance’s review of past Top 20 Best in KLAS Awards reports, Nuance is one of only four other healthcare IT vendors that have achieved a Best in KLAS product award for the past seven consecutive years. As noted in the KLAS report, 98 percent of customers surveyed indicated they would buy eScription again; this high level of customer satisfaction and confidence comes in 12 percentage points higher than the next highest ranked background speech solution.

“Throughout our partnership with Nuance, the eScription platform has never disappointed and in fact, has met or exceeded all expectations,” said Jonathan Bowers, Vice President Information Services, Carolinas HealthCare System.  “eScription’s ranking as the best speech recognition solution does not come as a surprise.  In 2006, we leveraged KLAS’ ratings as part of our speech recognition vendor selection; our diligence and intuition to partner with Nuance was validated. Today, we’ve reduced report turnaround time by an average of 75 percent, realized significant cost savings and as we approach an annual run rate of 100 million lines through the platform, we are confident with eScription as our standard speech recognition solution across all Carolinas HealthCare System sites.”  

Nuance’s focus on customer satisfaction was echoed at the recent annual Conversations Healthcare 2010 user meeting, where 39 healthcare organizations were recognized for saving one million dollars or more on medical transcription costs as a result of implementing eScription. Cumulatively, eScription Million Dollar Award recipients have reported savings of more than $140 million.

“2010 marks the eScription platform’s seventh consecutive Best in KLAS award, a year of growth for the platform and a year of innovation across our portfolio,” said Janet Dillione, executive vice president, Nuance Healthcare. “Nuance is honored to be recognized by KLAS and by our customers. This distinction comes at an exciting time, one in which we are focused on delivering more value to our customer base and the healthcare industry at large.”

Emphasizing Nuance’s commitment to innovation, earlier this month Nuance launched Dragon Medical Mobile Recorder, an iPhone app that offers clinicians a new level of clinical documentation flexibility by enabling mobile point-of-care dictation that is connected to Nuance’s speech-enabled transcription platforms, including eScription.

2010 Top 20 Best in KLAS Awards were determined based on 25 performance criteria in five categories: Sales and Contracting; Implementation and Training; Functionality and Upgrades; Service and Support; and General. KLAS, a market research firm, published its latest findings in the 2010 Top 20 Best in KLAS Awards: Software & Professional Services report (December 2010). The product rankings are derived from product evaluations and confidential interviews with healthcare information technology (HIT) customers, incorporating performance data collected over the past 12 months (November 15, 2009 – November 15, 2010).

eScription is Nuance Healthcare’s leading on-demand, enterprise-wide transcription platform.  Whether a healthcare organization has an in-house staff of medical transcriptionists (MTs) or uses a fully outsourced approach, eScription is proven to help healthcare organizations reduce document turnaround time, improve consistency and quality, and save costs, without impacting clinician workflow.

About KLAS

KLAS is a research firm specializing in monitoring and reporting the performance of healthcare vendors. KLAS’ mission is to improve delivery, by independently measuring vendor performance for the benefit of our healthcare provider partners, consultants, investors, and vendors. Working together with executives from over 4500 hospitals and over 2500 clinics, KLAS delivers timely reports, trends, and statistics, which provide a solid overview of vendor performance in the industry. KLAS measures performance of software, professional services, and medical equipment vendors. For more information, go to, email, or call 1-800-920-4109 to speak with a KLAS representative. © 2008 KLAS Enterprises, LLC. All rights reserved.

Nuance’s Healthcare Business

Nuance’s healthcare portfolio of proven, speech-enabled clinical documentation and communication solutions enable healthcare provider organizations to improve financial performance, enhance patient care, and increase patient safety. With more than 10,000 healthcare provider organization customers and 450,000 clinician customers worldwide, Nuance has the experience and solutions that meet the individual needs of any size healthcare provider organization.

Nuance Communications, Inc.

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. For more information, please visit

Nuance and the Nuance logo are trademarks or registered trademarks of Nuance Communications, Inc. or its affiliates in the United States and/or other countries. All other company names or product names may be the trademarks of their respective owners.

The statements in this press release, relating to future plans or future events or services, are forward-looking statements which are subject to specific risks and uncertainties.  There are a number of factors which could cause actual events or results to differ materially from those indicated in such forward looking statements, including fluctuations in demand for the Nuance products, the relationship with the customer or partner and the continued development of Nuance products.  The reader is warned not to rely on these forward-looking statements without reservation, since these are simply reflections of the current situation.  Nuance disclaims any obligation to update any forward-looking statements as a result of developments occurring after the date of this document.

eScription racks up a 7th consecutive “Best in KLAS” concurrent with a big expansion in the user base up by 24% since last year.
This is a huge testament to the Nuance team who have worked tirelessly to maintain quality and customer service and contributed over $140 Million dollars in savings to multiple healthcare organizations
Thanks to the customers for their vote of confidence and congratulations to the Nuance team who continue to excel at delivering increasing value to the healthcare industry


Technology helping Physicans Improve their Practice Management

Posted in Dragon, Nuance by drnic on December 17, 2010

The ability to access clinical information while make clinical rounds proved to be especially helpful to Jon Wahrenberger, M.D., a cardiologist at Dartmouth- Hitchcock Medical Center in Lebanon, NH where he was able to access information real time while at the patient’s side and used as a collaborative tool with patients reviewing the information with the doctor

Healthy Weight Loss and Dieting: How to Lose Weight and Keep It Off

Posted in Healthcare Information by drnic on December 16, 2010

obesity on the rise and the challenge of weight loss programs that fail make for a constant struggle. This piece on what works and what doesn’t is not filled with any major revelations but is stocked full of sound advice.
You might have noticed that the people around the table who are not carrying extra pounds are often the slower eaters – taking time over your food is important especially to allow the brain to “realize” the stomach is full – this can take 10 – 15 minutes!
In fact this piece over at NPR Health Blog Shots that looks at the effect of the mind on our hunger for food. In a controlled study a group of people who imagined eating M&M’s ate less after the study than those who just imagined moving them. IN fact paying attention to the food while you eat as opposed to watching TV or other activities will also help the brain realize you are full and reduce the desire to eat too much.
So when eating, focus on eating and take your time…much like the Mediterranean culture do with every meal an event.

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NLP in Healthcare Part 2

Posted in Clinical Language Understanding, IBM, Jeopardy, NLP, Watson by drnic on December 15, 2010

Following up from my post back in June (NLP in Health care) the Jeopardy challenge is on – coming to your TV February 14 – 16. There was lots of coverage of the announcement
This from the Washington Post – “‘Jeopardy!’ to pit humans against IBM machine” and the IBM release
Ken Jennings and Brad Rutter two of the leading Jeopardy winners will go up against Watson. Jennings had the game show’s longest winning streak at 74 games in a row and Rutter has won the most money standing at $3.3 million.

What is Watson

But what’s important is the possible future applications:

IBM is hoping the technology it exhibits will have some practical uses eventually, for instance helping doctors diagnose illnesses or solving customer problems at technical support centers.

Applying this in healthcare is part of the partnership announced back in October and featured in the posting  “Clinical Documentation Challenges”. It will be exciting to see the performance of Watson in Jeopardy on live TV but its the application of this in healthcare that will present some revolutionary opportunities…watch this space

iPad in practice: Applying the apps

Posted in iPad, MHC by drnic on December 15, 2010

iPad takes healthcare by storm – there are still some difficulties but form factor, battery life and ease of use win users over

President’s Council of Advisors on Science and Technology (PCAST) to Release Health Information Technology Report

Posted in Uncategorized by drnic on December 14, 2010
President’s Council of Advisors on Science and Technology (PCAST) to Release Health Information Technology Report


– Kathleen Sebelius, Secretary, HHS
– Lawrence Summers, Assistant to the President for Economic Policy and Director, National Economic Council
– David Blumenthal, National Coordinator for Health IT
– Eric Lander and Christine Cassel, President’s Council of Advisors on Science and Technology
– Private-Sector Discussants

This video is also available at…

We accept comments in the spirit of our comment policy:… 

U.S. Department of Health & Human Services (HHS)

Evidence Based Medicine, Medical Malpractice and Incentives

Posted in Evidence Based Medicine, Health Reform, Malpractice, Safety by drnic on December 8, 2010

A recent Dustin Comic like all good comics hit the proverbial nail on the head

Unfortunately the healthcare reform fails to address key aspects to the incentive problem in healthcare. The system remains centered on measuring what we do for patients rather than the end result.

There are moves by employers and the insurance industry to incentives patients towards healthier behavior. This approach is not without problems as highlighted in this piece in the New England Journal of Medicine “Carrots, Sticks, and Health Care Reform — Problems with Wellness Incentives” where the authors highlight the challenges for employers, employees and insurance in creating incentive and how this can introduce inequities that do more harm than good. As they point out

If people could lose weight, stop smoking, or reduce cholesterol simply by deciding to do so, the analogy might be appropriate. But in that case, few would have had weight, smoking, or cholesterol problems in the first place

There is no doubt that patient incentives must be part of the solution but require thoughtful design and implementation to avoid the pitfalls

Incentives for healthy behavior may be part of an effective national response to risk factors for chronic disease. Wrongly implemented, however, they can introduce substantial inequity into the health insurance system. It is a problem if the people who are less likely to benefit from the programs are those who may need them more.

But incentives aligned to the practice of evidence based medicine and in particular the financial challenges facing the ever increasing ordering of tests is where there seems to be significant progress. The announcement of a statewide adoption of Radport by the Institute of Clinical Systems Improvement (ICSI), a nonprofit comprising 60 medical groups, 9,000 physicians, and six payers and health plans was covered extensively at RSNA 2010 in Chicago this year and featured in this piece in Information Week “System Helps Doctors Pick The Right Tests” demonstrating a saving of $27 Million over the preceding year

During the yearlong pilot involving more than 2,300 ICSI-member physicians, ICSI saw no growth in the number of high-tech diagnostic imaging tests ordered. In previous years, the number of tests ordered grew about 8% annually…The lack of growth translates to a savings about $28 million for the year

But any discussion on incentives needs to include the issue of malpractice – liability drives behavior in the same way as incentives do (in some respects its incentive in another from). Peter Orszag opinion in the NY Times Malpractice Methodology makes the point that

The health care legislation that Congress enacted earlier this year, contrary to much of today’s overheated rhetoric, does many things right. But it does almost nothing to reform medical malpractice laws. Lawmakers missed an important opportunity to shield from malpractice liability any doctors who followed evidence-based guidelines in treating their patients.

President Obama weighed in on this issue in June 2009 when he spoke to the American Medical Association when he highlighted the “unnecessary tests and treatments (ordered by doctors) only because they believe it will protect them from a lawsuit” and as he put it

We need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine and encourage broader use of evidence-based guidelines

Medicine remains “more evidence-free” than should be the case:

One estimate suggests that it takes 17 years on average to incorporate new research findings into widespread practice

Addressing the issue of liability can take the traditional approach of limiting punitive damages but as Peter Orszag said “provide safe harbor for doctors who follow evidence-based guidelines” is a much better idea and one that would sit well with patients and doctors alike (I’d be interested to hear from lawyers who agree or disagree on the merits of such an approach).

There are some initial moves in this direction and a need to implement technology to help guide the treatment (as we see with ICSI) and all this would also lead to higher quality of care for everyone and possibly a new system that reimbursed based on the quality of care delivered versus the quantity of care.

Killer Drugs – Tobacco and Alcohol

Posted in Preventative Healthcare by drnic on December 7, 2010

IF you are in any doubt about the profound effects of tobacco and Alcohol read this post and watch the video

Ethyl alcohol kills large numbers of Americans every day (about 200), almost all legally.
Tobacco kills large numbers of Americans every day (about 1,200), almost all legally.

That’s 1,400 people per day – that’s over half a million people per year! For every 10 who drink 1 will become a problem drinker.

So HHS has gone with Scare Tactics for alcohol. Importantly

Scare tactics DO WORK when they are obviously, provably true, like telling a child to not sit on the railroad tracks when a train is coming.
Scare tactics DON’T WORK when they are patently false (think “Reefer Madness”).

So for alcohol take a leaf out fo Australia’s graphic advertising campaign found here
And the Montage of 20 years worth of adverts:

And some of the individual

8 years on HRT still prescribed in risky high dose format

Posted in Uncategorized by drnic on December 6, 2010
Despite a Randomized clinical trials (RCT) some eight years ago physicians continue to prescribe hormone replacement therapy (HRT) with regular dosage despite the risks associated with this therapy
High-Dose HRT Still Prevalent (CME/CE)

More evidence for the requirement for clinical support tools and integration of evidence based medicine (EBM) into regular clinical practice. Capturing clinical data at the point of care to enable these tools to provide relevant clinical input and guidance is critical to increasing quality and safety in medicine. The journey begins with capturing clinically actionable data as part of the documentation process without burdening the physician with hunt and click data entry tasks.

Head Out for a Daily Dose of Green Space

Posted in Uncategorized by drnic on December 4, 2010
Head Out for a Daily Dose of Green Space to improve health and well being. It may sound obvious but increasingly difficult

>>>>>We suffer from “outdoor deprivation disorder,” but a cure is just outside your door.
find some outdoor space nearby and use it…everyday