Accelarad Nuance Makes It Official

Dear Accelarad customer,You should have received an email from me on Monday of this week, when I provided our customers an early insight into the announcement that Accelarad is now a part of Nuance Communications. At this time, I wanted to provide you some additional information and invite you to learn more.

You can read the full press release here: (Nuance Unveils PowerShare – April 17,2014)As discussed, this new union brings together our cloud-based medical image sharing technology and Nuance’s PowerScribe radiology reporting and communication platform. The partnership will give you, our valued customer, access to Nuance’s expansive healthcare technology and professional services, while continuing to provide you with the proven software and solid relationships you have come to expect from Accelarad. With this partnership, Accelarad’s SeeMyRadiology solution has been rebranded to align with the Nuance diagnostic brand, and will be part of the Nuance PowerShare Network. To learn more about PowerShare | Image Sharing, sign up to join one of our webinars.

Most importantly, know that the products and people you have come to rely on will not change. Accelarad’s leadership team and valued employees will be deeply involved in creating a smooth transition for our customers, and our focus remains on making sure you continue to receive the excellent service you deserve.

Thank you again for your support and confidence in us. We will keep you informed about any incremental changes along the way and are open to your feedback.

Sincerely,                

Willie Tillery, CEO, Accelarad 

Rodney Hawkins, General Manager, Diagnostic Solutions, Nuance

For your viewing pleasure, here is the press release:

Nuance PowerShare Network Unveiled for Cloud-Based Medical Imaging and Report Exchange
Industry’s Largest Medical Imaging Network Helps Providers and Patients Coordinate Care and Share Information Across Distances and Disparate Healthcare Systems

BURLINGTON, Mass., – April 17, 2014 – Nuance Communications, Inc. (NASDAQ: NUAN) announced today the immediate availability of Nuance PowerShare™ Network, the industry’s largest cloud-based network for securely connecting physicians, patients, government agencies, specialty medical societies and others to share essential medical images and reports as simply as people exchange information using social networks. Nuance PowerShare Network promotes informed and connected physicians and patients who can instantly view, share and collaborate while addressing patients’ healthcare needs.

“Organizations are being tasked to communicate efficiently both in and out of their networks to provide clinical insight to physicians beyond one person or office to a much broader team involved in the continuum of care,” said Keith Dreyer, DO, PhD, FACR, vice chairman of radiology at Massachusetts General Hospital and Chair of the American College of Radiology (ACR) IT and Informatics Committee. “Nuance PowerShare Network addresses the information sharing challenge physicians face today with a network that supports things we’ve dreamed of doing for years,” he adds.

Fully Connected Patients & Providers
Nuance PowerShare Network is already used by more than 1,900 provider organizations for sharing images via the cloud using open standards. Made possible through the acquisition of Accelarad, this medical imaging exchange eliminates the costly and insecure process of managing images on CDs and removes silos of information in healthcare that inhibit providers from optimizing the efficiency and quality of care they provide. Anyone can join the network regardless of IT systems in place to instantly view and manage images needed to consult, diagnose or treat patients, enabling clinicians to more seamlessly evaluate and deliver care for patients who transition between facilities or care settings.

Nuance is already used by more than 500,000 clinicians and is a critical component within the radiology workflow and a trusted partner for 1,600+ provider organizations that rely on Nuance PowerScribe for radiology reporting and communications. Healthcare organizations that use Nuance PowerScribe, a group that produces more that 50 percent of all radiology reports in the U.S., can immediately leverage their existing investment and begin sharing radiology reports along with images, such as X-rays, MRIs, CT scans, EKGs, wound care images, dermatology images or any other type of image. This simplifies secure health information exchange between multiple providers, patients and disparate systems without costly and time-consuming interfaces, CD production or the need to install additional third-party systems.

“The challenge of sharing images with interpretive reports is something we’ve heard about consistently from our customers and EHR partners, and we know Nuance PowerShare Network will overcome this major obstacle, helping physicians treat patients more efficiently and effectively,” said Peter Durlach, senior vice president of marketing and strategy, Nuance Communications. “This nationwide network, one that is fully integrated into the EHR workflow and already connected to approximately half of all clinicians producing diagnostic imaging information, is a ground-breaking solution that delivers immediate benefits at an unprecedented scale to our healthcare system.”

“Integrated image and report sharing helps us deliver quality care and drive down costs especially when patients transfer from one facility to another. Whether at their desktop or on their mobile device, our physicians can see the study that was done along with the interpretive report, which provides the information they need to treat the patient and avoid duplicate testing,” says Deborah Gash, vice president and CIO, Saint. Luke’s Health System in Kansas City. “By integrating this with our EHR, PowerShare will enable physicians to manage inbound imaging through one point of access and login. Physicians in our 11 hospitals and 100-mile radius referral network see this cutting-edge technology as a way to deliver the highest level of patient care,” she adds.

To learn more about the PowerShare Network and the new image sharing solution, visit http://ift.tt/Rrdoxt to join one of our webinars. Connect with Nuance on social media through the healthcare blog, What’s next, as well as Twitter and Facebook.

Definitely an interesting constellation of services! I wonder where this might lead. Ironically, Rodney is also an old friend from the AMICAS days…

via Blogger http://ift.tt/1qPBqhK April 17, 2014 at 01:04PM

Film at Eleven…But I Need It NOW!!!A Bigger Share Of Image Sharing

A long time ago (November, 2005 to be exact), sitting in a radiology department far, far away from most of you, I bemoaned the problem of the “Portable Patient” in one of my early AuntMinnie.com articles:

Of the thousand daily frustrations I experience as a radiologist, perhaps the most painful is that of the “portable patient.” You see, patients migrate from hospital to hospital, from clinic to clinic, and from office to office. They may be searching for a second opinion, a superspecialist, someone who will give them the particular answer they seek (some want to hear good news, some prefer bad news), convenience, drugs, or some combination of the above.

As often as not, they acquire a mountain of imaging studies along the way. When asked why they had a particular study at a particular site, the answer is invariably, “My doctor told me to have it there.”

Add to that the dependence on our ERs for emergent (or maybe just impatient care, as I like to call it), and the ER’s love of imaging studies. Put them together and you’ve got a collection of the patient’s imaging studies spread across a city or even a state.

I was pretty smart back then, identifying a problem that many folks far wiser than I have been trying to solve since. And last year, I authored a follow-up article:

I’ve introduced you to a portable patient, and you can see what happened to her because no one knew about the examinations she had already undergone. She was irradiated, magnetized (probably less of a problem), and scared to death (arguably more damaging than radiation) because we have no way to connect the dots of her various studies.

Well, that isn’t quite true. We do have ways — we just aren’t using them… Many years ago, when our old PACS needed replacing, I suggested to the IT types that the three hospital systems in our average town in the South combine efforts to create a single citywide PACS to serve all three hospitals and, particularly, all of their patients. I was told by the illustrious chief information officer that we couldn’t even think of working with one of the other hospitals because it was “suing us” (which wasn’t quite a lie … they were challenging a certificate of need application). Millions of dollars and patient welfare down the toilet over C-suite egos.

There were and are other approaches. As an alternative to a central repository, connecting one PACS to another isn’t that hard. The best way to do this — and fulfill all HIPAA requirements in the process — is to use an image-sharing system such as lifeImage (my personal favorite by a mile).

Don’t even bother to suggest that CD-ROMs solve anything. They don’t. They get lost, they get broken, they don’t always load, the patient forgets to bring the disk, or the original imaging site forgets to send it, and darn, they’re closed today…

At one of the clinics we staff, the clinicians come at me at least twice a day, every day, with an outside CD. After three years, I finally was able to convince the powers that be to load the damn things into PACS and merge the data with local exams. But the clinicians don’t want to bother with waiting for the disks to load — they want results now. In my opinion, CDs aren’t even worthy of being drink coasters, given that huge hole in the middle. (And their older PACS rejects a significant percentage of the disks anyway.)

{snip}

Here’s where I’m going to anger a lot of people, and this is of course why you like to read my rantings. The following is something that needs to be said, however, and I’m going to say it.

Given that …

  • Not knowing that the patient has had prior studies leads to unnecessary imaging
  • Unnecessary imaging may expose the patient to unnecessary radiation, costs, and anxiety
  • Unnecessary radiation is bad for you, as is anxiety
  • We have ways to share prior studies

… then it stands to reason that today, in the 21st century, shirking our responsibilities to the patient in this aspect of medical imaging is malpractice. Yes, I used the “M” word. But that’s exactly what it is. We are not doing what we should — and what we must — for patient care. It is high time to apply technology that has been around for a long time to unify patients’ records, imaging and otherwise.

We are harming our patients out of ignorance, out of hubris (why would they go to any doctor/hospital/clinic other than me/mine?), and out of greed (I get the revenue if I repeat the study!). This is completely unacceptable…

Forgive the massive regurgitation of the last post, but you must acquire (or reacquire) the mindset of the necessity of image-sharing.

If you wondered if exams were really repeated under the “portable patient” scenario, let me assure you that they are.

A study from western New York showed:

(A)pproximately 90% of duplicate and potentially unnecessary CT scans were ordered by physicians who have little to no usage of the HIE when combining slices of users with less than 500 queries in 18 months. An opportunity therefore exists to reduce the number of duplicate CT scans if the physician is utilizing HEALTHeLINK to look up information and recent test results on their patients prior to ordering more tests. In addition, this also highlights a need to get more physicians participating and using the HIE in a meaningful way as more than 70% of duplicate CT scans were ordered by physicians who did not query HEALTHeLINK.

Another study from the University of Michigan found:

RESULTS:
In our sample there were 20,139 repeat CTs (representing 14.7% of those cases with CT in the index visit), 13,060 repeat ultrasounds (20.7% of ultrasound cases), and 29,703 repeat chest x-rays (19.5% of x-ray cases). HIE was associated with reduced probability of repeat ED imaging in all 3 modalities: -8.7 percentage points for CT [95% confidence interval (CI): -14.7, -2.7], -9.1 percentage points for ultrasound (95% CI: -17.2, -1.1), and -13.0 percentage points for chest x-ray (95% CI: -18.3, -7.7), reflecting reductions of 44%-67% relative to sample means.

CONCLUSIONS:
HIE was associated with reduced repeat imaging in EDs. This study is among the first to find empirical support for this anticipated benefit of HIE.

That’s a lot of repeat studies. And a lot of excess radiation. We can wait for the study to be delivered from the outside place, or the outside CD to be loaded (“Film at Eleven”) or we can redo the study. None of these choices are optimal. We can all see that.

So…Now that you’ve gone through the indoctrination, we can proceed.

I’ve known Hamid Tabatabaie for many years, starting back when he was CEO of AMICAS. (I guess that dates me. Like Mrs. Dalai’s grandfather who died at 93 after having outlived 5 of his internists, I’ve gone through two subsequent AMICAS CEO’s and I’m on my second or third Merge CEO. Justin, you’d better hope I get out of this business soon!) Hamid is one of the visionaries behind web-based PACS, of which AMICAS Merge PACS is still one of the best examples. Today, he heads lifeIMAGE, my favorite among the image sharing companies out there.

The story is making the rounds that Nuance, one of my least favorite companies, is diving into this arena, with the purchase of Accelarad. From Hamid’s blog (I guess everyone has one now):

I spoke with a friend today who is now the sixth person to have heard rumors about Nuance entering the image sharing market. He thinks it will announce the acquisition of a small Atlanta-based company imminently. I know the target company rather well, think highly of the founders, and I’m happy to see them finally reap some benefit from their 15-year-old startup odyssey. They started out as a small PACS company and then carved out a niche by selling data center based teleradiology PACS, which I think delivers the great majority of its $6M or so annual sales.

This little company is apparently Accelarad. More on them in a moment. Back to Hamid:

We (lifeIMAGE) started out working with innovators and early adopters who believed in our cause. We believe in eliminating duplication of imaging, avoiding delays in care and excessive radiation, and improving quality of care for patients. To realize our goal, we build software that helps make medical images part of a patient’s record and helps physicians access imaging histories conveniently, from any setting. We’ll soon announce our fifth anniversary as a well funded, privately held company, with many remarkable results that make our team very proud…

..(I)mage sharing for serving radiology, with 25,000 or so US radiologists, where Nuance has its major presence, has been around for a long time. Innovations in teleradiology are well past their prime, so, we at lifeIMAGE do not see a disruptive opportunity to innovate in that area. We are focused on the far broader need, which exists among large health systems that need to avoid the cost and problems associated with repeat imaging orders. Their ordering physicians, our end-users, are non-radiology image intensive specialists who need access to patients’ imaging histories in order to reduce the rate of repeat exams. 

The cure for the portable patient indeed.

Recently, I’ve been fascinated with what professor Everett Rogers called “the law of diffusion of innovation.” It basically spells out that there is a point at which an innovation reaches critical mass. “The categories of adopters are: innovators, early adopters, early majority, late majority, and laggards.[1]” The early majority buy into a technology when it’s been well vetted by innovators and early adopters first. Every innovative and disruptive company looks for the sign that its technology has started to be adopted by the “early majority.” Nuance’s entrance into the image sharing market is an indication for me that the market is getting ready for broad adoption, validating what we already see in the lifeIMAGE customer statistics. Professor Rogers suggests that once 16% of the market has signed up for a technology, that’s when the early majority starts to adopt. Current lifeIMAGE customers represent nearly 16% of all US physicians…

lifeIMAGE is the most utilized image sharing network, designed for use by physicians across a wide range of clinical disciplines—neurology, orthopedics, cardiology, oncology, surgery, etc. Our position is unique in that our engine of innovation is fueled by this population of doctors, who encounter patients with outside imaging histories on daily basis. We also help providers with patient engagement strategies and lead the way in providing access to patients who can in turn share their imaging records with providers of their choice. So, indeed new market forces may very well validate the market and expedite adoption of our disruptive and expansive technology, innovation for which is guided by multi-disciplinary specialists, including radiologists….

When I was CEO of AMICAS, our team spent some time studying the concepts around disruptive technology. Its definition in Wikipedia is, “A disruptive innovation is an innovation that helps create a new market and value network, and eventually disrupts an existing market and value network (over a few years or decades), displacing an earlier technology.” That is what our web-based PACS was back in 1999.

To me, being rather more concrete than some, a “disruptive” technology is one that interrupts my workflow, and nothing could fit that definition better than what Nuance is really known for: Speech Recognition, also incorrectly known as Voice Recognition. Here we have a technology that displaces the human transcriptionist, freeing the hospital from the tyranny of employing said human and paying their salary and benefits. It dumps the work of transcribing and editing onto the radiologist with no increase in pay for the effort. And it barely works. A friend who is totally enamored with SR tried to show me how wonderful it functions in his enterprise. I watched him focus his entire attention onto the report screen, which was three monitors away from the radiographic image he was supposed to be interpreting. Yah, this is great and wonderful stuff. Now it does speed things along. My friend claims to be able to read 300 exams in 8 hours with <1% error-rate because of his beloved SR. I’ll simply say that it wouldn’t work that well in my hands.

I’m digressing, but for a reason. Nuance and the other SR vendors have made inroads into hospitals and other imaging emporiums with their disruptive technology. They ride in on the white horse of decreased turn-around time (TAT) which warms the cockles of the administrative types who live and die by picayune metrics like that. In addition, they convince these folks that it’s CHEAPER to have the computer do the job than a cadre of benefit-sucking humans, and that’s all they need to say.

I’m sure Nuance wouldn’t enter the image-sharing market if they didn’t think it would be lucrative. Few in this business (including me) do things for free out of the goodness of their hearts. As Hamid implies, Nuance’s entrance to this space validates the concept, and I think validates lifeIMAGE as well, which I maintain does it better than anyone.

Accelarad seems to have the basics down, and Nuance has apparently made the GE-like choice of buying the technology en bloc rather than developing its own. Fine with me. Here’s their description:

Our medical imaging solution combines the ease of social networking with the clinical precision and security that medicine demands, making medical image sharing with patients, colleagues and other organizations easier than ever. Accelarad allows you to quickly and securely upload, access, manage and share medical images from any Internet-connected computer, mobile device or via our app. So you have images and reports from any originating institution, physician or system at your fingertips from a single portal, allowing you to focus on what you do best–delivering patient care.

They say all the right things, and I’m sure the product does what it says it does. However, I’m equally sure that lifeIMAGE does it better:

Don’t just take my word for it. Look at their website and arrange a demo.

In many ways, Nuance’s entry presents an opportunity for lifeIMAGE to get its foot into (or back into) doors that might otherwise be closed. I’ve tried to become a lifeIMAGE customer. I believe in their system, and I know most of their people, many of whom brought me AMICAS years ago. But I cannot convince those that control the purse strings that image sharing is a critical necessity. They see that lifeIMAGE has a cost associated to it, nominal per patient though it is, which can be eliminated by someone sticking the CD-ROM that came taped to the trauma patient into a workstation. IF it works. IF it came at all. But happily, if there wasn’t a CD-ROM to be found, well, gee, we’ll just have to rescan the patient and CHARGE for the privilege. In other words, image sharing LOSES them money on both ends. But it is still best for the patient, and I’ll stick to my inflammatory statement above: it is malpractice NOT to utilize it.

It may be that with Nuance pushing the concept using the salesforce that sold the bean-counters on SR, proper consideration will finally be given to image sharing at places that shunned it before. Then, we can have the real discussion as to which company does it best. I’ve had many an argument with those who say only the large PACS companies will survive. In the image sharing space, there are no large companies as yet, although Merge’s iConnect and Honeycomb are good starts. The entry of Nuance into the field could be a game changer…for the company that does it right. We’ll see. Film at Eleven.

via Blogger http://ift.tt/1icnhs6 April 12, 2014 at 03:02PM

Unretired

Courtesy Wikipedia

You may recall my earlier post declaring my retirement within two years.

Fuggedaboutit.

I had attempted to start my retirement clock, and we had some long discussions on the topic. In the course of the discourse, various factors were mentioned, introduced, revealed, discovered, or otherwise made to appear which had not been present before. The cost for officially entering the short-term glide-path became more onerous than I thought it should.

Therefore, my request is now withdrawn. When my numbers and the stars align properly, I’ll be giving my 90 day notice. That might be tomorrow, or it might be 10 years from now. So much for a heads-up to allow for planning, hiring, etc.

And this time, you may disregard the date of the post.

via Blogger http://ift.tt/1hwtNtz April 01, 2014 at 01:23PM