Nuance Targets Small Physician Practice With Latest Dragon Medical Update

The new release is a potentially lucrative play for the channel, according to Nuance, as smaller clinical settings adopt electronic health records (EHR) and seek additional software tools to drive productivity.

Dragon Medical Practice Edition is similar to Nuance's existing Dragon speech recognition options for health care in that it allows health care workers to create medical notes directly in an EHR system in real time. Nuance clocks the time doctors and assistants save from transcribing documentation or interpreting hand-scribbled notes as between 40 to 60 minutes per day.

"Any place where you can click and turn on the EHR is a place you can click and dictate notes," said Keith Belton, senior director of product marketing for Nuance. "But you can also create voice commands, which can shorten what might normally be eight to 10 mouse clicks in the EHR, or create macros that say 'write a prescription.'"

Practice Edition is specifically targeted at clinicians in practices of 25 employees or less, and is an update of the Nuance Dragon Medical 10 product that was released several years ago. Nuance also offers Dragon Medical Enterprise Network for large enterprise-wide deployments, and several Dragon versions beyond its health care practice.

The Practice Edition is available at about $1,600 per clinician and like previous Dragon Medical products is licensed on a per-user basis. Among its newer features are what Nuance calls "smart configuration," which optimizes a user's software whether Dragon Medical appears on a small laptop, a server, or any platform in between, and can run in multiple threads automatically when it detects multi-core hardware on that user's machine. It also offers analytics to alert a Dragon user when it detects that something about the audio connection -- a low-battery microphone, for example -- is hampering performance.

Dragon Medical works with any Windows-based EHR system, which covers the major EHR players in the market, but Nuance is also working on better compatibility with Mac-based and cloud-based EHR systems, too, Belton said.

Many of Nuance's products also work with mobile devices -- including a mobile-based medical version of Dragon that it announced last year -- but that is a separate initiative from Nuance Healthcare, which is the largest business unit within Nuance and responsible for about $600 million in annual revenue.

Belton said Nuance is seeing a spike in adoption for its software thanks to the push by physicians to implement EHR and make themselves eligible for what, under the American Recovery and Reinvestment Act of 2009, can be up to $65,000 in federal payment incentives for achieving "meaningful use" with their systems.

Nuance sells Dragon Medical 100 percent through the channel, which in it its case means about 200 VARs. It is offered in Nuance's usual licensing structure, but is also available as a subscription.

Paul Logan, CRNP, owner of Logan Solutions, a Philadelphia-based solution provider, is a Dragon Medical Premier partner and also a reseller of eClinicalWorks EHRs.

Most of Logan's Dragon business is packaging those two products together, he said, but Logan's Dragon Medical business has grown significantly in the past year and recently eclipsed its eClinicalWorks EMR business.

He and his team have done initial testing with the Practice Edition, and Logan said the updated software seems to have improved recognition accuracy and a more intuitive user interface.

Logan said he pitches Dragon to customers as an add-on, but also as a software tool to make their EMR systems do more of their work for them. Many physician practices, Logan notes, are still hesitant to implement EMR and don't always see the practical benefits.

"The small physician practices, especially the 1 to 5 provider group, are still sort of behind the curve," he said. "They haven't jumped on board as readily as the health systems have. Many of them are still saying, 'Well, I might retire before I need this' or being forced to document a certain way, which is wrong information."

The market is coming around, though, Logan said, thanks to the beginning of the actual stimulus payouts to physicians. Solution providers are the best resources for those cynical physicians, he said, to make informed decisions.

"I'm also a nurse practitioner, so I understand the value of being able to create a narrative note that doesn't sound like it came from a computer," Logan said. "It has all the components of the story of the patient encounter, from a history of present illness and the treatment plan along with the differential diagnosis, and normally you need to type all of that stuff in."