The Rise of Speech Recognition Technology in EHRs

For many physicians, traditional point-and-click software templates in electronic health records, or EHRs, are considered an inefficient way to document patient data. However, the use of these templates to record structured data is a critical part in qualifying for the Meaningful Use financial incentives from Medicare and Medicaid EHR Incentive programs.

According to a survey from Nuance Communications (NASDAQ: NUAN  ) , however, there is more at stake than money. Although 69% of physicians surveyed stated that the primary incentive to EHR adoption was stimulus money, 75% requested better tools within the EHR suite. An overwhelming 93% stated that their EHR program hadn't reduced the time necessary to document patient care.

67% of doctors stated that the dependence on a keyboard and mouse to document patient data was too time consuming, and 74% stated that EHR templates had "no uniqueness" and throttled the full potential of EHRs.

Most importantly, 79% of physicians stated that more efficient documentation could be achieved by merging EHR point-and-click templates with a physician narrative.

Two leaders in speech recognition
That's where two leaders in voice recognition software -- Nuance and M*Modal -- come in.

Nuance produces clinical language understanding, or CLU, software that listens to a physician dictate patient data and intelligently extracts the information to be recorded into a template without a single click. It also produces natural language understanding, or NLU, and natural language processing, or NLP, software so physicians can issue the EHR software spoken commands, just as Apple iOS users do with Nuance's most famous NLU product, Siri.

M*Modal also produces natural language software that can be integrated into a wide variety of software and hardware. Both Nuance and M*Modal use cloud-based voice recognition products that can carry over learned data between devices. This means that the voice recognition is no longer device or software specific, but customized to entire medical practices and their staff.

The evolution of cloud-based CLU and NLU software has opened the door to new medical scribe products, such as Nuance's 360 Healthcare mobile products and voice-recognizing mobile EHR software.

Allscripts and Greenway
Allscripts (NASDAQ: MDRX  ) uses technology from both Nuance and M*Modal in its EHR products. Last year, Allscripts also incorporated M*Modal's speech recognition technology into its Sunrise Mobile MD II EHR app for the iPad. Although Sunrise has been a popular choice with physicians who requested more mobile EHR products, it is still tethered to its desktop EHR program.

Last year, a Silicon Valley start-up, drchrono, released the first native iPad app that was not dependent on a desktop-based EHR program. The app proved immensely popular, and Allscripts responded by releasing its own native EHR app, Allscripts Wand, which uses the iPad's Siri interface to document patient data. Its recently released successor, Wand 2.0 for Enterprise EHR, even includes an app store to download specific medical apps.

In 2011, Greenway (NYSE: GWAY  ) added voice recognition capabilities to its EHR by integrating M*Modal's NLP engine into its PrimeSPEECH product. PrimeSPEECH allows physicians to dictate patient data, and is assisted by an embedded medical dictionary, spell check, and speech correction capabilities. The engine directly stores information back into its PrimeSUITE EHR software. The information can be accessed through its mobile platform, PrimeMOBILE, which is available for iOS, Android, and Windows Phones.

Cerner and Nuance
Health care IT giant Cerner  (NASDAQ: CERN  ) is another firm adopter of voice recognition technology. Last October, it announced that it was integrating Nuance's cloud-based medical voice recognition software, Nuance 360, into all of its EHR products, including its native iPad app, PowerChart Touch. As part of that collaboration, Nuance also tied its radiology reporting suite, PowerScribe 360, into Cerner's RadNet Radiology Information System, providing radiologists with a real-time documentation solution.

In March 2013, Cerner deepened that partnership with Nuance by integrating the latter's clinical documentation improvement technology into its EHR products. Physicians are currently using CDI software to upgrade the outdated ICD-9 medical classification codes used in the U.S. to the ICD-10 standards used by the rest of the world.

The Foolish bottom line
Allscripts, Greenway, and Cerner are only three major EHR companies that have recognized the need for integrated voice-recognition solutions. Other major players -- like Epic, General Electric, and athenahealth -- also use Nuance's technology in their EHR software.

For Nuance, which has declined nearly 20% over the past 12 months due to weakness in its mobile and consumer business segment, these medical collaborations could usher in a new age of growth for the company beyond Siri.

Rising health care costs continue to be a hotly debated topic, and even legendary investor Warren Buffett called this trend "the tapeworm that's eating at American competitiveness." To learn more about what's happening to the health care system -- and how to potentially profit from this trend -- click here for free, immediate access.

Editor's note: A previous version of this article incorrectly stated that M*Modal is a subsidiary of Medquist. The Fool regrets the error.


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