And the Winner is…

 All right, where were we? Back in November, Philips had announced its intention to sale its 70% ownership interest in transcription software company Medquist, however leaving the crucial question unanswered: who would take over custody? The Dutch Giant showed up on stage again yesterday, providing the audience with a much clearer roadmap. So the winner is…

  • CBay Systems Holdings (AIM: CBAY) (“CBay”)
  • Sale price: USD 11.00 per share, or “approximately USD 285 million (approximately EUR 185 million). The USD 11.00 per share purchase price represents a premium of 47% over the most recent trading price of MedQuist’s stock.”
  • Big picture: “The acquisition of the approximate 69.5% shareholding in MedQuist will complement CBay Systems Holdings’ existing portfolio of businesses in medical transcription, healthcare technology, and healthcare financial services, including CBay Systems & Services Inc, CBay Systems Private Ltd. and Mirrus Systems.”
  • Time frame: “The sale of Philips’ stake in MedQuist is expected to close during the third quarter of 2008, and is conditional upon applicable regulatory approvals, approval by CBay shareholders at a general meeting of shareholders, and the fulfillment of specific closing conditions.”
  • Payment: “In connection with this transaction, Philips will receive cash and a promissory note equivalent to approximately USD 7.50 per share, amounting to approximately USD 195 million (approximately EUR 125 million). The remaining per share consideration of approximately USD 3.50 per share will be paid to Philips in the form of a 7-year bond convertible into common stock of CBay.”
  • Accounting wise: “The financial results related to this transaction, which are expected to be immaterial, will be booked under “Discontinued Operations” in Philips’ third quarter 2008 results.”

    (source: Philips, May 22, 2008 press release)

What a cool start for MEDQ Saga, Season Two…

“You can have the best scanner in the world, but if there is no report, it is worthless”

 Well said, Mr. Radiologist. In a recent interview with AuntMinnie Radiology magazine, Dr. Giles Boland, medical director of teleradiology and vice chairman of radiology at Massachusetts General Hospital (MGH) in Boston, talks about the pressure Radiologists are facing when it comes to documentation. 

The article starts off with a rather capitalistic – although realisitic- view of the 21st century reading room: “radiologists today are measured constantly, whether it is in the number of images they read, their relative value unit (RVU) activity, or their report turnaround times.” Not only that. “You can get three different radiologists to look at the same scan and they can give very different lengths and styles of interpretations,” Boland continues. “How is a referring physician to navigate through those variable styles?”

The advantage of voice recognition is that it may be counterintuitive because if radiologists have to edit that report, they naturally will shorten the number of words they put in it. They don’t want to edit a report that is five pages long.

According to Boland and colleagues as per another interview with European Radiology (March 8, 2008), the adoption of an “integrated RIS/PACS and voice recognition system” is the only path to “reducing report turnaround consistently meeting stakeholder expectations.” Voice recognition systems “also offer the opportunity to create standardized, higher-quality reports,” they wrote.

Aunt Minnie editor goes on to comment how “MGH has utilized voice recognition technology for the past 11 years. During that time, the facility has reduced the average time it takes staff to go from a preliminary report to final sign-off to approximately three hours. Total report turnaround — the time from when a study is completed to when the final report is available on the system — is 12 hours.” Boland confirms:

“The majority of the reports that are signed in this institution are within a matter of a few hours of the exam having been completed. The heightened expectations have not increased reading errors by radiologists. Instead of leaving work unfinished, radiologists also are more inclined to complete their assignments.

“There is the (amount of time between the) completion of the exam to preliminary report, which really hasn’t changed much. That is a matter of an hour or two from when it is read to the time the exam is completed. The big change is the time from the preliminary report to final signing. For those groups with no residents or fellows, preliminary reports go away, so turnaround is even quicker.”

“Radiologists have to understand what their work product is — and that is ultimately the radiology report. The clear enhancement of value in that report is when you add voice recognition, because you can get it out quicker and remove that whole redundant route with transcriptionists. You also can structure it with macros and templates, shorten the report, make it more succinct, and the whole report turnaround time is faster,” concludes Boland.

Freshly Squeezed…

Freshly Squeezed …from the ConText blender. SpeechMagic is now served in the following flavours:

  • Consultations – US English
  • Emergency Medicine – US English

> View full ConText menu.

The Ten Commandments of Professional Speech Recognition

Ten Commandments From Stone to RFP…

I decided to turn my original Ten Commandments of Speech Recognition document into a more comprehensive list of the critical elements to consider before delving into the RFP writing process. Why? Because I believe that only a well documented Request for Proposal that reflects the operational, technology and legal issues at stake will provide the framework for the expected productivity and workflow improvements – your own organization’s Holy Grail.

> Download Tablets (1.2 Mb)

Re: Smells like Team Spirit

Answer to yesterday’s question:

They did.

They didn’t.

Smells like Team Spirit…

Go Habs Go!
No doubt Montreal physicians have experienced more productive days. Well, Montrealers in general. For now, our hearts are ringing busy in the middle of the Bell Centre arena until the crucial question finds its one-way answer: Who will dictate the rules tonight?

Philips Launches Professional Services Portfolio

Philips Launches Professional Services Portfolio Philips Speech Recognition Systems announced yesterday the launch of a comprehensive service portfolio for their integration partners worldwide, organized around four pillars:

1. Integration. Philips helps define and integrate the optimal set of SpeechMagic features; this includes input channels and the ability to deploy in Citrix Access infrastructures or on Windows Terminal Servers.

2. Deployment. Deployment services prepare for fast system roll-out with the aim of facilitating user acceptance and minimizing downtime during implementation and set-up.

3. Support. Support services provide the knowledge and tools for optimal system maintenance and fast resolution of technical issues, including training and workshops as well as standby and third-line support.

4. Productivity. Productivity services round up the service package, as Philips experts analyze end users’ working methods, evaluate results and user satisfaction, and provide recommendations to optimize workflows and processes.

Marcel Wassink, CEO of Philips Speech Recognition Systems, comments:

Philips has acquired a unique wealth of knowledge and proficiency while working with the world’s largest healthcare speech recognition sites which stretch across city-, region- and even country-wide health systems. The service offering now enables our SpeechMagic partners to apply this knowledge and experience directly to their IT applications. Our technicians, developers and consultants will help them design optimal solutions that boost productivity in hospitals and provide physicians with better information.”

> Read press release

Speech Recognition Goes South

South African Sunset The borders of the professional speech recognition community are expanding further South with a new member as of today:

Drs Conidaris and Partners, a private radiology group located at the Glynnwood Hospital premises in Benoni, South Africa, have completed the rollout of a Crescendo/SpeechMagic speech recognition system. After evaluating different technologies, the partners chose SpeechMagic for its wealth of built-in Radiology vocabulary and Crescendo’s unique voice streaming technology, which allows for immediate speech processing; a key feature for mission-critical environments” explains Kevin McEvoy, Managing Director, Datafer.

With the Crescendo/SpeechMagic technology, the practice was able to deliver on its initial objectives: speed up report production and reduce transcription costs. With the secretaries’ newfound ability to edit medical reports as opposed to typing them in full, fewer resources are required to process the same volume of reports. The first medical report dictated achieved over 75% accuracy and this rate is continually improving as the system learns.

“Skilled medical typists are extremely hard to find in the region, and a growing number of South African healthcare facilities welcome speech recognition technology as a reliable, cost-efficient way to address this issue. The technology has clearly matured significantly over the past few years and is delivering the expected results,” explain the radiologists at the practice.

Digital mobile recorders (Philips 9600) are used by physicians to dictate either directly from the practice or on the move. Every time the device is docked and a network connection is established, DigiService-IP automatically and securely streams completed voice files to the central server in real-time. The Secretary then uses DigiPlayer-IP, the Microsoft Word based playback and transcription application from Crescendo, to correct the document.

“South African hospitals and clinics are increasingly aware of the importance of digital technology to modernize both their practice and care delivery, and they are very selective in their purchasing process, with good reason” explains Costa Mandilaras, President, Crescendo Systems Corp. “This is why we chose a distributor, Datafer, with outstanding support services to properly deliver the Crescendo 18-year field expertise to South African customers. I believe that Drs Conidaris and Partners is the first of many more South African healthcare installations to come,” concludes Mandilaras.

Integration, Integration, Integration

Integration In a freshly inked article from Health Imaging & IT, healthcare IT executives and vendors unveil their respective visions and roadmaps for speech recognition. Integration clearly is the main course on the menu. While this is too bad for those vendors who think HL7 is the name of a 1990’s boy band, this article further confirms hospitals’ appetite for structured documentation with a direct impact on patient care.

  • Dr. Stephen Rosenthal, M.D. from the Jewish General Hospital in Montreal, QC, insists on the importance of interfaces between speech recognition and third-party systems in order to deliver the foundation for evidence-based medicine through searchable, standardized clinical data: “if speech systems aren’t relatively uniform, people will find systems on their own and use them. Then you have a hodgepodge of systems that don’t talk to each other and standardization is lost. We are much better investing in something uniform.”
  • According to Terence Matalon, MD, from the Albert Einstein Medical Center in Philadelphia, PA, speech recognition & PACS integration is a must have for Radiologists since it eliminates the need to re-enter patient information or “have two applications open to attain the same goal”. Matalon even pushes the point further by making integration expertise a competitive differentiator between vendors: “there are dozens of products that can reliably show you the current exam, prior exam and reports. The differentiating factor is how well they integrate with third parties and how well they reduce amount of work involved in interpreting reports and generating reports.”
  • On the vendor side, Klaus Stanglmayr from Philips Speech Recognition Systems explains how “interoperability and the ability to exchange data between systems and countries is becoming more and more critical in Europe. Standardized terminology would prevent the need to have data translated from one language to another.”
  • Finally, Chris Spring from MedQuist insists on vendors’ primary mission to “make it easier for the physician to accept the technology.”

Now what’s your vision? Share it on this blog!

Nuance to buy eScription

After Dictaphone in 2006, it is eScription’s turn to merge with Nuance. Here is an X-ray of the transaction that is about to take place in the speech-recognition-vendor supermarket:

  • Seller: eScription, a software vendor specializing in transcription, back-end speech recognition and workflow management applications for healthcare.
  • Buyer: Nuance Communications, giant provider of speech technology solutions – such as Dictaphone and Dragon Naturally Speaking – for consumers and businesses around the world.
  • Value: $400 million (compared to $357 million paid for Dictaphone in February 2006)
  • Payment:
    • $340 million in cash
    • $23 million in Nuance common stock
    • Assumption of vested employee options with a value of about $37 million
  • Time frame: deal is expected to close in Nuance’s fiscal third quarter of 2008.
  • Claimed objectives:
    • “Enhance Nuance’s ability to provide advanced transcription solutions”
    • “Evolve healthcare documentation and lower transcription costs by more than $1 billion over the next few years.”

The piece of news went public yesterday in the form of an official press release. The question is not so much whether this new deal will shake the competitive landscape, but more along the lines of a deeper, truly existential concern: “who’s next on Nuance’s shopping list?”

> Read press release

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