Front-End Speech 2014
Functionality Doesn’t Trump Physician Resistance

WORTH KNOWING

HIGH OPTIMISM THAT “CLOUD-BASED” MAY RESOLVE PHYSICIAN RESISTANCE:

Overwhelmingly, providers from all three vendors measured in this report indicated physician adoption to be the biggest hurdle to successful deployment. Providers purchasing Fluency Direct and those looking forward to Nuance’s cloud-based offering hope these solutions will lead to significantly better adoption, but thus far the easier learning curve and implementations have not outweighed physician resistance to workflow changes.

SPEECH ENGINE IS A COMMODITY; NUANCE’S COST AND SUPPORT OPENING THE DOOR FOR COMPETITION:

In general, providers feel that all three vendors in this report are comparable in terms of product performance. Providers that have switched from Nuance to Dolbey or M*Modal said they left Nuance for better up-front costs and/or support. However, long-standing relationships, industry reputation, and EMR collaboration continue to draw new customers to Nuance and to keep long-time customers from leaving.

WINNING FORMULA = EMR + SPEECH: CERNER CUSTOMERS SEE THE GREATEST BENEFIT:

By pairing speech functionality with EMR front-end tools, providers see a higher impact in every category measured in this study. Epic clients find that transcription costs are highly impacted by the use of their EMR smart tools alone and minimally impacted by the addition of speech tools. With Cerner, providers see minimal impact from EMR tools alone but high impact on all three areas measured when they add FES tools.

BEST PRACTICES 

1. DETERMINE ORGANIZATIONAL STRATEGY:

Have a plan surrounding deployment, adoption, and EMR integration to quickly maximize efficiency and value.

2. BUILD MACROS AND TEMPLATES FOR COMPLEX ENVIRONMENTS:

Especially in highly structured environments, templates and macros bring added convenience to users. Many find success with a hybrid of these and front-end speech tools.

3. RECRUIT PHYSICIAN CHAMPIONS:

Physician champions help foster physician buy-in despite workflow disruption and ultimately smooth the transition for users.

4. PLAN SUFFICIENT TIME TO TRAIN:

Lack of training hurts adoption; users who are not sufficiently trained become very frustrated.

BOTTOM LINE ON VENDORS

DOLBEY:

Fusion SpeechEMR received highest overall rating in this study. Dolbey got high marks for exceptional service/support and low cost, and customers rated them highest in ability to capture unique speech patterns. Although a few providers mentioned working through a learning curve before obtaining ease of use, several clients listed ease of use, implementation process, and lower up-front costs as decisive purchasing factors. By far the smallest of the FES vendors in this report, Dolbey was only considered by two M*Modal/Nuance customers.

M*MODAL:

Fluency Direct had the most clients cite price point as deciding factor. Cloud-based technology offering short learning curve, out-of-the-box functionality, and mobility creates optimism for better physician adoption. Across the board, most M*Modal customers saw significant reduction in transcription costs, although Epic customers tended to give much of that credit to Epic tools. Some providers expressed concern for stability after M*Modal filed for Chapter 11 in March 2014, although M*Modal recently won court approval to restructure.

NUANCE:

Dragon Medical 360 NE is highest rated for reducing transcription costs. Significantly more expensive than Dolbey or M*Modal, which deters some providers. However, industry reputation, extensive technology portfolio, and progressive development continue to attract new customers and keep many long-term customers who have seen Nuance’s products improve over the years. Several providers expressed optimism surrounding Nuance’s upcoming cloud-based solution. Many providers complained of poor service/support.

Project Manager
Robert Ellis