A collaboration between the University of Pittsburgh Medical Center (UPMC) and Nuance Communications, makers of Dragon Medical Enterprise, will offer several advantages: Doctors at the hospital can more effectively add information into their electronic medical record (EMR) software, the facility will save on traditional transcription service fees, and on a grander scale, their development agreement will use natural language processing to crunch all this data to improve clinical decision-making.

The Nuance app is not just being deployed at UPMC, it's being tightly integrated into its clinical workflow, according to Rasu Shrestha, MD, VP of medical IT at the medical center. "We see implementing Nuance as a big impetus to get clinicians to fully embrace our EMR system." The hope is that if clinicians can simply pick up a microphone and speak naturally, it will encourage them to more fully use the EMR system, said Shrestha.

For example, when a clinician wants to write up a discharge summary into an EMR, the IT team will integrate Dragon Medical Enterprise into his or her workflow so that it works seamlessly with the EMR's templates, macros, and dot phrases, speeding up the documentation process.

But the really forward-thinking aspects of the Nuance/UPMC collaboration center around their joint development agreement, which will eventually let the medical center extract diagnostic codes, procedural codes, and disease-specific medications and interventions from unstructured text so that the data can be "crunched" by their clinical analytics tools. Such analysis will generate smart alerts to ultimately improve patient care and clinical outcomes, according to Shrestha and Rebecca Kaul, who heads up UPMC's technology development center.

Other areas being explored by Nuance and UPMC include data mining specifically tied to the federal government's Meaningful Use requirements for EMRs and creation of tools that will allow clinical document repositories to be easily searched. Electronic tools developed as part of the agreement will be commercially available through Nuance starting late this year.

The partnership comprises an extensive technology and services licensing agreement in which UPMC will standardize Nuance's healthcare tools at more than 20 hospitals, 30 imaging centers, and more than 400 outpatient sites.

Jeffrey A. Romoff, president and CEO of UPMC, summed up the relationship succinctly: "Smart technology is essential to the patient-centered, accountable care that we are committed to providing at UPMC. ... By partnering with Nuance, we can enable smarter use of clinical data across the industry."

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