Nuance looks to shift mobile data processing to cloud

By Neil Versel
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Jonathan Dreyer, NuanceNuance Communications drew big crowds to its booth at the 2010 HIMSS conference when it introduced long-awaited mobile versions of its popular Dragon Medical Mobile Recorder and Dragon Medical Search speech recognition software, in the form of iPhone apps. Nearly two years later, the Burlington, Mass.-based software vendor continues to build its mobile healthcare portfolio.

As MobiHealthNews reported, Nuance announced the PowerScribe |360 Mobile app late last year at the Radiological Society of North America annual conference, a product that will allow radiologists to read and sign off on imaging reports from their iPhones when it hits the market in the middle of 2012. The desktop platform is available now.

Speech recognition can speed up data capture on many platforms, perhaps more so with mobile. "We know that speech is three times faster than typing [on a standard keyboard]," but it may be five to six times faster than typing on a touchscreen or tiny buttons of a mobile device, says Jonathon Dreyer, Nuance's senior manager for mobile solutions marketing in healthcare.

Dreyer spoke to MobiHealthNews Tuesday at the University of Pittsburgh Medical Center's Center for Connected Medicine, 60 stories above downtown Pittsburgh. Nuance is one of about a dozen partners that UPMC is highlighting at the center, a showcase for many cutting-edge technologies already in use at the health system.

Nuance is looking to shift much of the processing of data from mobile devices to the cloud in order to offer greater computing power and to safeguard sensitive healthcare information in case a device gets lost or stolen. The other benefit of cloud processing is that users can keep the same profile no matter how or where they access and application, Dreyer says.

(Interestingly, privacy laws in many European countries generally don't allow Nuance to host healthcare information in the cloud, so institutions often make use of private, in-house clouds that Nuance is able to update to, Dreyer says. Some Canadian institutions go this route, too, because the they are afraid of being subject to USA Patriot Act reporting requirements if they send data across the border. Some larger healthcare providers in the U.S. Also opt for private clouds and even host clouds for other organizations in their service areas, according to Dreyer.)

All of Nuance's internally developed mobile apps are free to download, but some require the purchase of host software on the desk top or server end. Dragon Medical Mobile Recorder, for example, only works on top of Nuance transcription platforms, according to Dreyer.

"We're taking a hybrid approach with our soon-to-be-released PowerScribe |360  mobile reporting app because that will be a free download. There is one free aspect of it with clinical content searching for radiology-specific sites – voice searching those sites – and there's another component, the report review editing and signing, which you obviously need to have the PowerScribe |360  reporting environment to have it work off of," Dreyer says.

Nuance is not actually building consumer healthcare apps, but recently released a development platform for healthcare programmers that connects to various services, such as speech-enabled technologies, and later this year, clinical language understanding (CLU), Nuance's name for natural language processing in healthcare. "Being able to keep all of our cloud-based services under one umbrella, it allows the developer to get everything they would potentially want or need from us from one platform," Dreyer says.

Clinical language understanding is in some existing Nuance products but has not been released for third-party developers yet. "We've had interest from a number of partners that want to be able to employ that technology in their applications," according to Dreyer.

CLU essentially is a means of helping computers make sense of all the unstructured data coming in to electronic health records and other healthcare software. "It's basic fact extraction, it's clinical data tagging, procedures, problem lists, medications, allergies," Dreyer explains. "So whether it be speech-recognized text that's coming in and then being parsed out and structured for the user or even actual text documents to begin with, there's a variety of different ways to get that data into a structured format. Providing a method for our partners to embed that in and add value to their applications is what the real takeaway for the CLU piece is."

Demand for text-to-speech services is growing as well, Dreyer reports. "We're seeing the acceptance or the expectation for that to occur in a consumer environment," he says. For example, an app for diabetes might employ text-to-speech to input blood-glucose readings. Dreyer noted that he saw several diabetes apps at the mHealth Summit in December that would be "a perfect fit for this type of technology." Much of this is theoretical at this point, but the technology exists.

Right now, Nuance's mobile apps are only designed for Apple devices. "Primarily because of the adoption of that platform in healthcare," Dreyer says. "We're seeing where Android and other platforms go and if there's a fit and if we get the requests for it."

He also pointed out that so many doctors already own Apple devices. "And the ones that don't, the percentage that are going to buy an Apple product is far greater than the other platforms."