In this video we check out two of the Dragon Medical Mobile Apps (releasing later this year) for the iPhone, Dragon Medical Mobile Dictation and Medical Mobile Search.  We recorded this video from Nuance’s booth at the HIMSS conference

Nuance, the makers of Dragon Medical Dictation, a favorite dictation service among many physicians, announced at HIMSS they are bringing the same medical transcription service to the iPhone.

Many readers may have noticed the recent arrival of a free Nuance “Dragon” app in the App store.  This simple app allows the user to speak directly into the iPhone and receive a nicely transcribed text document 15-30 seconds later, ready for email or for copy and paste.

At that time, Nuance did not specify their future intentions, but many speculated a medical version would be forthcoming.  Indeed, at HIMSS, Nuance announced three new iPhone medical apps: Mobile Dictation, Mobile Search, and Mobile Recorder, all named with the prefix Dragon Medical (i.e. “Dragon Medical Mobile Dictation”, etc).

Dragon Medical Mobile Dictate

The medical app of immediate interest to physicians is the Mobile Dictation one, which is similar to the free Nuance application, except for the very important distinction that the back end is now connected to the very reputable Dragon medical transcription engine – highly optimized to transcribe doctor speak. Like the most recent version of the desktop Dragon Dictation application, the specific “training” time is required, although the application does learn the user’s voice over time.

Currently, the application only returns text into the iPhone, albeit quickly, and the physician is required to transfer the text into another app via email or cut & paste. We were told the Mobile Dictation app should be available by Q3 2010 (late summer).  Pricing is not yet determined and it will initially launch on the iPhone but per Nuance, Android and Blackberry versions are planned.

Dragon Medical Mobile SDK

The real power of the application is the accompanying SDK (software development kit) that Nuance is previewing.  This SDK will allow electronic health record (EHR) vendors to directly access the application from inside the EHR.  For example, Epic’s Haiku iPhone app could allow dictation directly into a patient’s record in Epic without leaving the Haiku app.

Thus far, we are told that Eclipsys will be incorporating it into their nursing documentation module since they already partner with Nuance, although, having seen the demonstration, I would suspect the SDK will gain wide and quick adoption by the other EHR vendors. The other obvious future integration will be with the newly announced Epocrates iPhone based EHR – almost making the smart phone a complete doctor’s office.

Dragon Medical Mobile Search

The second application is called Dragon Mobile Search and is analogous to Google’s iPhone app in that it performs a search based on voice transcription. The difference is this app searches medical databases, such as Medscape, Epocrates, Medline or Google.

The search sites are displayed as a series of icons across the screen which the user can rotate through, described like a carousel by Nuance [reference above video]. It seems to work well enough but is hampered by the fact that the searches are presented to each site as a simple text query without the sub-categorizing that the Google app performs, which quickly allows the user to drill down to the actual item of interest. Perhaps if those databases exposed specific APIs for search, it would be more powerful. I would expect usage of this to vary on the individual level since its not always more efficient to say one word than it is to type it.  Nuance has a solid release date of April 30 for this medical app.

Dragon Medical Mobile Recorder:

The third application, Mobile Recorder, acts as a catalogue for previous recordings and allows the user to identify recordings with individual patients, if there is integration between the application and the physician’s or hospital EHR.  This recorder is designed for healthcare organizations that use Nuance’s enterprise dictation and transcription software, eScription, or the Dictaphone Enterprise Speech System.

The obvious advance for physicians will be use of Nuance’s SDK to integrate voice dictation dictation directly into EHR applications and thus make it seamless, rather than adding to the physician’s workflow.

In a separate announcement, Nuance also reported their advances in natural language processing. This consisted of two parts, the acquisition of a company named Language and Computing, described as a “a pioneering developer of clinical narrative processing technology” and a strategic partnership with Massachusetts General Hospital which had an internally developed natural language processing application they called “Smart Dictation”.

The vision is that a physician can simply dictate an encounter and, using natural language processing, the key parts of the note such as chief complaint, history, exam, etc. can be pulled out and used to populate structured data fields inside the EHR.  Pretty ambitious.

Like every other vendor at HIMSS, Nuance proposes this could help healthcare institutions comply with “meaningful use” and thus qualify for HITECH (stimulus) funds. More reasonably, they also claim this could help healthcare organizations with “data mining, coding for billing, disease management and clinical decision support.”

Nuance’s announcement seems to have generated a fair bit of interest, judging from other websites and the traffic at the booth. I suspect this is justified as physicians are only too happy to get rid of their dictaphones and not have to sit in front of a computer microphone, not to mention paying for transcription.  I’m also curious to see what other applications the SDK might find a home – reducing the need for keyboards, especially as a new generation of tablets starts to fan out into the health care field.