By Elaine Sanchez Wilson
During the last meeting of the Radiological Society of North America, Nuance Communications Inc unveiled its PowerShare Innovation Program, which invites third parties to propose concepts that may be integrated into the company’s cloud-based PowerShare Network.
“The goal of the Innovation Program is to accelerate collaboration in the radiology community and promote advancements in patient care and financial integrity,” said Christy Clark Murfitt, director, Diagnostic Solutions Marketing, Healthcare Division at Nuance. “There has been interest from a number of third-party organizations interested in the program as a means to more easily exchange information that until now has been difficult to share outside their health system or platforms.”
The first organizations to accept the challenge are Massachusetts General Hospital (MGH) and the American College of Radiology (ACR), both of which aspire to bring clinical guidelines directly to the radiologist’s workflow as well as ensure consistency in collecting and reporting quality measures.
Lincoln Berland, MD, FACR
According to Lincoln Berland, MD, FACR, vice chair of quality improvement and patient safety at the University of Alabama at Birmingham and a consultant to Nuance, the company’s PowerShare Network is particularly relevant given the direction that imaging is headed. “With all the outside pressures, like reimbursement, and new technical capabilities, this is something that people are going to feel that they need to have, that they have to have,” he predicted.
“I commend Nuance for taking that more open approach because companies tend to be very proprietary,” Berland said, regarding the PowerShare Innovation Program. “They’re saying we know that others have solutions, and we’re anxious to partner with you to take advantage of those.”
Specifically, MGH, in partnership with the ACR and Nuance, will produce an initial set of evidence-based clinical decision support guidelines that radiologists can access at the point of interpretation. Meanwhile, the ACR looks to automate the process of collecting and submitting Physician Quality Reporting System (PQRS) quality measures and other registry data on behalf of radiologists. “As these clinical guidelines are updated and expanded, Nuance will push these digitally to providers across the industry using the Nuance PowerShare Network so they will have the latest clinical guidelines at all times,” Murfitt said.
Berland believes PowerShare has the potential for a myriad of applications. For example, he pointed out that radiology—and healthcare in general—is experiencing “a chaotic situation, with the silos of medical information that occur.” However, the cloud-based network, which hosts 2,000 provider organizations, has the power to assist in transferring patients’ health information seamlessly among multiple sources and locations. “The PowerShare Network, which is broad enough to encompass all of the institutions patients are involved with, allows the institution to process, merge, and analyze their information potentially at the time or even before that patient arrives,” he said.
Citing a specific example, Berland described how his academic institution, the University of Alabama at Birmingham, is also one of the larger transplant services in the country. “People come in from anywhere when they need a transplant—kidney, liver, heart—and each hospital has a complex system for managing who and when people can get these kinds of transplants,” he said. “So getting all the medical information from multiple sources in a timely way is very important to making the correct decision and abiding by the rules of the major national transplant organizations. In this new world of tremendous time pressure and extreme complexity, the access to medical records is one of the foundations of being able to do things the right way.”
Through his service as chair of the ACR’s Body Imaging Commission, along with the society’s Information Technology Commission led by Keith Dreyer, DO, PhD, FACR, vice chairman of radiology at MGH, Berland is working to translate white papers of incidental findings into consumable content for companies like Nuance. “What we’re trying to help do is vet the appropriate phrases, sentences, paragraphs, and terminology, that we think are acceptable based on the papers that we’ve written and provide a system that then can be translated into a computer system,” Berland explained, adding that through tools like ACR Select (clinical decision support for ordering), ACR Assist (support for reporting), and ACR Common (creating a common language in communication), the society is hoping to take a proactive role in managing this kind of information.
“We understand that it’s really potentially going to be the foundation for some core changes in the way radiology and medicine in general is conducted down the road,” Berland said. “There seems to be a confluence of capabilities and activities going on between medicine, organizations like the ACR, and industry to try to make this happen. I think there’ll be a considerable amount of activity this year.”
“The backbone of making this all work from the Nuance perspective is through PowerShare,” Berland said, commenting that it would be difficult “to go around, touch each institution individually, and attempt to get all the new updated, constantly changing information.” On the other hand, a nationwide cloud-based system like PowerShare can more easily ensure that organizations stay current.
“Nuance developed their PowerShare system, and a lot of these capabilities are in evolution,” Berland said. “Obviously, there are technical challenges in integrating the information into an institution’s own information system and correctly querying the outside system to gather the information that they need—all of those things are being developed and in the works. But I feel strongly that these kinds of solutions are extremely important as medicine moves forward and tries to be more efficient and provide more consistently high-quality care. That’s what medicine is all about, starting with the right information.”
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