William Boonn, MD, had barely begun his career as a radiologist when his department colleagues started approaching him and fellow IT-savvy radiologist Woojin Kim, MD, with questions about analytics and data-mining. And why not? The two physicians had been interested in informatics and healthcare IT since the beginning of medical school.
As it turned out, many within their radiology department needed access to reliable data on a daily basis. Various department stakeholders were looking for data to successfully streamline operations and efficiency, improve quality and patient safety, ensure Joint Commission compliance and manage medico-legal risk, as well as advance the educational and research missions of the institution.
“These queries would get bottlenecked by a workflow that required contacting a data analyst to mine the RIS with obscure SQL or Crystal Report tools,” Boonn recalls. “In today’s world of Siri and Google, when you need to access information, you should be able to just go and query it yourself.”
That was the propelling vision and in early 2010 Boonn and Kim, together with radiologists Curtis Langlotz, MD, PhD, and Rajan Agarwal, MD, MBA, launched Montage Healthcare Solutions, Inc. Today, Boonn is the company’s CEO and Kim its Director of Innovation.
By now, Montage has refined its core functionality beyond simple search and productivity metrics. Leveraging their clinical domain expertise in radiology, the founders have developed sophisticated natural language processing algorithms and workflow tools to enable extraction of key concepts from unstructured radiology reports to drive improved quality and performance.
This powerful capability enables sophisticated analysis that “allows us to deliver a much richer, fuller set of quality metrics,” says Boonn, who remains an adjunct assistant professor of radiology at the Perelman School of Medicine at the University of Pennsylvania while remaining actively involved with the RSNA, ACR and Society of Imaging Informatics in Medicine (SIIM). “These can then be used to not only improve diagnostic confidence and patient safety but also drive revenue and improve quality and outcomes.”
When Nuance met Montage
Given these and other advances innovated by Montage, it made perfect sense when, in November 2010, the Philadelphia-based company began partnering with Nuance Communications, Burlington, MA, to integrate their analytics tools with Nuance’s industry-leading speech recognition platform. Users of Nuance’s PowerScribe 360 are the beneficiaries of this synergistic integration.
Not least among the benefits are proprietary data-mining techniques that pave the way to targeted quality, business and marketing analytics. Business performance can be measured, clinical decision support enhanced—and practice leaders, clinicians, researchers, and educators can search the radiology information system (RIS) and electronic medical record (EMR) for all sorts of dynamic data.
“As U.S. healthcare moves from volume-based to value-based reimbursement models, radiology practices and departments are looking to make sure they are contributing to providing optimal patient care with minimal expense,” explains Don Naugler, Director of Product Management, Diagnostics, Nuance. As Montage is integrated within the PowerScribe 360 platform, “we are now able to have report-level metrics really come to life. The facility can look for existing strengths or weaknesses, have those borne out by the sheer numbers of the metrics, and, even more important, apply those metrics to an individual, a group of individuals or a practice.”
Meanwhile, certain analytics are available even as reports are being dictated. Naugler points to client sites that have driven tightly directed initiatives from the ability to search and analyze reports in real time.
“If an imaging examination is performed on an inpatient and a follow-up biopsy or secondary procedure is recommended, you can have a very focused effort to make sure that it is done in an optimal time and thereby reduce length of stay,” Naugler says. “This is an absolute cost saver for a hospital. Similarly, you can also target lost revenue as a result of missed follow-ups.”
To this Boonn adds that the Montage–PowerScribe integration allows a radiologist to perform searches and queries directly within the workflow.
“If I’m looking at a study of a patient who has been in the hospital for several weeks and has dozens of prior imaging studies, and I come across