New company targets radiology communication systems

Commissure debuted in the medical documentation and communication market Oct. 6, releasing a spate of products that pick up where speech recognition systems leave off. The products fill gaps within RIS and PACS to improve communication between referring physicians and radiologists.

Taking its name from the dictionary definition of a point or angle where anatomic structures meet, Commissure will formally introduce itself and its products to the radiology community at the upcoming RSNA meeting. The company will sell its systems directly to hospitals, as well as through three major PACS vendors that will incorporate Commissure products in their own, said Commissure CEO Michael Mardini.

The company has already installed its software at several major sites, including Massachusetts General Hospital, New York University Hospital, Texas Children's Hospital, and the University of Alabama at Birmingham.

The mission of the company is to close the communication loop between referring physicians and radiologists, Mardini said. It has developed a front-end product line that helps clinicians submit orders for imaging studies that are appropriate for a particular patient.

RadPort Suite incorporates the American College of Radiology appropriateness criteria as well as input from more than 2500 clinicians to provide referring physicians with real-time decision support. These criteria and physician inputs guide the choice of an imaging study, indicating whether it is the most appropriate examination based on a patient's symptoms and medical history.

Payers and hospitals may also benefit from RadPort's decision support criteria, Mardini said. A number of payers in Massachusetts have accepted RadPort's method of scoring to preauthorize imaging studies. Hospitals that receive the same capitated amount for treating individual patients can save by reducing unnecessary or repeat studies.

The RadWhere Suite of products assists radiologists on the back end of the communication cycle by analyzing radiology reports and applying the proper ICD-9 codes. It also has an automated process for transmitting urgent findings to clinicians in keeping with requirements of the Joint Commission on Accreditation of Healthcare Organizations. Through a critical communications component, RadWhere identifies and pages the key referring physicians, communicates critical imaging findings, and documents that the physicians received the information on the radiologist's workstation.

Commissure plans to take advantage of its strength in voice recognition as well. Mardini founded Talk Technology, which produced one of the first speech recognition products for radiology and had more than 400 customers before the company was sold to Agfa in 2001.

Commissure's RadWhere Suite, which at its core is a reporting product, moves beyond standard dictation and macro block text functions by including a real-time speech-reporting component that uses patented natural-language-understanding algorithms. These algorithms improve the accuracy of the underlying speech recognition engine by automatically correcting terminology based on the nature of the imaging study.

The RadWhere Suite includes a search capability that electronically links radiologists with clinical information to help with diagnosis. Radiologists can click on a button to look at differential diagnoses that relate to a specific imaging finding or scan an anatomy atlas that is relevant to the image they are interpreting.

"We designed RadWhere knowing full well that, even if we gave radiologists 100% accurate speech recognition, it would still cost them more time than when they work with a transcriptionist," Mardini said. "We work to provide more functionality in other features that save radiologists time in other ways by providing clinical content, reducing search time, and tracking down and communicating with referring physicians."