This is the story of the Dictaphone FX project – of how it almost was, and how it got canceled – from someone very close to the project (me). I have since been released from Nuance and am now working for a company called Geneca. This article is rather lengthy for me and covers several topics. This is part 1, which covers the business perspective, or ‘Why Nuance canceled the project and laid me off’. Part 2 will cover the technical perspective, of ‘What went into FX’.
I will start with the business side. Let me begin by explaining a little about what FX was for, and what Medical Dictation and Transcription is.
At large hospitals (and increasingly at smaller clinics), the facility will create a medical report for every visit you make to the hospital, or for every test done while you are there. Your doctor will make a voice recording of your session, and that recording will get routed via the transcription workflow solution to a Transcriptionist that could be in the next room, or in the Philippians, to get transcribed (The hospital decides the routing). Once transcribed, the report will automatically print out at the hospital and/or get filed into the Hospital’s Electronic Medical Records system (EMR). When speech recognition technology is applied, the document is automatically transcribed and the Transcriptionist becomes an Editor.
Now on with the FX story: “FX” was just a code name. The product had been branded “Dictaphone Powerscribe MDx”, and later re-branded “Dictaphone 360”. This product was to be Dictaphone’s next-generation transcription workflow solution* – the successor to the aging iChart and EXText/EXVoice products. FX addressed all of iChart’s shortcomings, especially in the areas of scalability, reliability, and user-friendliness. It also had a few features which would have made it stand out in the market, including a complex yet intuitive MT & QA job allocation system, support for different QA levels, and a post-release QA grading system.
At the time Nuance announced its intention to aquire EScription, we were 2.5 months away from going to market with FX. The beta was in full swing and the schedule had finally stabilized. Everyone in the Chicago office had been putting extra hours(55+/week) on this project for the better part of a year. I was tired of the long weeks but also excited that the end was in sight. So what happened? Why did Nuance cancel FX? Honestly, I’m still asking myself that question. The information I have says that Escription has an inferior UI, less features, and an inferior architecture to that of FX. However, Escription’s speech recognition component is supposed to be considerably better. This is personally frustrating to me because while the speech team did work with the FX team, they were managed by different people. If speech is such a critical component and ours was obviously inferior to the competitor, why were we not putting more emphasis on improving it? Alternatively, why could FX not gone to market and then improved the speech system? In the end, as I understand it, it all came down to money. Because the EScription’s product’s profit margins were so high, Nuance could afford to pay them $460 million and still increase the earnings per share by $.01.
EScription’s profit margins are an area that I think needs a little more attention. The Nuance administration talked about Escription having the best profit margins they had ever seen. The charts I saw showed margins in the 45% range, meaning that they made $.45 on every $1 they charged a customer. The business was designed to create great margins, however. They only had around 10 clients, all of which were large hospitals. As anyone in the industry will tell you, there are higher margins to be had at larger hospitals. I have even heard that EScription would turn down smaller clients that did not fit their business model. The point I’m trying to get at here is that these profit margins will not be sustainable as the EScription product takes on more and more customers.
See part 2 of this article for the technical perspective of the ill-fated Nuance FX project.