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The Nuance of Synergy

May 5, 2014
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According to the Merriam-Webster dictionary, synergy is “the increased effectiveness that results when two or more people or businesses work together,” and nuance is “a very small difference in color, tone, meaning, etc.”  The recent announcement that Nuance Communications, Inc. ( had acquired Accelarad ( certainly represents an opportunity for Nuance to demonstrate synergy, but in contrast to the meaning of nuance, it is no subtle difference in terms of Nuance’s business – especially in terms of potential implications for healthcare!

Accelarad was founded in 1999 to capitalize on the opportunity for virtualization in radiology, and has expanded from remote reading applications to cloud-based image accessibility.  Nuance on the other hand represents the combination of a couple of premier speech recognition and document management companies.  Nuance started out of the roots of speech recognition from the original Dragon Dictate product, while a company known as Visioneer acquired Scansoft, which had its roots in Kurzweil Computer Products, a software company that developed the first omni-font character recognition system. 

The combination of speech recognition and document management are both areas important to healthcare entities.  The addition of Accelarad now brings imaging into the fold.  I have been a long-time user of Nuance products, including speech recognition and document management/OCR, but I have always been intrigued by how Nuance has not seemed to bring both sides of the house together for healthcare applications.  I had the opportunity to beta test Nuance’s OmniPage Ultimate product last year, and blogged on how I thought it could compliment Nuance’s speech recognition product for healthcare applications (  Through the use of OCR, Nuance has the opportunity to capture reports or other medical records documents and convert them using text to speech – potentially useful for playback of clinical information for clinicians on the go.

Another aspect of Nuance’s product progression has been the “Nuance Cloud” which is similar to a myriad of cloud offerings that enable direct application interaction with documents in the cloud.  With the acquisition of Accelarad, Nuance adds yet another cloud which it has renamed as PowerShare, whose emphasis is on image sharing between clinicians and patients.  While this represents a powerful capability, it seems to be evolutionary on Nuance’s part.

Nuance is entering a new realm that it has only peripherally played in – that of imaging.  As a major player in healthcare speech recognition, Nuance relies on a number of resellers that are themselves involved in imaging.  How Nuance chooses to mesh these strategies will be interesting.  If Nuance can figure out how to add additional value to its speech recognition base through extensions into its cloud offerings, it may be able to balance both reseller and direct sales.  On the other hand, given Nuance’s strong position in speech, the importance of EMR integration, and the value of cloud integration, Nuance may be emerging as a force to be reckoned with on its own.  Add to this the strong position Nuance has in document management (albeit no specific dedicated healthcare application), Nuance could have a powerful mix of technologies upon which to build its own presence. 

Imagine a means for healthcare providers to seamlessly manage and communicate clinical results, whether they be document, image, or speech in a unified way through a cloud?  There are endless possibilities for how this technology could revolutionize healthcare.  Only time will tell in terms of Nuance’s intent.  What will be fun is watching the “nuances” of their strategy play out!