DRMG is looking for a new transcription system to replace their legacy system. They are considering Commissure, a young company that offers an integrated speech recognition, reporting, and workflow system called RadWhere. RadWhere uses Dragon medical speech recognition and can integrate with many RIS and PACS systems. It could streamline transcription, reduce costs by eliminating transcription positions, and increase productivity. An analysis shows the system would pay for itself within 10 months and continue to save money in subsequent years. DRMG believes Commissure meets their requirements and would allow them to grow with changing technologies.

1. Executive Summary
In Search of A New Transcription System …
As DRMG moves into the 21st century, we are on a quest for a new PC based
transcription system that not only works with our current existing VitalWorks RIS, eMed PACS
but with future RIS or PACS systems as well. Most PC based transcription / reporting systems
now utilize voice recognition (VR) such as Dragon Naturally Speaking™ which has been the VR
engine deployed by many large transcription / dictation systems; Nuance’s Power Scribes,
Medquist’s SpeechQ, Commissure’s RadWhere …, to name a few. Planning to emerge from the
legacy Lanier system, DRMG’s administration team is looking at a young company by the name
of Commissure, Inc, that has been very actively and aggressively competing in the VR
transcription / reporting market in the past little over 3 years. Commissure, by the invitation of
DRMG’s I.T. team, performed a live demo at AIC for the administration team headed by Steven
Nguyen, Information System Director and the I.T. team.
Although young, Commissure has been recognized by some of the major RIS/PACS
systems such as IDX, IntelePacs, etc… Some of their largest clients are NYU MC, CC
Foundation, University of Maryland, MG Hospital, GM Center, LH Hospital, and many more…
Commissure has been known for its open-source integration with systems such as Vocada™
Veriphy™, McKesson Horizon, Philips iSite (Stentor) and Cerner RadNet®. Commissure also
partner up with major players in the healthcare industry such as RCG Healthcare Consulting,
Vocada Verifying, AMICAS, TeraRecon and Armisys STATdx.
S.W.O.T.T. Analysis
Strength
• Major radiology centers or departments have entrusted and endorsed their products.
• Partner with major companies such as IDX, AMICAS, TeraRecon and Armisys STATdx
to gain competitive edge over its rivals.
• Utilizing Dragon Naturally Speaking™ 9.5 Medical Edition engine makes RadWhere
more robust and adaptable to any RIS and PACS environment.
• Open software architecture allows integration with virtually any existing speech
recognition system on the market.
• Brings speech recognition, structured reporting, integrated clinical content and
communication tools together with one product.
• RadWhere listens and dictates everything a radiologist says with incredible accuracy
TM
and has the ability to manage workflow while communicating between disparate systems.
• Ability to bypass RIS and work with PACS directly, a favor option for imaging centers
in search of a new RIS system.
• Ability to integrate with almost any system that utilizes HL7 standard.
• Experienced and dedicated implementation and support team.
• Build upon the existing I.T. infrastructure.

2. • Ability to get started quickly with pre-built “out of the box” solutions.
Weakness
• Relatively young company.
• Radiologists have not had a chance to “test drive” the products.
• Interactive Demo not available for absent radiologists.
• Depends on Microsoft Server 2003 and its client access licenses (CAL).
• Required additional Microsoft client licenses to utilize MS SQL Server.
• Two to three months installation schedule from time of signing contract.
Opportunity
• Reduces transcription costs and improves turn-around time.
• Reduces transcription personnel thus reducing extra employee costs.
• State-of-the art system that will grow with DRMG growth plan.
• Will integrate with new RIS system should we decide to pursuit a new RIS.
• Integrated solutions save time in performing day-to-day tasks.
• Administrator Portal allows CEO, COO and I.T. manager to manage more effectively.
• Automated data processing and communication ensures optimal patient care.
• Lower startup cost versus other major system such as PowerScribe and SpeechQ.
Threats
• Radiologists who were not participating in the live demo may oppose to changes.
• Capital investment reallocation.
• Training curves.
• Radiologists’ fears of the unknown.
• Delay due to budget review.
• Hardware unavailable (very low risk)
• Not recommended on Windows 2000 systems
Trends
• Radiology community involvement remains Commissure’s primary focus.
• Through direct building of relationships and interconnectivity of ideas, Commissure will
continue to provide cutting-edge solutions for all size facilities.
• Positions itself at the forefront of advancement.
• The ultimate goal is to improve the existing landscape of radiology communication and
the acceptance of new convergence technologies.

3. Cost Analysis (Assume by-passing VitalWorks)
Startup Costs
Description Amount
Interface with AMICAS & eMed PACS 10,000.00
10 days training 15,000.00
10 SpeechMike 5276 2,225.00
Interface from & to eMed databridge 10,000.00
Hardware:
1 Server 9,400.00
Software:
MS Windows 2003 Server with Commissure’s O/S required specs.
(3 Years Open-Value + 20 users CAL for Server 2003 and SQL Client
Server @ $1,680.00 per year) 1,680.00
TOTAL One Time Cost 48,305.00
Return on Investment (ROI) Analysis:
One time startup cost 48,305.00
First Year Support & Maintenance on RadWhere & RadCube (Base on
an annual estimated of 120,000 studies) 67,200.00
Total Investment Year 1 115,505.00
Potentially eliminating positions in transcription
PTO: 44,000.00
Benefits: 13,200.00
Wages: 73,000.00
Other Expenses: 6,800.00 (Social Security Tax, Worker Comp, etc.) 137,000.00
Lanier Annual Support & Maintenance Fee 10,773.00
Total Potential Saving Year 1 147,773.00
Net Saving Year 1 32,268.00
Second Year Support & Maintenance on RadWhere & RadCube (Base
on annual estimated of 120,000 studies) 62,000.00
Microsoft Open-Value (Payment 2 of 3) 1,680.00
Total Investment Year 2 63,680.00
Potentially eliminating 2 positions in transcription
PTO: 44,000.00
Benefits: 13,200.00
Wages: 73,000.00
Other Expenses: 6,800.00 (Social Security Tax, Worker Comp, etc.) 137,000.00
Lanier Annual Support & Maintenance Fee 10,773.00
Total Potential Saving Year 2 147,773.00
Net Saving Year 2 84,093.00

4. Third Year Support & Maintenance on RadWhere & RadCube (Base on
annual estimated of 120,000 studies) 62,000.00
Microsoft Open-Value (Payment 3 of 3) 1,680.00
Total Investment Year 3 63,680.00
Potentially eliminating 2 positions in transcription
PTO: 44,000.00
Benefits: 13,200.00
Wages: 73,000.00
Other Expenses: 6,800.00 (Social Security Tax, Worker Comp, etc.) 137,000.00
Lanier Annual Support & Maintenance Fee 10,773.00
Total Potential Saving Year 3 147,773.00
Net Saving Year 3 84,093.00
The ROI Analysis chart above shows that the system will pay for itself in 10 months of its first
year’s operation. The following 2 years will yield higher savings since there will not be any
startup cost. In the fourth year in operation, DRMG will save even more because there will not
be anymore payment to Microsoft on the open-value licensing program.
Conclusion:
After comparing cost and carefully analyze the project, we feel confidence that
Commissure has met the requirements and technologies for business needs. It would streamline
the reporting processes, reduce workflows and costs, increase productivities and profit margins,
improve turn-around time and continue to grow with our business. Furthermore, with its open
software architecture and serious partnership with major RIS/PACS systems on the market,
Commissure would be at the forefront of technologies and able to integrate with almost any RIS,
PACS or 3D systems that chooses in the near future.