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Medical imaging AI vendor Annalise.ai and Nuance Communications, a vendor which specialises in reporting and ambient clinical intelligence tools, have announced a partnership which will connect Annalise.ai’s diagnostic support solutions to more than 12,000 healthcare facilities currently on Nuance’s Precision Imaging Network globally.
With the agreement, Annalise hopes to gain exposure to a greater number of sites, allowing it to scale rapidly, while Nuance can utilise Annalise’s solution to enhance its growing Clinical Analytics Platform and complement its Natural Language Processing tools.
The Signify View
Medical imaging AI vendors are keen to extol the virtues of their partnerships. While these vendors are often quick to boast that their algorithms are being hosted by one of a growing number of AI platforms, the truth is that these platform providers are sometimes not very discerning. Some platform providers aim to simply give customers the broadest range of solutions possible. Sometimes these are bundled into clinical suites or workflow packages, but the breadth of solutions on offer is usually of paramount importance.
The approach of Nuance, bolstered by its recent acquisition by Microsoft, is subtly different. The partnerships it has fostered do help offer a range of capability to customers, but above that ambition, Nuance has been more discerning, only partnering with vendors which deliver solutions that offer providers significant clinical value. It is essentially only interested in collaborating with the vendors it deems the leaders in any product category. This marks a divergence from its original platform play, which took the form of a more conventional ‘marketplace’ approach aiming to offer a wide variety of tools to the end-user, but that platform, like many of the early marketplaces, failed to gain significant traction.
Annalise.ai, as well as Nuance’s other announced partners, Densitas and Perspectum, embody this ‘quality over quantity’ approach. In the case of Annalise, which can be regarded as a market leader given the sophistication of its comprehensive solution, the clinical value it has the potential to offer and the funding and clearances it has secured, the adoption of a comprehensive solution eschews the need for Nuance to adopt and integrate solutions from multiple providers for the same body area modality combination. Nuance’s orchestration capabilities mean that customers on its Precision Imaging Network can leverage Annalise’s strength to identify a multitude of findings, before findings are pushed to their reporting solution, ensuring they can more readily be utilised in clinical workflows.
In addition to this, however, Annalise.ai’s solutions could be used in synergy with Nuance’s strength in natural language processing (NLP). Nuance’s NLP could mine historic radiology reports to identify reports of interest. These reports could then be analysed by Annalise to identify incidental findings. While this would, in the first instance, enable providers to improve patient outcomes, it would also have broader implications, allowing the health of entire populations to be more effectively managed overall.
As well as having a presence in almost 80% of US hospitals (according to the vendor) Nuance’s network connects radiologists, providers, health-plans, self-insured employers, life sciences companies and other imaging stakeholders. The two vendors will hope that this breadth will enable such retrospective analytics to deliver value to providers beyond the clinician, and identify other areas where additional value can be delivered.
This highlights the difference between Annalise and Nuance’s collaboration, compared to other comparable partnerships. Where often vendors in partnerships essentially co-exist harmoniously, Nuance and Annalise hope to collaborate synergistically. Working together they hope to enhance the quality of reporting and efficiently enrich the quality of reports with data directly from the algorithms.
Wider trends in the medical imaging market also emphasise the potential offered by the partnership. Annalise has, as noted in past Insights, been progressing quickly in Australasia and Europe. However, its progress in the US has been stymied by the US-FDA’s reluctance to approve comprehensive solutions, treating the detection of an individual finding as though it were assessing a separate tool. Such an approach effectively prevents Annalise, which claims its CXR chest X-ray solution can identify 124 findings, from gaining regulatory approval in the US. Resultantly, Annalise has, been forced to break up its solution in a bid to secure approval for smaller subsets of the solution. Further, to accelerate the pace of crossing regulatory hurdles and forge an installed base in the US, the vendor has also been forced to settle for its tool’s use as a triage and notification solution, rather than one that can be used for diagnosis.
These barriers mean that Annalise would be facing a long, hard road to gain ground in the US, especially in the face of other vendors which have gained success with a single solution before expanding out to encompass increased clinical requirements. Partnering with Nuance, and gaining access to its vast installed base, immediately ameliorates that difficulty. The scale of Nuance, as well as its integration into providers’ workflows, means that for the time being, the lack of regulatory approval for detection won’t severely hinder Annalise, enabling it to be valuable as just a triage solution, albeit for a smaller number of its CXR solutions. Further, if the US-FDA does eventually rethink its approach to comprehensive solutions, it will be well placed to dramatically capitalise.
Even at present, though, both companies stand to benefit, while also granting their customers new opportunities. This is particularly true given that Nuance’s workflow integrations will help tackle another of the hurdles facing providers hoping to utilise AI for historic analysis; how to bring the analysis of historic data into current clinical workflows. Annalise needs to be able to access the data harboured by Nuance’s 12,000 care facilities, which depends on that data not only being made available, but also being formatted into a unified manner, where NLP and image analysis can be leveraged.
The fruits of overcoming this challenging, in private markets at least, can be substantial. Providers connected to Nuance’s network who choose to use Annalise’s solution on their historic data could identify significant numbers of patients with incidental findings, missed findings or even misdiagnosis. In doing so, if these patients can be incorporated into hospital’s workflows, and assigned treatment pathways, they represent additional sources of revenue for providers. By utilising the collaboration between Nuance and Annalise, providers should be able identify patients that will benefit from interventions, which they themselves can charge for, while also improving outcomes for the patient.
Further, the purported access to data granted by the agreement with Nuance will also give Annalise another longer-term advantage, with the vendor being able to utilise the data as it continues to refine its algorithms and presumably expand into other clinical areas, as well as validating its solutions to increasingly convince providers and regulators alike of its merits.
Even with the apparent strengths offered by the partnership, there are several questions whose answers will be revealed over time. How invested in medical imaging is Microsoft and Nuance, for example? One of the motivations driving investment in medical imaging by cloud infrastructure providers is simply to sell more cloud services. This is likely one of the reasons for Microsoft’s acquisition of Nuance in the first place. The partnership with Annalise and other AI vendors will, if successful, aid in this regard, helping convince providers to transition to the cloud. However, Nuance’s heritage and strategy suggests this is not the sole motivation. Another question raised is why Annalise hasn’t developed its own platform? AI scale-ups offering their own platforms is fast becoming a developing trend, and Annalise are well placed to make such a move. However, the opportunity to scale with Nuance is too significant to ignore, especially in the US, and Annalise will hope to use it to “leapfrog” algorithm developers that natively developed platforms.
These are, however, relatively small matters in what is a grander ambition. The volume of platform launches throughout the year has increased dramatically, but against this backdrop, Nuance’s partnerships with Annalise, Densitas, and Perspectum have brought something different. Sophisticated AI solutions, AI orchestration expertise, a large global footprint of potential sites, backed by a global cloud technology behemoth with very deep pockets; a combination which could prove a recipe for success.
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This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. The content is only available to companies that have subscribed to this paid-for service. To view other recent Premium Insights that are part of the service please click here