1.      Describe NxOpinion. What is it, how does it work?
NxOpinion supports medical decision making by providing several key benefits – it dynamically evaluates current case evidence and generates a differential diagnosis based on statistical knowledge about diseases and their clinical manifestations, it dynamically assists the user by suggesting ‘what-if’ scenarios of high-payoff clinical findings not yet noted or considered by the user, it provides treatment therapy narrative descriptions, and it provides textual information regarding diseases, and clinical findings.

NxOpinion's knowledgebase is created from the perspective that each disease can be broken down into a description of findings such as symptoms, physical exam, medical history, and laboratory tests.  By incorporating data on how frequent a finding may be in a disease along with the prevalence of the disease in general, the diagnostic software can make a more powerful prediction as to the presence of an individual disease.  The knowledgebase itself is being created from a review of specialty text books as well as original medical articles.  But we know that the medical literature is incomplete, so input from specialty physicians is being incorporated into the database to ensure that every finding has the best data that can be found to substantiate it.

2.      How is NxOpinion different from the competition? Is it better? Why?
Several features make NxOpinion superior to competitive products.  First, the user interface has been painstakingly designed to promote rapid input of data that is much more intuitive than other programs.  Secondly, the software is flexible enough to allow the user to navigate through the knowledgebase in several different methods to match their style of work.  Thirdly, there are supportive features such as Formula Assistant which can guide the user through calculation of medical equations or "clinical decision rules".  And last, but probably most significant is the feature of Suggestions, which gently nudge is the user with information on what would be the next most appropriate piece of information to answer into the software.  In this way, the user does not need to guess what information is useful, but will be guided to efficiently capture the most relevant information.

3.      There are other medical diagnosis software support systems available.   What makes NxOpinion better than the competition?
NxOpinion separates itself from the pack by the fact that its inference engine is extremely efficient, compact, portable, and runs against very large medical databases, encompassing multiple simultaneous medical specialties. NxOpinion is the only product in its category able to lead the diagnostician to the next best question to ask or the next best test to order as evidenced by the symptoms already examined.  It evaluates symptoms and patient facts entered as evidence against disease prevalence and the significance of a symptom’s presence for a particular diagnosis and in near-real time produces not only a differential diagnosis but suggestions of related clinical findings. When complete, Microsoft has stated that it believes NxOpinion will have the most comprehensive and valuable medical database in the world.  Some of the other products attempt to provide a wide medical database, but are only successful delivering that breadth of support from a central server. NxOpinion was designed to run on a desktop, tablet or PocketPC.   NxOpinion is the only product available that interprets the findings to reach a diagnosis.

4.      Describe NxOpinion’s knowledge base. What’s inside all those ones and zeros in its digital realm? How was it researched and created?
Diseases in NxOpinion are described in terms of symptoms, physical exam findings, medical history and lab test findings.  NxOpinion then powerfully predicts the diagnosis using the frequency of a finding and how common it is to a disease, along with how often that disease occurs. 

The medical knowledgebase represents the best data available because it is created from a review of specialty text books and original medical articles; supplemented by expert physician input when published data doesn’t exist.

5.      RRI has a relationship with Microsoft. They have been particularly supportive of your mission and your technology. Tell me about that. 
Microsoft Research has been a technical advisor and program supporter of the underlying decision theory and inference engine approach.

Microsoft has been involved in varying levels throughout the development of our technology.  They provide technical, marketing and visionary input into our companies.  They also have formally recognized our accomplishments through their public statements about our mission and technology and through nominating us as the ComputerWorld Honors Program in medicine for 2004.  Microsoft has only nominated 8 medical product companies since 1988 and only two of those have been finalists.  RRI is one and the only one in the medical decision support category.

6.      How would NxOpinion benefit a physician’s practice?
NxOpinion has 2 primary benefits.  One is that it can help distinguish a diagnosis by asking about the presence of specific symptoms or by suggesting the next most valuable test.  The second is that it provides information about a disease and current treatment in real time.  Saving time saves lives and costs.

7.      Has NxOpinion been embraced universally or has there been resistance from the medical community?
Physicians from developing countries have been universally impressed and appreciative of our software.  US Physicians tend to be more reserved having seen other software products fail to deliver as promised.  I think it will just be a matter of time before Western medical communities adopt this powerful tool into everyday use.

8.      Is there any liability to using the software that a user may encounter?
There is no more legal exposure to a physician for using a software program than referring to a textbook.  NxOpinion is an educational tool to support clinical decision making.  It’s not a substitute for experience and judgment.

 Any perception of an office time liability will be quickly eliminated as users are familiarized with its ability to pre-record patient symptoms and health history and minimize all the time & costs associated with unnecessary tests.

9.      Once NxOpinion is released, how will the software be kept ahead of the technology curve?
The NxOpinion framework of technologies is very adaptable and was designed with extension and evolution in mind - for instance the engine utilizes a plug-in architecture for accepting different modules that perform some aspect of inference to satisfy different user and market needs. RRI is continually researching key aspects in medical informatics to include into the product base. NxOpinion is built using the Microsoft .Net development framework, and therefore affords greater flexibility, performance, and robustness than may other development platforms. One of the key architectural advantages NxOpinion lies in the way the medical domain has been modeled. RRI has created Unified Type System, a unique way of expressing complex medical concepts.

10.  Once it’s released how will NxOpinion stay current with evolving and changing diagnosis, treatment and pharmaceuticals?
NxOpinion will maintain a staff of medical professionals containing nurses, nurse practitioners, physician assistants and physicians to keep the knowledgebase current with the latest findings on a perpetual basis.  These updates will be available to the user whenever they connect to the NxOpinion website.

11.  Sell me on NxOpinion. How will it change how I do business or treat patients? Will it really save lives and reduce costs? 
NxOpinion translates into saved resources whether we are talking medical costs, time or lives.   The costs amount to savings in unnecessary tests, office visits, staffing at the office or hospital, or even liability rates.  NxOpinion is an instant QA for the diagnosis made.  Time savings incorporates time saved in reaching a diagnosis, time saved for treatment to relieve pain and suffering, time saved in intake procedures, time saved in making referrals,  and time saved in documentation.  Lives are saved by the provision of an accurate diagnosis and in some areas, through an increase in the patient to physician ratio.  Misdiagnosis is a repeatedly documented major cause of unintentional injury and death to patients.  

12.  How will you market the organization’s software products?
Our goal is to partner with existing marketing arms through the licensing of our technology.  We will customize our products to best fit the needs of our partners.  Because our expertise is in product development and support, we want to leave distribution to the marketing experts.

13.  NxOpinion has a “suites of products.” What does that mean?
It means that our products are built so modularly on the .NET framework that they can be easily customized for various applications; from direct to consumer markets to specialized applications such as university settings, individualized physician offices or mental health arenas.