Microphone Tips in Dragon® Medical Practice Edition 2
What Is the Software Microphone?
The Dragon® Medical software microphone is the entry point for all of the live dictation you need to perform—whether you’re a physician, nurse, radiologist, surgeon, dentist, or specialist. You can find it on the far left side of the DragonBar, which is the main interface module in the application.
In spite of what you might think, just because you’re speaking into a headset or a handheld microphone doesn't mean that Dragon Medical is listening to you. In addition to having the application running and an input device connected, you also need to have the software microphone activated. This alerts the program to start listening to everything that comes through your physical microphone.
Why Is the Software Microphone Important?
The software microphone is your primary feedback mechanism for knowing whether or not Dragon® Medical Practice Edition 2 is listening to you. It’s highly recommended to get into the habit of watching the indicator icon, to see whether or not the application is ready to take your voice input. Not only does this help you not waste your time saying things that the program can’t hear, it keeps Dragon Medical from hearing things it doesn't need to.
What does that mean, you ask? Well, in order for the speech recognition engine to be able to preserve a pristine picture of your voice—and in order to avoid transcribing side conversations with your medical assistant into you document—it’s important that you only have the software microphone on when you, personally, are ready to dictate. This will help protect both your profile recognition accuracy and your documentation.
Best Practices for Using the Software Microphone
In general, there are a few things you want to do when using the software microphone in Dragon Medical Practice Edition 2:
- Minimize any background noise where you are dictating. As we noted above, not only can this produce poor recognition results, but it can also eventually spoil your voice profile.
- Make sure that the software microphone is only on when you’re dictating or giving a command. It should otherwise remain off. You don’t want accidental dictation landing in the wrong field of your patient encounter. You can go back and fix it (if you catch the mistake), but we know you want it right the first time.
- Make sure that your physical microphone and the source you have currently selected in Dragon Medical match. If they do not, you are likely to get poor speech recognition results—and you run the risk of ruining the profile itself.
- Do a periodic audio check. From the DragonBar, click Audio > Check microphone. This will ensure that the volume you are speaking at, and the distance you place the microphone at, are properly accounted for.
If you've got lots of red in the volume indicator, this is the recommended solution.
- Don’t let other people speak into your profile. Dragon Medical thinks your voice sounds like you—and you’ll want to keep it that way. Doing otherwise will effectively ruin your profile. One exception is during the audio and quality checks: you may use a stand-in for these without risk of confusing the application.
Word Properties in Dragon® Medical Practice Edition 2
Word Properties in Dragon® Medical Practice Edition 2
You may already know about using spoken and written forms to customize how your words display. But there’s another method for manipulating how Dragon Medical Practice Edition 2 transcribes your words.
In Dragon Medical, each vocabulary word has word properties. Using these properties allows you to configure words to appear a specific way—whether related to spacing, lines and paragraphs, capitalization, or context.
Before we go any further, also note that we’re working with Dragon Medical Practice Edition 2 for Windows. The layout is only slightly different for the Mac edition of Dragon Medical, and the functionality is almost identical, so Mac users should be able to benefit from this information as well.
If you have an earlier version of Dragon Medical, such as Dragon Medical Practice Edition 1 or Dragon Medical 10, you will still have access to word properties. But, there may be some particular features that are only available in the latest version, Dragon Medical Practice Edition 2.
What Are Word Properties?
In Dragon Medical, word properties allow you to configure how many spaces go around a particular word, determine what kind of capitalization the surrounding words get, insert line and paragraph breaks, and more. You have the flexibility to set up a very specific set of display properties for any given word. You can even have the word show up completely differently when numbers are involved.
We know doctors and other healthcare professionals often need their text to look a certain way, whether due to formatting restrictions or workflow requirements, for ease of use, or simply because of a personal preference. In conjunction with the written form of the word, word properties provide the functionality you need to document patient encounters, send emails, and write referrals with the appropriate formatting.
Here are some cases where word properties would be useful:
- I need a word to display differently if it comes after numbers.
- When I dictate this word, it should create a new paragraph automatically.
- I want the cursor to tab when I say this word.
- The word after this one should always be capitalized.
- I want a new line after this word.
Keep in mind that for some of these cases, there are voice commands that can be used instead. What we’re going to discuss relates to the automation of specific formatting related to a word—so that you never have to use an extra command when you dictate that word.
Dragon® for Mac® Medical 5 vs Dragon® Dictate Medical for Mac® 4
If you use Dragon Dictate Medical for Mac v3 or v4 for your healthcare documentation, you already know how much easier it is to fill out a patient encounter using your voice. Now, you have the opportunity to upgrade to a new version of Dragon with a new name: Dragon for Mac Medical v5.
Upgrades And Updates
Upgrades: If you have Dragon Dictate for Mac v3 or v4, you can get a discount on v5 by purchasing an upgrade. And yes, the upgrade license does get you the full version of the program.
Updates: If you already have Dragon for Mac Medical v5, you'll want to get the latest update released since you installed it. Any bug fixes, improvements, and adjustments that Nuance has made to the application will be incorporated into Dragon for Mac Medical, and you'll be fully supported on the latest Mac OS operating system. And all for free.
Profiles And/Or Commands: If you have a profile from version 4 that you want to use in version 5, it should show up in your profile list automatically. You will need to run a brief upgrade on these profiles, which Dragon for Mac Medical will prompt you to do so when you try to open them after installation.
If you don't want to use your previous profile, but you have some custom commands that you want to keep, you can import them.
Now, let's look at the specifications your Apple® computer needs to meet in order for this version of Dragon to run successfully.
Operating System: Dragon for Mac Medical v5 cannot be installed on a tablet or a phone. It requires one of these three Mac OS X versions:
- Mavericks OS X 10.9
- Yosemite OS X 10.10
- El Capitan OS X 10.11
If you have El Capitan, which is the latest version of the Mac OS, you need to be running at least version 5.0.1 of Dragon for Mac Medical. The chances are decent that you don't have any updates installed, so be sure to check.
Processor: If you have a modern chipset, such as an i3 or i5, the thing to focus on here is clock speed. Nuance requires 2.4Ghz or higher.
RAM: If you have at least 4 GB, you'll be fine. If you tend to have 3-4 applications open at once, or use Dragon heavily, 8 GB (or more) is advised.
Storage: You'll need some free disc space, as the install files are quite large. Make sure your computer has at least 8 GB of hard drive storage space open—16 GB if you are installing from a download.
EHRs: Dragon for Mac Medical v5 has full text control in MacPractice v5 notes fields. This means that you should be able to do everything Dragon Speech Recognition can normally do in a text field. In other EHRs, Dragon for Mac Medical will still transcribe your speech, but you may have limited functionality for selection, correction, etc.
A Point-By-Point Comparison
Now that we've reviewed some of the peripherals, let's look at the major differences you'll find in Dragon for Mac Medical 5 (compared to the previous version):
- It is 15% more accurate than v4, and 35% more accurate than v3. That's a pretty significant leap—roughly a 1-in-7 improvement.
- They've added new terms to the medical vocabularies, which represent 90+ healthcare disciplines. Note: there were the same number of vocabularies in the previous version.
- They removed the American – Inland Northern accent and added American – Teens.
- There is increased speech recognition accuracy using the built-in microphone. If you prefer this method of dictation, it just got a little more viable.
- Version 5 provides better speech recognition accuracy for these accents: Canadian, SE Asian, Indian, and Australian English.
- Version 5 supports both Microsoft Word 2016 and Word 2011, whereas version 4 only supported the latter. If you have a newer computer, or like to stay up-to-date, this is an important factor for your documentation environment.
- You can now install from either a download or a USB stick. That means that if you don't have a DVD drive, you aren't limited to just downloading the application. And if you do, USB is definitely faster than using a disc.
How to Use Hidden Mode in Nuance® Dragon® Medical Practice Edition 2
What Is Hidden Mode?
For users of Dragon Medical Practice Edition 2, Hidden Mode provides two functions you wouldn't normally have access to:
- If your electronic medical record requires the use of the Dictation Box, Hidden Mode allows you to work almost as seamlessly as you would were you dictating directly into the patient chart.
- This mode also enables you to review other websites or applications, dictating notes without having to click the Dictation Box, and without it getting in the way of your research.
Before we go further with Hidden Mode, let's talk a little about the Dictation Box—because you may have never used it before.
What Is the Dictation Box?
In case you didn't know, the Dictation Box is the tool that Dragon Medical Practice Edition 2 uses to interface with the myriad EMRs available to clinicians. While it does serve other purposes as well, it is primarily a platform for integration.
You can find the Dictation Box by going to the Dragon Bar and clicking on Tools > Dictation Box. Or, you can simply use the verbal command, "Open Dictation Box."
What Does It Mean to "Anchor the Dictation Box"?
If you go into the settings menu of the Dragon Bar, you'll see a curious feature on the Dictation Box tab. Click Tools > Options > Dictation Box and find the checkbox at the top that says, "Anchor Dictation Box to application."
This is not Hidden Mode. Rather, anchoring the Dictation Box tethers it to the active application at the time it is opened.
For instance, open Notepad and the Dictation Box (anchored), and then start up a web browser. As usual, Dragon will change your speech into text and place it in the Dictation Box. When you use the "Transfer Text" command, your dictation will then be pasted into Notepad, regardless of where you click your mouse or which application is active. Then, the Dictation Box closes.
How Do I Use Hidden Mode?
Hidden Mode is slightly different. Go back to the Dictation Box tab in the Options menu. Jump down to the section labeled "Hidden Dictation Box behavior."
Here are the recommended boxes to check:
- (Required) Open Dictation Box as hidden
- Allow user commands when hidden
- Allow voice dictation commands when hidden
- Leave Dictation Box open after text is transferred
Also, leave "Dictation Box visibility" at 50% to start with—you can always change the transparency to suit your tastes.
With the above configuration, here's what will happen when you open the Dictation Box:
- The Dictation Box will start up in a translucent state.
- Any dictation that you make will end up in the Dictation Box, no matter where your mouse is pointed.
- In order to move a dictation to a specific field or application, click wherever you need the text to go and say, "Transfer text."
- After you transfer your Dragon-recognized text, the Dictation Box remains open.
- Continue with your patient note. There's no need to click back to the Dictation Box—Dragon Medical will put your text there automatically.
How Does That Help Me?
First of all, Hidden Mode powers you to do research and make notes without having to worry about whether your mouse is clicked into the Dictation Box. It also allows you to make the Dictation Box as visible or invisible as you need it to be.
Second, and more importantly, Hidden Mode enables you to work effectively within an EMR that doesn't play well with Dragon Medical Practice Edition 2. In essence, opening the Dictation Box as hidden allows you to dictate parts of the patient chart as needed, without having to move back and forth between Dragon and your EMR.
With Hidden Mode, you only need to dictate, click into the appropriate EMR field, and say, "Transfer text."
To learn more about Dragon Medical Practice Edition 2 or how to become a reseller click here.
How Does Nuance Dragon Medical Practice Edition 2 Support HIPAA Compliance?
Healthcare Data Privacy and Dragon® Medical Practice Edition 2
Dragon Medical Practice Edition 2 is designed to be an efficient, flexible, and accurate method for surgeons, nurses, general practitioners, and specialists to produce the necessary documentation to complete their patient note or encounter.
Given the changes urged forward by Meaningful Use, this happens, more and more, within the confines of an Electronic Health Record (EHR). Thus, healthcare professionals have to extend their concern for personal medical data and the privacy of the patient to the digital realm.
If you work in medicine, you likely already know how important it is to have software that supports your workflow and enables you to build a data stream that can be secured from end to end.
Dragon Medical is just that kind of software.
But before we dive head-first into an exploration of how the application works to secure your dictations, let's talk a little bit about HIPAA itself, as well as what it requires when it comes to Protected Health Information, commonly referred to as PHI.
HIPAA Regulates PHI Access
HIPAA stands for the Health Insurance Portability and Accountability Act. It was created, in part, to protect people from having their personal health information released to or viewed by anyone who shouldn't have access to it.
HIPAA, originally put in place in 1996, was fully implemented by 2003—although it wasn't until the recent HITECH Act that EHRs became subject to HIPAA. These acts essentially work together to prevent personally identifiable patient data from being shared without the patient's consent.
In general, though not exclusively, the patient decides who should access their PHI—healthcare providers and insurance companies, notwithstanding. That's why they have you sign a Notice of Privacy Practices form when you visit the doctor's office. You have to acknowledge you understand how your PHI may be shared.
The parts of HIPAA that you really need to concern yourself with, for the purposes of Dragon Medical, are what's known as the Privacy Rule and the Security Rule. One says that you have to protect patient data; the other tells you what standards you need to meet to protect it.
How Does Dragon Medical Software Protect PHI?
So, what does this mean? What does Dragon Medical Practice Edition 2 have to protect, specifically? Is the program considered HIPAA compliant?
Let me address that last question first.
HIPPA requires that Covered Entities and Business Associates handle PHI properly. Even if an application helps them do this, it is—in no way—a substitute for or a solution to the question of compliance.
That being said, Dragon Medical Practice Edition 2 does support HIPAA compliance. That means that the engineers at Nuance thought about healthcare providers when they were building the application, and they included features that they knew would make it possible to secure PHI while documenting patient encounters.
Now, there's really no practical way for Dragon Medical Software to know whether a clinician happens to be dictating what would be considered individually identifiable health information, or just a friendly letter to a colleague. That means that the software has to assume that everything being dictated is sensitive and needs to manage accordingly.
Tracing Speech and Text Through Dragon Medical
In order for us to understand how Dragon Medical Practice Edition 2 supports HIPAA compliance, let's follow the voice and text data as it travels throughout the program. Keep in mind that the only part of your workflow that the software can affect is the part that it's involved in.
What follows represents a standard workflow for clinicians dictating into an EMR.
When you begin to dictate into any program, Dragon Medical creates audio and text files. These are known as 'session files,' and they are temporary.
If you make corrections, they get put into .enwv files. These are used for optimization, and are encrypted before being saved to the profile.
When the session is over, your temporary Stage One files get put into a new .DRA file. This is then encrypted and saved to the local profile, or the local copy of the roaming profile.
During optimization, Dragon Medical Practice Edition 2 will use the still-encrypted .DRA and .enwv files to try and improve your local profile. Roaming profiles may transfer these files to the network roaming directory when synchronization occurs, where they can then provide data for optimization.
All of the above encrypted files must be opened by Dragon Medical. The DragonPad can't access them, because it's a feature present in non-medical versions of the software.
Potentially Unprotected Data
Now, let's talk about where you might need to shore up your defenses with regard to Dragon Medical and PHI.
- First, have a look at Tools > Administrative Settings > Miscellaneous. 'Encrypt patient health information' should be checked, but you'll want to verify this.
- Next up, take note that audio files you save on purpose—when dictating into a word processing application—aren't encrypted. You'll know whether or not this is happening by navigating to Tools > Options > Data > 'Save recorded dictation with document.' If the setting is 'Never,' you're in the clear. If it's 'Ask Me' or 'Always,' you're either being prompted to save unencrypted data, or you're saving it automatically. Make sure your PHI is protected.
- If you want to stop creating .DRA files (the encrypted kind described in Stage Three), go to Tools > Options > Data again and check 'Conserve disk space required by user profiles (for portability).'
- Finally, make sure to uncheck 'Store corrections in archive' in the same Tools > Options > Data window we've been working in. Otherwise, you could be creating unencrypted .nwv files when you make corrections. We don't want that. This last change may somewhat limit your ability to optimize your Dragon Medical profile. If this is a concern, we recommend running profile optimization more often.
Just In Case
Please remember that HIPAA compliance is the responsibility of Covered Entities and their Business Associates. We're just arming you with information that you can use to help meet your Privacy and Security Rule obligations as you operate Dragon Medical Practice Edition 2. And this information only applies to that particular version.
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Dragon Dictate Medical for Mac Version 4 Takes the Outstanding and Makes it Better
Nuance Communications has improved upon an already potent force with its Dragon® Dictate Medical for Mac Version 4, which is faster, more accurate and higher performing than the speech recognition software’s previous versions.
Among the improvements Dragon Dictate Medical for Mac Version 4 offers are:
- Enhanced compatibility with OSX Mavericks and Yosemite
- Heightened performance with pure 64-bit applications
- Support for full text control of Gmail within Safari and Firefox.
- Updated medical vocabularies
- New support for “General English” vocabulary
Dragon Dictate Medical for Mac Version 4 is the world’s most advanced medical dictation solution for practices with 24 physicians or less. Over 200,000 physicians worldwide have adopted Dragon Medical speech recognition technology as their tool for speech-enabling their EMR-EHR system and creating a more profitable practice. The software can turn speech into text three times faster than typing, with more than 99 percent accuracy, right out of the box. Dragon Dictate Medical for Mac Version 4 also features a medical vocabulary library that includes more than 90 specialties and sub-specialties.
Physicians can dictate patient notes, comprehensive treatment plans, and send emails, letters, referrals and more, all with the sound of their voice. Dragon Dictate Medical for Mac Version 4 streamlines documentation workflows and allows physicians to easily dictate appointment and clinical notes directly into Mac-based EMR-EHR systems, such as MacPractice. Additionally, Dragon Dictate Medical for Mac Version 4’s patented speech recognition technology recognizes 9 regional accents and can also be trained specifically to the way an individual pronounces a word so it clearly understands them every time.
The software also allows you to build timesaving, customizable macros to replace repetitive clicking and typing with simple voice commands to insert boilerplate text and commonly used terms. Dragon Dictate Medical for Mac Version 4 is also HIPAA compliant, another key reason this software continues to be the choice for physicians who utilize the Mac platform.
With Dragon Dictate Medical for Mac Version 4, physicians are able to spend less time on documentation and more time on what is most important to their practice – patient care.
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Speed Up Document Dictation with Dragon® NaturallySpeaking 13 Legal
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Create and Send Email with Dragon® NaturallySpeaking 13 Pro
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Set-Up Process is Made Easier With Dragon® NaturallySpeaking 13 Pro
A simplified set-up process is just one of the advancements offered by Dragon® NaturallySpeaking 13 Pro, as compared to Version 12 of the industry leading speech recognition software.
Dragon® NaturallySpeaking13 Pro improved out-of-the-box accuracy makes profile creation has been made even briefer in several key ways.
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Dragon NaturallySpeaking 13 Pro is the most advanced speech recognition software on the market to date. The software turns talk into text three times faster than typing and is a valuable tool in increasing a business’ productivity and profitability. Dragon 13 is easy to use and with all the helpful tutorials you are able to ramp up productivity quickly.
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Help your clients increase their efficiency with Dragon NaturallySpeaking Professional
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Speech recognition gets more intuitive with Dragon® NaturallySpeaking 13 for Professionals.
With a completely redesigned user Interface, Dragon NaturallySpeaking 13 is more intuitive than ever with key enhancements such as DragonBar, Learning Center and Interactive Tutorial.
The re-imagined DragonBar clearly provides the controls you need when you need them, then smartly collapses when you no longer have use for it – saving valuable screen real estate space.
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Superior dictation is served with Dragon® NaturallySpeaking 13 for Legal Professionals
With Dragon NaturallySpeaking 13 Legal, you use your voice to dictate documents or enter text in any space you normally type. It provides you with a voice-driven user experience that learns your words and phrases to deliver the most accurate results available in the speech industry today.
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