I'm in solo Primary Care and have had my EMR and Dragon 9 Medical for about 4 months.The EMR unfortunately isn't Dragon enabled at present (possibly in the future). I have to dictate my notes using a Philips Speech Mike Pro into the Dragon Pad and transfer them into the patient's chart in the EMR. After 3 months my accuracy has gotten fairly good but I still have occasional problems with small words, (probably as a result of my old medical dictation habits). I must admit I do find it cumbersome to have to pick up the Speech Mike up to 40X daily after each patient interaction, (the cable always seems to catch on something on the small desk in my smallish exam room). That being said the Speech Mike is great for navigating around the Dragon Pad as I create my notes. I've thought about using a digital recorder but am worried about loss of accuracy and the effort of transcribing the notes into the Dragon Pad and then into the EMR at the end of the day.
I'm looking from advice from more experienced users about how I can improve my efficiency; better techniques, different equipment etc.
Thanks!!
canadoc:After 3 months my accuracy has gotten fairly good but I still have occasional problems with small words, (probably as a result of my old medical dictation habits). I must admit I do find it cumbersome to have to pick up the Speech Mike up to 40X daily after each patient interaction, (the cable always seems to catch on something on the small desk in my smallish exam room).
Although the SpeechMike is good for navigation, it is as you have found, a pain to pickup/put down all day long. Many physicians are using our Sennheiser MD431II mounted on our Balanced Spring Microphone Arm. This leaves your hands free to use the mouse, and look at reports or films. See this at:http://www.emicrophones.com/microphones/prod_details.asp?subCatID=38&prodID=117
Martin Markoe, eMicrophones, Inc.
>>The EMR unfortunately isn't Dragon enabled at present<<
What EMR are you using that doesn't have any dialog boxes that won't accept text and therefore dictation? I'm curious because all text boxes that I have met accept dictation?
Additionally, the programmers should be able to add a memo field that would allow free text form and dictation. I'm thinking that a sales person told you that the EMR is not DNS enabled because he/she did not read it in the FAQ!
Chris Wilkerson, D.C. Carson Doctors Group TabletPCs in Medicine Editor-in-Chief www.MedicalTabletPC.com Home: www.Digital-Doc.com
mmarkoe: Everyone has trouble with small words. The tricks are to use the best microphone for superb clarity, enunciate clearly, speak in phrases and when an error occurs, correct not the single word but the word within the context of the surrounding words.
Everyone has trouble with small words. The tricks are to use the best microphone for superb clarity, enunciate clearly, speak in phrases and when an error occurs, correct not the single word but the word within the context of the surrounding words.
How would I correct more than the single word ?
Is there a technical reason why your "multi-word" correction method will yield better results ?
DrMurdoch:How would I correct more than the single word ?
In an article I was writing this afternoon, I said:
"The ordeal setup is excellent at setting the volume level of the microphone."
As this was a new user profile and I would likely use the term audio setup in the future, I said, "Correct the ordeal setup." Then in the Spell correction box, I changed "ordeal" to "audio." It now gets the audio setup every time.
Dragon NaturallySpeaking, like every other speech recognition software, is not only look for the sounds of words. It tries to make a best guess at the sound of the word you dictated but then it parses tables of probabilities of words in context. There are probably hundreds of thousands of these built into the software. This is why the software is able to get, "Two boys went to see a doctor because they ate too much food." How else would the software be able to understand homophones?
In view of this knowledge of how Dragon works, when you correct words in context, you are increasing the probability that they will be recognized correctly within that context the next time you dictate them. It may not work 100%, but we're in the past you would never see the word in the list of possible alternatives, now you usually see the phrase as one of the top alternatives in the correction box.
--
Martin Markoe, eMicrophones, Inc.The best microphones for Speech RecognitionSee us at: http://www.eMicrophones.com/index.aspRead, "Key Steps to High Speech Recognition Accuracy" at:http://www.emicrophones.com/docDetails.asp?DocumentID=38
then it parses tables of probabilities of words in context.
Thanks Martin. Just as I thought.
Q: is there a specific name/technology/method I can refer to when discussing this feature of DNS ?
ie. did they name the method ?
Q2: does the medical version come pre-bundled with likely medical probability tables ?
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
DrMurdoch:Thanks Martin. Just as I thought. Q: is there a specific name/technology/method I can refer to when discussing this feature of DNS ? ie. did they name the method ?.
Q: is there a specific name/technology/method I can refer to when discussing this feature of DNS ? ie. did they name the method ?.
It uses the Markov Model of speech analysis. Here is an easy to understand article:http://www.cs.brown.edu/research/ai/dynamics/tutorial/Documents/HiddenMarkovModels.html
If you understand this please explain it to me? :-)
Yes, or else why would you be paying several hundred dollars more than Professional?
Marty
mmarkoe: Q2: does the medical version come pre-bundled with likely medical probability tables ?Yes, or else why would you be paying several hundred dollars more than Professional? Marty
Yes, or else why would you be paying several hundred dollars more than Professional? Marty
Marketing ?
Thanks for all the great advice!
re: EMR
I'm from Canada and use Net Medical from Practice Solutions in Cambridge, Ontario.You can dictate directly into the EMR with Dragon 9 but because the software isn't fully Dragon compatible at this point the accuracy isn't acceptable. That is why I've been using the Dragon Pad and then cutting and pasting into the EMR. Any suggestions how to deal with this problem better.? The more specific the better, I'm a novice+++.
Thanks again to all!
canadoc: Net Medical from Practice Solutions
Net Medical from Practice Solutions
You have it deployed on PC ? or Macs ?
You can dictate directly into the EMR with Dragon 9 but because the software isn't fully Dragon compatible at this point the accuracy isn't acceptable. That is why I've been using the Dragon Pad and then cutting and pasting into the EMR.
I can't see how it's possible that Dragon Pad would get better results than your EMR's "Text Box". I have some friends that use MacMedical, I'll ask them. Not sure they use DNS. I think it's possible that NetMedical won't allow voice commands such as "Select" but I wouldn't think it's possible to have accuracy problems with the EMR's Text Box.
It says here Net Medical is compatible
However, here, it only says it's compatible with ViaVoice.
Thanks for the input!
I have it on PC. I waited for the PC version specifically because it could use Dragon. I have only tried dictating directly into the patient's record in the EMR and you are quite correct that when I try and correct an error the "Select" command doesn't work among a number of others. Since this approach wasn't working effectively I switched to the Dragon Pad. I'll have to check the EMR to find the "text box". Would I still have to cut and paste dictation? If I did find it and used it, would I be better of than using the Dragon Pad as I am now??
canadoc:I have it on PC. I waited for the PC version specifically because it could use Dragon. I have only tried dictating directly into the patient's record in the EMR and you are quite correct that when I try and correct an error the "Select" command doesn't work among a number of others. Since this approach wasn't working effectively I switched to the Dragon Pad. I'll have to check the EMR to find the "text box". Would I still have to cut and paste dictation? If I did find it and used it, would I be better of than using the Dragon Pad as I am now??
Place the cursor in the text field you want to text inserted and say, "Show dictation box." You can dictating to this box and make corrections easily. When you are finished, just say, "Okay." Some people have reported flakiness with the transfer so it may be a good idea the first few times you use it to say, "select all" and then, "copy." This will copy the contents of the dictation box into memory in case the transfer does not work properly when you click OK.
Text Box is really another word for "any place where you can type into". A great example of a Text Box is the box you type in to post a message (ie. the one I am typing in right now). I have learned that not all Text Boxes are the same (ie. Word, Notepad, Internet Explorer all have different text boxes).
I'd say it's a pretty big gaff for Net Medical to not support Dragon.
Q: Can anyone at Nuance verify this ?