Dragon Software, Training and Support Blog

Dragon Voice Shortcuts for Usernames & Passwords

2012-03-03T16:58:00.001-05:00

From this point forward there will be no more searching for passwords, struggling to remember them or typing them incorrectly – just say it!

This morning I provided Dragon training for Dr. Carl West, a physician with Gastroenterology Associates of Ithaca, located in Ithaca New York. Dr. West, Dragon and his Buddy FlamingoMic (microphone) got along extremely well so we got through instruction of the essential skills in a little over 20 minutes. He was very comfortable dictating and was pleased with his accuracy.

Now it was time to log into Medent, the electronic medical record used by his practice, and give Dragon a try in the real world. Dr. West was just recently trained on Medent and hadn't yet committed his username and password to memory. I observed him reach for his cell phone to locate the information – found it. He logged into Medent, located a free text area for note dictation, turned on his microphone and began dictating. Everything worked fine – easy.

As a rule, as much as I'm tempted, during the first training session it is important not to introduce more information than the essential skills. Our 12 years of research show that if any features/voice commands other than essentials are introduced during the initial session, the learning curve and risk of frustration and potential abandonment of the software increases dramatically. In this case I made an exception because the use of Dragon came very easy to him and what I was about to show him would be an immediate timesaver with very little effort. So what did we do? We created voice shortcuts for both his Medent Username & Password.

This is how we did it -- In the Vocabulary Editor's Written Form field we entered Dr. West's password. In the Spoken Form field we entered the words ‘my password '. What this does is allow him to simply say "my password" as opposed to having to look it up and type it every time. We did the same for his username. From this point forward there will be no more searching for passwords, struggling to remember them or typing them incorrectly – just say it!

Customer Testimonial: Robert J. Lunn, Esq.

2012-02-29T09:53:00.000-05:00

“I was totally impressed with its efficiency and accuracy,” he says. “I’m a fairly fast typist but my typing can’t compare to how fast Dragon is.”

Hon. Robert J. Lunn, JSC

Supreme Court Justice (Ret.), Partner

Trevett Cristo Salzer & Andolina PC

Rochester, NY

“Our entire profession is built on time,” observes Robert Lunn, a retired judge now back in private practice. Productivity is measured by the proportion of your day invested in billable hours, with much of that work consisting of generating case-related legal documents. The more documents you can create and disseminate, the more productive you are. While Bob historically dictated documents into hand-held dictating equipment, which he then handed off to a secretary or assistant, in the last year Bob has become a speech recognition convert. “It’s a tremendous tool,” he states. Although he has been using Dragon Naturally Speaking officially since early 2009, this is not Bob’s first foray into speech recognition technology. In the late 1990s, while sharing “neighboring” chambers, Justice Ark encouraged him to give the latest speech recognition technology a try. “[The software] was bad,” he says. “It missed every other word and took so long to correct mistakes that it wasn’t worthwhile.” He opted to stick with his trusty hand-held Dictaphone.

At the urging of Achieve Results President Dana Abramson, however, Bob was persuaded to give speech recognition software another chance. Now, Dragon is completely unlike the original software Bob tried more than a decade ago.After a quick tutorial and some one-on-one training, Bob began using Dragon software. “I was totally impressed with its efficiency and accuracy,” he says. “I’m a fairly fast typist but my typing can’t compare to how fast Dragon is.”

In addition to changing how he creates documents, using his spoken voice rather than fingers to type, Bob found that he could eliminate a whole step in the document creation process. Rather than dictating work and handing it off for transcription, which he might get back hours or even days later, Bob says he does his own edits immediately. He can see the completed document without having to wait for someone else to return it, which saves time and money. Bob estimates using speech recognition eliminates about 1/3 of the time it used to take him to complete a document. “That’s a big deal!” he says. Plus, “the accuracy continues to improve as it learns your speech patterns”.

Interview by Marcia Layton Turner, Layton & Co

Dragon Medical Software for Dental Offices

2012-02-23T17:09:00.000-05:00

Using Dragon to create well documented policies and procedures significantly reduces staff training time and the immeasurable cost of office miscommunication.

If you are the manager of a dental office,

or manager of any office for that matter, you have to read this.

Earlier in the week I met Jo Anna Gagliardi for lunch. We had been asked to speak at an upcoming event sponsored by M&T Bank on the use of Dragon software by dental practices. Periodically, as a value for their customers, M&T Bank offers educational presentations. On March 1, there will be a presentation on how Dental practices can dramatically reduce cost and improve turnaround time for patient documentation using Dragon.

Over four years ago I provided Dragon training for Jo Anna, office manager for Canandaigua Dental Health. We thought we would meet for lunch to discuss the presentation to be held on March 1. It had been a long time since we had spoken and I assumed that Dragon was being used in her office similarly to how it is being used by most medical practices -- typically the doctors, themselves, dictate into an electronic medical record. Yes, they do some of that in Jo Anna’s office, but to a significantly lesser degree than she had originally anticipated -- and this is why.

Jo Anna initially used Dragon to create a series of automatic Post Procedure Notes, a function of Eaglesoft, the practice management software used in her office. This is something she had always wanted to do, but the thought of typing the initial notes was daunting and she just never found the time to do it. Using Dragon made it quick and easy. Within several weeks she had personally dictated a series of Post Procedure Notes that could be utilized by the dentist to create a detailed, timely patient note, requiring very little effort.

Jo Anna didn't stop there. Now that patient documentation had been streamlined and the cost reduced to virtually zero, other than periodically updating or modifying the Post Procedure Notes and creating a few new ones here and there --that job was done. Joanna forged forward using Dragon for the next daunting office documentation task --documenting office processes and procedures. Once again, a documentation task that she had always wanted to do, critical to a well-run office, but never had the time. That too is now done. Using Dragon to create well documented policies and procedures significantly reduces staff training time and the immeasurable cost of office miscommunication. There are not a lot of technology solutions where you can receive such a dramatic, return on investment so quickly.

If you are interested in attending the M&T presentation on March 1, let me know so that I can get you the details. And of course, Jo Anna will be there to talk in more detail about her experience.

Dragon Product Review: Internal Microphones

2012-02-18T13:40:00.002-05:00

There is no other microphone option more convenient, and less expensive, than an internal mic.

Yesterday I provided Dragon training to Natalie Lopasic, an ophthalmologist and eye surgeon with Northeast Eye Center in Latham New York. Dr. Lopasic is just getting started with the Medent EMR and a Fujitsu Lifebook tablet computer. Dr. Lopasic’s plan is to carry the Lifebook with her into the exam room when she meets with the patient.

When I arrived for her training session she was all set to go with a headset microphone. Based on experience I am a strong proponent against the use of a headset microphone. Using a headset microphone is the single, most common reason professionals have a difficult time incorporating Dragon into their workflow. It's just a pain in the neck to take on and off and in the case of Dr. Lopasic, it's just one more thing she needs to carry around with her. There seems to be a major misunderstanding that you get the best accuracy with a headset microphone. This simply is not true.

Under normal circumstances I would've recommended a Buddy FlamingoMic. It is the most convenient external microphone providing exceptional accuracy - not to mention, reasonably priced. I usually carry extra FlamingoMic's with me to my training sessions, but it was Friday, a busy training week and I was totally out of them. So what did we do? We gave the internal mic a try. It worked beautifully. The accuracy was exceptional. There is no other microphone option more convenient than an internal mic.

So, if you have a computer with an internal mic, definitely give it a try before investing in a fancy, expensive microphone option. It only takes a couple minutes to determine if it will work for you and if you’ll be satisfied with the accuracy.

Dragon Training Support: Beware of the Dragon Champion

2012-02-15T21:37:00.002-05:00

The challenge, the Dragon Champion is not indicative of the individuals that can benefit the most.

I hear the term "Dragon Champion" used often when Dragon software is being considered or implemented for larger institutions. The concept behind a Dragon Champion is that one individual will embrace the technology, become the on-site expert and be the catalyst for the purpose of stimulating adoption throughout the institution.

Sounds like a good idea right?

In theory maybe, definitely not in reality, here’s why.

As a rule, the individual identified as the Dragon Champion is either self-appointed or has volunteered to do so. They have taken on this endeavor either because they are fascinated with technology, gadgetry, have a lot of spare time, or some combination of these characteristics. This individual will invest whatever time necessary to familiarize themselves with every possible feature and capability of the software.

Typically one of two things frequently happen; the Dragon Champion reports back that it’s much too complicated. The time investment would outweigh the benefits. The second thing that could happen is that the Dragon Champion finds the features and capabilities fascinating and neglect to pay attention to documentation accuracy. They create the perception for outside observers that using Dragon requires too much editing of documents and is far too complicated to use. The challenge, the Dragon Champion is not indicative of the individuals that can benefit the most.

We live in a culture where quantity is often valued higher than quality. To gain significant productivity benefits from using Dragon software it is not about quantity, how many of the features and capabilities you're using. It's about quality, how well you use the features and capabilities that increase your personal efficiency.

A Dragon Champion, in most cases, is more scary and [financially] dangerous than an actual Dragon.

Dragon Training Support: Dragon Users Group Meeting - February 8, 2012

2012-02-11T10:08:00.000-05:00

For those of you who attended the Dragon Users Group meeting earlier in the week, I hope you enjoyed it as much as I did. I so much enjoy reacquainting with those who attend regularly and meeting those who are attending for the first time. Without fail, I always walk away learning something new, that's my favorite part. For those of you who were unable to attend, maybe we'll see you at the next meeting in May. Click to view more photos!

I thought I'd share some highlights of the evening. So, here we go…

Just getting started, getting acquainted and reacquainted

Nixon Peabody and the Rochester City School District sharing their

Dragon experiences. Great combination!

Dragon for Windows and Dragon for the Mac, David uses both. And he's good at it!

University of Rochester and Unity Health System, who's been using Dragon longer?

I would love to know what they're talking about.

"Now, if I could have your attention please we are going to

Explore the Power of the Vocabulary Editor"

It would be a whole lot easier if you just pronounced it, “Dr. La vig knee”

Wow, leave it to Tom --great suggestion.

“Sexy Ex Ee” is the spoken form for “3101(d)”.

I love watching people's reactions when I say it out loud.

Yes, there are a limited number of characters that can be used in the Written Form field of the Vocabulary Editor. We need to do a bit of research to determine how many.

I have absolutely no idea what they were talking about.
But I bet I could've learned something.

That works for me too, every time!

Dr. Mathew, the Buddy FlamingoMic raffle winner.

No more need for that annoying headset microphone at her home computer

The acoustic optimizer. To be discussed in more detail at the next meeting.

Getting a Dragon error message, I'm your girl!

There hasn't been one that I couldn't fix.

Next Meeting...sometime in May

Best smile of the Evening!

There is a direct correlation between a positive attitude and good accuracy.

No doubt Charlie's accuracy is fabulous!

Click to view more photos

Once again, many thanks to M&T Bank and Jodie Davis for sponsoring our event.

Dragon Training Support: Accuracy

2012-02-07T09:12:00.001-05:00

“What happens if I have a cold, will Dragon still be able to understand me?”

Later this morning I will be off to visit Dr. Charlene Conners, a primary care physician in Rochester New York. Yes she has been a user of Dragon software for several years, but the purpose of my visit is not Dragon related. I have a very bad sore throat. I can barely talk and when I do talk I sound more like a man than a woman. The change in my voice has not negatively impacted my accuracy in the slightest.

One of the most commonly asked questions of new Dragon users is, “what happens if I have a cold, will Dragon still be able to understand me?” The answer, absolutely. Good accuracy has more to do with maintaining a steady tone and pitch when you speak than it has to do with what you sound like.

Right about now, I am so lethargic I appreciate my Dragon software more than ever because I can just sit back in my chair and still get some work done.

Dragon Product Review: Insync Buddy StylusMic 7G USB

2012-02-04T12:46:00.000-05:00

The accuracy capability and quality engineering of the Buddy StylusMic microphone is undeniable.

When I walked in the conference room where Dr. Brian Marien, a surgeon at Community Surgical Group in Kingston Pennsylvania, was waiting for me to begin his Dragon training session, I immediately noticed the unopened Buddy StylusMic microphone sitting next to his laptop. With just a slight hesitation I asked, "do you have your heart set on using that microphone?" His response, "I really have not even thought about it. Why?"

The accuracy capability and quality engineering of the Buddy StylusMic microphone is undeniable (MSRP $299.99). It's the comfort and ease of use that concerns me. When I work with professionals to incorporate Dragon software into their workflow, my primary concern is that they maintain good accuracy and achieve the greatest productivity gain with the least amount of effort.

Before you purchase any microphone, do a bit of research. The wrong microphone choice can increase the learning curve, make using Dragon more burdensome, create unnecessary frustration and in many cases cause people to totally give up on the use of Dragon altogether.

So if you are considering a Buddy StylusMic microphone, before you purchase it, hold a standard size writing pen in your hand about 1 inch from the corner of your mouth. Make sure your hand remains steady. Don't let it wiggle. Hold it there for five or 10 minutes; maybe even an hour - however long would represent the amount of time you would typically dictate. If your arm has not fallen asleep, you use a laptop that requires a stylist for point-and-click and you prefer using a stylist over using a mouse, the Buddy StylusMic is worth considering.

What are your alternatives? You can never go wrong with a Buddy DesktopMic if you use a desktop computer (MSRP $179.99) or a Buddy FlamingoMic for use with a laptop (MSRP $99.99). As long as you are facing forward and speaking clearly you will get excellent accuracy --nothing to hold. Your hands are free to flip through papers, use the keyboard or mouse or whatever else it is that you do with your hands.

As for Dr. Brian Marien, he is using a Buddy FlamingoMic for his dictation and a mouse for the point-and-click tasks when documenting patient notes into the Medent EMR.

Dragon Training Support: Speaking Numbers

2012-01-30T18:03:00.001-05:00

She was having a difficult time comprehending how it worked. She needed to see it for herself.

Betty Andelman, an accountant in Rochester NY, and I have been professional acquaintances for longer than I have been consulting on the use of Dragon software. Over the last year Betty has become increasingly more curious about how Dragon works. Last week she came to my office to see how I personally use Dragon. She was having a difficult time comprehending how it worked. She needed to see it for herself. I started off by showing her I how I reply to an e-mail. Currently I am using the Buddy DesktopMini microphone. The accuracy is excellent, though I do have to lean into it more than I do the traditional desktop Buddy. Given the choice, for the way I work, the original Buddy will be back on my desktop soon. Then I showed her how I use Dragon to enter notes into my electronic contact management system, which is similar to an electronic medical record (EMR) that would be used by a medical professional or a Time Management System that would be used by legal professionals. Within a few minutes of watching me, it clicked, she got it. It was easy.

"How does it handle numbers", she asked -- an obvious question for an accountant. We opened a blank Excel worksheet, spoke some numbers and dollar amounts, it worked beautifully. When I shared with Betty one of my most favorite uses for Dragon, entering my credit card number when making a purchase online. Typing in the credit card number is burdensome, it is so much easier to speak it. Then Betty said, "can't you just tell it to enter the credit card number?" I stopped for a second, felt a bit silly that I hadn't done it already, and then said sure, of course you can. In less than 10 seconds I had a custom command called, Insert Credit Card.

This is how you do it.

Type or say the credit card number. Highlight it with your mouse or use the Select That voice command. Turn on your microphone and say, Make That a Shortcut. Give the command a name, click Save. From this point forward when you need that credit card number, you simply turn on your microphone, and say, Insert Credit Card.

That was definitely a time-saving suggestion. I use it all the time now. Thanks Betty!

Dragon Training Support: The Read That feature

2012-01-27T16:05:00.004-05:00

As an addition to his standard proofing process, Paul has now incorporated the Read That feature of Dragon as one of his proofing steps.

Paul Bush, president of Persuasive Communications, a solutions-based marketing firm headquartered in Pittsford New York, is now a flourishing user of Dragon software. Paul was a bit hesitant about using Dragon initially. He is very busy, has a demanding work schedule and the thought of introducing more technology into his workflow was daunting. But he's using it now and that's the important thing. Due to the nature of Paul's work, he still relies heavily on the keyboard and mouse. The Buddy FlamingoMic gives Paul easy access to Dragon when he needs it.

In addition to dramatically reducing typing time for Paul, limiting client liability for error is what Paul has identified as a significant benefit that he had not even considered. Due to the nature of his business, documentation errors cannot be tolerated. A single print error is very costly for both Paul's firm and his clients.

For Paul, using Dragon provides much higher initial accuracy over typing. As an addition to his standard proofing process, Paul has now incorporated the Read That feature of Dragon as one of his proofing steps.

The Read That feature will read literally what is printed in your document. That way if mistakes go unnoticed using traditional proofing steps, there is a good chance you will hear them as Dragon is reading to you.

To use the Read That feature, highlight the text that you would like read to you. Highlight it either with your mouse or use the Select That command. Click Audio on the DragonBar. Click Read That. Sit back, relax, and listen. If something doesn't sound right, fix it.

For Paul's firm, using Dragon definitely saves time over relying strictly on typing. Yet, reducing client liability for error is what Paul has realized is the most significant value for him.

Just a note, Paul is using Dragon NaturallySpeaking Premium v11. If you are using Dragon Standard or Dragon Home Edition, this capability may not be available.

Dragon Users Group Meeting - Wednesday, February 8 at 5:30 PM

2012-01-22T12:06:00.000-05:00

It's time again for another Dragon Users Group meeting.
Click here for more details.

The Dragon Users Group meetings provide a venue for professional Users of Dragon software to enhance their skill and knowledge through peer collaboration and feature demonstrations in a relaxed environment.

Yes, there will be food, drinks and of course, valet parking -- this is Upstate New York in February.

One more thing to keep in mind, the professionals who attend this meeting are typically not of the technical variety. They are doctors, lawyers and business people who simply want to increase their efficiency and productivity through the use of Dragon software.

We look forward to seeing you on Wednesday, February 8 at 5:30pm in Rochester, NY

If the location is not convenient for you, please let us know. With enough interest we will be able to hold these meetings in other cities.

Dragon Technical Support: Why the poor accuracy?

2012-01-19T17:12:00.002-05:00

The new computers were faster with more memory, why the poor accuracy?

Several months ago I provided Dragon training for Dr. Moy and Dr. Wheeler, physicians at Excelsior Orthopaedics/Hand and Shoulder Center of Western NY. They were originally trained to use Dragon on their Fujitsu Lifebook computers and everything was working fine. Recently they received their new Dell all-in-one computers. Now their accuracy, not so fine. By the time my guidance was solicited, needless to say, they were a bit frustrated.

The new computers were faster with more memory, why the poor accuracy?

When they received their new computers it was recommended, by their IT support staff, that they create a new Dragon User Profile. I most likely would've made the same recommendation. As I observed Dr. Wheeler dictate, no question, the accuracy was bad, real bad. I was confident it was not a user issue. Dr. Wheeler understood the importance of Real-Time Dictation Technique and used it proficiently. He was using the Buddy Desktop Mini microphone plugged into a USB port. It was connected properly. No problems here.

Uh..Uhmm, what now?

I thought I might have Dr. Wheeler created new User Profile, thinking it might give me some clues to the culprit. It did. Here was the problem; when the doctors created their new User Profile, instead of selecting the USB option as the dictation source. They utilized the default setting which is the Mic-in option. Mystery solved. We created a new User Profile using the USB dictation source. They were both back up and running in no time.

Technical Support: Keep it Simple

2012-01-11T12:49:00.004-05:00

Don't make using Dragon complicated, because it's not.

Michael Flagg works in the call center of TD Bank North in Lewiston, Maine. Michael was given a very fancy headset microphone, providing flexibility to easily switch between using Dragon and the telephone.

Fancy, yes. Complicated to the point of frustration, YES!!!!

My training session with Michael had been previously rescheduled 2 times due to technical issues associated with the headset microphone. During our training session, after about 45 minutes of unsuccessful attempts to create a user profile using the fancy microphone, Michael and I pooled our highly technical skills, unplugged the fancy headset microphone and plugged in the basic one that came with Dragon. In about 10 minutes he was up and running.

Michael, your patience and tenacity do not go unrecognized.

For those of you who are regular readers of the blog, you are well aware I'm a strong advocate for keeping it simple. In order for Michael to use Dragon efficiently, all he needs is a simple desktop microphone plugged into a USB port. Don't make using Dragon complicated, because it's not.

Training Support: Formatting Dates

2012-01-07T11:04:00.000-05:00

The default setting in Dragon is set to produce the written representation of the date as it is spoken. It also provides the greatest flexibility when dictating dates. For most people this works fine.

For those of you who received your initial skills training from me, when dictating dates, you would have learned to speak the way you want the date to appear in your document. For example; if you said, January seven twenty eleven (in a single utterance), January 7, 2011 would appear in your document. If you said, one slash seven slash eleven, the result would be, 1/7/11.

Why do I teach this way? The default setting in Dragon is set to produce the written representation of the date as it is spoken. It also provides the greatest flexibility when dictating dates. For most people this works fine.

For Dr. Leela Mathews, a physician affiliated with Unity Health System, this was not efficient. It was not natural for her to speak the slashes when she was dictating dates. She simply wanted to say, one seven eleven and have Dragon format the data appropriately for her. By modifying the default setting this could be accomplished.

For Dr. Mathews this worked because of the type of work she does. As a rule that is the way she formats dates. If there is variation in terms of how you need to document dates, it's probably best to leave the default setting as is. But just know, you do have control over modifying the default setting if that will allow you to speak more naturally.

Hope you're enjoying "spring" in January!

Training Support: Spaces following a period

2012-01-04T15:01:00.003-05:00

Many of us were taught to insert 2 spaces following a period at the end of a sentence. When did the rule change?

As I was leaving after providing several days of Dragon training for Robert Lennon, a supervisor at Montgomery County DSS in Fonda New York, and his staff, he caught me as I was walking out the door and said, "Maybe I'm old-fashioned, but I like two spaces following a period. Can the software do that?”

As a default, Dragon is set to insert one space following a period at the end of a sentence. This default setting follows the grammatical rules based on the Chicago Manual of Style. But don't worry, it's just the default setting, you can change it. Click Tools on the DragonBar…Click Formatting Options (in some editions of Dragon it's referred to as Auto-Formatting Options)… Check Insert 2 spaces after period. Now, much better. Robert's happy, I'm happy, and everyone that prefers two spaces after a period can be happy too.

Many of us were taught to insert 2 spaces following a period at the end of a sentence. When did the rule change? I found an excellent explanation as to why this rule has changed on the Quick and Dirty Tips website. Here it is...

Two Spaces After a Period--The Old Way

Here's the deal: Most typewriter fonts are what are called monospaced fonts. That means every character takes up the same amount of space. An "i" takes up as much space as an "m," for example. When using a monospaced font, where everything is the same width, it makes sense to type two spaces after a period at the end of a sentence to create a visual break. For that reason, people who learned to type on a typewriter were taught to put two spaces after a period at the end of a sentence.

One Space After a Period--The New Way

But when you're typing on a computer, most fonts are proportional fonts, which means that characters are different widths. An "i" is more narrow than an "m," for example, and putting extra space between sentences doesn't do anything to improve readability.

Although how many spaces you use is ultimately a style choice, using one space is by far the most widely accepted and logical style. The Chicago Manual of Style (1), the AP Stylebook (2), and the Modern Language Association (3) all recommend using one space after a period at the end of a sentence. Furthermore, page designers have written in begging me to encourage people to use one space because if you send them a document with two spaces after the periods, they have to go in and take all the extra spaces out.

2011 Highlights...Happy New Year!

2011-12-31T09:25:00.001-05:00

The year 2012 may be the year of the Dragon, but for users of Dragon software 2011 wasn't too shabby.

Actually, 2011 was a fabulous year for professional users of Dragon software. A turning point year you might say. For whatever reason; faster computers, more acceptable microphone options, less resistance to change, the economic need to be more productive or just plain old-fashioned inertia, the use of Dragon software by professional users grew exponentially in 2011.

Thanks to the input of so many individuals, all of us can benefit by being more efficient with the use of Dragon. And, special thanks to Felisa Colón, a caseworker at New York Foundling Hospital in Queens, NY, who was the inspiration behind the theme for this blog post, The Year of the Dragon.

Here are some highlights from 2011…

There appears to be a notable misunderstanding that you get better results/accuracy from a headset microphone. This is simply not true. We no longer have to wear those silly headset microphones. - Posted on Saturday, December 10, 2011

How do I know if they’ll make me more efficient if I don't even know what they are? Benedene was the inspiration behind the blog post category of Voice Commands. - Posted on Tuesday, July 26, 2011

When it comes to technical issues, remember most times, the solution is simple, just not obvious. Thanks Elena! - Posted on Thursday, June 23, 2011

How is the Correct That command like a fad diet? Don't make it difficult, because it's not. - Posted on Thursday, November 24, 2011

Lorraine reminded us of the importance of the Show Dictation Box command. This should be in the voice commands repertoire of every Dragon user. Thank you Lorraine! - Posted on Tuesday, October 11, 2011

Nuance, the manufacturers of Dragon, released Dragon Medical Practice Edition which replace Dragon Medical version 10. Let me tell you what I did notice that was different, and it wasn't much. - Posted on Tuesday, October 4, 2011

Do you recall Oliver's enthusiasm prompting the question, What Is Your Productivity Hot Button? - Posted on Sunday, November 13, 2011

Your Dragon stopped working? Restore it immediately. Dr. Waheed reminded us of the importance of the Restore Feature. - Posted on Friday, May 27, 2011

My favorite post training follow-up e-mail response; In today's economy, your own personal secretary? Who would've thought. Mary, I am so pleased you're pleased. - Posted on Saturday, November 19, 2011

Having trouble finding what you want on the keyboard? Sometimes it's just easier to say it. This is one I see frequently printed and tacked or taped for easy viewing. - Posted on Tuesday, September 20, 2011

Our final highlight for 2011, thank you so much Dr. Genier. Just a quick reminder regarding how important it is to backup your User Profile. - Posted on Tuesday, August 30, 2011

Before you ask, YES, absolutely all of the entries in this blog will be spoken, not typed. Truthfully, I do not think I would have the patience to be responsible for a blog if I had to type it -- it would be slow, FULL of mistakes and frankly, who has the time. With that said, I feel it is important to make the time because there is so much mis-information about how to effectively use speech recognition software [Dragon]. I have personally been using Dragon for over 11 years. I don't use it because I have carpal tunnel or because I do not type well, I use it simply because I want to get the maximum amount of work done in the least amount of time. My very first Dragon Users Group Blog Post. - Posted on Monday, May 16, 2011

Like it or not technology is moving all of us in its direction. In the business world, it's not a choice any longer.

Please know how much I appreciate your confidence in my experience and ability to provide accurate information on the efficient use of Dragon software.

My very best, Dana

Industry-Specific: Casework

2011-12-24T08:49:00.002-05:00

Caseworkers are inundated with mandatory documentation necessary to support their efforts. The use of Dragon allows them to spend less time on paperwork and more time with people.

This afternoon my husband and I will be enjoying our Christmas Eve with a young mother and her two daughters. We were introduced to Joanne and her daughters through a family sponsorship program made possible by the Urban League of Rochester. This will be the fourth year that we spend with Joanne and the girls.

Every year we have provided them with a few gifts -- a coat, boots and gloves for each of them. Several days ago I called Joanne to make sure that she was expecting us this Christmas Eve. I could hear the girls giggling and asking questions in the background. I called Joanne to see if there was anything specific that the girls wanted. I heard her say to the girls, “it's Miss Dana, she wants to know if there is anything special that you want for Christmas". I heard the oldest daughter, in the background say, "I do not want anything. I just want to see them". As my heart swelled and my eyes filled with tears, I heard Joanne say with pride filled appreciation, "I do not need anything either. I have taken very good care of the coats you have given me, they are in good shape. I do not need another one”.

So, what does this have to do with Dragon software?

I spend a considerable amount of time providing Dragon training to caseworkers in organizations that provide services and support to people like Joanne. Their passion and dedication provide hope and opportunity for a population of people who would otherwise be left behind. These caseworkers are inundated with mandatory documentation necessary to support their efforts. The use of Dragon allows them to spend less time on paperwork and more time with people.

I spent several days during this holiday season providing Dragon training to a group of caseworkers at Montgomery County Department of Social Services. Linda Sheldon is one of the many caseworkers who spent much of her own time ensuring that every child she oversaw not only received a gift, but received something they had hoped for.

The assistance and guidance provided by these caseworkers is invaluable. Their dedication and passion provide opportunities that these individuals would otherwise not have. Opportunities that allow people like Joanne to stand tall with pride.

My wish for you is for a healthy and happy holiday season. My very best, Dana

QuickTip: "feel very awkward"

2011-12-21T17:34:00.003-05:00

Madison County Department of Social Services
Dragon Software Edition: Professional v11

Microphone: Logitech USB Desktop

Days Following Training: 1

Linda's Comment:

Dana:

I'm speaking this message to you. I feel very awkward using this software so far. However I'm giving it a go. Thanks for spending the time introducing me to Dragon.

Sincerely, Linda

My Response:

Morning Linda -

Thanks for letting me know how you're doing.

Just so you know, the "feel very awkward" is experienced by almost everyone when they first start using Dragon. Especially in an environment like yours where there are always other people around.

Just keep in mind, for most people, it really isn't much different than talking on the phone. The sound level and content of what you are speaking is usually very similar.

And remember, it does not replace your keyboard so don't feel you have to use it all the time for everything. Just use it when you are comfortable and it makes your work easier. Dana

This e-mail was spoken, not typed

Technical Support: The Dreaded Lag

2011-12-18T10:02:00.009-05:00

One of the biggest potential frustrations using Dragon is the "dreaded lag", the delay between when you speak and when the words appear on your screen.

Yesterday I provided training to four caseworkers at Yates County DSS in Penn Yan, New York. During their individual training sessions, with all of them, I observed a lag from when they spoke to when the words appeared on the screen. From a training perspective this is an issue that I pay close attention to. For some it can be the culprit of frustration that can lead to total abandonment of Dragon. No worries, there are things that can be done about it.

Sarah Laun, one of the caseworkers who is proficient with the keyboard, realized the lag immediately. WelI, I don't think she recognized it necessarily as a lag, she just felt, "I can type faster than this". Candidly, in most cases even with the lag there are very few people that can type faster than they can speak using Dragon. In most cases it is simply perception because when typing it requires physical movement that makes us feel we’re accomplishing more --Not really. Regardless, the lag is very frustrating. There are things you can do about it.

If you are experiencing the "dreaded lag" these are the things to look into and in the following order;

1. Make sure you are speaking clearly, naturally and with "authority". Not loud, but with control. If you're not sure, have a colleague observe you. Sometimes it's difficult to do on our own. This causes the lag because if you're not speaking clearly it takes the software more time to try to figure out what you're saying and in a lot of cases it still gets it wrong which makes it that much more frustrating.

2. Confirm that your hardware meets recommended hardware requirements. If you have an older computer, a slow processor or not enough memory, this could cause the delay.

3. If you have not shut your computer down in a while, say a couple days, do a complete shutdown. Not just to restart but a complete shutdown. You might be pleasantly surprised at how that alone can speed things up.

4. If you have a lot of applications open that could also be a culprit. But typically just closing the applications isn't enough. You will also have to do a complete shutdown.

5. This one may sound technical but it really isn't. When creating your User Profile there is a default setting referred to as Best Match IV. This option is not obvious when creating your User Profile. This setting has to do with the hardware you're using. Using the Best Match IV uses a lot of computer processing power that in most cases is not necessary. You have the option to select the Best Match III that does not require as much computer processing power. Because of this, in many cases it will resolve the "dreaded lag" issue without the need to invest in new hardware.

Hope this helps those of you who are struggling with the "dreaded lag". Maybe even those of you who have totally given up will give Dragon another try.

QuickTips: Ambient Noise

2011-12-16T08:30:00.004-05:00

Albany County DSS

Dragon Software Edition: Professional v11

Microphone: Logitech USB Desktop

Days Following Training: 1

Matthew's Comment:

I used it lightly so far with great success. The one problem I have encountered is ambient noise confusing it while I use it.

My Response:

I love that response "lightly".

Regarding the ambient noise, remember the greater the contrast between what you sound like and the surrounding noise, the better the software will be able to understand you. Make sure you're speaking clearly with "authority". If all else fails, lean more into the microphone.

Have fun!

This e-mail was spoken, not typed

Product Reviews: Buddy DesktopMini

2011-12-10T12:40:00.003-05:00

There appears to be a notable misunderstanding that you get better results/accuracy from a headset microphone. This is simply not true.

Selecting the appropriate microphone for use with Dragon is so much more important than most people realize. Without a microphone that is comfortable and easily accessible, the chances of Dragon becoming a can't live without productivity tool is so often unrealized.

I personally introduce sometimes as many as 30 new individuals per week to the use of Dragon software, and I assure you a large percentage of them work in an environment that is anything but quiet. It amazes me at the number of people that have the perception that they will get better accuracy from a headset microphone and have been resistant to using Dragon because they do not want to wear one. There appears to be a notable misunderstanding that you get better results/accuracy from a headset microphone. This is simply not true.

But what about a noisy environment?

If you are using a microphone with certified noise canceling capability it does not matter if it is a headset, handheld, or desktop microphone. The individual using Dragon may have difficulty concentrating because of background noise. But I assure you, a quality noise canceling microphone does not.

My good friend Parmod Gandhi, CEO of InSync Speech Technologies, Inc., the brilliance behind the Buddy microphone product line; the Buddy DesktopMic and the Buddy FlamingoMic, has released a new addition to the product line -- The DesktopMini. This unobtrusive desktop microphone utilizes the same patented FilteredAudio™ technology providing unsurpassed noise canceling capabilities. The microphone is reasonably priced at $69.95 as compared to the original Buddy Desktop Microphone priced at $179.99.

Thanks to inventors like Parmod, more and more professionals are benefiting from the productivity benefits of Dragon. Thanks Parmod!

Training Support: Step-By-Step Commands

2011-12-03T11:08:00.001-05:00

"Is it too much to ask to have the software automatically put in the new paragraphs for me?"

Several weeks ago on a relaxed Saturday morning, I worked with Dr. David Kopp, an internist at Cross Keys Internal Medicine in Fairport New York. Dr. Kopp is not yet using an electronic medical record, so creating custom commands was critical for developing an efficient workflow process for him -- when using electronic medical records the workflow is already defined for you. We worked together to create templates and shortcuts, creating a workflow process to streamline documenting his patient notes.

We created several custom commands; a template for his office visit, shortcuts for normals and a shortcut for his signature at the end of the note. When using this process, it required Dr. Kopp to say, New Paragraph 2 times before saying Input Signature. Dr. Kopp was pleased with the process that we set up. Though, he had one request, "is it too much to ask to have the software automatically put in the new paragraphs for me?" I thought for a moment and remembered the Step-By-Step Command feature of Dragon. Thanks to Dr. Kopp's creative thinking he now has a command that presses the enter key twice and then inserts his signature simply by saying Insert Signature.

The step by step command feature of Dragon allows you to capture a series of keystrokes and text that can be activated by voice. In the case of Dr. Kopp we created a command that had three steps and was activated by saying, Insert Signature.

Latoya Barley a caseworker for Monroe Department of Human Services had a similar need that could be satisfied using the step-by-step command. When working with Latoya she expressed to me that if she could open existing documents that she used frequently, using her voice, it would save her a considerable amount of time. At the time, I did not think of showing her the step-by-step command function. Thanks to Dr. Kopp for reminding me of this very useful feature. I will be sharing this information with Latoya and I am sure many others.

Much thanks to Dr. Kopp!

Note: The Step-By-Step Command feature is only available in the Professional, Legal and Medical editions of Dragon software. It is not available in the Home or Premium editions.

Training Support: Dictation Technique

2011-11-27T09:37:00.001-05:00

A Banker and a Dragon. Now that's an interesting combination.

Last night while enjoying a cigar at Havana Moe's Cigar Lounge on East Avenue in Rochester, an infrequent occasion, but one admittedly I enjoy. I met Noel Donnelley, a Vice President for Community Bank in DeWitt, NY. Pleasant casual conversation led to, what else, the topic of Dragon. With bubbling enthusiasm, which was interesting to see come from such a conservative looking fellow, Noel shared with me that he has been using Dragon for a very long time. "I spend so much time in the car", he said, "I keep my laptop turned on in the back seat, I use my Bluetooth and generate pages and pages of necessary documentation while I'm driving." My reaction was a combination of relief, that he wasn't looking at the screen while driving, and concern for his accuracy. My instinctive response, "how is your accuracy?" "Not bad", he replied. "What's not bad to you?" I asked in response. "About 80%" he replied. My response, "that would require a lot of editing". “But it's still better than having to type it or relying on someone else to do it for me”, he said with assurance.

Not too long ago I had a similar conversation with Dennis Nowak, Intergovernmental Relations Coordinator at Suffolk County Department of Social Services. Dennis, like Noel, relies heavily on Dragon strictly for the purpose of drafting documentation. Their conscious intention is the use of Dragon to capture their thoughts, not to generate final documentation.

The important thing to keep in mind is that both Dennis and Noel have made the conscious decision that their purpose for using Dragon is strictly for generating draft documentation. Why is that important?

There are two different dictation techniques when using Dragon; Traditional Dictation and Real-Time Dictation.

Traditional Dictation is just what it sounds like. It is the same technique used for dictating into a handheld recorder. The individual speaking may or may not speak clearly. They are not concerned with the speed at which they speak and they are not concerned with accuracy. Their primary concern is capturing the thoughts. The speaker typically relies on a transcriptionist to interpret the dictation into a final, accurate document.

Real-Time Dictation is when the speaker is responsible for the final document, email is a good example. It is important to speak clearly, naturally and correct mistakes as you go along. If you do not do this you are teaching the software, your Dragon User Profile, that it's okay to make mistakes. And you will continually struggle with accuracy.

Can you have both?

Sure you can. But make sure that you have two separate Dragon User Profiles. Use one profile when drafting documentation and a different profile when accuracy is the priority.

Training Support: Maintaining Good Accuracy

2011-11-24T13:01:00.005-05:00

How is the Correct That command like a fad diet?

The holiday season is upon us once again. From now to the end of the year there will be parties, family gatherings and all types of activities revolving around tantalizing food and alluring cocktails. Statistically the average person will put on 5 to 10 pounds between now and the end of the year. We know it. We complain about it. Yet most of us continue to do it year after year.

Come January we will be inundated with scientifically proven advice; articles, books and conversations revolving around dieting and how to lose that weight we gained over the holiday season. We will invest a considerable amount of time and money and most likely will get frustrated and give up before we lose the weight.

So, now what does any of this have to do with Dragon?

There are features in Dragon that I would compare to a fad diet. Functionality built into the software to make us feel like were improving our accuracy. In some cases the features have merit, but at what cost?

Let's take the Correct That command for example. Yes, it can be very effective if used properly. But the time and effort it takes to learn how to use it properly, and then the amount of time it takes to actually use it, is one of the biggest factors contributing to the comment I hear so often, "my documents take too long to edit". Which in many cases lead to frustration and total abandonment of Dragon.

The Correct That command, like a fad diet isn't necessary if you minimize the ineffective behavior in the first place. If you eat sensibly and get a little bit of exercise regularly there's no need for a fad diet. Speak clearly and correct your mistakes as you go along, there is no need for the Correct That command.

Give up the Fad

Note: For those of you who have received training from me personally you may not even be aware of the Correct That command. That’s a GOOD thing!

Testimonials: Mary Mcclure, Erie County DSS

2011-11-19T13:12:00.003-05:00

In today's economy, your own personal secretary? Who would've thought.

Mary McClure, a caseworker at Erie County Department of Social Services never would've imagined that she would be provided with the secretary. Well, maybe not an actual secretary, but the next best thing. Dragon.

Several days after providing Mary with Dragon training I received the following e-mail from her;

Hi Dana,

I used it for some long dictation- I felt like I had a secretary- awesome!

Mary

I have to admit, Dragon will not bring you coffee or pick up your dry cleaning. But it actually offers benefits that a secretary doesn’t. It types anywhere between 95 to 150 words per minute with excellent accuracy (if you maintain control and don't yell or get frustrated with it). Works tirelessly and is always there when you need it.

In today's economy, your own personal secretary? Who would've thought.

Training Support: Immediate Productivity Benefits

2011-11-13T11:36:00.003-05:00

What is your Productivity Hot Button?

His enthusiasm was contagious. Oliver Olwyn, a.k.a. 007 is a case planner for New York Foundling Hospital in the Bronx. Oliver was so excited to start using Dragon. He was not on the training schedule but was hoping we could fit him in. I was most definitely not going to be the one to squelch that enthusiasm.

Oliver had a very captivating accent. An interesting combination between British and South African. Dragon and Oliver will get along just fine, but it will take a bit of time for them to get comfortable with each other. Without question Oliver was convinced that Dragon was going to significantly increases productivity and he was going to get the most out of it.

For most people, when they first start using Dragon for dictation it is awkward. The cause of the awkwardness varies among individuals. For some, it's talking out loud with others around. For others it's maintaining a steady tone and pitch which is critical for achieving good accuracy. Others, their pronunciation of specific words is different from what Dragon is expecting (an accent). And for others they are so used to "thinking through their fingers", they need to rewire how they think before they talk. No question, for most people it takes time to get comfortable using the software before it can become a productivity tool. With that said, that does not mean you cannot begin increasing productivity immediately using other features of the software. Custom Commands are the quickest most effective way to do that.

When I got to the point where I explained to Oliver how to create custom commands you could just see the ideas churning in his head. We had hit Oliver's "productivity hot button". Oliver shared with me that he has 11 clients that he works with on a regular basis. I am going to create a custom command for each one of them that contains all the information that does not change from visit to visit. Currently I have to retype it every time. Can I do this? My response, great idea!

Oliver, thank you for the creative thinking. I have already shared it with others. This is a great way to achieve productivity benefits using Dragon immediately.

Training Support: How to improve accuracy

2011-11-10T07:53:00.006-05:00

"It is taking too much time to edit, but I'm still trying."

Several weeks ago I provided training for Karen Schwenger a caseworker at Monroe County Department of Human Services. A week later I received an e-mail from Karen saying that, it is taking too much time to edit, but I'm still trying.

When I receive responses like that, it's a telltale sign that "Real-Time Dictation Technique " is not being used effectively.

When you first start using Dragon it might feel awkward. It might take a bit of time to figure how to work it effectively into your personal workflow. But if you feel it's taking too much time to edit, you're doing something wrong. If you keep using it the same way, don't expect it to get better. Time is not going to make a difference.

If you effectively use Real-Time Dictation Technique you will love your accuracy. If not, you won't!

Training Support: Reduce the Learning Curve

2011-11-06T09:46:00.003-05:00

A positive attitude reduces the learning curve

One of the most commonly asked questions before an individual embarks on the use of Dragon software is, how long does it take to learn?

There are many factors that play into the length of the learning curve. But by far, attitude makes the most significant impact.

Let's take Kate for example. Kate Frost is a caseworker for Nassau County DSS. Kate is easy-going and open-minded, not to mention a fabulous smile. When I arrived at Kate’s cubicle for training she was welcoming, accommodating and looking forward to getting started. Kate was dictating, with accuracy into the state database within 20 minutes.

Do you want to dramatically reduce the amount of time it takes to learn how to effectively use Dragon?

Smile!

Training Support: Don't Be Stubborn

2011-10-29T10:32:00.005-04:00

To ensure efficiency and productivity it's so important not to get hung up using voice commands. Don't catch Summit Fever.

I received a call from Robyn Ruffier, practice manager for Dr. Peter VanBrunt, an internist for over 34 years in Rochester New York. I had provided training for Dr. VanBrunt several weeks earlier. Robyn was concerned because it was taking Dr. VanBrunt considerably more time every day to complete his notes. My initial response to Robyn, does Dr. VanBrunt want to continue using Dragon? Her response without hesitation, without a doubt, I want him to continue using it! We no longer have to wait for the notes. They are immediately available in the patient’s chart.

On a side note, Dr. VanBrunt is not yet using an electronic medical record. He is dictating directly into Microsoft Word, printing out the note and putting it in a paper chart.

I met with Dr. VanBrunt earlier this week to see if there was anything I could do to improve the situation. When I met with him I observed him dictate a note. His use of Dragon was excellent. His speech was steady and fluent. He was in control with a comfortable pace. I was perplexed. Then, as I thought I would have to leave without offering any useful advice. I heard him say, Number That. Nothing happened. He said it again. Nothing happened. He said it again and again. He stopped for a moment and said, I use it all the time. It automatically numbers for me. I really like it. He turned on his microphone, and continued with his attempts.

Ah Ha! The culprit. Summit Fever

I commented to Dr. VanBrunt, when using Dragon in order to ensure efficiency and productivity it's so important not to get hung up using voice commands. If it doesn't work the first or second time, use your mouse and keyboard to accomplish what you need and move on. If not, you will be amazed at how much time is lost. His comment, I know, I'm stubborn. I get Summit Fever. I asked him, what is Summit Fever? It is an anticipation of mountain climbers to reach the top of Mount Everest ignoring the signs of danger which will ultimately inhibit the achievement of the quest.

In comparison, that is exactly why Dr. VanBrunt was taking so long to complete his notes. Not because the software wasn't working. Not because he did not know how to use it efficiently. Because he caught Summit fever.

My recommendation, try not to catch Summit fever in the first place. But if you do, cure it quickly.

Training Support: Alternate Spoken Form

2011-10-22T11:07:00.003-04:00

Speaking out loud with other people around is difficult enough. Have some fun with it!

Bernadette McGilveary, is a caseworker for Monroe County Department of Human Services. At times it is necessary for her to use profanity in order to accurately document client conversations. Typing these words in her reports isn't a big deal. Speaking them out loud, well that's a little uncomfortable.

We came up with a solution.

The Vocabulary Editor, the feature we use for adding words to the vocabulary, has an alternative spoken form function. It allows you to say one thing and have something different appear in your document. Very cool!

This is how it works.

Turn on your microphone and say, Open Vocabulary Editor. Type the word that you want to be written in your document in the Written Form field. Type what you want to speak to make it appear in the Spoken Form field. Click Add. Click Train. Click Go. Speak the word. Click Done. You did it!

When I went through this with Bernadette, we typed the word Bullshit in the Written Form field and Sweetie Pie in the Spoken Form field. From now on, when Bernadette says, Sweetie Pie. The word, Bullshit will appear in her document.

Speaking out loud with other people around is difficult enough. Have some fun with it!

Voice Commands: Show Dictation Box

2011-10-21T10:11:00.007-04:00

Sometimes Dragon doesn't play nicely with other applications. There's a workaround.

If you find yourself in a situation where you are required to use an application where Dragon does not work well, using the Show Dictation Box voice command can help.

This is how it works.

Position your cursor in the application where you would like your words to appear, where you would typically type or dictate.

Turn on your microphone and say, Show Dictation Box.

The dictation box will appear. Go ahead and dictate. When you are done, click the transfer button.

Voila! Your dictation will be automatically pasted where you left your cursor.

Dragon Medical Software Testimonials: V. Brian Gagliardi, DDS

2011-10-15T09:47:00.005-04:00

What used to take 60 minutes or more to write up a policy or procedure now takes as little as two minutes.

V. Brian Gagliardi, DDS
Canandaigua Dental Health
Canandaigua, NY

Dentist Brian Gagliardi used to have 40-100 patient charts lying on his desk awaiting handwritten notes, says his wife, practice administrator Jo Anna Gagliardi, who shares that desk. “His desk was my desk and I didn’t have a place to work,” she explains. The reason those charts routinely piled up was that, “We’re both one-finger typists,” says Jo Anna, with the best intentions of typing up the notes, but because Brian knew how long it would take him to type them, the charts piled up.

Fortunately the Gagliardis implemented Dragon Naturally Speaking at their practice, Canandaigua Dental Health (www.canadaiguadentalhealth.com), and Brian’s desk is now visible. “Now he speaks the notes right after each patient,” says Jo Anna, making the information visible to everyone who logs into the electronic records system; previously hardcopy patient charts had to be retrieved to be read.

What is even more remarkable is the speed at which those notes are being completed – mere minutes. Speech recognition software has “90% better accuracy than my one-finger typing,” says Jo Anna, who reiterates that there have been no issues with accuracy or terminology. So far there have been a total of three words she has had to add, all the others were built right in.

The Gagliardis use a desktop microphone or a headset, depending on which computer they happen to be using. And while Jo Anna uses speech recognition for almost everything, including routine correspondence, she’s seen the biggest benefit from using it to write practice policies and procedures. What used to take her 60 minutes or more to write up a policy or procedure now takes her as little as two minutes.

“I used to dread writing policies and procedures. It hated it, it was so tedious!” she says. “I had a never-ending list of policies to write up, such as ‘How to scan an x-ray into a digital database.’ Now I can do a policy in two or three minutes,” she says.

As for initial concerns about compatibility with their computerized charting system or other programs, there have been “no issues at all.” In fact, Jo Anna has found that in addition to saving her considerable time, Dragon is also helping her get more organized, by being able to whip through her workload rapidly. “Everyone should use it,” she says.

Technical Support: Spacing and Capitalization is Inconsistent.

2011-10-11T09:09:00.005-04:00

Actually it's pretty easy. Dragon has a voice command which allows you to dictate with consistency in virtually any application.

If you are experiencing inconsistency with spacing and capitalization, Dragon may be incompatible with the program you're attempting to dictate into. No worries, we have a workaround.

I see this issue commonly when dictating into lesser-known EMR (Electronic Medical Record) Systems. Most recently, I experienced it while providing training for New York State caseworkers who are dictating into an electronic documentation program called Connections.

Why is this happening?

It requires some pretty sophisticated programming for Dragon to play nicely with other software programs. In order for this to happen the programmers from the Dragon company, Nuance, and the third-party application in which we are dictating, need to do joint programing to make sure that their programs work well together. As we can all imagine this takes time and costs money. So, not every third-party program out there has done this. The result, inconsistent results when dictating.

What do you do about it?

Actually it's pretty easy. Dragon has a voice command which allows you to dictate with consistency into virtually any application. Simply, it's an automated cut-and-paste feature. This is what you do. Make sure your cursor is positioned where you want your dictation to go. Say, Show Dictation Box. A dictation window will appear. Go ahead and do your dictation. When finished, click the Transfer button. Voilà, your dictation will be placed where you left your cursor.

Lorraine Romanucci-Stevens, the Connections facilitator for New York State Department of Children and Family Services reminded me of the importance of this voice commands. This should be in the voice commands repertoire of every Dragon user. Thank you Lorraine!

Product Review: Logitech USB Desktop Microphone

2011-10-09T11:42:00.005-04:00

For many it actually encouraged a natural position alleviating the concern that they were distracting their colleagues. Who would've thought!

Our company was recently awarded a New York State contract to provide Dragon software training to 764 caseworkers affiliated with the New York State Department of Children and Family Services. The use of Dragon software by New York State caseworkers, if used effectively, will significantly reduce the cost associated with mandated documentation. We are now two weeks into the project and without question this is the most rewarding work that I have ever experienced in my training career. I have the opportunity to work with a group of very smart, hard-working and passionate individuals whose personal effort have a direct impact affecting the quality of life for children and families within the state of New York.

This particular group had previously been provided Dragon training, but did not achieve the desired results due to the reasons commonly experienced; unacceptable accuracy, long frustrating learning curve, non-conducive work environment, inappropriate microphone selection, etc. The reasons for frustration and abandonment associated with the use of Dragon software are typical throughout all professions.

So, what does all of this have to do with the Logitech USB Desktop Microphone?

The Dragon project coordination team at New York State Department of Children and Family Services made the decision to give the caseworkers a microphone option. The caseworkers could choose between the headset microphone that came with the software and the Logitech USB Desktop Microphone. That decision in and of itself addressed two of the issues that contributed to the less than desirable results of the first training attempt. Most professionals are uncomfortable wearing a headset microphone. It is awkward, takes time to get situated, and candidly most people just feel silly wearing it. The Logitech Desktop alleviated all of that. Secondly and what I found most fascinating was that it addressed the non-conducive work environment issue. Because the caseworkers work fairly close with one another it can be fairly noisy. There is significant concern with distracting one another. With the Logitech Desktop Microphone, in order to achieve good accuracy, you do have to lean into it. For many it actually encourage a natural position alleviating the concern that they were distracting their colleagues. Who would've thought!

I get such a kick out of the responses following training; “This is all that's to it? This is easy" … “I love it!” … “This was so much easier than the first time” … “This is fun!” … “Now I can finally get caught up with my paperwork. Thank you!”

So far so good, we have provided 23 caseworkers with Dragon training. 741 more to go!

Dragon Medical Product Reviews: Dragon Medical Practice Edition

2011-10-04T09:32:00.002-04:00

Let me tell you what I did notice that was different, and it wasn't much.

A few days ago I provided training for Dr. Anthony Ragusa, an internal medicine physician in Rochester New York using the Medent EMR system. This was my first time providing training Using Dragon Medical Practice Edition. FYI - if Nuance, the makers of Dragon, had maintained consistency with their naming convention, we would be referring to this new product as Dragon Medical version 11.

Candidly, I was not too concerned teaching Dr. Ragusa to use this new software. I have been providing Dragon training since version 4 and other than the look of the DragonBar and the rearrangement and modifications to some of the features, the software from a fundamental perspective really hasn't changed much. To emphasize my point, the training method we developed over eight years ago continues to work flawlessly with Dragon Medical Practice Edition.

Let me tell you what I did notice that was different, and it wasn't much.

The first thing I noticed had to do with accuracy. Initially, I was not impressed. During all my training sessions one of the first things I do after explaining the importance of proper technique for achieving and maintaining good accuracy, I have the individual being trained to do a particular dictation that I use in every training session. Because of the way I instruct them to do this, virtually every time the dictation is flawless. This time, not so much. Three out of the five utterances had misrecognitions. Obviously I did not make a big deal of it during the training session and Dr. Ragusa didn't know the difference --but I was concerned. As we continue dictating, very quickly, with proper technique, the accuracy stabilized. So in the big picture everything was fine.

The only other thing I noticed, the Scratch That command behaved very differently. It behaved very similar to an Undo function, undoing the last action performed as opposed to strictly removing the last spoken phrase. Not sure yet if I agree that the change offers any value, the verdict is still out.

Other than that, the software behaved the same, that's a good thing.

For those of you who have read the sales and marketing material for Dragon Medical Practice Edition you might be wondering about all the new stuff that they talk about. From an efficiency and productivity perspective, mostly just fluff.

Voice Commands: Quotes That

2011-10-03T09:03:00.003-04:00

I said, Quotes That. Wow, didn't know I could do that.

The Little Theatre Film Society’s annual celebration is this evening and I wanted to get my work done so that I could head over to the theatre this afternoon to help set up. As I was rushing through responding to my morning e-mails there was one from Kym Meisner, a friend and colleague, who will be leaving in a couple days to attend the professional development class, Strategic Coach. Prior to attending she was tasked with asking colleagues to provide feedback on her "Unique Abilities". I knew exactly what I wanted to say, it was easy, she is one of those professionals that stand out among the rest. When I finished dictating my response for her I realized I wanted the phrase - unique abilities - capitalized and in quotes. So I did what I always do, I highlighted the words - unique abilities - with my mouse and said Cap That. In my haste, immediately following Cap That, I said, Quotes That. Wow, didn't know I could do that. The phrase was put in quotes without having to start the phrase with Open Quote and end it with Close Quote.

So, from now on when I want a word or phrase in quotes, I will highlight the word or phrase with my mouse and say, Quotes That. It's definitely quicker and easier.

One more thing, I realized it also works for brackets when I say, Bracket That. It does not appear to work for; single quotes, curly brackets, angle brackets, or parentheses. J

For those Rochesterians, hope to see you tonight at the Little for Dinner & a Movie. https://www.thelittle.org/events.php

Training Support: Don't forget to turn your microphone off

2011-09-30T12:52:00.002-04:00

It might seem like a simple thing, but remember to turn your microphone off when you're done dictating.

You may -- or maybe not-- be surprised how many people, including me, forget to turn off the microphone when they're done dictating...continue talking, and get those extra words as part of their document.

What inspired me to remind you of this were a couple experiences I had while training this week. Steve Ragan, a caseworker for Essex County DSS was so pleased with his accuracy, every time he finished dictating but forgot to turn his microphone off, would say "beautiful". Kelly Gough, a colleague of Steve's would end her dictation with "excellent". Needless to say I was very pleased to know they were satisfied.

So, just a reminder, when you're done dictating don't forget to turn off your microphone.

Voice Commands: Quotes and Brackets

2011-09-29T10:29:00.004-04:00

Dictating Quotes and Brackets are easy, if you know what to say.

Dragon Medical Software Training Support: Minimize the Learning Curve

2011-09-25T12:23:00.009-04:00

Whatever you do, don't try to learn your EMR system and Dragon at the same time.

I have provided training to hundreds of medical professionals using the Medent Electronic Medical Record. It is a well designed system and the ongoing support is excellent. Additionally, Andrew Hardy, a sales representative for Medent, I know personally. He is professional, has exceptional product knowledge and is a strong customer advocate. He is indicative of the staff at Community Computer Service, the makers of Medent.

Donna Mancuso, practice manager at Summit rehabilitation Associates located in Du Bois, Pennsylvania has reached that critical point where they've made the decision to move forward with implementation of an Electronic Medical Record. Based on our conversations with Donna they will be using the Medent EMR. They are in the process of making a decision on what vendor to go with for Dragon software and training. Donna was told by the representatives from Medent that the EMR system and Dragon should be implemented simultaneously -- I have to strongly disagree.

For a significant number of medical groups their initial exposure to Dragon software is through a demo they've seen from an EMR system manufacture. As we all know, a sales demonstration is a well-orchestrated and practiced performance. Definitely not representative of what you will be experiencing until your staff has been trained, bugs worked out, and the initial resistance to change issues have been minimized. With that said, whatever you do, don't try to learn your EMR system and Dragon at the same time.

Implementing EMR and Dragon at the same time is information overload. Whenever too much information is introduced to quickly you dramatically increase the learning curve, risk of frustration, and in many cases total abandonment of Dragon and/or the Electronic Medical Record.

From a training perspective, get comfortable navigating through your Electronic Medical Record. Type your notes directly into the EMR (temporarily). Once you are comfortable, anywhere from a couple days to a couple weeks, this is the time to introduce Dragon. If you do it this way the learning curve and frustration level are virtually nonexistent.

Technical Support: Poor Accuracy

2011-09-23T09:30:00.011-04:00

"It only misses about 1 out of every 100 words." Now it was inaccurate about 50% of the time. What changed?

I received a phone call this morning from Janet Brier, practice manager for Professional Orthopaedics Associates in Scranton Pennsylvania. She was concerned because Dr. Burke who had been dictating every patient note since he was trained several weeks ago was having trouble. All of a sudden his accuracy was terrible.

When I spoke with Dr. Burke directly he told me he had been dictating every note since I left and was very pleased with the accuracy. "It only misses about 1 out of every 100 words." Now it was inaccurate about 50% of the time. What changed?

In my blog post dated September 14 I talked about what to do when Dragon stops working. The solution to Dr. Burke's issue was resolved the same way. The symptoms were different, the remedy the same.

Most of us put such high demands on our computers. We have multiple applications, documents and webpages opened simultaneously sometimes our computers simply become overwhelmed. I think most of us can relate. Identifying the specific reason would be virtually impossible. Unless of course it happens on a regular basis then a bit more troubleshooting definitely should to be done.

Candidly, I would say more than 90% of the time by simply turning your computer off and turning it back on resolves the problem --Do a complete shutdown. I would speculate most of us could benefit from doing the same thing.

So, next time Dragon is giving you trouble, turn your computer off, relax a minute and turn it back on.

One more thing, not just a restart, a complete shutdown.

Technical Support: HELP! Click Send command stopped working

2011-09-22T09:35:00.006-04:00

We have not been able to get it to work. Any ideas?

Earlier in the week I received a phone call from Angela Iocolano a Director at Pathstone in Rochester New York. Angela has been using Dragon since 2008. To watch her use it you would think she was born with a microphone in her hand (on her desktop). When I commented how skillfully she used her Dragon, she simply commented “it's not you versus the software".

Angela had been using the voice command Click Send reliably and successfully to send her e-mails for quite a while now. One day it just stopped working. She did recall when it first stopped working there was an error message, she can't remember exactly what it was, but it did reference control keys. Now, when she says Click Send the send button highlights but does not send the message.

We have not been able to get it to work. Any ideas?

Testimonials: Joseph Sedita, Esq.

2011-09-21T10:10:00.001-04:00

“It was easy – easier than I expected,”

Hodgson Russ
Joseph Sedita, Esq.
Buffalo, New York

“The hardest thing about using Dragon was getting used to speaking naturally rather than one word at a time,” reports Joe Sedita, a partner in the business litigation group at Hodgson Russ in Buffalo. “It was easy – easier than I expected,” he says. Given that Joe has been using speech recognition software for only a few weeks, his satisfaction reinforces how quickly professionals can be trained and begin speaking their work, rather than typing. Joe actually heard about speech recognition tools two or three years ago but didn’t investigate further until about four months ago, when a colleague enthusiastically recommended Dragon Naturally Speaking. A quick call to Achieve Results resulted in a visit from President Dana Abramson, who gave him a taste of how soon he could be up-to-speed – it was a matter of minutes.

Although most Dragon users find the tool helps to create documents in Microsoft Word, Joe uses the software more for email, which he sends a lot of, he says. “Talking my email is easier than typing.” But to create documents, he still uses Dragon, talking through his notes and then transferring them via email to his secretary, who converts the file to Word and formats them as required.
Already he’s identified several advantages of using Dragon. First, “it makes you a better dictator,” he says, because you can see your spoken words on the screen in front of you. Second, you can also see where you’ve been – what you’ve already completed – “which makes it a lot faster to come back to something when you’re interrupted,” Joe finds.

The biggest benefit, however, is the impact Dragon has had on the work his secretary does for him. Rather than spending her days typing up dictated files, she can now “do more thinking work than typing…it’s a much better use of her time,” he says. The result? “It’s going to make us more efficient.” “I’m really pleased with it,” he says.

Interview by Marcia Layton Turner, Layton & Co

Voice Commands: Punctuation and Symbols

2011-09-20T09:49:00.007-04:00

Having trouble finding what you want on the keyboard?

Sometimes it's just easier to say it.

Technical Support: Locating the serial number

2011-09-15T17:54:00.006-04:00

Replacing the DVD is not the challenge, locating the serial number is.

Quite frequently we receive phone calls from Dragon users who need to reinstall their software or install it on a new computer, but have misplaced the DVD. Replacing the DVD is not the challenge, locating the serial number is. If you do not have access to the serial number you will not be able to install the software. So, take a few minutes and write the serial number down. Keep it someplace safe.

There are two places where you can find the serial number. One being, the sleeve that the original software came in has the serial number on it. If you are unable to find your original software DVD, you can click on the Help menu of the DragonBar. Click About NaturallySpeaking (for non-medical ) or click About Dragon (for medical ). A splash screen will appear. On the splash screen will be an 18 digit alphanumeric number. This is the serial number. Write it down, keep it safe. It will save a tremendous amount of time if you ever need it.

Technical Support: What do you do when Dragon stops working?

2011-09-14T10:24:00.003-04:00

sometimes our computers simply become overwhelmed.

A common technical support call to the Dragon Users Group sounds something like this, my Dragon just stopped working. Or, I'm getting question marks in the little yellow box and nothing is happening.

Most of us put such high demands on our computers. We have multiple applications, documents and webpages opened simultaneously sometimes our computers simply become overwhelmed. I think most of us can relate. Identifying the specific reason would be virtually impossible. Unless of course it happens on a regular basis then a bit more troubleshooting definitely should to be done.

Candidly, I would say more than 90% of the time by simply turning your computer off and turning it back on resolves the problem --Do a complete shutdown. I would speculate most of us could benefit from doing the same thing.

So, next time Dragon is giving you trouble, turn your computer off, relax a minute and turned it back on.

One more thing, not just a restart, a complete shutdown.

For those of you attending the Rochester area Dragon Users Group meeting tonight, I look forward to seeing you. For those of you who are unable to attend, distance is always the big issue, make sure to check out the photos on the Dragon Users Group Facebook page tomorrow.

Technical Support: Automatically start Dragon at startup

2011-09-13T09:38:00.004-04:00

Have Dragon start automatically when you turn on your computer.

Last week I provided training to five doctors at Professional Orthopaedics Associates in Scranton, PA who are using the Medent electronic medical record. It wasn't until the last training session that I realized I had not stressed the importance of opening Dragon first when using Medent. Thank you Michael for the reminder!

That experience was my inspiration to share with you how you can have Dragon start automatically when you turn on your computer by putting a copy of the Dragon application in your Startup folder.

Here's how you do it.

For those of you who are familiar with Windows. Go ahead and make a shortcut of the Dragon icon and put it in the Startup folder --That's all that's too it.

For those of us who aren't as computer savvy, here are more detailed instructions.

Step 1 - right click the Dragon icon on your desktop and click Create Shortcut. You will now have a duplicate copy of the Dragon icon on your desktop.

Step 2 - left click and hold the Dragon icon that you just created. Do not stop pressing the left button of the mouse as you do the following;

Step 3 -drag the Dragon icon over the Start menu in the lower left-hand corner of your display.

Step 4 -drag the Dragon icon over the All Programs menu.

Step 5 - drop the Dragon icon into the Startup folder. Your Done!

From this point on, when you turn your computer on Dragon will open automatically. I love this one!

Testimonials: Jaeckle Fleischmann & Mugel

2011-09-12T08:43:00.004-04:00

“significantly reduced the need for manual typing.”

Jaeckle Fleischmann & Mugel, LLP

Vincent O. Hanley, Partner

Four years ago attorney Vincent O. Hanley hit a turning point in his work life. Although his secretary typed all of his letters and the initial drafts of documents, e-mail had become the predominant means of communication. Attorneys regularly negotiated and exchanged documents electronically. These changes in the practice of law made it impossible for Vince to avoid typing - something he admits was never one of his strong-points.

The increased typing brought on a tennis elbow/ tendinitis problem so severe that even typing brief e-mail messages had become extremely painful for Vince. The medical specialists he consulted identified the problem as a form of repetitive stress injury (also referred to as "RSI"), and they advised, among other things, eliminating or significantly reducing his reliance on a keyboard.

Even though he had the assistance of a secretary, Vince knew that, given the fast pace of the practice of law and the increased demands for efficiency and productivity in the profession, it would be impossible for him to avoid typing altogether. That reality prompted him to have a conversation with a member of Jaeckle Fleischmann & Mugel’s management information system (MIS) team who recommended speech recognition software as a potential solution. Ready to try any alternative to typing, Vince agreed to meet with a trainer at Achieve Results to determine whether speech recognition software might be the answer. It was.

In fact, after being cautioned to set reasonable expectations for the software, Vince says, “it was much easier than I thought it was going to be to train and use the software. I was able to use the Dragon Naturally Speaking software productively very soon after I was trained."

Today, Vince says he uses his speech recognition software constantly and has “significantly reduced the need for manual typing.” He has also expanded the types of documents and correspondence he tackles with Dragon Naturally Speaking. According to Vince, he uses the software “for everything that previously required typing, including e-mail correspondence, creating and revising documents, and completing electronic forms." He added, "The software is very user-friendly, and far more versatile than I had expected.”

One difference Vince points out between the version of Dragon he was initially trained on and the latest version which he uses today is that “the version I have now is extremely accurate.” Vince says that, given the improved accuracy of the program, he now spends relatively little time making corrections.

That, however, does not mean he always speeds through his work. In fact, Vince has found that because the recognition software is easy to use, he often communicates with clients and other attorneys in greater detail than he would if he were typing manually. He noted, "The ability to generate detailed correspondence easily and efficiently is clearly one of the advantages to using speech recognition software."

So thrilled is he with speech recognition software that Vince has become a near champion of the cause, in part because of the improvements and enhancements he has witnessed in the software in the last few years. “When I was using the original version,” Vince says, “I only recommended it to people who had physical problems that prevented them from typing because the original version was such a chore to correct.”

Not so anymore. “Now I think using voice recognition software makes sense for anyone who does a lot of typing - even if it's just e-mail correspondence,” says Vince.

Interview by Marcia Layton Turner, Layton & Co

Rochester Area Dragon Users Group Meeting

2011-09-09T13:35:00.004-04:00

Just a reminder, next Wednesday, September 14 at 5:30pm, is another Rochester area Dragon Users Group meeting. It's like the blog Live. I have selected a few of my favorite blog posts from the Voice Commands category and will be demonstrating them.

Our speaker this month will be Parmod Gandhi, CEO and founder of InSync Speech Technologies. Parmod is the founder of the noise cancelling FilteredAudio™ technology which allows microphones, used with Dragon software, to produce excellent accuracy in the noisiest environments. Parmod makes microphones with superior performance that are actually convenient and simple to use. The Buddy Desktop and FlamingoMic are his creations.

Once again M&T Bank will be hosting our event. This meeting is being held at the M&T Bank East Avenue location. We are thinking this might be our permanent meeting location. The conference room is more conducive for demonstrations and group discussions than our previous locations.

The meeting is open to Dragon Users Group members, nonmembers, long-time Dragon user's, new Dragon users, and anyone just starting to think about it. Everyone is welcome!

Come hungry there will be plenty to eat.

For more information or to register call (585) 586-4550 x225

Looking forward to seeing you next week.

P.S. For those of you who read my blog yesterday, once again this blog post was dictated using Dragon Dictation on my iPhone.

Product Review: the Dragon Dictation App

2011-09-07T22:29:00.015-04:00

Dictating is easy.

The accuracy --fabulous.

I am out of town this week providing training for a group of doctors at Professional Orthopedics in Scranton Pennsylvania and also for the Community Surgical Group in Kingston Pennsylvania. When I was checking into the hotel this evening it occurred to me my only option for writing my blog for the next couple days is either typing on the computer in the hotels business center or using Dragon Dictation on my iPhone. I do not own a computer with wireless Internet access. The thought of typing was daunting. Since typing wasn't an option, I guess I would be putting Dragon Dictation to the test. I do use Dragon Dictation quite often for short e-mails and text messaging, But I have never used it for anything lengthy.

Let me share my experience......

I dictated my first paragraph. My initial reaction, this is easy. Until a text message came in. without thinking I replied and lost my entire first paragraph. A bit frustrating, but realizing I had no other option I redictated my first paragraph. This happened to me three times before I came up with the genius idea of dictating one paragraph at a time and copying and pasting it to the notepad app of my iPhone one paragraph at a time. A little kludgy, but a whole lot better than typing. The accuracy is absolutely amazing. My plan, once I am finished I will copy the information from the notepad of my iPhone, paste it into my e-mail and have someone in my office post it to my blog in the morning. If you're reading this blog, you'll know it worked.

Couple observations

It does a great job with basic capitalization; beginning of a sentence, proper nouns et cetera. The "scratch that." Command does not work. The "new paragraph" command does. Punctuation and special characters work fabulously, watch this…!*© [] "" &.

General impression?

Dictating is easy, the accuracy -- fabulous. If I do need to edit, which is very rare, I can use the tiny little keyboard. Not bad at all. It took me a bit of time to define the "workflow", how to get the dictation to where I want to go. But now I know how to do it for the future. I love it!

Dragon Software Product Review: What Dragon product is right for you?

2011-09-04T12:11:00.005-04:00

If it is not clear what product is right for you, do not rush to purchase or upgrade.

Over the next couple weeks I anticipate I will be talking a lot about service packs and new versions. Before I do that, I want to provide a foundation for you to ask good questions to ensure you make the right product decisions.

Several months ago Nuance, the makers of Dragon software, announced the release of Dragon NaturallySpeaking version 11.5. This announcement was for what is referred to as a "service pack" release, not a “new version”. A "service pack" release is typically a free upgrade that addresses problems with the software and minor enhancements applying to the current software version, in this case version 11. If you have an older version of Dragon NaturallySpeaking, version 9 or version 10, there is a cost associated with upgrading to version 11.5. Additionally, just two weeks ago Nuance announced a “new version" of Dragon Medical. There is always a cost associated with a new version. The purpose of a new version is to significantly improve the features and functionality of the existing product. Word of caution, just because the new version looks significantly different does not necessarily mean there has been improvements or enhancements. Sometimes you are forced to upgrade to assure compatibility with other applications and sometimes a new version is optional.

For those who have never purchased Dragon software or are in a position where they need to upgrade their current software, it can be confusing. So I thought I'd offer some information that will make it easier for you to navigate your options.

Nuance, the makers of Dragon software, have three primary Dragon software categories; Dragon Medical, Dragon for the PC and Dragon for the Mac. Internally at Nuance these three categories are managed by separate business groups, hence the potential confusion.

The Dragon Medical category consists of two products; Dragon Medical Practice Edition designed for healthcare groups with 24 or less medical providers. And, Dragon Medical Enterprise Network Edition designed for healthcare organizations with greater than 24 medical providers. That decision does not get much easier.

The Dragon for the PC (Non-Medical) category consists of five products; Dragon NaturallySpeaking Home, Dragon NaturallySpeaking Premium, Dragon NaturallySpeaking Premium Student/Teacher, Dragon NaturallySpeaking Professional and Dragon NaturallySpeaking Legal. If your primary purpose for purchasing Dragon software is to reduce your typing time, every product in this category has that capability. The differences between the products would be additional features and capabilities beyond dictation. For example; a broader range of third party application compatibility, the ability to create macros, third-party editing, remote installation the software. In the case of Dragon NaturallySpeaking Legal it provides automatic formatting for legal citations.

The Dragon for the Mac category consists of three products; Dragon Dictate, MacSpeech Dictate Legal, MacSpeech Dictate Medical. This category of products is fairly new to the Nuance offering. They were recently purchased by Nuance from a third-party company, MacSpeech Dictate. The market demand for the Mac category of products is considerably low. Because of this the training and support available for this category is limited.

If it is not clear what product is right for you, do not rush to purchase or upgrade.

Technical Support: Backing up your User Profile

2011-08-30T11:44:00.002-04:00

Just a quick reminder regarding how important it is to backup your User Profile.

I received a call recently from Dr. John Genier, an internist in Fairport, NY and Rochester’s comparable to Grey’s Anatomy Dr. Derek Shepherd (It‘s popular opinion, I’m told). He was getting an error message and unable to open Dragon.

Just a quick reminder regarding how important it is to backup your User Profile.

Your User File is created as part of the setup step before you can start using your Dragon software. As you use Dragon, customize your vocabulary and create custom commands, these modifications become part of your User Profile. If for whatever reason your Profile becomes damaged, also referred to as corrupted -- all is lost.

As a precaution it is strongly recommended that you export your user profile to a 4 GB jump drive. If you do this you can very quickly, on your own, get back up and running by simply importing the User Profile from the jump drive.

Another thing to remember, as soon as you realize there is a problem, a corrupted User Profile, you can use the Restore feature of Dragon and be back, up and running in about a minute. If you open and close Dragon a couple times you are going to miss the window of opportunity to utilize the feature. So don’t mess around.

If you have missed the window of opportunity to use the restore feature of Dragon or have not made a backup, your only option is to re-create your User Profile.

I helped Dr. Genier create a new User Profile. Not a big deal because he did not have any custom commands. Still, play it safe and backup.

Note: More details on backing-up your User Profile available in the Members Only section at DragonUsersGroup.com

Dragon Medical Software Customer Testimonials: Buffalo Heart Group

2011-08-29T10:14:00.006-04:00

“Our ultimate goal is to eliminate transcription costs entirely,”

Brad Hall, Business Manager

Buffalo Heart Group

Buffalo, NY

EMR System: Medent

When Buffalo Heart Group’s director of administration Brad Hall first saw Dragon Naturally Speaking demonstrated at a conference in 2005, he was eager to test it out. The practice was in the midst of rolling out an electronic medical records (EMR) platform and Brad was hopeful that speech recognition could be integrated. His goal was to simplify the transcription process and eliminate the practice’s rising medical transcription expense, which was already close to $150,000 a year and climbing.

Six months ago, Brad and his team, which included Kathy Heary, Buffalo Heart Group’s privacy officer and health information manager, made the commitment to use speech recognition as part of the EMR platform. Brad and Kathy recognized that EMR and speech recognition could help the practice achieve its goals of increased overall efficiency and increased quality of service, while enabling providers to do more with less. However, they also understood there would be resistance on the part of some of the providers to adopting speech recognition.

So the duo began the important roll-out by identifying potential speech recognition champions within the practice and partnering with Achieve Results to provide the important training component. Champions were important, explains Brad, as a way to gain acceptance of a new documentation methodology among the practice as a whole. Although speech recognition has made great strides in being accepted within the medical community, says Brad, he reminded himself that patience would be key.

Fortunately, the group immediately had some success stories with doctors who elected to adopt Dragon and be trained in its use. Those successes continue. Today, there are six providers using speech recognition on a regular basis and several more have registered for training. This gradual adoption pace is exactly what Brad was hoping for: “we wanted to build momentum,” he says.

What has been surprising to Brad and Kathy is that they anticipated that several of the group’s providers would be somewhat reluctant to modify their documentation protocol and convert to the new voice recognition dictation platform. Surprisingly, these providers have actually embraced the new technology and have found that they really like it. In addition, all the providers in the practice’s new satellite office have already become converts in a matter of weeks.

Besides the cost savings, many of the practice’s providers value being able to complete documentation on a real-time basis. “There is no more waiting for a letter to come back for review,” explains Brad, “and letters are more concise because we’re striving for efficiency.” The doctors who are using speech recognition are reveling in the fact that documents are already done in the patients’ charts at the end of the day.

“Our ultimate goal is to eliminate transcription costs entirely,” he reports, with a first-year target of cutting transcription costs in half. They are already well on their way, with more doctors using Dragon than anticipated at this point in the process. “We are realizing success,” he says

Interview by Marcia Layton Turner, Layton & Co.

Training Support: Training Stubborn Words

2011-08-26T11:28:00.004-04:00

Typically every Dragon user has a couple words that the software is stubborn about. I assure you, you do not need to tolerate it. Remember you’re in charge!

Dr. Bruce Thompson, is an Emergency Medicine physician at Unity Health System in Rochester, New York. Dr. Thompson is one of several physicians that use Dragon in the emergency room. For those of you who have ever been concerned with dictating in noisy places, I assure you it does not get much noisier than the environment these doctors work in.

Last week I provided training to Dr. Thompson. The training actually took place at his workstation in the emergency room. In less than an hour Dr. Thompson was using Dragon for his notes. His comment following the training, this is fun.
Yesterday he contacted me because there was one particular word that the software continued to misrecognize -- numb. It kept giving him -- normal. He explained to me that he had trained the word several times the way I had showed him. It still wasn't working.

This was my recommendation. Using ESSENTIAL Skill #2, Training Words and Phrases, in the process, when it was time to click the train button and speak the word, I had him do that step three consecutive times. It did not work. I had him go through the process again. Voila , it worked.

Let me explain why.

Most likely over the past week when the word -- numb was being misrecognized, there is a good chance it was not being corrected real-time. Which means that the software thought it was doing the right thing. In order to undo that bad training, he had to speak the word correctly a series of times to train the word correctly.

Typically every Dragon user has a couple words that the software is stubborn about. I assure you, you do not need to tolerate it. Remember you’re in charge!

Voice Commands: Zoom In and Zoom Out using the Press command

2011-08-25T11:09:00.002-04:00

When viewing a webpage you are able to enlarge it, zoom out, or reduce it, zoom in, by using a specific keyboard combination. We can make that into a voice command using the Press command.

I discovered this function on accident. I was using my keyboard to type a + sign. Yes, I was using my keyboard. I sincerely believe that the most skillful users of Dragon software use whatever combination of keyboard, mouse and microphone allow them to be personally most productive.

Okay, so where was I?

When I was intending to press the shift key in combination with the plus key, I accidentally hit the control key and the plus key. My screen got larger. Admittedly at first I had no clue what happened. But when I realized what had happened I was very excited.

So, what happened?

When viewing a webpage you are able to enlarge it, zoom out, or reduce it, zoom in, by using a specific keyboard combination. We can make that into a voice command using the Press command.

If you want to zoom out and make your webpage larger, say, Press Control Plus Sign.

If you want to zoom in to make your webpage smaller, say, Press Control Minus Sign.

Remember to say all the words in a single utterance without stumbling when you speak or it will not work.

Oh, one more thing. I'm pretty sure it only works in Microsoft Windows 7.

Dragon Voice Commands: The Read That Command

2011-08-24T11:13:00.002-04:00

Proofing a speech generated document is very different from proofing a typed document.

The Read That command is a highly effective proofing tool for documents that were spoken, not typed. Proofing a speech generated document is very different from proofing a typed document. Traditionally the mistakes that are made during typing are transposed letters. Mistakes that are made during speaking will never be transposed letters, they will be the wrong word. There will never be a misspelling in a spoken document.

For most people it is difficult to self-proof a document that was spoken because our brains are used to seeing transposed letters, not the wrong word. That's where the Read That command comes in handy. My all-time favorite.

The Read That command will read to you, in a computer sounding voice, what was literally interpreted by Dragon. So if you don't catch it with your eyes, there is a good chance you will catch it with your ears.

This one is so simple, this is how it works.

Select/highlight the text that you would like to proof, either with your mouse or your Select That command, and say, Read That Listen!

Give it a try!

Dragon Voice Commands: The Select Command

2011-08-23T10:10:00.009-04:00

The Select Command is an alternative to selecting/highlighting text with your mouse. If you are an individual that is masterful manipulating the mouse, the select command could slow you down. If you are an individual that is a bit tenuous with the mouse, the select command could help increase efficiency.

This is how it works.

Speak the word Select in the same utterance (breath) as the word or phase you would like to selecting/highlight.

Using the sample dictation below, when you say, Select female, the word female is highlighted as if you selected/highlighted it with your mouse.

Chief Complaint: 25-year-old female presents today was severe abdominal pain. The pain has been severe for more than three days. No nausea or vomiting.

Try these…

Say, Select chief complaint colon

Chief Complaint: 25-year-old female presents today was severe abdominal pain. The pain has been severe for more than three days. No nausea or vomiting.

Say, Select the pain Through vomiting period (using the word through allows you to select a long phrase that would be difficult to say in a single utterence)

Chief Complaint: 25-year-old female presents today was severe abdominal pain. The pain has been severe for more than three days. No nausea or vomiting.

Say, Select All

Chief Complaint: 25-year-old female presents today was severe abdominal pain. The pain has been severe for more than three days. No nausea or vomiting.

Do I personally use the Select command?

Sometimes. During the busy workday I find it more convenient and efficient to use my mouse. I do find myself using the Select command when I'm not rushed. It allows me to physically relax while still getting work done.

As with all voice commands, if the Select command makes your life easier use it. If not, don't.

Dragon Medical Software Customer Testimonials: Greater Rochester Orthopaedics

2011-08-22T09:37:00.009-04:00

Transcription cost dropped from its $100,000 pace to $6,000.

Al Campagna,Business Manager

Greater Rochester Orthopaedics

Rochester, NY

EMR System: eClinicalWorks

Al Campagna and his colleagues at Greater Rochester Orthopaedics had heard about Dragon Naturally Speaking software from colleagues, in discussions with other practice managers, and at conferences, but it wasn’t until the group’s annual transcription costs topped $100,000 that they decided to add it to their own operations.

In 2005, Greater Rochester Orthopaedics set several business goals, the first of which was to significantly reduce – if not eliminate – the professional cost of transcription, which went beyond the $100,000 bill and included the supporting labor cost. Other goals included increasing internal operating efficiencies, improving client service, and expediting the authorization process for diagnosis and treatment, all of which would be impacted by the new speech recognition software if it worked as they hoped it would.

Nine people in the practice were scheduled to be trained, starting in October 2005, with the two doctors who were the most enthusiastic about the software’s prospects as the lead trainees. Within a few weeks, once they were comfortable with the program, two more practice members were trained, then two more - each pair staggered a couple of months after the previous two. In total, it took six months for all nine professionals to be trained.

In that time, the transcription cost dropped from its $100,000 pace to $6,000. In addition to reducing the office’s reliance on outside transcription, the Dragon software has also changed the operating process within the office, reports Campagna, because there is far less paper to contend with.

But Campagna and his crew aren’t resting on their laurels. “We’re still looking for ways we can evolve,” he says. “At a recent meeting, we talked about forming a working group to come up with new applications and share techniques.”

Interview by Marcia Layton Turner, Layton & Co.

Dragon Voice Commands: Scratch That, Delete That and Undo That

2011-08-18T22:17:00.004-04:00

All three commands were designed to remove something.

There are three Dragon Voice Commands that do similar things, but are designed for different purposes. All three commands were designed to remove something. If you aren't clear on the intended purpose of these commands and use them interchangeably you may not always achieve the desired result, creating more work for yourself. If they are used for their intended purpose they are extremely useful.

The Scratch That command was designed to be used strictly while dictating. The Scratch That command will remove all the words in the last spoken utterence (back to where you paused last). The Scratch That command is the quickest most efficient way to remove text that was interpreted inaccurately, giving yourself an opportunity to re-speak more clearly, during original dictation.

The Delete That command was designed for removing existing text during the editing process. If you want to remove text from an existing document, you first need to select/highlight the desired text either with your mouse or a voice command and then say, Delete That.

The Undo That command is an alternative to the "undo" feature in certain applications. The Undo That command is designed to remove your last action. If the application has a manual undo feature, Microsoft Word and Outlook for example, The Undo That command will work. It comes in handy for those times I have left my microphone on unintentionally and come back to a document that is a mess. I simply turn on my microphone and say, Undo That (pause slightly) Undo That (pause slightly) Undo That (pause slightly), until I get back to where I was.

As always, if these commands make you more efficient use them, if not, don't!

Dragon Medical Software Product Reviews: Nuances Announces the Release of Dragon "Medical Practice Edition"

2011-08-17T18:11:00.002-04:00

So, I guess that means they’ll have worked out all the bugs by the time it gets to us. Yippee!

Ready or not, here it comes....the next version of Dragon Medical Software has been announced by Nuance, the makers of Dragon software. They are calling it “Medical Practice Edition”. No version number to continue the tradition, no “Medical version 11”. It’s simply being called “Medical Practice Edition”.

The official public announcement was today and it is expected to begin selling it in the United States in September. It has been available in the UK and in Ireland since January. So, I guess that means they’ll have worked out all the bugs by the time it gets to us. Yippee!

For those of you who are ready to get started with Dragon for the first time or are ready to purchase it for additional providers in your practice, I wouldn't hesitate. You will only have a limited time to purchase the current version of Dragon, version 10. When version 10 goes away, so does Dragon Medical Small Practice. I have been providing training to medical professionals using Dragon Medical Small Practice version 10 in a multitude of EMR's for over two years now. It has all the functionality needed for smaller medical groups and is $400 less per provider. Believe me I am going to miss it.

Right now, all I know about the features and capabilities of the Dragon Medical Practice Edition is what is being promoted in the professionally orchestrated press releases. What I do know for sure is that you can feel confident that earlier versions of Dragon will continue to be supported and you will be able to upgrade from Dragon version 9 or 10 at any time that is convenient for you.

As I get more information on the actual benefits of the new edition for medical professionals, I will definitely let you know.

Dragon Voice Commands: The Click Command

2011-08-17T08:07:00.006-04:00

The Click command is the spoken way of pressing the left button of your mouse.

Now here's another staple for your Dragon Voice Commands repertoire, the Click Command. Remember how we said that the Press command is an alternative to pressing the keyboard keys with your finger. The Click command is the spoken way of pressing the left button of your mouse. This is a quick and easy way of controlling your computer without having to learn a multitude of complicated commands.

Let me show you how it works. Right now I am dictating into Microsoft Word 2007. The menubar at the top of my screen has the following menu selections;

File Home Insert PageLayout References Mailings Review View

Speak the word Click in the same utterance (breath) as the menu choice you would like to activate. For example; by saying Click File, the drop-down menu under the File menu selection would appear. by saying Click References, the drop-down menu under the References menu selection would appear. Get the pattern? When the drop-down menu appears, speak the word Click followed by the words describing what you would want to do. Below are some examples;

Now let's assume that your goal is to insert a footnote. This is how it would be done.

Click References (pause slightly) Insert Foot Note.
Give it a try!

Here's another one.

Click Review (pause slightly) Click Word Count.
I use this one all the time!

Word of caution, as always when using voice commands don't be sloppy. Commands need to be said clearly, literally, and in a single utterance. If you are off slightly chances are high that command will not work as expected. Create a repertoire of voice commands that enhance your productivity. Remember, more is not necessarily better.

Dragon Training Support: How long does it take to learn?

2011-08-15T14:12:00.004-04:00

Since you left I have been using Dragon for practically all of my keyboard input

Recently I provided training to a retired Cornell professor who is 82 years old. I did spend about 2 1/2 hours with him. Candidly, about two of those hours were conversation that had absolutely nothing to do with Dragon. He was such a fascinating individual I could've stayed all afternoon.

So, what is my point?

With no more than an hour of instruction, one day following the training session this is what he had to say;

Dana

Since you left I have been using Dragon for practically all of my keyboard input. I'm getting very good accuracy. When correcting mistakes or rewriting existing files I use the cursor and select phrases that I wish to overwrite. It has been working very well for me. I'm very pleased with the training session.

Thanks also for the tip on how to back up the user profile. That worked beautifully.

P.S this e-mail was spoken not typed.

Testimonials: Allergy Doctors of Western New York

2011-08-14T13:14:00.007-04:00

“I’m done. I don’t have to review my reports the next day, so by the end of the week there is no backlog of unfinished reports to look at.”

Andrew Green
Allergy Doctors of Western New York

West Seneca, NY
EMR System: Medent

Although the quality of medical transcription that allergists Dr. Andrew Green and Dr. Rita Sloan received from their transcription service was excellent, the thousands of dollars spent per year and the hour or two Dr. Andrew Green or his partner had to spend reviewing notes on the weekend were reason enough to explore alternatives like speech recognition. Now, six weeks after being trained in the use of Dragon Naturally Speaking, Andrew couldn’t be more satisfied with the improved workflow, increased office efficiency, reduced cost, and additional free time at week’s end.

The biggest reason Andrew and his partner began exploring speech recognition software was the time delay between dictating notes and receiving the typed reports back. “Some came back the same day,” he says, “and others took until the next day.” Once received in the office, the doctor or two physician’s assistants (P.A.’s) would review what had been typed and approve it; the doctors also review and approve the P.A.’s work. With the lag time, whichever doctor was responsible for checking the P.A.’s reports that week (they take turns) had at least two hours worth of backlogged letters to review at weeks end.

Add to that the annual cost of using a transcriptionist and the practice had a major incentive to give speech recognition a try.

Andrew and his partner were initially concerned that speaking their notes would be slower than dictation, but a conversation with another practice that is successfully using the software allayed their fears. Andrew agreed to be the office guinea pig, volunteering to be the first to be trained. One of the P.A.’s was next, followed by his partner and the second P.A., who is scheduled to receive training next month.

The biggest difference Andrew noticed immediately after being trained was the lack of unfinished business on Friday. After he talks through a report, “I’m done. I don’t have to review my reports the next day, so by the end of the week there is no backlog of unfinished reports to look at,” he says. And given the value of their professional time, the doctors receive the equivalent of hundreds of dollars of savings each week.

Using Dragon “has changed the dynamics of the practice in terms of work flow,” says Andrew. In addition to being able to finally incorporate speech recognition into the electronic medical records (EMR) system the practice bought four years ago, speech recognition has improved the practice’s efficiency.

Despite such significant changes in the practice’s internal operations, adopting speech recognition was much faster and easier than Andrew anticipated. “Dana came out at 10:00 am on a busy Wednesday to train me and by the end of the day I was fully functional,” he says.

While Andrew says he found it very easy to learn, he cautions others against trying to save some money by buying it online without training. “Don’t even consider buying it yourself,” he says. “I couldn’t have mastered this program without Achieve Results. The training is absolutely phenomenal – second to none.”

Interview by Marcia Layton Turner, Layton & Co.