eTIPS

Did you know the “Accuracy Center” gives access to tools you can use to improve recognition accuracy?

The “Accuracy Center" gives access to all the tools you can use to improve your recognition accuracy including; personalizing Dragon’s vocabulary by letting Dragon analyze text, or importing lists of custom entries. Say “Start Accuracy Center” or use the DragonBar’s Tools.

Alternatively, if you are unsure of which Dragon tool to use, let the Accuracy Center help you by saying, “open Accuracy Center,” then click or say, “which tool should I use?” to start the accuracy assistant.

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Did you know you could optimize recognition accuracy by speaking in complete phrases or sentences?

You can optimize recognition accuracy by speaking in complete phrases or sentences. Speaking too slowly, in short phrases or single words, makes recognition more difficult for Dragon, since longer phrases provide context which Dragon uses to guess what it should write; this is especially important for sounds that could be spelled different ways.

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Did you know why Dragon might spell out dictated symbol names rather than recognize the symbol's character?

When dictating into a target application, Dragon might recognize symbol names by spelling them out instead of using their single character representation. Here are two examples:

• When dictating "seven point six", the recognized text is 7 point 6 instead of 7.6
• When dictating "seven plus six", the recognized text is 7 plus 6 instead of 7+6

If the Dragon user's workflow requires character representation for symbols instead of the complete spelling, confirm the following Formatting setting within Dragon.

1. Under DragonBar, click Tools > Formatting.
2. On the General tab, click the Format Other Numbers checkbox to enable it.
3. Click Apply, and then OK.

Re-launching the Dragon application or re-opening the User Profile should not be necessary.

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Did you know what is required for MEDITECH EHR compatibility with the Dragon Medical 360 | Network Edition vSync feature?

The MEDITECH EHR (Electronic Health Record) system when interfacing with DM360|NE (Dragon Medical 360 | Network Edition) must adhere to minimum requirements in order to be compatible with the DM360|NE vSync feature.

Note: MEDITECH upgrades can require months of planning and testing to migrate from one release to another. The MEDITECH customer should always consult with their MEDITECH vendor for the most recent information related to Dragon usage with MEDITECH.

vSync Overview

The DM360|NE vSync feature allows Full Text Control (Dragon Select-and-Say support) within Citrix-published applications across a Citrix environment exclusively. The vSync feature is comprised of both a DM360|NE Client component as well as a Citrix server component. The vSync feature is enabled in both the NMC (Nuance Management Console) and at the DM360|NE Client.

In general, the DM360|NE Full Text Control (Dragon Select-and-Say support) capability requires constant, real-time monitoring of the data for the target application's (EHR) screen content. This would include aspects such as: utterance mapping, correction support, cursor location, audio preservation, element tracking, navigation command and control, and formatting support.

A simplistic view of how the vSync feature works is that vSync mirrors the data from the screen content of the Citrix-published EHR application and provides that data to the DM360|NE Client application running at the local workstation.

Prerequisites for DM360|NE vSync compatibility with MEDITECH

There are three (3) separate MEDITECH platforms with numerous versions and priority pack levels within each platform. Please see the prerequisites below.

Note: vSync is currently compatible with the MEDITECH Client Server product.

1. The MEDITECH Text Editor (MEditor) must be at version 2.6. The current availability of MEditor 2.6 is listed below:
   • Client Server 5.65, Priority Pack 15 and higher - available now
   • Client Server 6.x - availability is pending
   • Magic (all releases) - availability to be evaluated by MEDITECH
2. DM360|NE Service Pack 3 or higher is required.

In general, EHR vendors can certify their EHR applications with Dragon by working with the Nuance Engineering Team to develop fully-compatible versions. MEDITECH is actively pursuing this now. For information on enrolling in the Nuance EHR certification program, refer to Nuance's Dragon EHR Certification web site.

Implementation Architecture

The following terms are used when describing how Dragon and MEDITECH applications can be implemented in different scenarios:

• Fat / Thick / Local - describes an application that is installed "locally" on the workstation
• Thin / Remote / Virtualized / Web-based - describes an application that is installed on a remote server where the client workstation accesses the provided application through host software like Citrix, or Terminal Services, or Internet Explorer.

There are three (3) potential scenarios for how Dragon is implemented with MEDITECH or any EHR application.

Note: Currently, a majority of MEDITECH customers are configured for scenario 1. However, more customers are beginning to adopt scenario 2 as their configuration.

Scenario 2

Under this scenario, MEDITECH users are normally trained to use the Dragon Dictation Box feature and transfer text into the MEditor window. Alternatively, when dictating directly into MEDITECH comment boxes (i.e., after clicking a check box or radio button), MEDITECH users are instructed that any corrections will likely need to be performed manually.

When MEDITECH is a Citrix-published application, the DM360|NE vSync feature can provide Full Text Control support, provided the aforementioned prerequisites are met.

Scenario 3

This scenario, where both applications (Dragon and MEDITECH) are published by Citrix in the same Citrix session and from the same Citrix server, is ultimately dismissed by most customers for two technical challenges:

1. The network bandwidth required to move the dictated audio from the local workstation to the Citrix server can be too large.
2. The number of simultaneous active users per Citrix server that can be supported is small, requiring additional Citrix server resources.

DM360|NE vSync is not required for scenario 3.

Citrix Smooth Roaming

Also, if the Citrix Smooth Roaming feature is being used, please login to iSupport and search for solution 14898: Configuring Citrix Smooth Roaming in a DM360|NE (vSync) Environment. If you are not an iSupport subscriber, click iSupport Timesaver for information about how to get stated.

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What's New

For a complete listing of all updates for all released versions, login to iSupport and search for solution: 14274 "What's New in Dragon Medical 360 | Network Edition Software and can I Download the Current Version?" If you are not an iSupport subscriber, click iSupport Timesaver for more information and learn how you may get started.

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iSupport is a Proven Timesaver

iSupport is an Internet based support site where you can search our dynamic knowledge base for answers to your questions, access our library of operational manuals and quick reference guides, view the latest product enhancements, and submit online requests for service.

iSupport Knowledge Base Content Update:
A number of important knowledge base articles have been added or reissued with updated information to iSupport, as follows:

• 14918 Dragon Profile access fails with McAfee DLP scans
• 14120 eTIPS Newsletter Archive - Dragon Medical 360 | Network Edition & Dragon Medical Practice Edition (reissued 8/27/12)
• 14909 DM360|NE Speech Nodes running on Windows® Server 2008 R2 require a specific Microsoft® Update to work properly
• 14908 Language Model Optimization will postpone modifying a DM360|NE profile that has changed
• 14907 Advantages and disadvantages of automatically switching to the workstation's default microphone
• 14906 How to merge Medication Updates into the DM360|NE dictation users' vocabulary
• 14898 Configuring Citrix Smooth Roaming in a DM360|NE (vSync) Environment
• 14111 Dragon Medical 360 | Network Edition User's Guides (reissued 8/22/12)
• 14843 DM360|NE Error 1722 during installation of vSync MiniTracker component (reissued 8/15/12)
• 14892 ASW and what the Set Audio Levels on each machine really means!
• 14859 What to check for if the Dragon Medical 360 | Network Edition - Nuance Management Console (NMC) User Profile Association tool locks up (reissued 8/10/12)
• 14274 What's New in Dragon Medical Software and Can I download the current version? (reissued 8/8/12)

To see the details of any item on the above listing, simply log in to iSupport and search for the article number that precedes each item.

Getting Started with iSupport
Registered iSupport members are able to use the full features of iSupport and submit online service requests. Click Getting Started with iSupport to see instructions on how to register to become an iSupport member. You will also learn how to access and log into iSupport, configure your iSupport profile, search our knowledge base for solutions, manuals and quick reference materials, and how to use iSupport to submit a request for service.

Optimize Your iSupport Profile
If you are already an iSupport subscriber, you may want to consider accessing the Getting Started with iSupport link above and view the instructions. There is valuable information that will help you optimize your iSupport User Profile, thereby enabling you to submit a service request in minimal time. You will also learn how to enable additional timesaving features, requested by our customers, on the iSupport home page.

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Contacting Support

A dedicated Healthcare Support team available 24x7x365 services DM360 | Network Edition & DMPE customers who have an active maintenance contract with Nuance.

Nuance Healthcare Technical Support
This organization can offer assistance via remote on-line connectivity to your systems. It's available toll-free at 800 833-7776 via our "Say Anything" menu. So say, "Dragon Medical 360 | Network Edition Support" at the prompt.

On the other hand, save the call and access Nuance Healthcare's Support Center through our iSupport, Internet-based website at https://isupport.nuance.com. If you are not an iSupport subscriber, click here for more information and learn how you may get started.

Additional information about how to contact Nuance's Dragon Medical 360 | Network Edition customer support team is available at Nuance's Technical Support website at http://www.nuance.com/support/dragon-medical/.

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