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September 2015, Volume 7, Number 9

Nuance is pleased to present you with this edition of eTIPS, where you will find tips about:


eTIP 1:
Launching Dragon Medical Flashes Splash Screen Momentarily, But No DragonBar is Presented.
 

eTIP 2: Disabling "Always copy acoustic information to network" Option Can Avoid Profile Corruption.
 

eTIP 3: Problems Running Security / Antivirus Programs Concurrently.
 

eTIP 4: DFS Replication Problems Cause Performance Issues and Profile Corruption.
 



Driven By Dragon - Webinar Series

ATTENTION: As of July 16, 2015

  • We have changed our webinar hosting service to WebEx Event Center.
  • Therefore, if you have previously registered for the October 8th webinar, please click here to register again
    and receive new meeting coordinates.
  • All audio will now be available through your computer's sound system (including the Question and Answer audio). A teleconference call is no longer required.

Click here for information to keep you up-to-date with Dragon Medical's Driven By Dragon Webinar series.



Tina

        Tina - Web Interactive Support Tool

Click here for the latest improvements and information.

 

eTIPSeTIPS

Did you know how to resolve Dragon Medical from flashing its splash screen momentarily, but no DragonBar appears?

This video topic applies to the following Dragon Medical  products:

  • Dragon Medical 360 | Network Edition (DMNE)
  • Dragon Medical Practice Edition (DMPE)

This video topic covers the cause and resolution for the symptom where the Dragon Medical splash screen flashes momentarily, but Dragon Medical does not seem to start and the DragonBar does not appear. This is generally caused when the Dragon Medical NatSpeak process (natspeak.exe *32) is already running and needs to be manually ended through Windows Task Manager.

Click the image below to play this video.


Click Here

VIDEO: Dragon Medical flashing splash screen momentarily, but no DragonBar appears
(1:50 minutes, provided by Bradd Weidenbenner)



To learn more and to keep current with any changes to this topic, log in to  iSupport and search for solution 16823: VIDEO: Launching Dragon Medical flashes splash screen momentarily...but no DragonBar

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Did you know that disabling the "Always copy acoustic information to network" option can avoid profile corruption?

Customers using Dragon Medical products with roaming or master profiles should disable the Always copy acoustic information to network option. This advisement is due to potential profile corruption under certain scenarios where checksum errors are generated.

Dragon Medical client dragon.log files can exhibit the following excerpts:

    07:10:56 Roaming: CopyNewRoamingUserToLocalPrivate copying acoustic 'voice' from [master profile location] to [local cache profile location]
    07:11:00 S2: ERROR: checksum failed on <enu_fmed_p1.usr>
    07:11:00 (E:\work\1250relmini\shared\roaming.cpp,1868) : pSRAcoustic->AcousticCopy() returned unexpected value 80041049 (0x80041049) in "natspeak.exe" process.
    07:11:00 
    07:11:00 Roaming: CopyNewRoamingUserToLocalPrivate threw; local user loc = [local cache profile location], NetworkUserLoc = [master profile location], topic =Emergency Medicine - Large, voice = voice

Specifically, when this setting is enabled, a large acoustic file (.usr) is saved to the master profile location. If there is a network interruption during the updating of this .usr file, the file can become corrupted.

This .usr file is only updated when the user performs additional speech training. With this option enabled, the optimization (improvements) to the user's acoustic model (ACO) that resulted from running the additional training, is immediately saved to the master profile. However, if the option is not enabled, the ACO still takes effect, but later when the next ACO task is run.

At this time, customers are advised to disable (uncheck) this option.

The plan for Dragon Medical 360 | Network Edition (DMNE) version 2.5 and Nuance Management Server (NMS) version 5.1 is for this option to be disabled by default and removed from the Nuance Management Console (NMC).

Additionally, Nuance is looking into a more robust approach to copying up profile data to avoid corruptions.

Procedure

For the Dragon Medical 360 | Network Edition (DMNE) product, this option is located in the Nuance Management Console (NMC) under the Master User Profile section.

  1. Click on Manage organization & sites.
  2. Right-click on a Site and select Details.
  3. Click on the DM360 Network Edition tab and expand the Master user Profile section.

IMPORTANT: Again, customers are advised to disable (uncheck) this option.

To learn more and to keep current with any changes to this topic, log in to iSupport  and search for solution 16839: Disabling Dragon Medical "Always copy acoustic information to network" option can avoid profile corruption

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Did you know about problems running security / antivirus programs concurrently?

Problems have been reported by Dragon Medical customers installing more than one (1) security / antivirus program and running them in parallel. Here are some security programs that have conflicted with one another when run concurrently:

  • Lumension Endpoint Security Device Control
  • Symantec Endpoint Encryption
  • McAfee EndPoint Encryption

Running security programs in parallel can cause application issues. See the iSupport solution mentioned below for an example of Windows Event Viewer logs presenting a sequence where the MSI installer activity for Lumension is followed by cascading application errors and warnings, including the McAfee frameworkservice.exe application.

Symantec Recommendations for Concurrent Security Programs

Note: Issues caused when running multiple security programs concurrently, is in no way exclusive to Dragon Medical installations.

Please refer to the summary recommendations from Symantec stating security programs should not be run in parallel:

    https://support.symantec.com/en_US/article.TECH104806.html

    Symantec strongly recommends that you run only one (1) antivirus program at a time. Having more than one antivirus program active in memory uses additional resources and can result in program conflicts, false virus alerts, and lowered protection.

    Risks of using more than one antivirus program

    Antivirus and antispyware programs are generally written with the expectation that they will interrupt actions taken by other programs, in the interest of security. If more than one such program is running, there are a number of ways in which they can interfere with each other.

    To give a simple example, suppose that antivirus scanners A and B are installed on a computer. Program A copies a file to a temporary location for scanning. Program B notices the file activity, and copies the file from program A's temporary location to its own. Program A notices that file activity and makes another copy, and so an infinite loop forms. This could end with the computer running out of memory or hard drive space, hangs or crashes in the antivirus scanners, or other undesirable behaviors.

    Types of programs that can cause conflicts

    The following types of programs should not run concurrently:

    • Antivirus and antispyware real-time scanning programs such as Norton AntiVirus, Symantec Endpoint Protection (SEP), McAfee VirusScan, or Kapersky AntiVirus.
    • On-demand scanning programs, such as the Windows Malware Removal Tool.
    • Single-use malware removal tools that are designed to remove files from individual threats.

    Types of antivirus programs that can run concurrently

    On certain types of servers, there are antivirus programs that specifically scan the content that the server handles. For example, Symantec Mail Security for Microsoft Exchange (SMSMSE) scans the messages that come through Microsoft Exchange, and nothing else. To protect a server running SMSMSE, another antivirus program such as SEP is required.

    Programs such as SMSMSE can run concurrently with real-time scanners such as SEP, provided that they are prevented from scanning the same files. In the case of SEP and SMSMSE, the SEP Auto-Protect real-time scanner has built-in folder exclusions that prevent it from scanning the folder that SMSMSE scans. With other combinations of server and endpoint programs, such exclusions may need to be created manually.

Related iSupport Solutions:

  • 16830 - Lumension Endpoint Security Device Control interferes with Dragon Medical Input Devices
  • 14918 - McAfee Antivirus Interferes with Dragon Medical Operation
  • 16645 - PowerMic II Delays caused by third-party "Sophos SafeGuard" antivirus software
  • 15981 - Anti-Virus recommendations for Dragon Medical 360 | Network Edition

To learn more and to keep current with any changes to this topic, log in to  iSupport and search for solution 16831: Problems running security / antivirus programs concurrently

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Did you know DFS Replication problems cause performance issues and profile corruption?

DFS Replication Issues

Customers using Dragon Medical master/roaming profiles stored across a  Distributed File System (DFS) can see potential performance and profile corruption issues. In this case, DFS replication errors are likely evident.

For example, symptoms experienced because of DFS replication issues can include an inordinate amount of time is consumed when manually copying/restoring a Dragon Medical master/roaming profile. Investigation may reveal that the contents between the DFS File Servers and the provider's local workstation are different and synchronization is not successful.

IMPORTANT: DFS event IDs should be monitored by the customer's IT personnel.

The Windows Event Viewer hosts the DFS Replication log under Applications and Services Logs.

General Recommendations

The following general recommendations are provided as multiple problems seem to be caused by the overall DFS system health.

  • Monitor the Windows Event Viewer on DFS servers where Dragon Master user profiles are stored, for:
    • Errors and warnings specific to DFSR events
    • General errors and warnings
  • For DFS servers where Dragon Master user profiles are stored, have the local DFS or storage expert:
    • Review the DFS configurations for proper operation
    • Advise on DFS best practices for scheduling regular server maintenance reboots at times when the impact is minimized with respect to services running
    • Examine the Windows Event Viewer logs following each reboot
  • Verify Dragon Medical users are setup properly in the Nuance Management Console (NMC) before deploying Dragon Medical.

Microsoft Recommendations

IMPORTANT: Microsoft recommends making a backup for any server (preferably using Windows Server Backup or RoboCopy) prior to the application of these recommendations.

1. Exclude DFSR System Folders from Antivirus Scans

See the article link below for Microsoft`s Antivirus recommendations for Distributed File Systems (DFS) Enterprises:

    https://support.microsoft.com/en-us/kb/822158

    Review these sections from the above Microsoft article:

    Turn off scanning of DFS files

    The same resources that are excluded for a SYSVOL replica set must also be excluded when FRS or DFSR is used to replicate shares that are mapped to the DFS root and link targets on Windows Server 2008 R2-based, Windows Server 2008-based, Windows Server 2003-based member computers or domain controllers.

    Turn off scanning of SYSVOL files 

2. Microsoft Recommended Hotfixes

  1. Install the DFSR hotfixes as per
    https://support.microsoft.com/en-us/kb/968429
  2. Install the NTFS hotfixes as per
    https://support.microsoft.com/en-us/kb/2473205
  3. Here are hotfixes for Windows Server 2012/2012 R2:

    DFSR : https://support.microsoft.com/en-us/kb/2951262
    NTFS : https://support.microsoft.com/en-us/kb/2899011

3. How to Determine the Minimum Staging Area DFSR Needs for a Replicated Folder

Determine if DFS Staging Area Problems Exist

Detect staging area problems by monitoring for specific events IDs on DFSR servers. The list of events include: 4202, 4204, 4206, 4208 and 4212. The texts of these events are listed below.

    Note: It is important to distinguish between 4202 and 4204 and the other events. It is possible to log a high number of 4202 and 4204 events under normal operating conditions. Think of 4202 and 4204 events as being analogous to taking a pulse, whereas event 4206, 4208 and 4212 are like chest pains.

Review the Windows Event Viewer to verify that the DFS Replication restarted correctly. The Windows Event Viewer hosts the DFS Replication log under Applications and Services Logs.

To see a table of common Event IDs (including errors and warnings) and their descriptions, refer to the iSupport solution below.

To learn more and to keep current with any changes to this topic, log in to iSupport and search for solution 16821: DFS Replication problems cause performance issues and profile corruption

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Driven By Dragon - Webinar Series

ATTENTION: As of July 16, 2015

  • We have changed our webinar hosting service to WebEx Event Center.
  • Therefore, if you have previously registered for the October 8th webinar, please register again by clicking the REGISTER button below to receive new meeting coordinates.
 
  • All audio will now be available through your computer's sound system (including the Question and Answer audio). A teleconference call is no longer required.

The next quarterly Webinar for our Dragon Medical customers is: Thursday, October 8th, 2015. To register, please click the Register button below:

Click to Register

   Thursday, October 8th, 2015 at 2:00 PM EST

Recently on July 10th, Dragon Medical Technical Support presented our latest Driven by Dragon Webinar. The content included the following topics:

  • Customer Stories
  • New and pending software releases for Dragon Medical products
  • Documentation and iSupport content improvements
  • Technical Spotlight: PowerMic Mobile installation and operation
  • Question and Answer

To review recorded Webinars from the Driven By Dragon series, please click the video links below:

Dragon Medical Driven By Dragon
Quarterly Webinar Recordings

Description Length
(Min:Sec)
File
Size
Posted
Revised

3Q' 2015 - July 10
Requires several minutes to begin playback

53:25

488 MB

7/10/15

2Q' 2015 - April 9

42:44

117 MB

4/10/15

1Q' 2015 - January 8

48:08

190 MB

1/8/15

4Q' 2014 - October 9

32:12

51 MB

10/13/14

3Q' 2014 - July 10

21:25

20 MB

7/18/14

To learn more about the Driven by Dragon Webinar Series and to keep current with any changes to this topic, including external links to recorded video for customers without iSupport access, log in to iSupport and search for solution:

    #16449: Dragon Medical "Driven by Dragon" - Quarterly Customer Webinar Series

If you are not an iSupport subscriber, click iSupport Timesaver for information about how you may get started with iSupport.

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TinaWhat's New with Tina?

Tina, Nuance's web interactive support tool, is a text-based, chat window hosted on your iSupport Home tab that delivers self-service support. Tina offers a human-like conversational approach when communicating with Nuance's customers. The focus for Tina is to quickly and accurately answer common questions about the Dragon Medical product.

August Analytics
This past month's reporting analytics for Tina show the following metrics:

  • 266 Conversations
  • 73% First Contact Answer again...where the percentage of user inquiries are resolved with the first answer.

Latest Content Addition To Tina!
In order to further improve our customer's experience, the Dragon Medical Support Team continues to add additional content and optimize Tina's capabilities. The table below outlines the most recent content added and the corresponding iSupport solutions.

So, please continue to ask Tina your questions!

Content

iSupport
Solution

Sign up to receive DataCenter Maintenance Alerts 16768
Subscribe to iSupport solution notifications using Quick Links  
Driven by Dragon webinar registration and playback 16449
Available tutorial, video, and training resources 16775
Windows 10 support 16782
Nuance Management Console (NMC) login procedure 16773
Maintaining free disk space 16721
Monitoring DMNE server services 16691
Recommended startup and shutdown order for DMNE server services 16691
How mobile devices can be used with Dragon Medical 16697
16711
Disabling Audio Setup Wizard (ASW) Prompt 16809
Resolving hotkey conflicts 16780
QuickStart Mode operation  
How the five recognition modes work 16777
Dosage abbreviations and expansions 16683
Apache WebDAV configuration 16401
athenaNet EHR recommendations 16778
MiniTracker install / upgrade 16704
Enable MiniTracker logging 16705
Change the MiniTracker.log file location 16762
Resolve "Error opening installation log file" uninstalling MiniTracker 16708
Confirm MiniDragon process is running 16706
SQL Certificate of Software Purchase 16733
SQL End User License Agreement (EULA) 16733
Dragon Medical client End User License Agreement (EULA) 16465

Tina Demonstration
Press the play button on the following eTIPS video image for a brief demonstration on the operation of Tina.

Tina Introduction Video

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iSupportWhat's New with Software Releases?

Dragon Medical Hosted on Nuance Cloud
DataCenter customers subscribe to Dragon Medical 360 | Network Edition and Dragon Medical 360 | Direct, hosted on the Nuance Cloud.

New[DataCenter update completed 8/16/15]
Nuance Management Server (NMS) version 5.0
(build 5.0.33.2)

    This NMS 5.0 release is currently not released for upgrades to customer, DMNE on-premise systems.

For information on new features and enhancements for NMS 5.0 from the What's New document, please login to iSupport and search for solution:

    #16800: NMS 5.0 (build 5.0.33.2) release for Hosted Dragon Medical products on Nuance Cloud


Dragon Medical 360 | Network Edition

    [Available for download from iSupport 7/14/15]
    Dragon Medical 360 | Network Edition client, version 2.4.1 (build 12.51.204.108)
    ENU (North American English) and ENG (UK English)

For a complete listing of all software releases and associated release documentation, login to iSupport and search for solution:

    (North American English only)
    #14274
    : Dragon Medical 360 | Network Edition or Enterprise Edition - What's New and Can I download the Current Version?"

    (International)
    #16657
    : DMNE Software Downloads for International Customers - ENG (United Kingdom English)


Dragon Medical 360 | Practice Edition

New[Released 8/20/15]
Dragon Medical Practice Edition, International version 3.0
(French, German, UK English)

    [Available for download from iSupport 12/1/14]
    Dragon Medical Practice Edition, version 2.2,
    ENU (North American English) with Windows 8.1 support

For a complete listing of all software releases and associated release documentation, login to iSupport and search for solutions:

    North American English only
    #14640
    : Dragon Medical Practice Edition - What's New and Can I Download Replacement Software?

    International
    #16678
    : DMPE International Software Downloads


Dragon Medical 360 | Direct

New[Released 8/6/15]
Dragon Medical 360 | Direct, version 2.0 Service Release 6

For a complete listing of all software releases and associated release documentation, login to iSupport and search for solution:

    #15913: Dragon Medical 360 | Direct - Documentation & Release Notes


PowerPack™ Search My Commands™ Clinical Calculators™

New[Released 9/16/15]
PowerPack For Cloud (Direct) Version 1.0

    PowerPack for Cloud is specifically for the Dragon Medical | Direct product hosted on the Nuance Healthcare Cloud. This package includes 21 specialties (.dat files) that collectively contain over 650 templates for the NMC Administrator to import into the appropriate customer NMC groups.

For more information on this Dragon Medical product offering, login to iSupport and search for solution:

    #16430: DM360 PowerPack™/Search My Commands™/Clinical Calculators™ - Software Download and Documentation


If you are not an iSupport subscriber, click iSupport Timesaver for information about how you may become an iSupport member.

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MaintenanceScheduled DataCenter Maintenance

The table below posts pending, scheduled maintenance events for the following Dragon Medical products hosted on the Nuance Healthcare Cloud:

  • Dragon Medical 360 | Network Edition
  • Dragon Medical 360 | Direct

A reminder communication will be sent approximately 15 days prior to each respective maintenance event that will detail the specific impact to all applicable system components.

Date

Day

Start Time

End Time

18-Oct-15

Sunday

3:01amEST

7:01amEST

20-Dec-15

Sunday

3:01amEST

7:01amEST

If you have any questions about these upcoming maintenance events, please contact your Project Manager directly or call (800) 833-7776.

To register additional customer contacts to be notified by email distribution, please login to iSupport and search for solution 16768: Customer Notification for Nuance DataCenter Maintenance Alerts

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iSupportiSupport 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:

  • #12612 "Failed to launch UI automation server / 64 bit server" error when launching Dragon Medical
  • #14918 McAfee Antivirus Interferes with Dragon Medical Operation
  • #16072 Dragon Medical: Power Outage causes either missing PowerMic II Dictation Source or unable to add Mic-in Dictation Source
  • #16341 Workaround for Login Delays caused by built-in Auto-texts on DMNE 2.1 Clients
  • #16827 Dragon Medical installation error "Key not valid for use in specified state"
  • #16830 Lumension Endpoint Security Device Control interferes with Dragon Medical Input Devices
  • #16831 Problems running security / antivirus programs concurrently
  • #15981 Anti-Virus recommendations for Dragon Medical 360 | Network Edition
  • #16461 DM360 Direct Errors caused by blocked network ports
  • #16678 DMPE International Software Downloads
  • #16821 DFS Replication problems cause performance issues and profile corruption
  • #16823 VIDEO: Launching Dragon Medical flashes splash screen momentarily...but no DragonBar
  • #14111 Dragon Medical 360 | Network Edition User Documentation
  • #16728 VIDEO: Dragon Medical - nsdefaults.ini HTML Elements Fix Dictation and Performance Issues in HTML Windows
  • #16809 Disable Audio Setup Wizard (ASW) Prompt
  • #16821 DFS Replication problems cause performance issues and profile corruption
  • #14734 Did you know there are written/spoken form format guidelines for adding new words to the Dragon vocabulary?
  • #14760 How to completely uninstall and reinstall Dragon Medical Client - Remover Tool
  • #16427 Using Dragon Medical with Athena EHR

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 view instructions on how to register to become an iSupport member.

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Contact SupportContacting Support

A dedicated Healthcare Support team available 24x7x365 services 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. At the prompt simply say:

    "Dragon Medical 360 | Network Edition Support" or
    "Dragon Medical Practice Edition"

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 iSupport Timesaver for information about how you may become an iSupport member.

Nuance Depot Repair Service

Click here for a Web Form to submit a Depot Repair Service Request for Connexions Station (C-phone), Optic Mic, PowerMic, Philips Speech Mic, tape-based recording devices, digital recorders, etc. iSupport members can save time by simply logging in to iSupport and submitting a service request choosing "Depot" as the Request Type.

NOTE: There is no need to submit a Depot Repair Service Request on a PowerMic under a current Nuance Maintenance Contract. Call Nuance's Customer Account Management team at 800-339-7683 to get the broken PowerMic replaced. At the prompt simply say, "PowerMic Replacement."

Nuance Healthcare Technical Support

Additional information about how to contact Nuance's customer support team is available at Nuance's Technical Support websites:

Click here for Dragon Medical 360 | Network Edition

Click here for Dragon Medical Practice Edition:

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We are very much interested in your feedback regarding this eTIPS newsletter.
Click here
to reply to this email with your comments or suggestions.

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Click here
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Thank you for taking time out of your busy workday to allow us this opportunity to keep you informed about Nuance Healthcare Solutions Global Support Services.

Sincerely,

Nuance Healthcare Solutions Global Support Services
Nuance Communications, Inc.

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