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December 2015, Volume 7, Number 12

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

eTIP 1:

Resolve user profile errors about "cannot be accessed" and "break the lock".
 

eTIP 2:

Troubleshoot PowerMic and USB device detection issues.
 

eTIP 3:

Use Notepad++ to analyze dragon.log files.
 

eTIP 4:

Dragon Medical and ICD-10 compliance.
 

eTIP 5:

Dragon Medical support for the HIPAA Security Rule.
 



Windows 10 Support

Log in to iSupport and search for solution
16782: Dragon Medical Support for Microsoft Windows 10


Driven By Dragon - Webinar Series

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.


New Software Releases

Click here for new Dragon Medical software releases.


Scheduled DataCenter Maintenance

Click here for scheduled maintenance events for hosted
Dragon Medical products.


eTIPSeTIPS Articles

Click the eTIPS icon on the right to submit ideas for Dragon Medical topics that you would like to see.

Thank you!

 

Did you know how to resolve user profile errors "cannot be accessed" and "break the lock"?

For Dragon Medical profile errors, the video below provides information on the potential causes, the categories of resulting errors, and how to resolve common problems like:

  • Inadequate Windows permissions for profile folders, files, and network shares
  • Breaking the lock on locked profiles
  • Interrupted profile actions causing profile lock issues:
    • username.lck file
    • "_DgnRenamed" character string appended a profile sub-folder or file name


Click Here

 VIDEO: Resolve user profile errors "cannot be accessed"
  and "break the lock"

 (12:27 minutes, Provided by Jeff Schneider)

Refer to the written recommendations listed below to eliminate common causes for these profile access errors:

  1. Close the same Dragon user logged in at any other workstation(s).
  2. Confirm that the Profile folder structure is not being accessed by another application, including Windows Explorer or any text editor. Windows Explorer from any workstation accessing the folder structure can lock the Profile and therefore it should be closed.
  3. Check the profile folder structure for any username.lck files, or folder/file names with _DgnRenamed appended.
    username.lck
    The username.lck file is commonly found under the Profile's \current sub-folder and can simply be deleted. Search for this string over the entire profile folder structure.

    _DgnRenamed
    This character string can be appended to the name of a profile sub-folder or file. It is commonly seen as:

    \[input device]_container\aoptions.ini_DgnRenamed ...or \current\options.ini.DgnRenamed

    Search for this string over the entire profile folder structure.

    • If the unappended file is also present, compare the modified dates for both files and retain the most recent file which will require renaming both files.
    • Otherwise, if the unappended file is not also present, simply rename that file by removing the "_DgnRenamed" string.
    • If a folder name is appended, simply rename that folder by removing the "_DgnRenamed" string.

    Dragon places a lock on the folder structure and certain files while synchronizing, saving, and updating the Profile. The presence of the above appended files/folders means that process was somehow interrupted. The causes include:

    • The user shutting the workstation down ungracefully, resulting in Dragon not being able to complete its own proper closure of the user's profile (most common)
    • Network drop-out / latency issues
  1. Verify that each Windows user account has the appropriate Read/Write/Modify NTFS permissions to the entire Dragon local/locally-cached, and master roaming folder structure (including the Delete Subfolders and Files permission).
  2. Add the proper file exclusions for Dragon Medical to all antivirus/malware/security software. This should include the complete profile folder structure for all sub-folders and files. See solution:
    15981: Anti-Virus recommendations for Dragon Medical 360 | Network Edition.
  3. Temporarily disable Antivirus Real-time or Endpoint protection modes to isolate this as a cause.
  4. Eliminate any other application or process from locking that profile folder structure (including Windows Explorer, Dragon Acoustic and Language Model Optimization, Antivirus/Security/Malware software, IT backup software, etc.)
  5. Try renaming the locally-cached Dragon profile on the workstation. DMEE (Enterprise Edition) Roaming configurations and DMNE (Network Edition) maintain a copy of the master roaming profile on the client workstation.
  6. Review the Windows Event Viewer logs on the client workstation, and if applicable on any servers where Dragon profiles are stored, for evidence of errors or interference with Dragon Medical by another process.

If the problem's source cannot be identified, then the next time this occurs, Dragon Medical Technical Support will need to review the dragon.log file and remote into the workstation to look at the profile folder structure.

To learn more and to keep current with any changes to this topic, log in to  iSupport and search for solution Solution 14646: Dragon Medical User Profile Errors: "cannot be accessed" and "break the lock"

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Did you know how to troubleshoot PowerMic and USB device detection issues?

Dragon Medical supports USB input devices (microphone and headset). Detection of a device by Dragon Medical is contingent upon the Windows operating system successfully detecting this same USB device, first. Depending on several factors including the actual USB device, computer hardware, operating system, and user's workflow; failure to detect USB devices can occur.

The detection process for USB devices by Windows operating systems is called enumeration and involves multiple steps through the operating system software stack, USB hub driver, and PnP Manager.

Each time a USB device is plugged into a USB port, enumeration must occur, even for devices previously enumerated on that computer. This means, for example, that when a PowerMic II microphone that was successfully used on one (1) USB port is unplugged and then plugged into another USB port, re-enumeration must take place.

Note: Enumeration is a function of the Windows operating system, and not Dragon Medical.

Further, under certain circumstances when switching USB ports, re-enumeration can fail, resulting in Dragon Medical being unable to either recognize, or use all of the function of the PowerMic II.

There are several troubleshooting steps below when USB device enumeration fails.

  1. Start troubleshooting by capturing the exact wording of any error messages, if presented.
  2. Close and re-launch the effected application(s) and try to reproduce the issue using the same steps.
  3. Next, try rebooting the computer with the device connected.
  4. If the USB device is connected to a USB hub or a laptop docking station, instead unplug and connect the USB device directly to a USB port on the desktop computer or laptop.
  5. If the problem continues, test the audio record function of the USB device with a third-party application like Windows Sound Recorder. Click the red record button on the Windows Sound Recorder interface to record, as the record button on the USB device will not be active. If the audio record channel is not working on the computer, the issue is not with Dragon Medical and should be addressed by the customer's computer support staff (IT/IS department).
  6. Check the Audio Device Properties of the Windows Sound Settings on the computer to ensure that the USB device is properly detected and configured as the default device for recording.
  7. If available, replace the USB device with the same device to further determine if this is a device issue.
  8. Update the USB device firmware, if applicable.
  9. There could be a power consumption issue with the USB device. Normally, the internal USB Root Hub provides 500 mA of current per port. However, be wary of USB ports on the front of some computer platforms that provide lower power. Instead, try connecting to USB ports at rear of the computer. As well, some USB devices may consume more power when initially connected. Both the power consumption information and power management settings are located in each USB Root Hub's properties under the computer's Device Manager applet.

    Note: It is strongly recommended to disable the computer's ability to turn off the USB device to save power (even on battery-operated laptops). This setting is located under: Device Manager>Root Hub properties>Power Management tab.

    Also, try testing with an active (powered) USB hub to ensure adequate power is available.
  10. If the problem continues, reboot the computer and try again.
  11. If the problem continues, perform a software repair of the target application (for example Dragon Medical) through Windows Add or Remove Programs. Otherwise, uninstall and reinstall the software application.
  12. Otherwise, eliminate all present and non-present USB device drivers using the Nuance iSupport article below:

    Solution 16459: Troubleshooting Input Device Installation: USB Device Cleanup

    USB device drivers will accumulate unless manually uninstalled, and can introduce conflicts to USB function. First, obtain permission from the customer to disconnect all connected USB devices.

    Note: Re-installation of some USB devices may require special software drivers and manual installation.

    After the computer is restarted, the operating system will reinstall the USB Subsystem. This process may take a few minutes. Do NOT connect any USB device until the operating system has completely reinstalled the USB subsystem. Connect only the USB device in question. At this point, the operating system should install the software drivers for the USB device automatically. If however, appropriate drivers cannot be found, install the drivers from the original driver media or from a driver download.

To learn more and to keep current with any changes to this topic, log in to iSupport and search for solution 14252: Resolving USB Device detection issues where Dragon Medical is installed

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Did you know you can use Notepad++ to analyze dragon.log files?

Dragon Medical customers can simplify client troubleshooting practices by setting up Notepad++ templates for reviewing and analyzing Dragon.log files.

Notepad++ is a free source code editor and Windows Notepad replacement, and can be downloaded from multiple internet sites.

With Notepad++ installed, simply import the attached file from the iSupport solution listed below and open the template using the following steps:

  1. Click Language > Define your language



  2. Click Import.



  3. Close Notepad++.
  4. Open Notepad++.
  5. Open the tab with Dragon.log.
  6. Click Language > Dragon.


    See the screen below showing DragonLog.xml Edit++ Language.

Edit++ users can make their own templates as well, based on the issue being researched. See the screen below showing how to add/edit words to templates.

     

To learn more and to keep current with any changes to this topic, log in to iSupport and search for solution 16860: Notepad++ template for analyzing Dragon.log files

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Did you know about Dragon Medical and ICD-10 compliance?

The question of ICD-10 compliance has been asked with regard to the following Dragon Medical products:

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

Generally, since the function of the Dragon Medical product is speech recognition (dictation), and not coding for billing and insurance purposes, the question of ICD-10 compliance within Dragon Medical is not directly applicable.

However, the Dragon Medical team is aware of the new ICD-10 coding and its release (October 1, 2015). We are monitoring the ICD-10 implementation with regard to Dragon Medical and will respond to any issues, if they occur.

Note, that a design review of the Search ICD-10 capability was completed for the DMNE version 2.5, pending release.

To learn more and to keep current with any changes to this topic, log in to iSupport and search for solution 16908: Dragon Medical and ICD-10 Compliance

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Did you know about Dragon Medical support for the HIPAA Security Rule?

For detailed information on how Dragon Medical supports HIPAA (Health Insurance Portability and Accountability Act), refer to the HIPAA Policy page below at the Nuance website:

http://www.nuance.com/for-healthcare/resources/hipaa/index.htm

In addition, log in to iSupport and search for the following solutions:

  • 12231: How Products and Services support the HIPAA Security Rule
    - To learn more and to keep current with any changes to this topic.
    - To view a whitepaper on HIPAA Compliance for Maintenance Service to
    evaluate the security aspects of Products and Services as part of your risk analysis required for HIPAA Security Rule compliance.

    Note, this document is in PDF format and require a PDF Reader to view. Nuance provides download of a free Nuance PDF Reader from our web site.

  • 12244: Remote Diagnostics Whitepaper
    - HIPAA Compliance for Remote Diagnostics.

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Driven By Dragon - Webinar Series

  • We have changed our webinar hosting service to WebEx Event Center.
  • All audio is now 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, February 18th, 2016. To register, please click the Register button below:

Click to Register

   Thursday, February 18th, 2016 at 2:00 PM EST

Click to Register

  Thursday, May 12, 2016 at 2:00 PM EST

Click to Register

  Thursday, August 11, 2016 at 2:00 PM EST

Click to Register

  Thursday, November 10, 2016 at 2:00 PM EST

Recently on October 8th, Dragon Medical Technical Support presented our latest Driven by Dragon Webinar. The content included the following topics:

  • Healthcare Stories
  • New and pending software releases for Dragon Medical products
  • Documentation and iSupport content improvements
  • Technical Spotlight: Dragon Medical version identification
  • 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

4Q' 2015 - October 8
Requires several minutes to begin playback

63:08

413 MB

10/8/15

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.

November Analytics
This past month's reporting analytics for Tina shows the following metrics:

  • 243 Conversations
  • 73% First Contact Answer...where the percentage of user inquiries
    are resolved with the first answer. There was a 7% difference from
    last month (see chart below).

    Two (2) survey questions are used to poll our customers and are
    answered up to 20% of the time.

    The Dragon Medical team is investing more resources to improve
    customer satisfaction.

    This metric shows that only 11% of customers logging into
    iSupport actually take advantage of Tina's self-service benefits.


Tina Improvements
Recently added topics and improvements include:

  • Compatible versions of Windows operating systems, Microsoft Word,
    and Internet Explorer (IE)
  • Supported versions of Epic EMR
  • Latest Dragon Medical software releases
  • Available user accent models
  • Windows support for PowerMic™ and PowerMic™ Mobile
  • How to find the version of your Dragon Medical product
  • How to search for iSupport KB solutions
  • How to implement Dragon Medical with VMware View
  • Minimum requirements
  • PowerMic™ Mobile installation
  • How to create a user profile in Dragon Medical
  • Contacting Technical Support
  • Technical Support availability (hours of operation)
  • DFS support with Dragon Medical
  • How to view recent recognition history
  • And...workflow improvements to 20 other existing topics

Please continue to ask Tina your questions!

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.

    [DataCenter update completed 10/12/15]
    Nuance Management Server (NMS) version 5.0 SP1
    (build 5.0.41.2)

    This NMS 5.0 SP1 release is currently not released for upgrades to customer, DMNE on-premise systems.

For information on new features and enhancements for NMS 5.x from the What's New or Release Note documents, please login to iSupport and search for solution:

    #16800: NMS 5.0 releases 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 12/7/15]
Dragon Medical Practice Edition, International version 3.1
Service Pack - (French, German, UK English)

    [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 11/17/15]
Dragon Medical 360 | Direct, version 2.1 SR2

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 For Cloud™
PowerPack Plus™
PowerPack for EHR™

    [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 medical 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


Dragon Medical NuanceLink Medical Updates

    [Released 9/25/15]
    Medication Update

    A recent medical update have been made available for Dragon Medical 360 | Network Edition (DMNE) customers. The customer's Nuance Management Server (NMS) will automatically "pull" (download) these updates as they become available. Once these updates are downloaded, each update will need customer approval through the Nuance Management Console (NMC) Messages page before the update is made available through the Profile Optimizer Server for distribution to the DMNE end-users. Once approved, the task status can be checked through the NMC Utilities under the Profile Optimizer Task List.

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

    #14281: Dragon Medical NuanceLink Medical Updates


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

20-Dec-15

  Cancelled

17-Jan-16

Sunday

3:01amEST

7:01amEST

21-Feb-16

Sunday

3:01amEST

7:01amEST

20-Mar-16

Sunday

3:01amEST

7:01amEST

17-April-16

Sunday

3:01amEST

7:01amEST

15-May-16

Sunday

3:01amEST

7:01amEST

19-June-16

Sunday

3:01amEST

7:01amEST

17-July-16

Sunday

3:01amEST

7:01amEST

21-Aug-16

Sunday

3:01amEST

7:01amEST

18-Sep-16

Sunday

3:01amEST

7:01amEST

16-Oct-16

Sunday

3:01amEST

7:01amEST

20-Nov-16

Sunday

3:01amEST

7:01amEST

18-Dec-16

Sunday

3:01amEST

7:01amEST

If you have any questions about these upcoming maintenance events, please contact your Project Manager directly or contact Technical Support.

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:

  • #14274 Dragon Medical 360 | Network Edition or Enterprise Edition What's New and Can I Download the Current Version?
  • #16678 DMPE International Software Downloads
  • #16860 Notepad++ template for analyzing Dragon.log files
  • #15913 Dragon Medical 360 | Direct - Documentation & Release Notes
  • #15981 Anti-Virus recommendations for Dragon Medical 360 | Network Edition
  • #15981 Anti-Virus recommendations for Dragon Medical 360 | Network Edition
  • #16928 PowerMic II button control over RDP for Dragon Medical clients
  • #13784 Available Accent Models and guidelines for their selection.
  • #14111 Dragon Medical 360 | Network Edition User Documentation
  • #14120 eTIPS Newsletter Archive - Dragon Medical 360 | Network Edition & Dragon Medical Practice Edition
  • #16711 VIDEO: PowerMic Mobile - Introduction, Resources and Training
  • #16879 Microsoft CEIP causes client issues with performance, crashing, and hanging
  • #16920 Microsoft Compatibility Matrix for Dragon Medical clients
  • #16921 INTERNAL: Troubleshooting DM360 Direct ClickOnce Deployments
  • #16381 Dragon Medical support policy for Epic EHR
  • #16722 Implementing VMware View with Dragon Medical
  • #16782 Dragon Medical Support for Microsoft Windows 10
  • #16879 Microsoft CEIP causes issues with performance / crashing / hanging
  • #16889 VIDEO: Identify version and build numbers for Dragon Medical products
  • #16915 Bit9 Endpoint Security (antivirus) issues with Dragon Medical resolved
  • #16918 PMM Android Error "This webpage is not available"

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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Nuance Welcomes Your Feedback

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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