Home Forums Discussions Problems Dragon and Amazing Charts - Augh!!!

I need to vent. I had heard that older versions of Dragon (Ver 11.0 or older) could be used with Amazing Charts, so I ordered one from Amazon. I ordered Dragon Premium, Version 11.0 but was sent version 11.5. Of course when I tried to install and use it to dictate into AC, it informed me that I need to purchase Dragon Medical to dictate into the EMR. What absolute bullshit! (excuse that). I think it is simply illegal for them to restrict the use of their software simply to force the practitioner to spend $1800 for essentially the same program. It's like selling someone a car and then telling them that they can drive it where ever they want, except on interstate highways. For that, they need a different car that's not really any better, just more expensive. I forget that as medical doctors, we are all rolling in the money. Could this be grounds for a class action lawsuit? Additionally, maybe someone could tell me how Dragon knows that I am dictating into an EMR. What is written in the code of Amazing Charts that lets Dragon know it is an EMR rather than a word processor, or a note pad? Maybe Amazing Charts could provide a patch that would defeat Dragon's restriction. That would teach them a lesson!

EyeGuy,

First, let me say that I understand your frustration. Unfortunately, this isn't something you can do anything about other than buy the correct version of the software you need.

It is not uncommon for software vendors to come out with multiple editions of their software for different needs. Take Microsoft. You have the following for Windows 7:

Windows 7 Starter
Windows 7 Home
Windows 7 Professional
Windows 7 Enterprise
Windows 7 Ultimate

For years and with every version of Windows I watched people go out and buy Windows XP/Vista/7 Home Edition for their business. In some cases, they just didn't know any better. In other cases (actually, the main case) they bought the Home Edition because it was cheaper. Of course, they began the usual rants about the situation not being fair when I told them the Home Edition wouldn't do all the things they need it to do.

Some messes are best avoided, not cleaned up after. I recommend before making any Big Software Purchase like this to consider the following:

* Come to this board and ask. You have myself, Indy, Sandeep, Bert, and many others that can help you.

* Consult an IT person. Every practice should have a reputable IT person on speed dial. Horrifically, many don't.

Try to return the software, if you can. You may be able to exchange it. Consult with the vendor you bought it from.

Does one edition of Dragon do pretty much the same thing other editions do? Yes. So why is Dragon Medical more expensive than the others? There are very good economic reasons for that which I will not get into here. Suffice to say, software is priced more on a value system of Economics rather than the traditional production system we are all accustomed to.

JamesNT

It?s not Ver. 11 but Ver. 9 that will work in an EMR but at this point, the technology has improved so much that even if you could purchase Ver. 9 and you?re still willing to work with Windows XP (because it cannot be installed on Windows 7/8) it would be equivalent to changing your car?s spark plugs with an adjustable wrench. While I can appreciate that the cost of Dragon Medical is high at $1600, you wouldn?t purchase your stethoscope at Kmart. Even if you could use DNS Premium in your EMR, you wouldn?t have the command capability, network capability or the proper language model (among many other features that are designed for physicians). DNS Premium also comes with a $5 microphone which may or may not work on your computer. This is why I recommend contacting a proper speech recognition consultant because all you need is one weak link in the chain to make you think that speech recognition isn?t ready for prime time. You?d be amazed at how many people return their software because they didn?t realize that their integrated soundcard wasn?t up to the task. If speech recognition is going to play an important role in your workflow, don?t purchase the equivalence of over-the-counter eyeglasses from Walmart. Purchase from specialist.

Dragon Medical is MAP priced everywhere and while I can?t do much about that price, I can include virtual Onsite support, free training (there is a bit of a learning curve) and a complimentary copy of our KnowBrainer 2012 command utility (simplifies the learning curve while increasing your efficiency). Our company is also offering a Dragon Medical Forum Special.

The previous recommendation is the right way to do it but there are other options. If you feel that you simply cannot justify that price, you can use DNS Premium and cut and paste from other applications such as Microsoft Word or DragonPad but every time you click into your EMR, the microphones going to be turned off.

Another, slightly more expensive option would be KnowBrainer 2012 Medical which not only incorporates our KnowBrainer command utility but additionally incorporates medical language models (medical vocabularies) and a rich text editor which will allow you to dictate into Amazing Charts. Here?s how it works: Place your cursor inside of the field you wish to dictate into in Amazing Charts. Your microphone will be turned off but there?s nothing we can do about that because Nuance has all the cards. Now click the KnowBrainer Medical Editor Window which will pop up our rich text editor while simultaneously turning on your microphone. After you finish dictating say ?Transfer? and your text will disappear from the KnowBrainer editor, land in the Amazing Charts field, tab to the next Amazing Charts field (note that your microphone will turn off but this is no longer a problem), re-open the KnowBrainer Editor and turn the microphone back on so that you can repeat the circle of events. Is this as good is being able to dictate directly into Amazing Charts? Absolutely not but the price of combining KnowBrainer 2012 Medical with DNS Premium is less than $700. We still recommend going with the full Dragon Medical product but at least you have an option.

You can forget about the class-action suit, notifying a federal prosecutor or taking any other legal action because Nuance has managed to quash all previous attempts and they have managed to get away with this for over 5 years. While I completely disagree with Nuance?s marketing strategy (I prefer the carrot approach) it doesn?t look like anyone can change their policy.

Dragon knows that you are dictating into Amazing Charts because it?s been coded directly into the application. Dragon also reads the Window name of your application. For example, if you open a Microsoft Word document, name your document Amazing Charts, save your document and reopen the document, NaturallySpeaking will turn the microphone off because it suspects that you are attempting to dictate into an EMR. The reason why NaturallySpeaking reads the Windows is because many EMRs are web-based and NaturallySpeaking would have no other way to identify the application. I?m afraid that Nuance is holding all the cards.

Thanks to James and Tom for the detailed explanation and insight... and damn those computer geeks!

Heh! It's not the geeks. It's the CEO's and marketing guys.

JamesNT

This conversation occurred some years ago, when Nuance changed its policy to restrict use of non-medical versions in EHRs.

Well, sometimes it is okay to resurrect these issues if only to complain about them some more

Does anyone know if they have changed the Dragon Remote Microphone Iphone app such that it will work with Dragon Medical? Right now it only works with Dragon Dictate v 11.5 or higher (which makes no sense)???

Remember that you are not buying the software, only paying for a license to use it according to their terms (EULA).
It is not the same as buying a car or other properties.
Irritating but apparently is a profitable decision in their eyes.
Unfortunately they seem to own the field of voice recognition, until competition comes along they have their own way.
Greg

LuisP,

You are correct that it makes no sense. Unfortunately the short answer is no, this is something to look for in Dragon Medical 12 which is still far away.

Windows Voice recognition really isn't that bad and for less than $300 you can buy tools and medical vocabulary from emicrophones
http://www.emicrophones.com/c-8-windows-speech-wsr.aspx

I've wondered about this. Is Dragon *that* much better than the built-in speech recognition in Windows 7?

Well one factor that often gets overlooked is the quality of the microphone when people use voice recognition. The sad fact is that most are pretty bad and it's hard to find a good one. There are often trade-offs between portability and usability.

Lots of computer microphones are omnidirectional and pick up all sorts of sounds that interfere with recognition. Also, the quality of the sound card comes into play in some machines. Built-in sound cards are newer computers are pretty good nowadays. But lots of voice recognition software includes a USB sound card or USB mics.

Dragon 11.5 is awesome. I hate typing and always have been a one finger kind of guy. As I looked into dictation options, including the built-in Microsoft version, found that Dragon 11.5 for medical professionals was program that I needed to try. The nonmedical addition of Dragon I looked into of course because it was cheaper. However, I found out that the regular nonmedical addition of Dragon would not work with most medical EMRs including Amazing Charts. That explained to me why the big price difference between the 2 versions.
My current Dragon allows me to finish charts much quicker and much more accurately. My staff even says I'm overloading them with dictations. The accuracy is so good is almost scary. It even understands my read neck dialect.
In reading through the above posts, I have noticed something that may require a word of caution. There has been a request from some 2 others to borrow the dictation software. I would advise against this because it would be equivalent to software piracy.
More letter
Nate

For testing purposes you'll need at least version 10.1 if you're running on Windows 7. The home version is little more than a toy so I strongly suggest using Premium/Preferred at minimum. You can actually use the product up to 5 times without registering it online and using up an activation. If you put your computer in hibernation mode rather than turning it off you can make those 5 uses last a few weeks.

The integrated soundcards are still not good for Speech recognitoin with Realtech Audio being at the bottom of the heap. A good microphone is not hard to find at all but too many people go for microphones that were intended for Voip and video games. Thier are amazing microphones that range in price from 50.00 to 500.00.

I dont think it's piracy if I'm not using them!

I'm not using them because I am using AC!

(We are actually using DragonMedical 8 and DragonPreferred 9.5, which means that we cannot go forward from Win XP)

Gene

Microsoft hoped to generate lots of excitement from the general consumer market with the Vista speech engine but failed. Upon failing they pretty much stopped R&D and cut funding to the project. Comparing the Windows speech engine and its capabilities to even NaturallySpeaking Preferred is like comparing Notepad to Microsoft Word. Trigram used to sell their medical vocabularies for 300.00 as an add on to DNS as well as WSR and they did a lot of business but they are now almost unheard of.

Free in OS,trainable to new words,with or without the add on vocabulary from Trigram; Windows Speech Recognition works well for me
On the other hand maybe Microsoft should take a lesson from Nuance and require physicians to buy the highest level/cost OS at an exhorbitant price and rig thier lessor OS offerings to not allow them to work with EHR's