Home Forums Discussions General Discussion Starting A-C on aTablet PC.

I am planning to switch to Amazing-charts soon but I have many questions about the hardware and initial setup.
I am an Allergist, in solo practice for 24 years. I am not at all good at typing.I have limited computer skills but I am willing to learn! Changing to an EMR seems like a dauntig task.So I can use all the help and advice I can get.
I am planning to use a Tablet PC (Hitachi or HP?) so I can use the handwriting recognition feature along with Dragon NS .Should I buy the Medical version(9.0)? Also I plan to scan my charts (4-5pages initially/chart).Would a scanner like Xerox Documate- 152 be a good choice?
I look forward to getting feedback from your forum.Thanks.

Please check out this recent post and it should steer you in right direction.

http://amazingcharts.com/ub/ubbthre...ds=&topic=0&Search=true#Post5896

A high speed Canon scanner is recommended in the higher end shopping list that works very well.

For the tablet PC's, simply swap out your preferred model either one of the desktops or the laptop from the high end shopping list. Be sure to try them out in a store as the tablets are a very personal choice and you want one that will feel "right". I believe there are higher rated models than either the Hitachi and/or HP available.

Thank you(EricB) for your suggestion on the Canon scanner.If any member has a recommendation for a Tablet PC please let me know.Thanks a bunch.

I use Fujitsu tablets. I got a great deal on refurbished tablets from their eBay store.

If you use the Search feature on this website, and set it for the past 6 months or so, you will find lots of past threads on tablet PCs and Dragon Naturally Speaking, including links to other websites.

I would recommend either buying DNS 9.5 or looking into one of the KnowBrainer medical vocabularies. Tom Hamilton from KnowBrainer posts here from time to time.

Here's a good website with lots of tablet PC reviews:

http://www.tabletpc2.com/

Now we could have just gotten stuck with a lemon, but the one Toshiba tablet (M-275) we bought has been a real dog. It has always been slow, came with tons of extra bloat software that I am not good enough to know which need to stay and which can go; and it is now on it's "Third" motherboard!!!

Now the main part of the motherboard didn't actually go, but twice now the video section of it crapped out pretty much without warning rendering the machine very suddenly useless. And then even though I had the company's extended coverage, the idiots I had to deal with on the other side of the world, just to finally get my on-site coverage started, so someone could start fixing it was just insane.

This is the problem with most computer reviews as I see it. Unlike car magazines that do long term updates on a certain amount of cars to help consumers know how much service did it need and how well it was holding up, computer reviews are one time only. Yes, many laptops come with all sorts of great features, but I want to know who is making solid ones that will stand the test of time. Just like with my Jeeps, I just want to know that if I take reasonably good care of it, the darn thing is going to wake up and drive every morning, and not leave me stranded. Computer reviews, especially with laptops should let them live with their staff in the real world and do follow ups as they do in the car mags.

On the other side of the coin, we really like our two Gateways tablets. We and a few other AC users are really upset that they kind of ditched the "business" side of the operations, no less many of their machines have very limited amounts of customizing or options to choose from. I keep window shopping Dell, but as of yet can not bring myself to pull the trigger. I just really want my good old Gateway back.

Anyway, watch out for well featured but fragile laptops and tablets. That my two cents worth anyway.

A few years back, one of my sisters recommeded Gateway because she had had good luck with them (and she had previously bashed Compaq--back in the day). So I purchased one for Dr. C. It was great, and I eventually ordered several Gateways for her and for my personnal use. Then Gateway sold off their Business business. I don't know what I'm gonna due for the next purchase. But from what you've said I won't be choosing a Toshiba.

I own 3 Toshiba labtops (2 of which are laptops) and think they are wonderful. I got my first tablet 4 years ago. I am typing this reply on that machine (a Toshiba R15-S822). The R15 series of Toshiba was a good bargain-around $1000-$1100 with a nice feel and pretty good battery life on the standard battery (I get just under 3 hours in the clinic). The only downside is that they are a little heavy for a laptop. This model is no longer manufactured but I'm sure the subsequent Toshiba tablets are equally sturdy, albeit more expensive. (I use one tablet in clinic and a second at home. The third Toshiba is for family use/Internet access)

There is a nice website called medicaltabletpc.com which can give you some feedback from others. I'm not sure how free they are of commercial bias, but I haven't sensed a ton of it. (I'm sorry I don't know how to set up the website as a hotlink)

2 other tidbits: There is a neat little program called RitePen that lets you write anywhere on the screen and not just in the text box. It only costs $29 and is decent. You can find the link for it on the medicaltabletpc.com site. Secondly, in my area (Arizona) many of the drug reps use tablets, and you might consider asking them about how reliable their machines are.

Finally, I just bought a true touchscreen computer which is also like a tablet. It is the HP IQ775 and I plan on integrating it into one of my exam rooms. It is an all in one type of machine. You can read about it on the HP website and Circuit City and Office Depot display it so you can try before buying (although the salespeople aren't that knowledgeable about this machine.) It may be something to look at just for an alternative. It is pricey ($1500 or so unless you find a store going out of business like I did) yet it is a real powerful machine. Best of luck.

Welcome to AC J. Wow, you are new to AC. That's awesome. I know very little about tablets or laptops in that I have never used them, but my guess is you are thinking that a link must be technically complicated. You only need to type it out:

http://yahoo.com or www.google.com

Or like this Bert?

www.twincityfamilymedicine.com or www.riverviewpediatrics.org

I think he is trying to do it the classy way, like this:

Cool Timewaster

I can tell you quite a bit about the Sahara Slate, and it works just fine with Dragon 9.5. You can visit the blog and go to the tablet area and find all kinds of stuff, and I have done a couple You Tube videos as well, using dictation in a not so good area, and it was working pretty well with the dual array microphones, in other words, no headset required.
http://ducknetweb.blogspot.com/

We've been working off and on with Amazing Charts and we're planning on supporting it, from a command point of view, in an upcoming version of KnowBrainer 2007 which should help.

You can save a good deal of money, as previously mentioned by Brian Cotner, by adding a 3rd party medical vocab (language model) to DNS Pro and you'll find this recommended in a bundle at NaturallySpeaking Medical 9.5. Because you are using a tablet computer you might also want to take a look at the new Buddy StylusMic tablet computer microphone.

When it comes to purchasing a tablet computer you may also consider posting your computer related questions on the KnowBrainer Computer Forum which is hosted by Chuck Runquist, the former head developer of NaturallySpeaking. He is much more knowledgeable than we are when it comes to computers. We will just say that if you're going with Windows Vista, get 3 Gb of RAM and if you're going with Windows XP, get 2 GB of RAM and make sure that you purchase an Intel core 2 duo chip (no AMD) with a minimum of a 2.0 GHz processor.

KnowBrainer, Inc. Support Staff – Tom Hamilton
A Nuance Gold Certified Endorsed Vendor

Tom:

Please explain how this works.

I thought I had seen a post by you on another forum stating that you could add KnowBrainer and your Medical Vocabulary to DNS *PREFERRED*, and have kind of a discount version of DNS Medical.

Is that not the case? Does it have to be DNS Professional?

When you say that KnowBrainer will *support* AC, what exactly would that include?

We don't normally make this recommendation for professionals because the consumer versions of NaturallySpeaking lack network compatibility, multiple vocabularies, industrial-strength Vocabulary Builder, real command capability and a number of other amenities but you're absolutely correct. When you add our KnowBrainer command software to Preferred 9.5, in many ways you have the equivalent of DNS Professional on steroids because you have the ability to add scripting commands plus our 11,000 time saving commands. When you add our Medical vocabularies to DNS Preferred, in many ways you have the equivalence of DNS Medical but you should probably verify that it will work with Amazing Charts. We suspect it will and it will definitely cost far less.

KnowBrainer does not currently directly support Amazing Charts but a number of our clients have already started creating custom commands for KnowBrainer which also includes the ability for you to add your own advanced scripting commands; a feature that DNS Preferred lacks because macro capability is only available in DNS Pro or KnowBrainer.

KnowBrainer, Inc. Support Staff – Tom Hamilton
A Nuance Gold Certified Endorsed Vendor

Very interesting. I have been using DNS 9.5 to create command and control macros for AC and it has been a blast. I am starting to get into the Advanced Scripting now which has opened up new horizons.

I could not pull off AC without DNS, for physical and practical reasons.

I have reached the point where I can select patients, open their records, manage diagnoses, labs and meds, nearly hands-free.

I am hoping to demonstrate how this all works at the User's Conference in June.

I am interested in experimenting with going wireless or picking up a Buddy StylusMic, but the cost is a little prohibitive for experimentation.

Again, Tom, I hope I don't seem dense, but explain what it would mean if Amazing Charts was "supported" by KnowBrainer. What benefits would accrue? I have read about KnowBrainer, but I still don't understand what the difference is between a "supported" and "unsupported" product.

Buddy StylusMic?

The headset that I use may be way too inexpensive to the likes of hard-core Naturally Speaking aficionados... Tom may even refer to it as "cr*p"... I'm almost embarrased to post it, but here it goes:

-- LifeChat LX-3000 Headset USB Headset --

Costs about $12 on ebay. Sends off a clear, crisp reception that allows Naturally Speaking 9.5 Preferred to give me about a 98% accuracy. The quality is incredible, at any price. If your little daughter steps on it like mine did after just 4 days of use, just buy another one... ebay is dumping them as we speak!

The reason that I use NS9 Preferred is that it sells for $60 on eBay, and is accurate enough that adding medical language tables is really overkill. I'm amazed when it hears something like "esophagogastroduodenoscopy" and it gets it right on the first try (probably because it reviews my doc files on my computer thoroughly). I've used NS8 Medical before, and I find it to be as good if not better for my referral letters than the NS8 medical. I have NS9 Preferred licenses in both English and Spanish, and get great accuracy in BOTH languages.

But I'm just a cheap buyer...

MS Headset: http://search.ebay.com/search/searc...LifeChat+LX-3000+Headset+&category0=
DNS9 Preferred: http://search.ebay.com/search/searc...agon+naturally+speaking+9&category0=

(Unfortunately there are no "preferred" DNS9 items selling for $60 "Buy It Now" deals currently, but you can bid on them and get one for much less than $100. In about a week, I'm sure some $60 deals will come back.)

If you have to bid: DON'T! Use a service to bid for you at the last moment, or to do multi-bids. I personally use BIDSLAMMER, found here: http://www.bidslammer.com/

I use a $20 Logitech USB mic from Wal-Mart right now and it is working well.

I am interested in a wireless solution so that I can dictate and stay mobile with a slate PC.

Brian-

That's the mic that I use at work! Works really well...

The ability to dictate in a mobile fashion can be important. That's the one drawback of my prior solutions- from the Windows CE-based Airpanels (no dictation software could be loaded) to the HP TC-1000 tablet (had a limit of 750MB ram from which the display drew its share of memory) which just didn't allow for dictation.

I currently dictate to my desktop, which isn't bad, as it allows me to separate from the patient then hand off the chart to my nurse. The 3.4 GHz CPU with 3GB RAM makes dictation a breeze.

BTW- found a cheap DNS9 Preferred "Buy It Now" ($76 incl S&H): http://cgi.ebay.com/Naturally-Speak...287QQssPageNameZWDVWQQrdZ1QQcmdZViewItem

Exactly. I recognize the benefits of completing the note in the room like many members of this forum do. However, I like stepping out, setting down my thoughts, discussing the case with my nurse and coordinating the plan, without further interjections and complaints from the patient.

("While you're setting up my BMI, Doc, could I tell you about this other problem I've been having? No doctor has ever given me a satisfactory diagnosis. It began in 1973...).

Also, I dictate in a quiet room across the hall, with plenty of table space to spread out their old paper chart.

I am still in the process of conversion from paper, and the first time I see a patient who has never been entered into Amazing Charts, I do an audit of the old chart and enter pertinent info into AC.

Dictating with Dragon allows me to flip pages with both hands and talk about what I'm seeing.

The new voice command enhancements in the current Beta mean that I can navigate to the text entry fields using voice commands, without resorting to the mouse or keyboard, which speeds up this process.

My 1st recommendation would be to check out What is KnowBrainer PDF file to learn more about what KnowBrainer can add to NaturallySpeaking. Being supported by KnowBrainer means that we have added our own collection of commands which you are no doubt currently doing and with one of the professional versions of NaturallySpeaking. KnowBrainer is basically a collection of 11,000 time saving commands that will allow you to add personal Advanced-Scripting commands. Advanced-Scripting technology is currently only available in the professional versions of NaturallySpeaking. KnowBrainer not only includes 11,000 prefab commands but the ability to add Advanced-Scripting commands to DNS Preferred. Our friend Alborg may be patting himself on the back for saving a small fortune by buying a pirated copy of DNS Preferred for $60 on eBay (which I'm sure he didn't realize at the time) but that's about equivalent to driving a car on 3 wheels. DNS Preferred is only capable simple boilerplate commands and cannot be used to automate other software which can drastically limit the functionality and efficiency of any professional.

Note: you can tell that DNS is pirated by looking at the back of the paper sleeve on the 1st CD. You should see the copyright information in 8 different languages and you should see 3 copies of the serial number. 2 of the serial numbers are peel off labels which are designed by the manufacturer so that you can stick the serial number on the CD and the manual. Speaking of the manual, pirated software doesn't include a manual and when the vendor claims that they made a special deal with Nuance and that the help files are on the CD, they're lying. We know of no manufacturer that makes a special deal with any eBay vendors because it's less expensive to simply destroy defective software. Additionally, Nuance certified/licensed vendor contracts prohibit them from selling on online auctions such as eBay and that's why you won't see our name on eBay. We work for Nuance. Also note that when you purchase DNS from an online auction you have no support from the manufacturer and there is no such thing as vendor support on eBay. When you purchase NaturallySpeaking from a licensed vendor you gain an additional layer of Technical Support and when you purchase from us to get our training guide and our virtual on-site technical support. Within the next couple of days we will be putting our legal copies of Preferred 9.5 on sale for $120 and NaturallySpeaking Pro 9.5 on sale for $500 which should make them the lowest legitimate price on the Internet. DO NOT PURCHASE SOFTWARE FROM EBAY. 1 of the things that eBay vendors like to do is make 10 copies of every legitimate copy of NaturallySpeaking so that when they sell you a pirated CD it will install on your computer but when you go to install the software on another computer in a couple of months, you will find out that you're out of activations. When you call Nuance they will tell you that you're using pirated software and that the vendor sold an additional 9 copies of it before selling you your copy. Do you really want to support software piracy and do you really want to risk losing your software by saving $20 on DNS Preferred? There is no such thing as a legitimate copy of DNS Preferred for under $100 because the wholesale price on DNS Preferred is considerably more. It simply isn't possible for these eBay vendors to make a profit selling software below their own cost and that means it's pirated. Unfortunately Nuance cannot keep up with piracy but they typically go after the major offenders.

Purchasing KnowBrainer wouldn't specifically help you with Amazing Charts because you have already written your own commands but we will be adding Amazing Charts commands in future versions of KnowBrainer. The only reason for getting KnowBrainer at this time would be to increase your efficiency everywhere else and increase your dictation command efficiency. You'll find dozens of examples in the previously mentioned PDF file.

KnowBrainer, Inc. Support Staff – Tom Hamilton
A Nuance Gold Certified Endorsed Vendor

I'm afraid I have to disagree with Alborg’s LifeChat LX-3000 and your Logitech USB microphone recommendation. 1 of my jobs is to test microphones for Nuance and various speech recognition vendors. No Logitech microphone has ever come close to meeting our requirements. The Plantronics DSP line of consumer microphones came the closest but no cigar. There's a reason why your stethoscope has an L. on it rather than a K. as in Kmart. It is because quality counts. We don't even recommend using DNS Preferred in a professional workplace (although you can get by with it) and we certainly don't recommend using consumer grade microphones even if you are getting relatively good results which most end-users will not. There's a reason why a professional mechanic doesn't buy his tools at Wal-Mart and neither should you. The noise cancellation on these types of microphones are almost nonexistent, they are typically uncomfortable and the microphone elements are extremely small. These types of microphones are primarily designed for VoIP and gamers; not serious speech recognition use.

If you're looking for a real wireless microphone solution you have many options which you will find on our Microphone Comparison Matrix but you will want to narrow down your choices. Decide if you need an extremely noise canceling wireless headset that will double as a wireless headset for your landline telephone and cell phone. You may not need a very noise canceling microphone or even a headset microphone if you dictate in a quiet office. Perhaps a lapel microphone will do. You probably don't need a microphone with 2 giant speakers on each year, like most commercial grade headsets but you may have other requirements. Privacy/security may also be a concern. You'll also be able to compare these microphones for comfort, pricing, accuracy and noise cancellation.

KnowBrainer, Inc. Support Staff – Tom Hamilton
A Nuance Gold Certified Endorsed Vendor

I'm a newbie to AC (officially) but have been playing aroung with it on the periphery. I use a Toshiba satellite R15-S829 with Dragon Medical without any microphone except the one built into the tablet. Been using this tablet for a couple of years this way and it seems to work well.
I don't know why this is but DNS seems to be more responsive, less pause, in AC as compared to other applications. Probably because I want it to be, I mean, there is no reason for a quicker response, right?
I love placebos
Tom

Hi Tom:

>>> We don't even recommend using DNS Preferred in a professional workplace (although you can get by with it)

Why? They use the same engine as the "medical", and provide macro support.

I simply cannot afford to purchase 4 "medical" licenses of DNS9 at $1000 a pop, especially when the "preferred" performs nearly as well with the most difficult medical terms after only 10 minutes of training, and gets even better with time.

An excellent review of DNS9 can be found here: http://www.consumersearch.com/www/software/voice-recognition-software/review.html

>>> LifeChat LX-3000 and Logitech USB microphone recommendations... The noise cancellation on these types of microphones are almost nonexistent, they are typically uncomfortable and the microphone elements are extremely small.

Both of these headsets are very comfortable and work even in a moderately noisy office, and sure as heck will beat any lapel microphone, and possibly most laptop mics which I find usually do not to work well. I guess the "Leatherette ear pads" can be improved by using REAL leather lined with gold, but that's expecting a bit much, and even the most expensive Plantronics sets aren't as lucky!

Tom, your site is nicely laid out and the review of the handful of headsets is a good beginning but I take issue with the fact that:

1) You're a headphones vendor with an obvious and I'm sure heartfelt bias against cheaper headsets.
2) I would prefer to see a review of the products by an independent company, s.a. cnet or by consumer reports.
3) Your review of headsets should include some cheaper sets, including their stats. These could serve as "controls".
4) I'd like to see reviews by end users. If you look at general cnet.com reviews for the DNS9 software, cnet gave DNS9 an "8" when endusers give it a more realistic "5.4".
5) I can see where a quality mic might be needed, s.a. for music, but for voice recognition, a much less expensive unit can be more than enough.

(Example of what you can do to add less expensive mics to your reviews! URL from $7.99 price- http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&rd=1&item=200224268492&ssPageName=STRK:MEWN:IT&ih=010 )

If you wish to see a very detailed, positive video presentation on the LX-3000 by Mike Gannotti (in his blog site) go to http://sharepoint.microsoft.com/blogs/mikeg/Lists/Posts/Post.aspx?ID=830 .

Another seemingly unbiased review of the LX-3000 can be found here: http://www.goodgearguide.com.au/index.php/taxid;2136212935;pid;3573;pt;1 .

(These mics get no respect!)

Al,
I love Rodney.... Non-CCHIT EMR's don't get no respect either, right?

Al,
I'll have to stand by my test results but different opinions are the foundation of discussion forums.

I would at least like to see you take advantage of an NFR Copy of KnowBrainer 2007 for having over 2000 posts at EMR Update.

KnowBrainer, Inc. Support Staff – Tom Hamilton
A Nuance Gold Certified Endorsed Vendor

Just got my replacement of my $8.00 headphones; the original set lasted only a week- my 6 year old daughter stepped on them and destroyed the plastic frame. Another reason to not go overboard on buying this stuff- children. Cute little darlings with a prediliction to destroy HIT.

Thanks for all the good information, Tom.

I looked at the PDF you referred to me and it was very informative.

I have been working with Jon on adding enhancements to the controls of Amazing Charts to facilitate Dragon command and control capabilities. A lot of great improvements occurred in the latest Beta. I believe this will be a big help to users with disabilities and can also help to prevent disabilities by reducing repetitive stress injury.

It is also just plain cool.

A few points, particular to the Amazing Charts crowd:

1. People on this forum are generally very frugal, to use a nice term! Amazing Charts is an excellent EMR for stressed-out solo docs and small practices who are trying to keep their overhead down.
2. People here are interested in voice recognition, as a means to creating personalized notes while keeping transcription costs and overhead down.
3. To that end, from a marketing standpoint, you're going to have a lot better luck getting folks to try DNS Preferred with the medical vocab, then getting them to add on KnowBrainer if they decide they are missing those capabilities.
4. The Logitech headset gives adequate recognition for me, even using my Dell's internal sound card. I realize that may not be the case for everyone, but for me it is adequate. And, adequate is adequate.
   1. My biggest problem is actually discomfort -- I can't wear it for a long time -- it hurts my ears.
   2. Also, I use a K-Mart stethoscope, not a Littman.
5. A number of folks here have tried Dragon and rejected it because it made embarrassing mistakes or they could not train it properly. I am sure this is because of inadequacies in training or equipment, but if they are unwilling/unable to correct these things with $95 Preferred, they would have had the same problem with $950 Medical version.

Hey its OK we really are a bunch of cheap B@$t@rds...

And with congress's idea of a fee schedule is it any wonder??? Does Dragon allow someone a trial to play with??? I'm wondering about it with Al's favorite mic. If I could just allow Nancy to play with it without spending a lot upfront for what might be a no go, that would be sweet.

And don't knock cheap mics (price wise). As an audio engineer although there really is a difference between poorly designed and well designed mic, one of the most used, appreciated, abused, it took a lickin' and kept on tickin' mics has been around forever. The infamous Shure SM58. Remember Roger Daltery??? You can literally hammer a nail with the thing, have it look like it just got hit with buckshot while the "the microphone smells like a beer" and it just won't quit. Same frequency response and S/N ratio. Now is the thing as sensitive as some $1000 condensor mic? Will it even have that big radio sound of the EV's? Will it ever be as warm as a good ribbon? Will it capture those sizzle highs for great high hats and the like? Hell no, but try getting some top of the line condensor to be that reliable day in and day out no matter what. So if the software and computer recognize what you say as speech, does it really matter???

Hey Tom; as an old Audio tech, how much of the processing of the signal since it is starting as an analog signal from the air to the mic and it's diaphram thru it's coil and connections back to the PC has to do with the actual sound card recieving it? Both in terms of the analog side of the card (I'm sure there are old fashioned analog signal issues there, these things certainly are not running on XLR balanced connections with top sheilding at plus 4 or 8 studio or broadcast type levels) ; as well as the A/D conversion itself? And what about any software and processing anywhere along the chain?

This is not meant to bust on you at all, it is a sincere attempt to understand the process better. Also what I'm getting at is might there be several other factors that might explain things like Al's good outcomes with modest equipment verses standardized, control all variables and then only change one type testing.

Also are there things in software and processing that a decent end user could adjust that might help the program understand things, clean up the signal or help clarify things so it can better do it's job??? I could even see that perhaps what would be a great mic for actual sounds good to the human ear type things, might not actually be all that great for the software or computer. They may want to "hear it" in a way that isn't all that good for us, but it works for the software...

I remember when digital just came out, tape and CD's, everyone was talking about how clear but "cold" it all sounded. Meanwhile I would take stuff home to my old Sherwood set up and these new recordings sounded great in my living room with just this old stero and average speakers or decent Sienheizer headphones. Well it took awhile for my to realize why they sounded just as good timber wise for me at home while everyone else was choking on them. I was doing what we all do now with our studio recordings, I was adding my own warmth back in with my wonderful old tube amp. Now most engineers and producers are adding tube pre-amps to their signals before the board to gain back some of that old fashioned lost warmth that only good old analog had to offer. So what is "good" for the human animal is not always what is best for the computer.

Heck you know just how many of us audio guys are half deaf and have a real notch in our hearing right around those really important 1-4K hz frequencies that bring out the intelligbility in speach. But hey if you and I agree that is a kicking snare drum then whether or not our hearing is obviously different, then it is still a great snare drum. Sure I care about basic specs but one thing I learned was to pick what worked, I've used all sorts of against the rules, the standards, mics. Sometime because I was being forced to punt, I didn't have access to my first or second choice. And the second thing that recording and live sound reinforcement taught me was mic placement combined with understanding one's house, once out in the air as you well know the house, the people in it all play heavily in the final outcome. I'm like Mr Scott, I respect the laws of physics and try to work with, not against mother nature.

Just sort of thinking out loud and throwing it to you since you work with these things all the time. It's beeb awhile since I could talk this kind of shop with someone. Thanks much.

I just found out an interesting tidbit, on why the eBay DNS9 DNS softwares may be so cheap. When my computer got hit by a virus, I set up everything back OK, but my DNS9 wouldn't pass the activation routine.

It seems that DNS9 has only 6 or so activations allowed. The sellers most likely bought in bulk for the occasional sale priced DNS9 Preferred at $99, then split it up into 3 sales of $60 each, making a good profit. It can still be a good deal if your backups work- I switched my hard drive and my backup got scr*wed with the failed WinXP repair installation.

Nuance refused my reactivation of my software, but to make good, they offered the DNS9 Preferred for $99. So I got 6 DNS9 setups (plus free headset)... not a bad deal!

Now, if this would have occurred with the $950 DNS Medical, I would have been royally upset (no "special pricing" there). Heck, I can't even get my paid-for DNS Medical 8 to work on any computer due to activation issues (and this one was purchased from Nuance)!

Al, I upgraded my Medical 8 to Medical 9 for a couple of hundred dollars - is that an option for you?

Hi Brian:

The problem that I had was that Medical 8 was an upgrade itself, and unlike any other software company, it has to actually be installed, and there was a problem with installing multiple versions of DNS to finally get to DNS8 to install for the upgrade.

THAT's why I refuse to pay past the preferred- I got royally scr*wed. Their policy on activation sucks. Anyhow, the preferred really is more than enough for me... it learns well and fast. I just pass my training around to all of my computers.

And because they make the leading product in this niche market, they can get away with it to a large extend also.

"and they call me mad, I'll show them mad!!!!!!"

I find it very, eh,, difficult when I am asked to pay 10 X higher costs because I am a professional. They make DNS in foreign languages? And is it $1,000? But in medical it costs 10 X more to manufacture? I will continue to work on my typing skills. (and I will read a little more about Linux in my spare time!)

I agree, Martin- anything with "medical" attached to it automatically increases the widget price by a factor of 10. Same goes with EMRs (except AC, of course!).

>>>they make the leading product in this niche market

Niche market??? Hell, they OWN this market- remember that Nuance was the owner of ViaVoice, and when they bought out DNS, they decided to let that product die and only upgrade DNS. They still sell ViaVoice for those with slower computers.

I guess that is the situation that HIT is headed to if CCHIT/P4P/eprescribing takes over.

I started out on Preferred and I didn't feel the performance was there. I found a copy of Medical 8 on eBay, and then later upgraded to Medical 9. I felt that I experienced a major improvement in performance.

The major deficiencies with Preferred are the lack of medical vocabulary, and the inability to create macros.

This is why I was excited to see Tom's post on another forum, where he described adding KnowBrainer and KnowBrainer Medical Vocabulary to Preferred.

I saw this as a way to get AC users excellent voice recognition and command and control capabilities for $300-$400 less than buying the medical version.