I am using the new medical version DMPE 4.3, which is astoundingly accurate despite needing almost no training. I believe it uses the same "speech engine" as the non medical version 15 that Tom uses, so the only advantage of the ridiculously priced medical version is the medical dictionary.
I can report the same issues as everyone above in using Dragon to dictate to the cloud version of AC. No space after punctuation, spell checking, cut & paste, auto capitalization, etc. It will capitalize after "." is dictated, and will capitalize if you dictate "cap" before the word, however. Also, depending on the internet connection speed, it will mangle longer dictations if you speak rapidly. I have maxed out Spectrum Business upload speed at 25 mbps, which really helped, so I would encourage everyone using Dragon over the 'net to do likewise.
I have experimented with the dictation box and then transferring text, or dictating directly at a moderate pace, and have stuck with the latter (I don't
think that fast anyway). For those of you who like the dictation box/transfer text method, there are
settings that automatically open a transparent dictation box (without saying "open dictation box") when dictating into a Dragon-unfriendly program like cloud AC. By the way, I know a doc who uses Dragon Medical to dictate into Athena which is also cloud-based, and he has the same issues as we have with AC cloud.
I have thought of trying Dragon Anywhere, which is Nuance's consumer-grade product that uses a mobile phone for dictation. Reading about it however, I'm not sure how to transfer text into AC. Board member jimmie has
posted about using Dragon Medical One cloud version -- but the $88-120/month price tag is more than I want to pay. I have also read some
complaints about Dragon Medical One on one of the Speech Recognition forums.