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Topic Title: Dragon Medical & MS Remote Desktop Protocol tweaks
Topic Summary: Nuance recommends changing nssystem.ini for RDP enhancements
Created On: 05/13/2011 07:15 PM
Status: Post and Reply
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 Dragon Medical & MS Remote Desktop Protocol tweaks   - frankcava - 05/13/2011 07:15 PM  
 Dragon Medical & MS Remote Desktop Protocol tweaks   - Chucker - 05/14/2011 09:08 AM  
 Dragon Medical & MS Remote Desktop Protocol tweaks   - Redwine - 04/14/2012 01:48 PM  
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 05/13/2011 07:15 PM
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frankcava
Junior Member

Posts: 8
Joined: 10/02/2006

I've noticed on the board frustration using Dragon Medical through Microsoft Remote Desktop Protocol (RDP) to dictate into whatever EMR.  I'm currently one of the unfortunates using Dragon Medical 10 through RDP on a Vista SP2 32bit configuration (which btw works much better than a fresh install of Dragon on Win 7 pro SP1 64bit)  the accuracy logically is not like dictating directly into MS Word. 

Today Nuance Healthcare eTip #5 arrived  and states after making changes on the Terminal Services Configuration on the RDP Server, alterating the  nsapps.ini, nssystem.ini, dictation box options and the RDP connection windows options on the client machine it "will provide an enhanced experience for the end user community".  The questions I have would this work only on the Enterprise Edition as listed, (if I'm not mistaken EE is sold by Nuance to groups 25 or more providers) and if it can be implemented on a normal Dragon Medical how does one upgrade from my current ver. 10.10.000.272 to 10.10.300.048 that has the RDP enhancement? Using the check update doesn't offer any further updates.  I am attaching a copy of eTIP 5 for review and comments.  I this doesn't workout then I'm still on Lunis' email list awaiting version 11.

Frank 

 

 Did you know that using Dragon through Microsoft’s Remote Desktop Protocol (RDP) creates special challenges?

INTENDED AUDIENCE: Dragon Medical Administrators of Enterprise Edition 
LEVEL: Advanced

Microsoft RDP is often used as a remote connectivity solution RDP functions in a similar manner as Citrix Independent Computing Architecture (ICA) protocol. Some features are fundamentally different between these two systems and the proper configuration of RDP will provide an enhanced experience for the end user community. These configuration adjustments will take place on the RDP Server and the Dragon Client system. Within the client computer you will be adjusting the Dragon ini files, the Dictation Box properties and the RDP Connection window options. Additionally it’s important to note that Dragon Medical 10.1 version 10.10.300.048 includes enhancement for RDP.

The process works as follows:

  1. On the RDP Server open the Terminal Services Configuration utility found in Administrative Tools.
  2. Right Click on the RDP-TCP Connection and choose Properties.

    RDP Config 1

  3. Click the client settings tab and ensure that Audio and Clipboard is not disabled.  
    IMPORTANT: These two options are critical for Dragon and the Dictation Box. The other settings can be configured based upon your organizational standards 

    RDP Config 2

  4. Close the Terminal Services Configuration Utility. 
    NOTE: This same process must be completed on every Terminal Server that will be hosting your RDP connections.
  5. On the Client device, navigate to C:\Documents and Settings\All Users\Application Data\Nuance\NaturallySpeaking10 and launch the nssystem.ini file.

    RDP Config 3

  6. Under the Settings section add the line Use Clipboard Stack=1.

    RDP Config 4

  7. Save and Close the nsysstem.ini file.
  8. On the Client device, navigate to C:\Documents and Settings\All Users\
    Application Data\Nuance\NaturallySpeaking10 and launch the nsapps.ini file.

    RDP Config 5

  9. Search for the section [.Global\Global Dictation Level Default] and add the lines TscShellContainerClass=1 and OPContainerClass=1.

    RDP Config 6

  10. Go to the bottom and add the section [MSTSC\Enable Clipboard Stack Class Names].  Add the values TscShellContainerClass=1OPContainerClass=1.

    RDP Config 7

  11. Add the section [MSTSC]. Add the values Wait For Keys=1Key Delay=3.

    RDP Config 8

  12. Save and Close the NSApps.ini file.
  13. Open Dragon and from the Dragon Bar and choose, ToolsOptions and then the Dictation Box tab.

    Please note: You have three choices in the Paste options section. You may want to try your new configuration with each of these three options to see which one works the best with your applications. Additionally, enable “Keep transferred text in clipboard” and disable “Exit Dictation box after transferring text” to make it easier to recover if an issue occurs.

    RDP Config 9

  14. Review your settings when you launch the RDP Connection Application. Click the Options button.

    RDP Config 10

  15. Click the Local Resources tab and ensure that Remote computer Sound and the Clipboard are enabled.

    RDP Config 11

  16. With these configurations in place, you should note improvement in the deployment of Dragon Medical with RDP.
 05/14/2011 09:08 AM
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Chucker
Top-Tier Member

Posts: 9671
Joined: 10/10/2006

Frank,

First, you don't have access to version 10.10.300.048 because that is the Enterprise Edition version of DNS Medical. Version 10.10.000.272 is the highest you're going to get. That is, you have the latest and greatest version of your copy of DNS Medical 10.1. The only way that you would get the other version would be if you were to purchase the Enterprise Edition version. There is no upgrade path to that version.

Second, the eTip #5 may be directed at the Enterprise Edition and specifically to that version noted in the chip, but it's a general RDP setup for use with Dragon NaturallySpeaking. In fact, it may even work across all versions of DNS as long as using DNS across RDP is not directed towards an EMR application. The settings outlined are pretty standard for both Dragon and RDP.

While there may be some differences between the Enterprise Addition and the standard DNS 10.1 Medical, I would attempt applying these and see if they do you any good. The worst-case scenario is that they wouldn't work in your case. However, making the changes that are noted in the tip will either work for you or they won't. They won't do any harm your system. To restate the above case, making the appropriate changes, if they don't work, will simply be ignored. They won't cause any untoward behavior with Dragon or RDP.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower® Ultimate

For the things we have to learn before we can do them, we learn by doing them. T Aristotle (384 BC - 322 BC)



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 04/14/2012 01:48 PM
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Redwine
Junior Member

Posts: 1
Joined: 04/14/2012

I tried the above steps and it does work great to help with functionality while using dragon medical in a RDP setting. I am using Dragon Medical 10.1 and since making the changes i have noticed that it will either leave out letters in a word or double the letters. For example a sentence that states, " The patient states they are feeling improvement" may turn out like "The atient sates he arre eeling impvt". Is there a way to improve this. It did not do it before the change and i know i could always undo what i put into the .ini files but i am hoping maybe someone knows another line of code that i can add or alter to improve on this function. I have tried changing the key delay number as well as adding a repeat delay that seems to help but not reliably, meaning that it will work and then when i use it again later it is back to the missing or doubled letters.
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