KnowBrainer Speech Recognition
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Topic Title: "Full text control" in sight?
Topic Summary: Disabled, can't navigate with Dragon Medical 11.5
Created On: 01/28/2012 12:43 AM
Status: Post and Reply
Linear : Threading : Single : Branch
 "Full text control" in sight?   - kate - 01/28/2012 12:43 AM  
 "Full text control" in sight?   - Lunis Orcutt - 01/28/2012 01:59 PM  
 "Full text control" in sight?   - monkey8 - 01/31/2012 04:31 PM  
 "Full text control" in sight?   - kate - 01/31/2012 05:13 PM  
 "Full text control" in sight?   - Chucker - 01/31/2012 06:04 PM  
 "Full text control" in sight?   - kate - 01/31/2012 06:23 PM  
 "Full text control" in sight?   - Chucker - 01/31/2012 06:53 PM  
 "Full text control" in sight?   - kate - 01/31/2012 07:22 PM  
 "Full text control" in sight?   - monkey8 - 01/31/2012 08:02 PM  
 "Full text control" in sight?   - kate - 01/30/2012 09:05 PM  
 "Full text control" in sight?   - Larry Allen - 01/30/2012 09:29 PM  
 "Full text control" in sight?   - kate - 01/30/2012 10:24 PM  
 "Full text control" in sight?   - Lunis Orcutt - 01/31/2012 01:27 PM  
 "Full text control" in sight?   - Chucker - 01/31/2012 09:46 PM  
 "Full text control" in sight?   - kate - 02/01/2012 12:06 AM  
 "Full text control" in sight?   - MDH - 02/01/2012 12:59 AM  
 "Full text control" in sight?   - kate - 02/01/2012 02:36 AM  
 "Full text control" in sight?   - monkey8 - 02/01/2012 04:03 AM  
 "Full text control" in sight?   - Chucker - 02/01/2012 09:33 AM  
 "Full text control" in sight?   - kate - 02/01/2012 11:53 AM  
 "Full text control" in sight?   - Chucker - 02/01/2012 03:37 PM  
 "Full text control" in sight?   - Chucker - 02/01/2012 07:24 AM  
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 01/28/2012 12:43 AM
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kate
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I am a disabled physician using Dragon for navigation in our EHR as well as for dictation. I open results queues, sign, print, etc all with Dragon. As you know, one can navigate in Yahoo!, Sermo and numerous other sites and programs, including my EHR, iKnowMed, via Dragon Medical 8, 9, 10.. However, DMP 11.5 represents an unpleasant set back-I can navigate in Microsoft office apps and that's about it. Now, several months after the release, I have not found any more applications with "full text control".  It looks like I'll be rolling back to 10.1 -- for now?  forever? Are there any rumors out there? Has Nuance any plans? 

Kate Kolibaba

Dragon Medical 10.1,  Puget Systems  Intel i7 2760QM 2.4 GHz, 8GB RAM, Windows 7 Pro 64-bit, Sennheiser mic

  



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/28/2012 01:59 PM
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Lunis Orcutt
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In our opinion, the biggest hurdle is the federal government. All it would take is the federal government insisting that every application be SAPI compliant and there is already a law in place to that effect. This would give all future and current speech recognition applications such as WSR (Windows speech recognition) and NaturallySpeaking full support. Furthermore, it would take very little effort, on the part of developers, to add these simple changes. Unfortunately, developers are for the most part, ignorant to the needs of speech recognition applications because neither the public or government is applying enough pressure to force compliance.

Unfortunately, it would appear that the developers of your EHR simply haven't kept up with the latest technology. It's easy to put the blame on Nuance but they are really not at fault. The problem is software manufacturers cutting corners by not keeping up with the latest technology. We urge you to contact the manufacturer of your EHR because of any EHR intends to stay in business over the long haul, they will have to support speech recognition or eventually perish because quite frankly, there are a lot of other EHR's, like TextTALK that go the extra mile by taking care of their customers and enabling Full Text Control.

On another note: Did you know that KnowBrainer 2011 is free to the physically disabled? Just fill out the short form at the bottom of page 1 in the previous PDF file for your NFR copy. Please also note that although KnowBrainer will not help you dictate into a non-Full Text Control application but it includes numerous timesaving workarounds commands which might serve as a Band-Aid fix until other software manufacturers come around.


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 01/31/2012 04:31 PM
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monkey8
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I think there is a lot of confusion around the forum in terms of what makes an application accessible and compliant with speech recognition such as WSR and Dragon.

 

Basically it boils down to the individual programming components used in the application in terms of text boxes, buttons and other widgets. In turn this basically means that the most important thing is the programming IDE (integrated development environment) that is used to produce that particular application.

 

By far the best IDE for producing applications (requiring very little extra work by the programmer), that are compatible with Dragon in terms of voice command accessibility and select and say, is Visual Studio. Although visual studio itself is not fully accessible to Dragon in terms of a select and say editor it is in terms of voice command control of menus using Active Accessibility etc. However the most important thing anyway is how accessible the applications are that Visual Studio produces and the answer is very accessible with little or no extra work by the programmer (this is true of Windows Form, WPF and Silverlight applications produced in visual studio).

 

The problem with most browsers, other than Internet Explorer and Firefox to an extent, is that they are written in Java and other languages using IDEs like Eclipse that are not exactly very friendly to voice recognition in terms of the components they use. Dragon is pretty much optimised to work with Microsoft components and APIs like Active Accessibility and UI automation and open source projects like Eclipse are not going to use these for commercial and other reasons.

 

So in short Microsoft have put a lot of money into making their programming components friendly to voice recognition and they have also invested considerable money in developing accessibility APIs that are easy to use as well as optimising Visual Studio to produce applications supporting these components and APIs. Until the other IDE vendors adopt a similar approach then it is going to be up to the programmer using such IDEs to do a fair bit of work in building in accessibility for Dragon. Alternatively they can use Visual Studio but that costs money whereas Eclipse is free.

 

When I did my degree just a few years ago there were movements in the open source industry to produce accessible Apis and components but how far this has gone I simply do not know.

 

Lindsay



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www.pcbyvoice.co.uk

 01/31/2012 05:13 PM
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kate
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That's helpful.

So, iKnowMed went live in our practice in 2006, and has "full text control' with Dragon 10.1 (and 9). The iKnowMed developers, who have gone to great lengths ( just for me, I think-- I'm likely the only disabled doc among 1000 in the US Oncology network) ask "how is the speech engine in 11.5 different?".   Is there an easy answer?



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/31/2012 06:04 PM
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Chucker
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Lindsay has nailed it down quite well and quite simply (i.e., as non-technically possible).

As far as Full Text Control (Select-and-Say) is concerned, this simply means that any text box or text window that supports those rich text edit controls that allow speech recognition applications, specifically Windows Speech Recognition (WSR) and/or Dragon NaturallySpeaking in this case, to access and act upon any visible text in terms of dictation and commands. The common term used in this case is "standard windows". When Dragon, through SAPI, is able to identify that text boxes or text windows are SAPI supported, it applies the appropriate "compatibility" mode and Full Text Control (Select-and-Say) is enabled. When Dragon is unable to identify text boxes or text windows as SAPI supported, it attempts to apply the most applicable compatibility mode support. Such application text boxes or text windows are commonly referred to as "nonstandard" windows. In such cases you may or may not be able to dictate into such. However, even if you are able to dictate, Dragon is only able to access the last utterance(s) dictated stored in the speech buffer. In such cases, selecting and correcting or re-dictating text will generally be limited to the last thing that you dictated. Pausing for any length of time and/or moving around the visible text manually or using any of the Global commands, such as "move back five words" will generally result in behaviors such as no capitalization after terminal punctuation, pausing or moving around in a text box or text window resulting in no spacing when you move back to the point where you wish to continue dictating, as well as other Full Text Control (Select-and-Say) features. The behavior that you may experience in "nonstandard" windows, or more simply put – non-SAPI compliant windows, can vary from application to application.

Lindsay hit the nail right on the head as far as making applications Dragon compatible. The above is simply attempt to explain as simply as possible when and where applications are Full Text Control (Select-and-Say) compatible and what behavior you may expect when they are not. You can get additional information on Full Text Control (Select-and-Say) by searching the Dragon Help for "Full Text Control".

One thing to tuck away in the back of your mind is that when an application is Full Text Control (Select-and-Say) enabled, Dragon can only act on the visible text displayed. Any text that is above or below that which is visible on the screen is not accessible via Full Text Control (Select-and-Say). That may seem like a "Duh!!!" statement because in most cases you're not going to know what text is not visible. However, I had clients try to do it and wonder why it doesn't work.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, We make it better!

"About the time we can make the ends meet, somebody moves the ends." Herbert Hoover



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 01/31/2012 06:23 PM
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kate
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That's a good tip about Dragon responding only to visible cues in the Full Text Control context. That actually matters a lot when using an EMR with Dragon instead of a mouse.

So is the change between Dragon 10.1 and Dragon 11.5 related to SAPI 5.4 as in Windows 7 rather than SAPI 5.3 of previous versions?

Kate



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/31/2012 06:53 PM
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Chucker
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Quote:
So is the change between Dragon 10.1 and Dragon 11.5 related to SAPI 5.4 as in Windows 7 rather than SAPI 5.3 of previous versions?


Kate,

All versions of Dragon up to and including Dragon 11.5 use SAPI 4, or more correctly SAPI 4.0a. Only Windows Speech Recognition (WSR) uses SAPI 5. It may sound like Dragon is still in the dark ages, but SAPI 4 is actually more robust than SAPI 5, not better than, just more robust because it supports more low-level SAPI functions and features. SAPI 5 was designed with third-party developers mind. Nevertheless, there is no better or worse version of SAPI. Some folks seem to think that Dragon is behind the times, but that's not the case in all. The reason why Dragon uses SAPI 4 is "If it ain't broke, don't fix it." Nuance may eventually drag Dragon over to SAPI 5, but as long as SAPI 4 is still viable, Nuance will stick with it.

The bottom line is, it doesn't matter what version SAPI Dragon is using, what makes applications Full Text Control (Select-and-Say) enabled is the same whether you're using SAPI 4 or SAPI 5. That much hasn't changed. Applications that do not support Full Text Control (Select-and-Say) are still nonstandard windows whether you're using Dragon NaturallySpeaking or Windows Speech Recognition (WSR).

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, we make it better!

It is of interest to note that while some dolphins are reported to have learned English -- up to fifty words used in correct context -- no human being has been reported to have learned dolphinese. - Carl Sagan (1934 - 1996)



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 01/31/2012 07:22 PM
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kate
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So then would you expect my EMR that has Full Text Control  in Dragon 10.1 to still have it in 11.5?  That does not seem to be the case.

However, what I did was put during 11.5 directly on my new laptop sandy bridge i7 etc, after installing the EMR. I guess a better test would be to put Dragon medical practice 11.5 on the old  laptop that presently functions okay with full text control of Dragon 10.1 in iKnowMed

Kate



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/31/2012 08:02 PM
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monkey8
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Quote:
So then would you expect my EMR that has Full Text Control in Dragon 10.1 to still have it in 11.5? That does not seem to be the case.


Yes you would but not necessarily, so when you say full text control with version 10.1, if you show the Dragon bar of one type or another do you get a green checkmark while dictating into the appropriate text box?

With version 11.5 (where presumably you have no green checkmark) can you dictate at all into the EMR edit/text boxes?  And if you can is it just see ability to select and replace text that is different?

Dragon has its own way of making various types of text boxes/edit boxes have full text control without it being related to SAPI in any way so they may have changed something with 11.5.

Lindsay

Edit: just as an example of what I say in terms of adding full text control to a particular application with Dragon, irrespective of anything to do with SAPI, read the information sheet below.  Granted this is an old technical note but recently updated and still relevant with version 11 today (this could be one outside chance of making your EMR have full text control again if something has been changed).  See the second article below if you are using Citrix which I think was mentioned above.

http://nuance.custhelp.com/app/answers/detail/a_id/2744/kw/Full%20text%20control/session/L3RpbWUvMTMyODA1OTYyOS9zaWQvRU5rWWx6UGs%3D

http://nuance.custhelp.com/app/answers/detail/a_id/5178/kw/Full%20text%20control/session/L3RpbWUvMTMyODA1OTYyOS9zaWQvRU5rWWx6UGs%3D



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 01/30/2012 09:05 PM
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kate
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I think that the developers of our EMR do mean well, as they asked me if the new speech engine would work. Should all software devlopers know what SAPI is all about? If so, then I certainly need to ask for upgrades at these various websites. I am guessing that the new technology works backwards, allowing previous versions of DNS as well as the new one to enjoy full text control?

I have always been grateful for KnowBrainer's support of the disabled, thanks for pointing that out on the forum. I would not have been able to continue to work in this practice when the EMR came on in 2006 without the help of this forum.



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/30/2012 09:29 PM
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Larry Allen
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Kate,

It appears that iKnowMed is a browser-based EMR.  If so, have you tried using different browsers?  Often Dragon Medical will work better in Internet Explorer than in Firefox or Chrome.

Have you tried changing the options for HTML commands?  Those sometimes affect how effectively one can use a browser-based application.  These are in Tools, Options, Commands tab.  If those are different on your R11 setup then the results could easily be as you describe.  Don't presume that a browser application works best with HTML support, some work better with that option off.  If you still have your Release 10 user files, you could import them (possibly with a different name) and look at the options you used on Release 10.

Are you by chance using Citrix or Terminal Services to access this EMR?  If so, they have the same sort of challenges and could have complicated your situation.

 

Lunis,  I am 99.9% certain there is no law in North America insisting that applications be SAPI compliant.  What law is this?  As one who programmed full-time for many years and now deals in Dragon products, I disagree that it takes little effort on the part of programmers to make the changes needed for effective navigation of browser-based applications.  That is true in some cases, but for many browser-based applications major changes would be needed.  Microsoft's primary development platform, Visual Studio, is not accessible.

I'll agree that there is little pressure on programmers to make the changes.

 



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Larry Allen
Softnet Systems, Inc.
http://www.pcspeak.com

 01/30/2012 10:24 PM
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kate
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Thanks so much for the reply.

iKnowMed is IE based, I don't think that I can choose another browser, but I will ask. I use IE8, Windows 7. I tried IE9 for one evening, no need to say more! Given my dependence on Dragon for navigation, I am still using Dragon Medical 10.1 on my desk top PC at home and the office, with 11.5 only on my laptop. I am using the same HTML settings, never thought to try it differently.

Our hospital EMRs go through Citrix, and I have never been able to navigate, though I can of course dictate. Is it possible to navigate through Citrix?  iKnowMed through Citrix offers much greater speed, but no navigation, so I launch from the desktop, "native version".



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 01/31/2012 01:27 PM
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Lunis Orcutt
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You are already using IE (Internet Explorer) so you wouldn't want to switch browsers even if you could.

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Click SpeechStart+ to take SpeechStart+ on a 15 Day test drive

 01/31/2012 09:46 PM
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Chucker
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Quote:
So then would you expect my EMR that has Full Text Control in Dragon 10.1 to still have it in 11.5? That does not seem to be the case.

However, what I did was put during 11.5 directly on my new laptop sandy bridge i7 etc, after installing the EMR. I guess a better test would be to put Dragon medical practice 11.5 on the old laptop that presently functions okay with full text control of Dragon 10.1 in iKnowMed

Kate,

First of all, if you're using DMPE, that is not version 11.5, it's version 11.0. Nuance has not yet updated DMPE to 11.5, and therein may lie some of the problems that you are that you are having. However, Full Text Control (Select-and-Say) should not be one of them. Nothing has changed between DNS 10.1 Medical and DMPE 11.0 Medical as far as Full Text Control (Select-and-Say). If iKnowMed supported Full Text Control (Select-and-Say) in DNS 10.1 Medical, there is nothing inherent in DMPE 11.0 that would make it not support Full Text Control (Select-and-Say) in iKnowMed as long as you have not updated iKnowMed to a different version. Or, to put it more simply, if the green indicator light for Select-and-Say in DNS 10.1 medical was green, then the checkmark to the right of the microphone icon in DMPE 11.0 should also be green.

Second, if you are accessing iKnowMed via Internet Explorer, then Internet Explorer must be loaded before Dragon (whether you're using DNS 10.1 Medical or DMPE). If you load Internet Explorer first and then launch Dragon with your user profile, Full Text Control (Select-and-Say) will not be enabled because you have not given Dragon the opportunity to test and load compatibility mode [Full Text Control (Select-and-Say)] for Internet Explorer. If you subsequently load iKnowMed under this condition, then iKnowMed will not be Full Text Control (Select-and-Say) enabled. Regardless of which version of Dragon you're working with, you can test this out with a simple experiment.

1.  Open Internet Explorer first without Dragon being loaded and go to the KnowBrainer forum.

2.  Then open Dragon NaturallySpeaking with your user profile loaded.

3.  Open and attempt to reply to a post.

4.  Take a look at the Full Text Control (Select-and-Say) indicator, which will be around circle to the right of the microphone icon and volume meter on the DragonBar in DNS 10.1, and the checkmark in the same location in DMPE 11.0. I would be willing to bet that either one would be grayed out.

5.  Now close and reopen Internet Explorer with Dragon loaded and go back to the KnowBrainer website. Again, reply to a post. I would be willing to bet that the Full Text Control (Select-and-Say) indicator will be green for either DNS 10.1 Medical or DMPE 11.0.

Although Nuance claims that it is not necessary to open Dragon before you open Microsoft applications, the only place with this seems to apply, and not particularly regularly either, is Microsoft Outlook and it also seems to be reliable only for Outlook 2007 and 2010. However, Internet Explorer must be launched after Dragon in all cases. Otherwise, Full Text Control (Select-and-Say) will not be available.

You can also test this with iKnowMed. If iKnowMed supports Full Text Control (Select-and-Say), then following the same test procedures as above should produce the same results. Otherwise, iKnowMed does not support Full Text Control (Select-and-Say) regardless of whether you're using DNS 10.1 Medical or DMPE 11.0. In short, if iKnowMed supports Full Text Control (Select-and-Say) in one version of Dragon NaturallySpeaking, then it supports it in all versions of Dragon, or it doesn't support Full Text Control (Select-and-Say) in any version. In other words it's an all or none support issue. That is, either it does or it doesn't. It's either black or white, there is no gray.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, We make it better!

Education is when you read the fine print. Experience is what you get if you don't. - Pete Seeger



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 02/01/2012 12:06 AM
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kate
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Thanks for correcting me, DMPE 11.0 it is.

 In iKnowMed, Select-and-Say is very easily defined by the ability to speak names on buttons as commands such as "order cosignature" or "result review" from the opening screen and have those queues pop right open. "Regimen", "order Rx" "new orders" and more can all be pulled up by Dragon 10.1 from patient charts. Dragon dictates in any box, anywhere, but it is the command/navigation that substitutes for a mouse that is so valuable.

With the very interesting test that you proposed, DMPE 11.0 indeed is GRAY when launched after IE8 to attempt to write in this forum.

However, 10.1 goes directly to work with a GREEN circle, launched first or not.

DMPE is not responding even in IE text boxes, I am going to do a clean re-install

Kate

Dragon Medical 10.1, Intel i7 920@2.67 Ghz, 12 GB RAM, Windows 7 Pro 64-bit SP1, Sennheiser KnowBrainer mic with Andrea sound pod

 



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 02/01/2012 12:59 AM
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MDH
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Quote:
then it supports it in all versions of Dragon, or it doesn't support Full Text Control (Select-and-Say) in any version. In other words it's an all or none support issue. That is, either it does or it doesn't. It's either black or white, there is no gray.
 

Chuck, Lindsay, and Kate,

I access my EMR, Greenway, via Citrix. It is a web-based EMR, using Internet Explorer. In this EMR, it depends what window you are in as far as behavior. In doing a correction in various EMR windows, I may get one of the following:

1. No Selection of text dictated at all.

2. Selection of only last utterance.

3. Selection of both last and recent utterance.

4. Upon attempt at Selection, the cursor moves to the beginning of the word that I attempted to Select, but no actual Selection (not highlighted).

As far as Corrections of those words or phrases actually Selected, one of the following may occur:

1. Correction is made and properly substituted.

2. Correction is made and word or phrase is put next to the word or phrase that was Selected.

So, there are lots of "grays" in terms of Select and Say (Full Text Control) even within the same application, depending which window or data box you are in.

MDH



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 02/01/2012 02:36 AM
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kate
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I am grateful for the contributions of all.

First, I am lauching iKnowMed directly through IE, after loading Dragon, NO Citrix.  I compared settings between 10.1 and 11, and unchecked Options, Commands, Require click to select hyperlinks in HTML windows in DMPE 11, that's all that I found differently. DMPE 11 won't let me enable email and calendar commands.

With the GREEN check mark showing, all that I can get DMPE 11 to do is dictate, just dictate. Nothing more. It is not reading a single "button" in iKnowMed, and doesn't see a single underlined word on web pages. In Microsoft word 2007 it opens the tabs "home" "insert" "review" etc. GREEN CHECKMARK still on. I can produce eloquent text beautifully.

However, with the checkmark off, it now does navigate fine elsewhere, and does look just like 10.1, though it won't let me correct something in the results box that is not dictated into some sort of text box.  For example, on this webpage, if you speak "KB Home", or "shop" or "members list", both versions will take me there, but green button in 10.1 and Green checkmark in 11 go away/turn gray when you do that. For all of you that must also be the case, right? Is there a way to turn the checkmark off on purpose so DMPE 11 stops trying to dictate and sees the words on those buttons instead?

So I guess the functionality that is so important to me is not "Full text control" after all, since the navigation occurs without the Green checkmark. What do you call the function/feature that pushes buttons like a mouse then, anyway?

And yes, I am just glad it's working, though it is for me right now far less nimble between dictation and mouse function than 10.1.

Kate



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 02/01/2012 04:03 AM
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monkey8
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Quote:
So I guess the functionality that is so important to me is not "Full text control" after all, since the navigation occurs without the Green checkmark. What do you call the function/feature that pushes buttons like a mouse then, anyway?


This functionality is provided by the Microsoft API Active Accessibility (MSAA) and UIAutomation which I referred to above.  As you have already found out you can turn on and off the accessibility features offered by these APIs by checking/unchecking the 'Voice-Enable menus and dialogue controls'on the Miscellaneous tab of the Dragon options.

Lindsay

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 02/01/2012 09:33 AM
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Chucker
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Quote:
First, I am lauching iKnowMed directly through IE, after loading Dragon, NO Citrix. I compared settings between 10.1 and 11, and unchecked Options, Commands, Require click to select hyperlinks in HTML windows in DMPE 11, that's all that I found differently. DMPE 11 won't let me enable email and calendar commands.

Kate,

It's confusing I know. "Require click to select hyperlinks in HTML windows" simply disables the necessity to say "click" when selecting links (hyperlinks) in HTML windows. All that simply means is that if Dragon can identify specific links (i.e., most often those that are blue and/or underlined), then you can say "text links" and Dragon will number those links such that all you have to do is to say the number of the link that you want opened. Otherwise, with that option enabled, you would have to say "click text links". That's the extent of it.

As regards enabling e-mail and calendar commands, those commands are only for Microsoft Outlook. If you're not using Microsoft Outlook as your e-mail client (application), then those options are not available to you. That's why Dragon won't let you enable them.

Quote:
With the GREEN check mark showing, all that I can get DMPE 11 to do is dictate, just dictate. Nothing more. It is not reading a single "button" in iKnowMed, and doesn't see a single underlined word on web pages. In Microsoft word 2007 it opens the tabs "home" "insert" "review" etc. GREEN CHECKMARK still on. I can produce eloquent text beautifully.

The Green checkmark or The Green button [Full Text Control (Select-and-Say)] only relates to dictation and text editing.

As Lindsay pointed out being able to access menus and controls is not based on Full Text Control (Select-and-Say), but on Active Accessibility (Microsoft Active Accessibility (MSAA). While the feature selection is different between DNS 10.1 and DNS 11-11.5, you will find it as one of the options in the Dragon Options dialog | Miscellaneous tab, "Voice enable menus and dialog controls" (DNS 11-11.5) and "Use Active Accessibility for menu and dialog controls" (DNS 10-10.1).

If it can't read "buttons" in iKnowMed, then they (i.e., those buttons and/or tabs etc.) are not speech accessible. That is, they are not Active Accessibility enabled.

Quote:
However, with the checkmark off, it now does navigate fine elsewhere, and does look just like 10.1, though it won't let me correct something in the results box that is not dictated into some sort of text box. For example, on this webpage, if you speak "KB Home", or "shop" or "members list", both versions will take me there, but green button in 10.1 and Green checkmark in 11 go away/turn gray when you do that. For all of you that must also be the case, right? Is there a way to turn the checkmark off on purpose so DMPE 11 stops trying to dictate and sees the words on those buttons instead?

Apples and oranges. First, you can't edit anything that shows up in the "results box". That is simply for display depending upon how you have it enabled because it's different in DNS 11-11.5 that it is in DNS 10-10.1. In DNS 10.1 Medical, the results box shows you the results of your dictation (i.e., text), or the results of the execution of a command, along with the recognized command name surrounded by a blue border.

The green button or the Green checkmark become grayed out only because you have left a Full Text Control (Select-and-Say) area. If you go back into the message area of KnowBrainer and simply review post, the green button or the checkmark will remain grayed out until you open a message box to reply to a post. Again, Full Text Control (Select-and-Say) is for dictation and text editing. Those indicators will only turn green under those conditions and only if, under those conditions, the text box to text Windows supports Full Text Control (Select-and-Say).

Quote:
So I guess the functionality that is so important to me is not "Full text control" after all, since the navigation occurs without the Green checkmark. What do you call the function/feature that pushes buttons like a mouse then, anyway?

Already explained by Lindsay and above.

Quote:
And yes, I am just glad it's working, though it is for me right now far less nimble between dictation and mouse function than 10.1

Nature of the beast. DNS 11-11.5 introduced multicore/multithreading with BestMatch IV. It's also a major rewrite even though the basic underlying functionality hasn't really changed. Because of the way DNS 11-11.5 works, you can see more latency (i.e., slower responsiveness). One of the things you can do to improve the response time in DMPE is to move the Speed vs. Accuracy slider all the way to the left (Fastest Response). We are finding, generally speaking, that overall general accuracy is not affected with this setting, but performance (speed) in terms of text-to-speech is improved, especially for slower processors. In addition, DMPE, being only version 11.0 vs. 11.5, is still subject to some of the bug issues that were fixed in the other Professional versions via the 11.5 update. Since the medical version is now under the Nuance healthcare division vs. the retail division, even though the programmers work for both divisions, product control for DMPE is under the Nuance healthcare product management team's control. What that has led to is that Nuance is unfortunately is now under a left-hand/right-hand conflict such that the left-hand doesn't know what the right hand is doing and vice versa, and we end-users are left out in the cold so to speak.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, We make it better!

"Better a diamond with a flaw than a pebble without one." -  Chinese Proverb



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 02/01/2012 11:53 AM
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kate
Junior Member

Posts: 22
Joined: 11/29/2006

Chuck, Lindsay, thanks so much for the education and assistance.

I will change settings to speed, rather than accuracy. Latency/speed are critical issues for task completion. I review labs, sign orders and results, order prescriptions, imaging, appointments and chemotherapy all via Microsoft Active Accesibility, all day, every patient encounter.

These are the specs on the laptop I am using to trial DMPE 11.0: 

 Puget V542i 15-inch Notebook w/ GT 555M, 802.11 b/g/n, Bluetooth Motherboard Intel Core i7 Mobile 2760QM 2.40GHz 6MB 45W CPU 2 x Kingston SODIMM DDR3-1333 4GB Ram

Any guesses about what could be gained in terms of speed/latency from 11.0 to 11.5 or the Ivy Bridge processor when available?

Kate



-------------------------

Kate Kolibaba


Intel i-7 920 @ 2.67 GHz 12GB RAM, Windows 7 Pro 64 bit SP1; Speechware USB 3-in-1 Tablemike, DNS Medical 10.1. My EHR is iKnowMed

 02/01/2012 03:37 PM
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Chucker
Top-Tier Member

Posts: 11271
Joined: 10/10/2006

Kate,

Your notebook configuration is more than adequate for use with DMPE.

DMPE 11.5, if and when it is released, may reduce some of the latency issues, but I wouldn't take it to the bank. It will be basically a bug fix with some additional features not present in 11.0.

My educated guess would be that Ivy Bridge will make a difference. However, unfortunately, Ivy Bridge is not available for testing with Dragon NaturallySpeaking until later this spring. The technical specifications, including and especially the tri-gate transistors (3-D transistors) and a couple of the other known technical advances would indicate that such would be ideal with Dragon NaturallySpeaking and perhaps significantly improve overall performance. However, that remains to be seen and tested. Looks good from a distance, but we still have to get up close and personal to know for sure.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, We make it better!

"About the time we can make the ends meet, somebody moves the ends." Herbert Hoover



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 02/01/2012 07:24 AM
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Chucker
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Posts: 11271
Joined: 10/10/2006

Mark,

First, I think you misunderstood what I was trying to say. Regardless of whether you're using DNS 10.1 or DMPE there is a Select-and-Say indicator to the right of the microphone control icon and the volume meter in the DragonBar. Whenever you are dictating into any text box or text window, that indicator is either green or grayed out. That's what I meant by the fact that Full Text Control (Select-and-Say) is either enabled or it is disabled. More simply put, it's like a light switch. It's either on or it's off. There is no in between.

The behaviors to which you are referring to are simply the text edit controls available in those "nonstandard" windows in your EMR based on the compatibility mode enabled by Dragon. If you read the Dragon Help on Full Text Control (Select-and-Say), it clearly indicates that you may have certain text edit controls available to you under any given condition in any text box or text window that are speech-enabled. However, these do not indicate that you have Full Text Control (Select-and-Say). Lumping them together and saying that there are lots of "grays" in terms of Full Text Control (Select-and-Say) does not mean that these capabilities indicate that you are using Full Text Control (Select-and-Say). It only indicates that you have certain voice-enabled text edit controls depending upon where you are in Greenway (your EMR). They also indicate that you are dictating into an "nonstandard" window. The key word in Full Text Control (Select-and-Say) is "Full", not "Partial", although the Dragon Help on Full Text Control (Select-and-Say) that explains the differences could be phrase to say that you MAY have "Partial Text Control" in nonstandard windows.

Chuck Runquist
Technical Project Manager
VoiceTeach LLC
Home of VoicePower®: We don't make Dragon NaturallySpeaking, We make it better!

I know that you believe you understand what you think I said, but, I am not sure you realize that what you heard is not what I meant.



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