KnowBrainer Speech Recognition
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Topic Title: DMO work/equipment system help
Topic Summary: Recs, questions on how best to maximize funds w efficiency and needs
Created On: 07/01/2021 12:36 PM
Status: Post and Reply
Linear : Threading : Single : Branch
 DMO work/equipment system help   - Chay - 07/01/2021 12:36 PM  
 DMO work/equipment system help   - Alan Cantor - 07/01/2021 01:18 PM  
 DMO work/equipment system help   - Lunis Orcutt - 07/01/2021 02:45 PM  
 DMO work/equipment system help   - ax - 07/01/2021 02:47 PM  
 DMO work/equipment system help   - Lunis Orcutt - 07/01/2021 04:03 PM  
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 07/01/2021 12:36 PM
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Chay
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I work for large hospital facility. We have Dragon360 and DMO. 
I can't run 360 bc it lags EMR/computer too much.

DMO accuracy is hit or miss. It's not terrible...but it is always a clinically important word that is missed.

I can't do much about this. I use PowerMicIII...the cord is shorting out so I need to replace, and I've never been the biggest fan of it.

I do want a wireless headset for at home and I am nearly sold on the Speech Mike Air (hope that's the name) for work. 

I will pay for accuracy- I know it's in the voice and all/we will think of it as risk mitigation by using the best tools ?? However, I won't get everything at once as much as I would like to.  I have a soft voice and nearly whisper while dictating. 

I used an insane amount of scripting w Epic- both dragon and programmed mouse, hot keys.
I now use CPRS and I could use the scripting!
I can spend 20m looking for one button through the immense screens and clicks. Yet I don't have time to script anything during the day, and 360 doesn't work on thin clients/remote. 

Leads me to this>>

Will know brainer work for scripting in this situation- remote access from home pc into virtual desktop, with KB on my home computer? Same question for Dragon capture? I think I can use both via USB at work. They have been really good with personalization, specs regarding computer set up. 
need a bigger, monitor? Here ya go. Need more RAM, here ya go. So there's that.  But the 360...may be the internet, may be the processor; not sure. DMO + PowerMic much less accurate than 360 though.  

Can the Speech Mike air be positioned to go with me, hands free- I dictate while driving sometimes...if it's one of those days at work. 

I don't like having the ear piece at work, I'm on the phone, stethoscopes, some of my older patients don't appreciate it.  Otherwise I would get the Phillips wireless. 

For a sound card- I have a Martel's Electronics stenographer mic and mount (my mothers). It is new but doesn't work for Dragon currently- says the audio quality is poor. Would a sound card remedy (in theory, I know no one knows for sure)? That would be quite nice for my nurse to use, as she has to sit very close to the rooms and hates to type. 

I cannot stress accuracy need enough.  A difference in 1% w the right/wrong word, is a lot in terms of impact. She is not going to spend a lot of time perfecting her voice for speech recognition...would the speech ware care be required much more useful vs the cheaper option. 

I appreciate the help.  I was reading all of the cache threads while site down.  

 

 07/01/2021 01:18 PM
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Alan Cantor
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I use PowerMicIII...the cord is shorting out so I need to replace, ... I will pay for accuracy- I know it's in the voice and all/we will think of it as risk mitigation by using the best tools


I suggest changing your microphone ASAP. A quality sound system is key to Dragon's accuracy. Electrical interference, static, distortions, etc. degrade performance.

I recently replaced my five year old microphone, and immediately saw significant improvements in Dragon accuracy and responsiveness.
 07/01/2021 02:45 PM
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Lunis Orcutt
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                    Welcome (See Mission Statement)

 

We prefer the Philips SpeechMike Premium Air SMP4000 (push buttoncontrol) and Philips SpeechMike Premium Air SMP4010 (slider control) (wireless and USB Handheld/TableMike) which include a 2 year warranty. The Nuance PowerMic III only includes a 90 day warranty.

KnowBrainer 2017 will only work with Medical 360. KnowBrainer will not work in DMO. In order to make DMO function, Nuance had remove 75% of its functionality which includes Advanced-Scripting command capability. They are working on a solution but there is no ETA. Unfortunately, Medical 360 is based on the Dragon 12 engine and woefully out of date. Although we offer Dragon Medical One (DMO) (Dragon Medical Build 15.5), we only recommend DMPE 4.3.1 


We understand that the Philips SpeechOne gives you a cyborg look but the SMP4000 and SMP4010 are handhelds that can optionally be used as a table microphone. Your patients may not even notice that you are using a microphone but it's also a better solution because you can manually toggle your microphone on and off. 

Do not use any stenographer facemask microphone because they are extremely inaccurate. Court reporters are required to use this type of microphone but you should only use it if you have to. We can all but guarantee that you will take a 50% accuracy hit with this microphone. The Dragon message is probably accurate. Your Martel microphone probably already has an Andrea communications USB soundcard. This is pretty much universal. You would never plug it into your computer sound card. More often than not, Dragon doesn't even recognize a RealTek soundcard which is the most common built-in computer soundcard.

Your mother not spending a lot of time perfecting her voice is probably doing it right. Physicians already know how to dictate (long smooth relaxed dictation). Never try to adapt to Dragon. Let Dragon adapt to you. Your mother definitely needs a new USB Microphones. Any microphone on our website (wired, wireless, handheld or TableMike) would be significantly more accurate.



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 07/01/2021 02:47 PM
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ax
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First of all, echo Alan, a seasoned dragoneer around here (and Happy Canada Day to you Alan ... or a "reflective Canada Day" as it goes this year), that OP's equipment is failing, if the cord is "shorting".  A functional PowerMic III is a quality piece of gear.  I use the wired speechmike at home, and have had a go with SMP Air, too.  I slightly prefer SMP myself.  But with a super quiet, "wispering" kinda voice, PowerMic III shouldn't do you any harm (it "picks up" really well, assuming the gain on Windows hasn't been driven down).

 

Don't know nothing about 360.  Haven't used DMO myself.  But I do use DME (embedded cloud dragon with essentially no local installation) daily.  One of the hidden culprits in DMO/DME is their penchant for aggressive AGC (you'd have to search for this subject on the forum).  

 

In DMO there may be a toggle to switch AGC off.  In DME it is built-in and can't be tempered with.

 

I have a husky voice which isn't that great for dictation (we dictate with the voices we got, not the ones we want to have, as pointed out a few years ago by the honcho who passed away a couple days ago ... along the same line of going to war with the army one has got). 

 

I find in general AGC works against me.  Therefore just recently I started using an AutoHotKey script to check for mic gain every 10s.  If not at 100, reset it to 100.  

 

I can't give you any more specifics as I don't know the AGC implementation on DMO or if you can toggle it off.  Beware that Teams and other applications that use AGC, some even "surreptitiously", can depress your Mic gain as well, and in turn wreck your accuracy without you knowing "what even happened".

 

The tiny script I use acts at the Windows level and counteracts effects from all of these AGC-crazed devils.

 

 

Originally posted by: Chay

 

I used an insane amount of scripting w Epic- both dragon and programmed mouse, hot keys. I now use CPRS and I could use the scripting! I can spend 20m looking for one button through the immense screens and clicks. Yet I don't have time to script anything during the day, and 360 doesn't work on thin clients/remote. 

 

I do hear from Epic users on the thoughtfulness and customizability of Epic implementation in general.  You current setup seems very much anti-automation unless they let you install some tools on the server side.

 

I am on Meditech Expanse, which is sluggish as a hog on a hot day.  But at least I can interact with some things through elementary JS/CSS tools.

 

Otherwise your options are limited to screen coordinate manipulation on the client side.  AHK and a whole host of other utilities will do that for you.  But there is a learning curve.  There are potentially OCR-based tools you can use on the client.  They seem a bit avant garde at the moment.  

 

 

Originally posted by: Chay

 

Will know brainer work for scripting in this situation- remote access from home pc into virtual desktop, with KB on my home computer?

 

If Citrix is your interface, I am fairly certain that client-side KB will mainly offer you screen coordinate type of automation.  Make no mistake, if you spend some time to get it working, it will be your workhorse and save you time.

 

Although KB doesn't work with DMO at this point, there is nothing preventing you from installing DPI (or similar) on your local client (i.e., home computer) with KB, and automate away with screen coordinates to your heart's content.  One advantage of DMO/DME (at least as I have been told) is that it doesn't prevent you from using on-device Dragon concurrently, as long as you can sort out which button activates what.

 

Above is my own "backup" plan, btw, should I need to.

 

 

Originally posted by: Chay 

 

I dictate while driving sometimes...

 

I need to get some counselling after reading this.

 

 

Originally posted by: Chay  ... That would be quite nice for my nurse to use, as she has to sit very close to the rooms and hates to type ... She is not going to spend a lot of time perfecting her voice for speech recognition...would the speech ware care be required much more useful vs the cheaper option.

 

Now you need counselling.  You are better off getting a scribe, even though it costs an arm and a leg.

 

Your post is heartfelt and incredibly depressing.  It reflects what's wrong with all of us (physician "community" in North America that is).  Not one thing you posted makes me think of what we are doing "right".

 

P.S., I do wish you best of luck, OP, for a vast number of us are in the same boat more or less.



 07/01/2021 04:03 PM
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Lunis Orcutt
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When you open the DMO options, you will be offered less than a half page of personal preferences. In DMPE 4.3.1, you get 7 full pages of options plus additional microphone options that you will not find in DMO because it cannot handle the overhead in the cloud. 1 of those MIA options allows you to remove auto-gain and run the Dragon Microphone Check. Dragon refers to this as Automatically adjust the microphone level as I speak. We are bringing this up because around 50% + of our medical customers appreciate a notable increase in accuracy when defeating this feature. This is just 1 of many reasons why we are not currently recommending DMO/DME.



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KnowBrainer Speech Recognition » Dragon Speech Recognition » DMO work/equipment system help

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