Hey all,

I am a radiologist who is dictating 180-200 reports regularly during an eight hour session. Therefore every single insufficiency in my work flow is adding up to hours of lost time each month. I currently am using PS One with a Nuance Powermic III and am simply getting tired of 1) dictation errors slowing me down to correct, 2) the latency from when activating the record button on the microphone to when PS One starts listening, and 3) my thumb is getting tired from the neccessary pressure required to activate this microphone. I typically dictate in a personal office and do have the bad habit of playing low level music in the background to keep my sanity. I know a radiologist who purchased a foot pedal and a Blue Yeti from best buy and reported an improvement in accuracy.

So I write this post to ask any there is anyone out there that would have recommendations for how to improve dictation accuracy and work flow for a radiologist who listens to low level music?

My first thought is to get a wired heatset microphone to free up my left hand. I do not want a earpiece to playback sound or prevent for hearing people enter the office. It looks like the FlexyMike DE would be a good choice as the cardioid direction would phase out the background noise. But this begs the question, is this microphone any better/accurate than the Powermic III? Would this mic have any performance difference compare to a large diaphragm condenser microphone or a studio/podcast microphone like the Schure MV7/SM7B? Is the Flexymike more accurate than the Sennheiser ME3-II or the various Shure performance headset microphones?

Now, by switching microphones I will need to have a method to toggle the microphone on and off. I don't think the foot pedal would be a great choice since I keep my feet elevated from some old sports injuries. Some rads have said they use a Logitech g602 and map the Powermic buttons to it. Now I use a Logitech G502 and have all the buttons mapped to may most used PACS software functions. I am not a fan of the smaller side keys to map additional functions so I don't want to switch to the more button G602. So this begs the question, what other alternatives are out there to trigger microphone recording and won't tire your thumb? It needs to have onboard memory as software hotkey solutions is not an option due to software restrictions on the computers. At least 3 buttons to toggle record, next field, and delete would be nice (most use buttons on the powermic). I was intrigued by the Tazor Tartarus v2 as it has on board memory to map, and therefore can cluster my most used buttons to use with my left hand than using the keyboard. Has anyone used this device with dictation? Any other toggle options out there?

Lastly, wanted to inquire about the sound card? Does the Speechware Multiadapter external sound card really make that much difference? How about compared to the close range Speechware Adapter or the Andrea PureAudio adapter? My home PACS has an Asus ProArt motherboard with integrated sound and "two-way AI noise cancellation". My works PACS has whatever Dell's standard integrated card is in place. Since I plan to only dictate close range with the headset would the Sppeechware Multiadapter be neccessary since I wouldn't use the long range or is there features it has that be helpful that the short distance Speechware adapter doesn't have?

Thank you for your guidance. It's difficult to make this $400 change without knowing if performance will be better than the Powermic III (or even upgrading to the Powermic 4) Or being able to try it out in person before buying.

Tl;dr:

- does FlexyMike DE perform better than Powermic III or Powermic 4?

- does FlexyMike DE perform better or worse the studio large diaphragm condenser microphone?

- does FlexyMike DE perform better than Sennheiser ME3-II or Shure headsets?

- what strategies for toggling microphone on/off that is plug-n-play without software and not a foot pedal?

- external sound card necessary? 

- Any difference between Speechware Adapter VS Multiadapter for short distance dictation? Speech Ware VS Andrea PureAudii VS integrated with AI noise cancellation?

- any other recommendations for radiology dictation workflow optimization?

thank you!

Potential strategies are explored in some depth here: 

https://www.knowbrainer.com/forums/forum/messageview.cfm?catid=10&threadid=35214

Basically look under QMK and KatiesGadgets.

Alternative "enterprise" solution is MacroWorks 3.1 for X-keys.  Both QMK and MacroWorks are for programming USB buttons/macropads for "plug-and-play" use.  They don't need to be installed on your work computers.  

Both can simulate PTT, as long as PowerScribe One has a built-in keyboard shortcut for toggling microphone, which I believe is Shift+F4 by default.  It might be even easier if end user can customize/reassign the function to a different hotkey without modifier.  But I am guessing it probably won't make much of a material difference.

Ditto for the other keyboard shortcuts for field navigations, etc.  These can similarly be remapped through QMK/MacroWorks.

KatiesGadgets will like do the programming for you, as long as you are precise as to which keyboard shortcuts are to be mapped.

                     Welcome (See Mission Statement)

• We recommend disabling the Push-to-talk hotkey which most end-users do not like. Most end-users prefer Microphone on/off. You can change this setting by opening Dragon's Options to the Hot keys tab. It's a pity Nuance doesn't thoroughly listen to physician requests; like not forcing them into DMO.

• We found the Blue Yeti to be less accurate and no more noise filtering than your existing PowerMic III

• If you are considering a headset and do not wish to cover your ears, we recommend checking out the new Shokz OpenComm UC Bluetooth Bone Conduction headset microphone. High fidelity playback pads go on your cheeks. There are no speakers, the accuracy is higher than any microphone we have tested and you can play your background music as loud as you want. We tested by playing Light My Fire by the Doors 'circa 1967' at 85 dB, which is 5 dB below safe. You can optionally listen to somewhat high fidelity music through your cheekbones

• The SpeechWare FlexyMike DEC (dual ear wired cardioid headset) microphone rests on the back of your ears. It includes good noise filtering and is comfortable but don't forget to add a USB soundcard. It is slightly more accurate than the PowerMic III and will allow you to marginally increase your music volume level

• The Sennheiser ME3 headset is very noise filtering and will let you play your music at pretty much any volume level. We discontinued caring the Sennheiser ME3 because the required extension cable disconnects too easily. We replaced it with the less expensive equivalent Audio-Technica Pro 8HEmW microphone (w/KB PLUS PACK). Both of these microphones require a USB Pod 

• Dragon includes microphone off, go to sleep and wake up verbal commands. However, we prefer using a Dragon keyboard hotkey [noted in our 1st paragraph]

• We understand you are concerned about accuracy. With that in mind, we doubt you will be satisfied with the Blue Yeti or the Logitech line of microphones. They do not meet our speech recognition standards

• By toggling your microphone on and off, you won't have to worry about making your thumb tired and by using a hotkey. You'll even have a finger choice. If you are using other programmable buttons, we recommend staying with your PowerMic III. Keep in mind that you can program your other buttons to jump to the next field, delete and any other existing Dragon command

• The PureAudio USB-SA Pod is inexpensive and features excellent accuracy. The SpeechWare SpeechMatic MultiAdapter USB soundcard uses the same Texas Instruments patented technology (like the PureAudio) but additionally includes auto-gain, auto EQ (helps when dictating over a distance), a smidgen of noise filtering and utilizes a rubber casing, rather than plastic, to protect it's exclusive circuit board. It also includes a blue button to bypass the the previous effects. Note that these additional features will only marginally increase your accuracy

• You do not need and probably shouldn't use so-called AI noise filtering. We believe this should be left up to your microphone

• The SpeechWare MultiAdapter won't be much of an improvement when using a close range microphone.

- The FlexyMike DEC does not noticeably perform better than the PowerMic III but this is a bit of an apples and oranges comparison. The FlexyMic is more noise filtering and slightly more accurate. The FlexyMic is more noise filtering but your PowerMic has programmable buttons

- The FlexyMike DEC is designed specifically for speech recognition. Large diaphragm studio condenser microphones are much more expensive and no more accurate. The FlexyMike DEC is also more noise filtering. We owned a recording studio in the late 70s through early 90s. Studio microphones are accurate enough, especially when you already own them, but we found them to be a bit unwieldy and not any more accurate

- The FlexyMike DEC is notably better and replaced the DE. It should probably be noted that we are 1 of the developers of all SpeechWare microphones. The FlexyMike DEC's most important feature is arguably comfort.

- The DEC accuracy is equivalent to the ME3 and Shure headsets but the DEC is not as noise filtering. However, the DEC is more comfortable

- In our opinion, if you are close to your existing keyboard, map any key to any Dragon feature

- Thr SpeechWare MultiAdapter versus SpeechWare USB adapter probably won't make any difference. In our opinion, the SpeechWare USB adapter is equivalent to the PureAudio, which is less expensive and that's why we don't offer it on our website. We recommend avoiding AI noise filtering

- NOTE: In our opinion, the PowerMic 4 is only aesthetically better than the PowerMic III, which is in its end-of-life cycle. The PowerMic 4 only works with cloud versions of Dragon Medical and Professional. It cannot be used with DMPE 4.3.1 while your PowerMic III can be used with all Dragon utilities.

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