Special Feature: Discuss on Sermo

The May issue of MDNG featured an article on implementing voice recognition software into practice. We posted a link to it on Sermo and asked members of that community to share their thoughts and experiences with using this technology. Below is a sampling of their replies and opinions.

I’ve been using Dragon (now Nuance) NS since version 4 in 2000. I agree that it hasn’t (as far as I know) been road tested for Vista adequately. I wasn’t sure about upgrading from 8 to 9 because of the need for adequate hardware, and I was right. DNS8 was pretty good, but 9 runs fairly slowly on my 4 year old Gateway tablet, but that’s because of the 1.4G processor and only 1G of RAM. It’s pretty good on my newest Dell Vostro with a 3G Core2 Duo with 4M L2 cache and 2G of RAM. I’m not so sure about running it on a tablet with the compromise in processor. BTW, it’s not optimized for a quad core processor, so that doesn’t improve anything. I’ve been told not to use an AMD processor since they lack the L2 cache which DNS purportedly “loves.”

The accuracy is significantly better than 8, so it’s worth it if you have the hardware. I’ve been surprised about its ability to handle medical terminology, even newer words; but I suppose that’s why you pay far more for the medical version than even the professional. It works a lot better when you use a combination of macros. I use voice macros that I create within DNS and some with a spiff y little program called Active Words. Active Words lets you use macro substitution across various programs, which is especially useful if you like to type shorthand abbreviations instead of longer words or use keywords to insert phrases or paragraphs. But it even will open folders and navigate to websites; eg, I just type “costco” and it will open the Costco pharmacy website where I look at prices for drugs. Typing “fpnb” no matter what program I’m in takes me to www.fpnotebook.com. Th e leading geek for VRS is Lunis Orcutt, who manages a site called KnowBrainer at www. knowbrainer.com which has an active user forum which is very useful. He has an add-on for DNS which is a whole bunch of additional commands and macros.

- Green Lantern, a family medicine physician on Sermo

With voice recognition software and hardware, once you have it working it is not a good idea to keep upgrading hardware or the OS. I have not seen better results by doing so. Dragon products work poorly on notebooks or tablets. A good quality manufacturer-approved USB boom microphone is a must. Th e medical version is not worth the expense. Using a VR product consistently for few months is essential to make it functional, no matter what the manufacturers claim. It is also important to correct string of words to improve contextual recognition of phrases and words (for example “sigmoid colon” as opposed to “Sigmoid:”). I hope IBM gets back into this arena. Unfortunately they started off with poor marketing, very lousy products initially which made VR a joke. Most initial users of IBM voice products in the ‘90s would be scared to even try them again. We use both Via Voice and Dragon ( 8, 9.5) in our practice.

- a gastroenterologist on Sermo

I used Dragon—purchased 3-4 years ago, the medical version. I think it cost me about 1K. I never got it to the point that it could understand what I said enough that it was worth it—took me about 3 times as much time to dictate, but part of it was probably my own perfectionism and wanting everything to look just right. (I was also dissatisfi ed with dictating, because it took me so long to proofread and correct the pages when they came back, usually several days later, so maybe it was just me).

- a family medicine physician on Sermo

I’ve been a Dragon medical user since version 1.0. I have never had a problem with upgrades. I have used it on desktops and laptops and currently on a tablet. Th ere is still a need for proofreading. Learned that when I was completing a consult and signed off “sincerely yours.” It was interpreted as “sensually yours.” Haven’t had a referral from that guy since! Dragon also works very [well] with Amazing Charts. I’m a newbie at AmazingCharts, but I sure like my Dragon. Nuance also has a new program where they collect up to 500MB of your dictation and use it to build a more custom vocabulary for the user. I believe it has something to do with word use in context.

- crestondoc, an internist on Sermo

Sermo is a free online community for physicians with 65,000 members and growing. To view this and thousands of other physician discussions, join at www.sermo.com. Enter promo code “MDNG” to receive a $15 Amazon Gift Card as a welcome gift.