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Unbiased Review of Dragon 10 from NY Times
Submitted by Martin Markoe on Thu, 08/07/2008 - 15:39.
No need to wait for any other reviews of Dragon NaturallySpeaking 10 from Dragon dealers. Below is a truly unbiased review from David Pogue, technology editor of the New York Times.
Matthew, posting for Martin who is on vacation.
http://www.nytimes.com/2008/08/07/technology/perso...
Speak Up, a Computer Is Listening
By DAVID POGUE Published: August 6, 2008
Of all the high-tech fantasies that sci-fi movies tantalize their escapist audiences with, surely that bit about giving your computer spoken orders is one of the most alluring. Ever since “Star Trek,” we’ve dreamed of being able to say, “Computer, display all known sources of dilithium crystals in the Kraxon Nebula!”
[admin: Due to copyrights, for the remainder of this article, you'll need to go to the above link at the New York Times website]
Unbiased, YES. Complete, NO
Excellent review, but it only scratches the surface and tends to leave out things that are, at least IMHO, important. Once end-users have had an opportunity to install and take a good long look at DNS 10, I would be glad to expand on this analysis. There is a lot to talk about, but not this time.
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS for Lernout & Hauspie
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)
Another Review - Biased
I've no problem for David Pogue's review considering his audience. But for much of the audience reading speechcomputing.com it isn't very informative.
I've posted a more technical review at http://www.pcspeak.com/release10.shtml that is aimed at those of you who are already using Dragon NaturallySpeaking.
For a cute view of speech recognition (1 minute video) see: http://www.youtube.com/watch?v=uGL--XbP_lA
(you won't learn a thing from the video. But it's clever IMHO.)
Larry Allen
http://www.pcspeak.com
Larry, I appreciated being
Larry,
I appreciated being able to get a discount on your text "Scripting for Dragon NaturallySpeaking 10" when I ordered my upgrade to Pro 10.
Bruce
Larry, You mention on your
Larry,
You mention on your website that Professional won't dictate into EMRs. Can you expand at all on that?
Stan
DNS Pro Is Crippled
Nuance would prefer that medical practitioners purchase DN$ Medical rather than adding third-party vocabularies to DNS Preferred or Professional. Previously, the only difference between DNS Professional and DNS Medical was the built-in language modeling in the Medical bundles but when Nuance raised the SRP on Medical 9 to $1600, a lot of physicians started looking for alternative solutions such as DNS Pro with a medical vocabulary or DNS Preferred with a medical vocabulary and a third-party command utility.
Nuance has supposedly crippled DNS Pro 10 so that it will not work in many EMR programs. Nuance has also added third-party transcription capability to Medical and Legal 10 which doesn't exist in Pro 10.
Lunis Orcutt - Developer of KnowBrainer &
Host of the http://www.TheSpeechRecognitionStore.com
A Nuance Gold Certified Endorsed Dragon NaturallySpeaking Partner/Trainer
ALWAYS Ask If Your Speech Recognition Partner Is Nuance Certified
KnowBrainer wrote:Nuance
Nuance would prefer that medical practitioners purchase DN$ Medical rather than adding third-party vocabularies to DNS Preferred or Professional. Previously, the only difference between DNS Professional and DNS Medical was the built-in language modeling in the Medical bundles but when Nuance raised the SRP on Medical 9 to $1600, a lot of physicians started looking for alternative solutions such as DNS Pro with a medical vocabulary or DNS Preferred with a medical vocabulary and a third-party command utility.
Nuance has supposedly crippled DNS Pro 10 so that it will not work in many EMR programs. Nuance has also added third-party transcription capability to Medical and Legal 10 which doesn't exist in Pro 10.
Just to add to Lunis' explanation, rather than use the term cripple, what Nuance has done is remove the EMR support modules from DNS 10 Professional. That doesn't mean you cannot try using DNS 10 Professional with EMR applications. What it does mean is that it won't be smooth sailing and it will probably be significantly more difficult to do so with that version. Otherwise, it's a little difficult to say at this point exactly what DNS 10 can and can't do as regards this issue.
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS with Lernout & Hauspie
"Life's Rule #1: Once you pull the pin, Mr. Grenade is no longer your friend." (Variant of Murphy's Law - Edward A. Murphy, Jr)
Chuck, Lunis: Thanks. Do
Chuck, Lunis:
Thanks. Do know you if that support removal has anything to do with whether DNS will work with Citrix--we use that technology with our EMR here.
Stan
DNS 10 and Citrix support
Stan,
From the Dragon NaturallySpeaking 10 Professional data sheet.
Dragon NaturallySpeaking 10 Professional offers complete enterprise network support, including new security features, a special management guide for IT professionals and support for Citrix deployments.
Although then Nuance website is kind of messed up at the present (i.e. not all locations are accessible and some of the information needs updating because it's simply incorrect relative to DNS 10), you might want to take a look at the following URL:
http://www.nuance.com/naturallyspeaking/pdf/ds_DNS...
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS
"We learn by doing." -- Aristotle
Chuck, I am looking at the
Chuck,
I am looking at the very end of that document and note again the bold warning that this version does not support dictation into an electronic medical record.
That's hard for me to understand as there are so many different varieties of EMR running on different platforms and different networks. It's beyond me what the underlying reason is for that statement--unless, as suggested, it's all about not buying Prof with a third-party doc package.
Well, just wait and see, I guess...
snsok wrote: Chuck, I am
Chuck,
I am looking at the very end of that document and note again the bold warning that this version does not support dictation into an electronic medical record.
That's hard for me to understand as there are so many different varieties of EMR running on different platforms and different networks. It's beyond me what the underlying reason is for that statement--unless, as suggested, it's all about not buying Prof with a third-party doc package.
Well, just wait and see, I guess...
Actually, what it says specifically is:
* This edition of Dragon does not support dictation DIRECTLY into Electronic Medical Record (EMR ) Systems. For EMR support, please use Dragon Medical Edition.
Note that the key word is DIRECTLY. That doesn't necessarily mean that it can't be done at all. My guess is that they have simply removed any direct support for EMR's and that you will likely have to use the dictation box and other methodologies to get around any limitations. I would also surmise that the medical version has designed support for designated and/or specific EMR's, along with specific support for EMR systems (complete packages including network support/Citrix). However, this is simply guessing because no one has seen, or is likely to see, the medical version until it is released.
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS
"It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so." -- Mark Twain
Review of Dragon 10, EMR's
Chuck,
I am looking at the very end of that document and note again the bold warning that this version does not support dictation into an electronic medical record.
That's hard for me to understand as there are so many different varieties of EMR running on different platforms and different networks. It's beyond me what the underlying reason is for that statement--unless, as suggested, it's all about not buying Prof with a third-party doc package.
Well, just wait and see, I guess...
I disagree with Lunis' review in this area. He states:
"Although you will still be able to dictate into all EMR software with Pro or Preferred 10, Select-&-Say has been disabled in many of the popular EMR programs, which is Nuance’s way of telling you that they want you to purchase Medical 10. You should still be able to dictate into EMR fields but you'll no longer have full integration."
With some EMR's, in NaturallySpeaking Pro/Preferred Release 10 dictation and commands are disabled. It isn't just disabling Select and Say -- you dictate, and if you have a DragonBar it will notify you that you can't dictate into the EMR. No results except perhaps "???" in the results box. Some users, particularly those using the Tray icon mode, will simply think DNS isn't working. Show Dictation Box doesn't allow dictation. I've only verified this with a couple of EMR's to date. The best solution with most of these will likely be to upgrade to Medical 10.
Yes, you can dictate into WordPad and copy/paste (using the keyboard) into an EMR field. That's a workaround but is so inefficient I can't imagine it being done except as a stopgap measure.
(Comments and review are based on my testing this past week with Professional 10. I presume the same restrictions are in Preferred 10, and would appreciate any confirmation.)
If you are a doctor in doubt, send e-mail telling exactly what EMR you are using. If you are happy with your Dragon reseller, ask them instead.
Larry Allen
http://www.pcspeak.com info @ pcspeak.com
Workaround
Good catch Larry. It would appear that we made a mistake in assuming that dictation would be available in EMR software or at least minimally pseudo-Select-&-Say enabled with the Dictation Box. It seems Nuance is serious about forcing end-users to use Medical 10 in EMR applications. However, we can ease that pain a little by porting our current Dictation Box commands into Notepad. KnowBrainer 2008 will feature commands like “Next Field” which will press the Tab Key, cut any text it finds in the field to the clipboard, open Notepad, paste the contents of the field into Notepad (which would be blank in the event of a blank field) and highlight the text (in the event that there is text that needs editing). After finishing your dictation you can say “Next Field” (from within Notepad) to cut the contents of Notepad to the clipboard, minimize Notepad, paste the Notepad contents into the EMR field, Tab to the next field, copy the contents of that field to the clipboard, restore Notepad and paste the contents of the clipboard into Notepad again (continuing the loop). There are a number of other commands but you get the general idea. Obviously this isn't the best solution but it's a lot easier than manually cutting and pasting from another application and it is actually pretty fast in practice. We introduced a variation of this concept in 1996 until you and a marvelous lady at Dragon Systems (whose name I probably shouldn't mention publicly) created the 1st Dictation Box which would be another option. We may need to bring that feature back
Lunis
I can understand that many
I can understand that many medical users of DNS Pro might feel that this new policy is an unfair burden -- I'm sure I would feel that way. OTOH, it can be argued that their old policy involved a subsidy to medical users (i.e., the special programming for the EMR compatibility modules) for the purpose of establishing a market, and they are now trying to extract fair value from that market. Of course, there's an awful lot of "haggle" factor about what might be fair given the difference between the prices of the Pro and Medical packages -- to the extent that you could view the differential as a "soak the rich (or at least those who can claim a tax deduction)" tax.
Please note that I have no connection with Nuance, and indeed might be considered a very unlikely exponent of their cause.
Bruce
There are some us out there
There are some us out there who do more administration (ie, business dictation) than patient care.
Pro works fine for me. All the medical words seem to be in the backup vocabulary (or whatever you call it)and after a couple years with Pro, I have brought forth about all the medical words I need to use.
Pro 9.5 works pretty well with our EMR. I hate to take a step backwards just to get the new features of ver 10.
The vast majority of docs in this country have not gone to EMR, mostly due to the fantastic upfront expense. (At our clinic, it's costing around $30K per doc). I think the pricing of ver 10 Medical is going to be tough for docs who just funded EMR. That's too bad, as EMR is the perfect time to adopt SR.
I didn't understand all the
I didn't understand all the factors involved. It will be interesting to see if the policy sticks.
Bruce
Pro 10 won't work in EMR software
If you are considering upgrading to Ver. 10 and you use EMR software, you need to know that only Dragon Medical 10 will work in most EMR applications. Pro 10 will probably not work in any EMR program because the Nuance developers have written code that automatically turns off the microphone. We are currently tweaking a KnowBrainer 2008 workaround via notepad but if you even so much as try to respond to an e-mail with “eClinicalWorks” in the subject line or open a document that is labeled “S.O.A.P. Notes” in Preferred and Pro 10, the microphone will disable itself and you will not be able to turn it back on until you click into another program. DNS 10 disables the microphone by reading the name of the window. We discovered this a few hours ago when attempting to respond to an e-mail with “eClinicalWorks” in the subject line.
Lunis Orcutt - Developer of KnowBrainer &
Host of the http://www.TheSpeechRecognitionStore.com
A Nuance Gold Certified Endorsed Dragon NaturallySpeaking Partner/Trainer
ALWAYS Ask If Your Speech Recognition Partner Is Nuance Certified
I concur with KnowBrainer's findings
I concur with Lunis. This definitely does occur, and it represents probably one of the most unethical approaches to restricting user access.
Many years ago Microsoft wrote a technical specification for writing programs (MSDOS days). In it, Microsoft wrote basically that no function in any program should do any of the following things without properly notifying the end-user and allowing the end user to opt out or employ another method.
1. No program should execute any function or feature that would install an application, delete data, remove an application, or otherwise interfere with the normal operation of either the operating system, window, or application in which the user is working.
2. No operation should be performed that in any way negatively impacts on the user's system without prompting the user with a reasonable and complete explanation of what is about to occur.
3. In all cases of #1 and #2 above, the respective command options should always default to that option (i.e., in terms of focus) which prevents accidental loss of data or any negative impact on the user's system. For example, if a user should select "Delete" relative to any application or file operation, than the default command button (focus) should always be "Cancel." Microsoft stressed that in no circumstance should pressing the enter button or any other operation that would cause the operation to continue work to the detriment of the user or cause damage to the users application or system.
In those days, it was common to double query the user if they elected to continue, say for instance deleting something on their system. That is, applications always contained an "Are you sure..."
George Orwell's "Big Brother" has always been around even before 1984. However, to me this represents a blatant statement on the part of Nuance that they are "Big Brother" and that they intend to remain the master of their domain irrespective of appropriate ethical constraints and proper programming methodology.
Regardless, this represents a bad idea evolving into potential chaos.
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS
"Problems cannot be solved by the same level of thinking that created them." – Albert Einstein
Chuck Runquist wrote: I
I concur with Lunis. This definitely does occur, and it represents probably one of the most unethical approaches to restricting user access.
...to me this represents a blatant statement on the part of Nuance that they are "Big Brother" and that they intend to remain the master of their domain irrespective of appropriate ethical constraints and proper programming methodology.
Regardless, this represents a bad idea evolving into potential chaos.
Chuck Runquist
Former Dragon NaturallySpeaking SDK & Senior Technical Solutions PM for DNS
"Problems cannot be solved by the same level of thinking that created them." – Albert Einstein
It definitely displays bad faith on the part of management -- maybe they've reached the tipping point of panic vis-a-vis Vista SR?! I would have thought its much too soon for that, but its like predicting stock movements: Insiders have the best possible viewpoint. Unfortunately, while there are (admittedly less than uniformly enforced) laws governing stock divestment by insiders, there is little to control ethical behavior in the absence of legal constraints.
Bruce