If you would like to read the KnowBrainer 7 page pictorial preliminary review of DNS 10 click here: NaturallySpeaking 10 Forum Review.
Lunis Orcutt - Developer of KnowBrainer & Host of the Http://www.KnowBrainer.com Speech Recognition Forum A Nuance Gold Certified Endorsed Dragon NaturallySpeaking Vendor ALWAYS Ask If Your Speech Recognition Vendor Is Nuance Certified
David Pogue has a great and comical review of DNS. He is with the New York Times. Well worth watching as are all his tech reviews.
http://www.nytimes.com/2008/08/07/technology/personaltech/07pogue.html?_r=1&oref=slogin
I watched his video podcast, but the above is text.
Chris Wilkerson, D.C. Carson Doctors Group TabletPCs in Medicine Editor-in-Chief www.MedicalTabletPC.com Home: www.Digital-Doc.com
any info on 64 bit
Dr. Pogue says DNS 9 users shouldn't bother with 10.
I was just reviewing the DNS upgrade offer and noticed the * at the bottom of the page. If you buy version 10 preferred for $100(upgrade price), it is not compatible with EMR and the medical version is now up to $1600. My experience using DNS 9.5 preferred with "the boom" mic is that medical vocab is complete for most specialties in 9.5 and now they need a way to force physicians into the $1600 version even if you do not want or need network support and the handfull of PRO ad ons offered. Words like forefoot valgus, subtalar, equinus, calcaneonavicular synostosis are recognized much more readily than "he" and "the". Interesting that I can't find the "small practice version for $900 that was available in v. 9 all the way back in uh January.
Also note v.9 and 10 are 32 bit vista compatible only, newer computer deals with 64 bit vista are incompatible. There are work arounds but with medical dictation software, dropping the ability to support any aspect of your charting just isn't worth going the "workaround" route.
digital-doc, David Pogue is probably one of the best generic technology reviewer's you'll ever run into but when it comes to NaturallySpeaking, he's not a specialized expert. We would agree that from an accuracy point of view, which we pointed out in our NaturallySpeaking 10 Review, DNS 10 isn't worth upgrading to. Our DNS 9 accuracy is about 99% and even if we are able to acquire a 20% boost in accuracy, it would only equate to raising our accuracy to 99.2% which would be such a small improvement that it couldn't realistically be measured. However, David Poque completely missed the obvious reasons for upgrading which are productivity. The following is quoted from OUR review: If you're considering upgrading for higher accuracy forget it. You might experience higher accuracy when transcribing from a digital recorder but you probably won't be able to appreciate the difference over a standard microphone user input profile. HOWEVER, what you will be able to appreciate is significantly higher productivity especially if you take advantage of the Vocabulary Editor and new formatting options. There's nothing like being able to say Delete <word or phrase> and see your cursor bounce back to where you were working instead of the usual 3 steps of selecting the word or phrase, saying Delete and then having to say something like move to end of paragraph or just Continue if you are using KnowBrainer. There is nothing more comforting than seeing your words appear immediately in the document when you take a breath. If you make the mistake of waiting for your text to appear in your document before continuing (something most of us are guilty of), it can really slow down productivity because DNS 9 takes between 2 and 3 seconds to deposit your text even on a fast computer. Although we found the new Internet and computer Search commands to be impressive, that's not what most of us care about 99% of the time. What we really care about is accuracy and productivity because we spend most of our time dictating. The new dictation commands, eliminating the text delay, cleaner faster coding, elimination of the extra unwanted space before punctuation and higher stability are the real reasons why we recommend upgrading to DNS 10. For me personally, just eliminating the time lag when the text hits the page was reason enough fro me to upgrade.
socofused, DNS 10 will not include 64-bit support or install on any 64-bit operating system. We have heard rumors that Nuance is working on SAPI 5 compliance which would permit a Ver. 10.5 release of NaturallySpeaking that would not only be 64-bit but likely be a free upgrade. However, this is currently only a rumor. We feel relatively certain that Nuance will eventually go 64-bit but there is very little advantage between 32-bit and 64-bit other than for any users who have made the mistake of purchasing a 64-bit computer too soon. Most software manufacturers won't be 64-bit compliant for at least a couple more years and 32-bit software runs much slower on 64-bit operating systems than it does on true 32-bit operating systems because it has to be thunked down. One reason why DNS doesn't offer a 64-bit version of DNS is because there is a tremendous amount of work involved in becoming SAPI 5 compliance.
lightfootpod, We are not overwhelmingly pleased with Nuance's decision to disable DNS Preferred and Pro but they are quite serious. Our understanding is that you not only won't be able to dictate into many EMR applications but you won't even be able to use NaturallySpeaking's built-in Dictation Box feature. However, the 3rd version of KnowBrainer 2007, which was formally released in 1996, was designed specifically deal with NaturallySpeaking’s shortcomings and design flaws. KnowBrainer 2008 will offer a new Select-&-Say feature that will utilize Notepad to pseudo-Select-&-Say enable any program; including those that Nuance has chosen to disable. This is just one of the 11,000 reasons why KnowBrainer exists. Note that some EMR programs like TextTALK will not be disabled. To some degree we concur with your findings about a lot of medical words already being included in the DNS general large vocabulary but what that also tells us is that you most likely haven't used DNS Medical or a real 3rd party medical vocabulary. DNS Preferred simply includes a partial list of medical words and you could improve that word list by running the Vocabulary Builder but that's only about 1/3 of what makes up a professional vocabulary and that is why professional vocabularies are referred to as language models. A language model doesn't just consist of words. It additionally includes special properties, Written Form/Spoken Form (commonly used medical phrases) and acronyms. If you're serious about medical dictation, NaturallySpeaking without a medical vocabulary is going to be far less accurate and the bottom line is you're going to have to spend a lot more time correcting. We are not saying that you necessarily need to purchase NaturallySpeaking Medical 10 and we can certainly appreciate your reluctance considering the $1400 price tag but it really isn't a scam. Medical 10 really is notably more accurate than NaturallySpeaking Pro 10 or Preferred 10 but because we sell these products, we get free copies of everything which gives us a testing advantage. Both DNS Pro and Preferred do reasonably well with medical dictation but Medical 10 tends to be about 30% more accurate and those are our findings. Nuance claims 40% higher accuracy. Interestingly enough, if you attempt to dictate a nonmedical e-mail with the DNS medical vocabulary, you may be surprised at how poorly it performs because it's really designed to be used for medical dictation. When dictating an e-mail, you should experience significantly higher accuracy with the general vocabulary that's included with the other versions of NaturallySpeaking. Note that the general vocabulary is also included with DNS Medical. When you think of it in those terms, it might be easier to understand how Medical 10 outperforms other flavors of DNS in a medical environment. Think of it this way: If you suspected you had a heart problem would you consult a GP or a Cardiologist?
>>> We are not overwhelmingly pleased with Nuance's decision to disable DNS Preferred and Pro but they are quite serious.
Yet another reason to not purchase a CCHIT-certified EHR. Amazing that when there is money to be made on the back of physicians, even 3rd party software vendors will chime in. <sigh>
I'm glad that I'm still using my complex, but non-CCHIT certified MS Access EMR...
Al Borges, M.D.
● Oncologist in a Small Group Practice in Virginia
● My website URL: http://msofficeemrproject.com/
So far I have dictated about 200 charts with a fair amount of Podiatry Jargon with possibly 100% accuracy on the jargon, My problem is with the little common words. It sounds like you are telling me to upgrade for better than perfect results while increasing my frustration with common usage, where the actual problem lies. If My cardiac surgeon wanted to put in a prophalactic stent in my heart where I had no blockage but I did have alight allergy to the nickel in the stent what result would I end up with?
Marc Garfield, DPM FACFAS
Williamsburg, VA
You're going to find that DNS 10 still has a problem with plurals but there has been some improvement on words like “an” verses “and”. Another possible negative is that NaturallySpeaking's accuracy can plummet if you allow tension to enter into the dictation equation. It seems that the more accurate NaturallySpeaking gets, the more delicate it also becomes. You will no doubt appreciate the speed and accuracy of Ver. 10 but it's important to remain relaxed while you dictate. We wish we could say that we always dictate in a relaxed state ourselves but on the flipside of the coin, DNS 10 may actually be good for your heart because it will literally force you to dictate in a relaxed manner. At least that's our take but let's hope the Nuance advertising team doesn't get a hold of this information. When we say relaxed, we don't mean slow dictation. Think of it as coming back from a 3 martini lunch but not slurring your words If you're considering going with DNS 10 you will need to be aware of one other feature that we recently stumbled across. Only Dragon Medical 10 (new name) will work with most EMR software. In fact, if you so much as open an e-mail with eClinicalWorks in the subject line or save a document by the name of Amazing Charts, NaturallySpeaking will automatically disable the microphone if you're using Standard, Preferred, Professional, or Legal 10. Only Medical 10 will allow you to dictate into an EMR application. Note that we will be adding some workaround commands into KnowBrainer 2008 which will allow you to dictate into EMR programs if you're not using Medical 10. However, they are workarounds and nothing is going to be as user-friendly as being able to utilize Select-&-Say and dictate without a workaround. We are not particularly pleased with Nuance's decision to prohibit all but Medical 10 from working seamlessly with EMR applications.
KnowBrainer:We are not particularly pleased with Nuance's decision to prohibit all but Medical 10 from working seamlessly with EMR applications.
How is it doing this? Has it been programmed to recognise popular EMRs and to then not work?
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
According to Lunis' excellent email explanation:
Unfortunately, Nuance has disabled the ability for NaturallySpeaking Standard, Preferred, Professional and Legal 10 to work in EMR software. Only the new Dragon Medical 10 (new name) will work natively. What the Nuance developers have done is to disable dictation in any Window that displays a popular EMR name such as eClinicalWorks, S.O.A.P. Notes, Amazing Charts etc…. These restrictions are so tightly enforced that if someone so much as sends you an e-mail with “eClinicalWorks” in the subject line or you save a document by the name of “S.O.A.P. Notes”, when you try to respond to that e-mail, open that document or attempt to dictate into almost any EMR application, NaturallySpeaking will turn off your microphone to prevent any dictation or even use of the Dictation Box.
I say that we should all consider boycotting DNS for version 10. I am appalled that they find that they have to resort to these tactics to sell their overpriced DNS 10 Medical software. That is blatantly WRONG!!! This is what is destroying HIT- there are unseamly things that are meant to pick the pockets of physicians who are perceived to be forced to purchase under duress. When docs don't go along, then they wonder why... When pirates continue to thrive, they wonder why...
Fortunately for me, my EMR is nameless, so it's exempt, but I'll go along with any boycott that physicians put together. Lunis, see if you can resolve this!
Sounds like extortion.
So, are now legal documents not dictatable without the legal version? Or, do they only consider docs a soft target?
KnowBrainer:32-bit software runs much slower on 64-bit operating systems than it does on true 32-bit operating systems because it has to be thunked down.
Thanks for generally excellent review. I thought I had a pretty good knowledge of computers but do not understand the phrase you used, "thunked down."
Sincerely,Martin Markoe, eMicrophones, Inc.See us at: http://www.emicrophones.com