Brendon: I have not used it with any EMR but ours. Unfortunately I was unaware of this nor can I confirm it. After all we have the OEM Embedded version so all of our customers will receive the Version 10 Medical as part of our application software. Thanks for the update on this, I feel that someone from Nuance should address this forum. I will forward this thread to them and see what they say. Regards,Brendon
I have not used it with any EMR but ours. Unfortunately I was unaware of this nor can I confirm it. After all we have the OEM Embedded version so all of our customers will receive the Version 10 Medical as part of our application software.
Thanks for the update on this, I feel that someone from Nuance should address this forum. I will forward this thread to them and see what they say.
Regards,Brendon
This all makes for an interesting triangulation.
Some EMR vendors, such as Brendon, are probably happy to see Nuance do this, since usage of the $99 version provided 99% of the functionality of what they pay big bucks for in the OEM version. It makes the other EMRs a little less attractive if docs have to spend $1600 more for a usable voice recognition.
Other EMR vendors, ones that don't incorporate an OEM embedded version, will hate this. Probably most of the CCHIT vendors are probably on the 'Nuance hit list'. Their EMR customers will hate it even more.
Nuance of course is hoping that we will all jump ship and run to the Medical version.
IMHO, hell will freeze over first.
Nuance has some serious remediation to do. If this is how they do business, then it is time to get behind their competition. Even if it is Microsoft. MS has done some dirty deeds in the past, but not THIS dirty.
Nuance, SHAME ON YOU.
Reddy
William "Reddy" Biggs, MD Endocrinology Amarillo, Texas
Unbiased and independent, YES!
"Live on eClinicalWorks since 2/1/2007" http://tinyurl.com/ywqd49
Companies have a right to license their software as they wish. You as the customer have the right not to purchase their software.
Sometimes, software is licensed for commercial use only and is free for home use.
DVDs are licensed per region eg. USA is region 1, and we are in region 4.
Nuance appear to take the view that EMR users are not to use their cheaper products. Publishing ways of bypassing their licensing might be seen as a breach of copyright.
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
gchiu: Companies have a right to license their software as they wish. You as the customer have the right not to purchase their software. Sometimes, software is licensed for commercial use only and is free for home use. DVDs are licensed per region eg. USA is region 1, and we are in region 4. Nuance appear to take the view that EMR users are not to use their cheaper products. Publishing ways of bypassing their licensing might be seen as a breach of copyright.
First, I think we can safely assume that Graham's Synapse EMR is not on the Nuance hit list?
If not, Graham are you OK with me submitting it to Nuance for addition to their 'turn off the microphone' trick?
ATTENTION TO NUANCE: PLEASE TURN OFF ACCESS TO THE EMR KNOWN AS ‘SYNAPSE’ WITH THE NEXT MAINTENANCE UPDATE.
Now that Graham is supporting our side, I need some help.
Perhaps one of you can help me find a DNS version 10 Preferred EULA. Apparently it is elusive. http://www.eulascan.com/product.aspx?pid=27 . I can't find it with any of the printed materials they send, and it is not accessible in the program itself or the DVD documentation.
Perhaps KnowBrainer can locate it, and see if it prohibits usage with an EMR somewhere. I am not sure how enforceable that would be.
The DVD analogy is flawed. When you own a region 1 DVD player, you buy region 1. You need not read 1600 lines of legalese to determine whether or not you can play your DVD. The terms of the arrangement are well understood in advance by all parties, they are a surprise to no one. It’s right on the label of the DVD.
Nuance approached me, not the other way around, and asked me to upgrade. Nowhere did they say in their email to me, or their web site, or on the Digital River e-commerce site, that I was buying ‘cripple-ware’.
They promoted this as having all these numerous advantages over the previous version. This evening I performed a text search for ‘emr’ in their email to me, and the web site that I was directed to. Nowhere does the term ‘emr’ exist. Nowhere on the packaging does it say “Not for use with an EMR”. It doesn’t mention any limitations of Preferred version at all.
They sold me a crippled program, needlessly, in order to force me to purchase the more expensive Medical version that I don’t feel that I need. I just want the upgrade that I thought I had paid for, which does roughly the same as the previous Preferred version I was successfully using.
IMHO, this is a deceptive trade practice. As such, it could potentially be submitted to the states attorney generals. This is a ‘bait and switch’ as well. I paid for the upgrade with the expectation that it would perform at least as well as the previous version. The previous version is labeled ‘Preferred’, and it works fine with my EMR. Yet they have intentionally, and needlessly, disabled the new ‘Preferred’ program from working with my EMR, and didn’t disclose that to me until I actually purchased and used the product. When and where was I ever notified that this was a ‘cripple-grade’ rather than an up-grade ?
Yes, this will fly REALLY well with the attorney general’s office.
I’m not sure that Nuance really wants to go there. Who knows?
reddybiggs: ATTENTION TO NUANCE: PLEASE TURN OFF ACCESS TO THE EMR KNOWN AS ‘SYNAPSE’ WITH THE NEXT MAINTENANCE UPDATE.
Dunno .. haven't tried DNS at all.
reddybiggs: Perhaps one of you can help me find a DNS version 10 Preferred EULA. Apparently it is elusive. http://www.eulascan.com/product.aspx?pid=27 . I can't find it with any of the printed materials they send, and it is not accessible in the program itself or the DVD documentation.
Try reinstalling again and see if it appears, and have to agree to it. If it is there, but you didn't read it ... well, that's not so good.
reddybiggs: They sold me a crippled program, needlessly, in order to force me to purchase the more expensive Medical version that I don’t feel that I need. I just want the upgrade that I thought I had paid for, which does roughly the same as the previous Preferred version I was successfully using.
Certainly sounds deceptive.
reddybiggs: Yes, this will fly REALLY well with the attorney general’s office.
And that sounds like the appropriate remedy ... not advising people on how to break the copyright protection on someone else's intellectual property.
Graham,
Out of curiosity, which program are you using? Or, are you not using one?
I tried looking at the EULA, and amazingly there is no mention of an EMR restriction.
It appears that I am not violating any terms of use. I have not modified their software whatsoever.
Let's see what the response is from Nuance first. Perhaps they will do the right thing, and change their mind.
Sometimes even big companies come to their senses when they realize that they are damaging their own reputation. The companies that we hold in highest esteem are the ones that recognize when they have made a mistake, and do their best to correct it.
Let's see whether or not Nuance fits into that category.
reddybiggs: Out of curiosity, which program are you using? Or, are you not using one?
No, I used DNS way back when I had a 486 laptop .. and haven't tried it again since. I just type when I need to.
reddybiggs:I tried looking at the EULA, and amazingly there is no mention of an EMR restriction.
Bizarre.
This is a strange thread. The accusation on the floor for Nuance's Dragon Medical Team is that they did this on purpose. I would love to find out if this is true or false. I think I will research it and I suspect someone from Nuance will way in on this issue soon.
I don't think that Nuance would purposely turn off a Microphone based on a application. On the other hand, I can see how technically a component/(application window) will not work with Dragon, I don't think Reddy you would experience any different results if you installed the Medical Version vs. the Preferred version. Did you test this? The Medical Version does not actually change the Engine in any way, at least it never has.
So Reddy is it your test results that when you got version 10 Medical and installed it it worked and the Microphone did not cut off? If this is case, then equals, shame on Nuance. If you installed Dragon Medical 10 and the Microphone did not work, then - incompatability between Dragon and Application Software, shame on software manufacture of EMR or end user just has to wait until it is properly supported or implement work around.
It is up to Dragon to encourage upgrades as this is there revenue stream. I doubt they would do something to hurt this.
Regards,
Brendon
Brendon,
Bizarre, indeed!
I don't have version 10 Medical. I have versions 9, 9.5, and 10 Preferred.
I can tell you for sure, that run straight out of the box, launching eClinicalWorks and clicking an eCW window turns off the microphone. It is NOT an accident, or a programming bug. It gives you a status message that says " See EMR Restriction in Help". Going there provides a link to sell the Medical version.
When I made a very minute modification to eClinicalWorks, the Preferred version 10 now works fine.
What they appear to have done is made DNS 10 Preferred read which process is active, and if it is eClinicalWorks, it turns off the microphone.
This restriction apparently applies ONLY to doctors and EMRs. So far, writers, architects, lawyers, pharmacists, and IT directors do not have their DNS 10 turn itself off.
I guess doctors are special.
IMHO, this is no accident. This looks to me to be a ploy to sell more Medical versions.
See if you can get your hands on an EMR and version 10 Preferred. Or I can set up a VNC setup if you want to see what I am seeing.
It's unbelievable.
Lets see ... 70,000 users of dragon medical applications which is about $100,000,000!
Maybe the same number of users who are not using Medical ... who can be upgraded ... which is another $100,000,000.
This is no small change so they might not be persuaded to change this new policy.
gchiu: Lets see ... 70,000 users of dragon medical applications which is about $100,000,000! Maybe the same number of users who are not using Medical ... who can be upgraded ... which is another $100,000,000. This is no small change so they might not be persuaded to change this new policy.
Good point. That might make it more likely for the attorney general's office to take interest. In addition, Nuance has a functional monopoly on this category of software, and abuse of that market position against doctors should raise eyebrows.
reddybiggs: It gives you a status message that says " See EMR Restriction in Help". Going there provides a link to sell the Medical version.
It gives you a status message that says " See EMR Restriction in Help". Going there provides a link to sell the Medical version.
WOW
reddybiggs:In addition, Nuance has a functional monopoly on this category of software, and abuse of that market position against doctors should raise eyebrows.
Microsoft give away speech recognition software inside Windows Vista. It may not be as good .. never used it and so can't comment, but there is no monopoly.
Any eyebrows raised will be because Nuance is competing successfully against Microsoft ... so far i.e.
There is nothing in the EULA that would prevent you from using DNS Preferred or DNS Pro 10 with EMR software but as Reddy pointed out, if you attempt to dictate in most EMR products or even so much as an e-mail with the word “soap” (as in S.O.A.P. Notes), NaturallySpeaking will turn off the microphone and you won't even be able to use a macro to copy and paste from another program into your EMR software. Your only option would be to inefficiently paste manually. When utilizing the Dragon Bar you will also see the message “See EMR Restriction and Help” where you'll be prompted to upgrade to Medical 10. However, as Reddy also pointed out, a very slight modification to most EMR programs will eliminate the problem without violating the EULA because you will not be making any changes to DNS. Considering this new policy, we can certainly appreciate a new interest in the Vista speech engine but when it comes to medical dictation, we really don't think you'll be satisfied with VSR because even though it is very good, it is designed more for consumer use and last time we checked, Microsoft owns a large percentage of Nuance stock.
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
gchiu: reddybiggs:In addition, Nuance has a functional monopoly on this category of software, and abuse of that market position against doctors should raise eyebrows. Microsoft give away speech recognition software inside Windows Vista. It may not be as good .. never used it and so can't comment, but there is no monopoly. Any eyebrows raised will be because Nuance is competing successfully against Microsoft ... so far i.e.
Again, a flawed analogy. We're looking at market share, and specifically market share in terms of dollars paid for the voice recognition product, and in terms of number of installations of paid-for voice recognition software.
Furthermore, Microsoft was able to be sanctioned in the US and EU despite the fact that multiple alternate OS's were readily available, such as Linux, for free.
I think there is an excellent chance that this would be seen as an abuse of market power, to unfairly coerce doctors into purchasing a product costing 15x more than the previous version, when they don't actually need the more expensive version.
Nuance should come clean and remove the EMR restrictions.
reddybiggs:Furthermore, Microsoft was able to be sanctioned in the US and EU despite the fact that multiple alternate OS's were readily available, such as Linux, for free.
Flawed analogy ... an OS is needed to use the computer, and VRS is not.
Maybe this is an attempt by Nuance to fill their coffers before they close up shop?