gchiu: 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?
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?
Hey, it is an anology, not an exact match.
In any event, for those of you who want to see the EMR restriction and how it works, simply launch your DNS version 10 preferred.
Go to the Windows/system 32 directory and find FTP.exe. Make a copy of FTP.exe. Rename that copy something like eclinicalworks.exe . Run the renamed program.
Launch DNS 10 Preferred.
Click on the title bar of the renamed FTP program which now says eclinicalworks in its title bar.
You will see that simply renaming the ftp.exe program will prevent DNS from working inside that window, and will turn off the microphone. There is nothing about the FTP program that is malfunctioning or buggy. It simply has a name which is restricted from use, and even though it is not an EMR product, simply having the same name as an EMR causes DNS 10 to become crippled.
Reddy
William "Reddy" Biggs, MD Endocrinology Amarillo, Texas
Unbiased and independent, YES!
"Live on eClinicalWorks since 2/1/2007" http://tinyurl.com/ywqd49
Erica Hill (rep from Nuance) responds in a letter posted here: http://www.amazingcharts.com/ub/ubbthreads.php/topics/10306/Only_DNS_10_Medical_will_work_#Post10306
The whole letter is a great read on the bizarre thinking over at Nuance, but here's a quote:
"You are correct that we decided to remove EMR support from thenon-Medical versions of Dragon. We thoroughly test dictation into EMRswith our medical products and have specific features that make DragonMedical much more suitable for medical applications. We found that somelarge hospitals were using the consumer editions of Dragon and notgetting the accuracy, quality and manageability that would be achievedwhen using Dragon Medical. It is also a common practice in the softwareindustry to create feature packages for several markets and sell them atdifferent price points (e.g. Microsoft Office). That practice allows usto maintain a low consumer price point for Dragon while offering highervalue solutions for our Medical customers that come with a higher pricepoint, but also deliver much more significant benefits."
So I guess they think that they are doing us all a favor by forcing us to use DNS correctly...
Al
Al Borges, M.D.
● Oncologist in a Small Group Practice in Virginia
● My website URL: http://msofficeemrproject.com/
A bit deceptive, eh?
The didn't do anything other than just put in blockers to read the process and the title bars.
I am perfectly fine using the preferred software as is, without it being EMR crippled.
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.
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.
An excerpt from the NY Times article about DNS 10
"Apart from Vista, NatSpeak really has no competition. Philips has dropped out of the American market. I.B.M.’s own ViaVoice hasn’t been updated since 2003, and its sole distributor is, get this, Nuance."
http://www.nytimes.com/2008/08/07/technology/personaltech/07pogue.html?pagewanted=1&_r=2&ref=business
Sounds like a monopoly to me.
Here's a comparison between SpeechMagic vs Dragon.
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
We would have to disagree with some of that review. You only need to train NaturallySpeaking for 7 minutes and in Ver. 10, you even have the option to skip general training. You could just run the Audio Setup Wizard for 30 seconds and your accuracy will be almost as good as training. In fact, if you do additional “extended” training you can actually damage your accuracy. It definitely helps to feed 50 to 100 patient notes through the Vocabulary Builder but you certainly don't have to train for more than 7 minutes. The review also casted some doubts about NaturallySpeaking’s network compatibility. The professional versions of NaturallySpeaking (Pro, Medical and Legal) are not only fully network compatible but even permit Select-&-Say across the network. SpeechMagic can only dream about true Select-&-Say capabilities and DNS 10 kicks all that it up a notch. As far as SpeechMagic is concerned... we were asked to test this product from the only US distributor. The distributor thought that it might have a marketplace between the consumer and professional versions of NaturallySpeaking but the product was barely beta in our opinion. Our version of SpeechMagic had so many problems that we had no choice but to give it a thumbs down and US distribution eventually declined to carry the product. We are not certain that you will even find this product in the United States because it can’t compete with DNS. Note that DNS includes a 30 day no restock fee customer satisfaction guarantee. We suspect that SpeechMagic has a similar guarantee. You can always purchase both products, but we suspect the odds are very high that you'll wind up returning SpeechMagic. If SpeechMagic was a viable solution, the Nuance VAR channel would be carrying it because we don't work directly for Nuance; we are simply certified and licensed by them as we are by other manufacturers like Olympus and Philips.
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
I am happy with my decision to embed the Medical Version into eMedRec. Now all of our customers that have kept software assurance will get this version as part of the Maintenance.
I am sorry for the limitation obviously put on the software. Oh well, adds value to our software application.
This is a surprising thread to me. If anything Dragon is going to push customers away, but then again, many customers just will not upgrade, like Vista from XP. After all, you don't have to upgrade to get great results.
Brendon: I am happy with my decision to embed the Medical Version into eMedRec. Now all of our customers that have kept software assurance will get this version as part of the Maintenance. I am sorry for the limitation obviously put on the software. Oh well, adds value to our software application. This is a surprising thread to me. If anything Dragon is going to push customers away, but then again, many customers just will not upgrade, like Vista from XP. After all, you don't have to upgrade to get great results.
The XP to Vista upgrade didn't cost $1500, either.
So far I've written to the Wall Street Journal, and New York Times asking them to do a story on this. I actually got a reply from a live human being at the NY Times in a matter of minutes (after midnight no less). I'm not sure they have a real grasp on the impact and significance of Nuance's maneuver, so I've no idea whether they will follow up.
This story could have some real legs, if we find a writer who is willing to run with it.
This could wind up in courts of various kinds, including the court of public opinion.
Reddy,
They only charged you minimal for your upgrade. You could uninstall it and go to version 9.5 again.
I am not advocating Dragon Position. i am actually against it also. What I am saying is that they are licensing under there own terms and you have the right as a consumer to not give them your money. THat is why Vista is failing and all computers are sold with XP available still.
Ironically, now Microsoft makes you buy Vista Business with XP Downgrade.
As I already stated, I strongly disagree that it is perfectly okay to unilaterally impose a change of terms like this.
There was no advance notification prior to my purchase that program was restricted. What I thought I was purchasing was a program that had the same or better capabilities as the previous versions with the identical name. There was no warning that the feature set was reduced to zero in a EMR program that is really the primary reason for having the voice recognition product in the first place.
This is a bad example of bait and switch, and is a deceptive trade practice. Once they baited me with the cheap version that has worked well in previous years, they want me to switch to a version costing $1500 more.
Furthermore, it's an abuse of market power with this company. They clearly know that they are the dominant company for speech recognition software, and feel that they can get away with such an action. If there was any serious competition for this category of software they would've never even tried this.
We've seen lesser infractions subjected to actions by state Atty. Gen.'s, and class action suits.
I don't think it's too late for Nuance, Inc to come clean, announce 'King's X', or 'WHAT were we thinking' and provide copies of Preferred or Pro without the EMR restriction to anyone who requests.
Reddy is saying that they are abusing their monopoly position though I don't see the difference between MS offering Office Professional and Office Home and Student .. where the latter is much cheaper, and can not be used in a commercial environment.
No one is being forced to downgrade from 9.5 to 10 are they?
Graham, big difference with this analogy.
Huge difference, in fact.
When you purchase the Home and Student it has big labels all over it stating it is not for commercial use. Furthermore, they have never sold the Home and Student version for commercial use. It has always been intended for home use.
In this particular instance, the Dragon software can be used for any commercial use except EMR. Previous versions were perfectly compatible with an EMR.
Nowhere on the packaging, e-mail that I received, or any other material that I could access made any mention of this EMR restriction.
There was never any notification that the software was EMR incompatible. Previous versions were all EMR compatible. The EULA has absolutely no mention of the EMR restriction.
This is a bait and switch, and one of the most blatant I've ever encountered.
When I first purchased DragonDictate ( with no medical vocabularies ), it cost me about $1800 and there was no cheap version out there. It didn't work too well on my 486 laptop, nor on my Pentium I 233Mhz when I upgraded. I could type faster. I haven't used it since though I moved on to Pentium II, Pentium III, Pentium IV, and now Core Duo laptops, and I gather the recognition engine has much improved.
Now the name has since changed to Dragon Naturally Speaking, and they have a cheap edition for the masses. Sounds like a bargain for the home users to me.
reddybiggs:There was no advance notification prior to my purchase that program was restricted. What I thought I was purchasing was a program that had the same or better capabilities as the previous versions with the identical name. There was no warning that the feature set was reduced to zero in a EMR program that is really the primary reason for having the voice recognition product in the first place.
Agreed wholeheartedly. Worse, your dictionary and macros are upgraded, so even if they offered you a refund it would be useless.