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We have transitioned from an older version of Dragon (10.1) to the new cloud-based Dragon Medical One. The difference in voice recognition accuracy is remarkable. It even works quite well for our providers with heavy accents. We've also been able to add step-by-step commands that invoke existing EMR quick texts via voice. The ability to manage vocabulary globally instead of by user is also a plus. The ability to create an auto-text with predefined variables allow, for example, a surgeon to insert an entire template for a given surgery type and then just navigate through the patient specific variables via voice. This is a real time saver.
One issue that we have experienced is something we are calling the "jumping cursor" when dictating into Centricity EMR. While we experienced it rarely in the old version of Dragon it is more pronounced with Dragon Medical One. When working in a encounter form the cursor can jump from one field to another or insert text in the middle of a sentence when the cursor is at the end of the sentence. It seems to be prevelant with some of our forms but not all.
I am wondering if anyone else has similar issues and if any resolution was found. I'd really apreciate any info or input from folks seeing the same thing.
I suspected it might have something to so with the TE Edit Control and TX Text Control versions that Centricity uses but have been unable to find out any specifics as to what those might be. I explored looking at the forms via VFE to see if the info was there and couldn't find it. I also was unable to identify a pattern in form development that might explain why some forms are more problematic than others.
We have engaged Nuance Support and they are trying to help identify the problem but we've had no luck so far.
Finally, greetings from Austin! I hope that those of you coming to CHUG this year enjoy your visit.
Posted : September 8, 2016 7:54 am
We are seeing this problem as well. We are on CPS 12.0.12 and use VFE forms.
I am curious if anyone has found a solution.
Thank you
Posted : September 8, 2016 8:09 am
We are on CPS 12.0.12 and use CCC forms and have the same problem with the cursor bouncing. The provider and be in the middle of dictating and it will bounce and place the end of what they are dictating in the middle of what was already dictated.
Posted : September 9, 2016 4:41 am
Wasn't there a recent service pack that had a bug that affected dragon users? I can't find anything about it in the forum archives but I seem to remember hearing about a bug.
Posted : September 14, 2016 9:32 am
Topic starter
Thanks for the input. I have not heard about a recent service pack affecting Dragon users. Perhaps that was 9.8.11?
We recently upgraded from 9.8.10 to 9.8.12 and the problem remains.
Posted : September 14, 2016 11:40 am
I thought I remember it being older than 9.8.11 which is the version we are on.
Posted : September 14, 2016 11:44 am
This is a problem for us as well, and we are not using Dragon. It happened on 12.0.10 and 12.012. I believe the cursor jump is happening during one of the chart refreshes. If you watch the screen you will also get a slight flicker or flash in full screen mode. If your window is not full screen, I have seen where the window goes completely black for a second and comes back white, and the cursor is gone. It's a real problem if the provider is typing while looking at the patient and not the screen. They have to type complete sentences over again.
Posted : September 15, 2016 9:53 am
We were told yesterday if you open the emr.ini file and change the entry: DoSkinning= 1 to DoSkinning=0, this may reduce the occurrence of this.
Posted : September 15, 2016 10:35 am
Topic starter
Excellent! I will give this a try and report findings. Were you told this by GE or Nuance by chance?
Afrer looking, this setting is in a file called "skinning.ini" on our installs and version of C-EMR.
Posted : September 15, 2016 10:49 am
Were you told by GE Support about this? Have you done it yet in CPS and if so, has it helped?
Posted : September 16, 2016 3:36 am
Topic starter
We've tested this with 3 Providers over the past few days and they report a modest improvement of about a 10% reduction in cursor jumping. Addtionally one Provider reported that one of the "select all" buttons we had in a customn lab letter disappeared when this setting was enabled. We have a WebEx support session scheduled with Nuance engineers tomorrow and are also preparing to involve GE and Nuance together in the investigation soon. Both GE and Nuance have been willing to engage on this. I'll report any findings/progress here.
Posted : September 19, 2016 7:36 am
Topic starter
I wanted to update our findings here. The cursor jumping issue was not related to Centricity EMR.
We found that the issue arose when a user used their mouse or keyboard to make a correction in dictated text while the microphone was still on and Dragon was "listening." Dragon "heard" these clicks and took a moment of proceessing to try and determine if the sound it heard was speech. If the cursor was moved manually during that processing we could create the jumping cursor at will. The solution was to toggle the micorphone off during manual edits via keyboard or mouse. While Dragon does support a keyboard hotkey to toggle the mic off, we saw that as a extra first step before editing. So we used a programmable Logitech G300S mouse to set the mic toggle to one of its extra buttons. The idea being that the mouse would likely be used in edting anyway. We are also testing a software solution that allows press to talk emulation like the Nuance PowerMic does. We found a free utility called MicMute that runs at startup and does just that.
Posted : September 26, 2016 7:23 am
We are using CPS version 12.0.12.2500 and this is happening randomly to our users, both those using dragon and those who are not. Has anyone found a resolution to this issue yet?
Posted : May 5, 2017 10:06 am
Topic starter
From above:
"We found that the issue arose when a user used their mouse or keyboard to make a correction in dictated text while the microphone was still on and Dragon was "listening." Dragon "heard" these clicks and took a moment of proceessing to try and determine if the sound it heard was speech. If the cursor was moved manually during that processing we could create the jumping cursor at will. The solution was to toggle the micorphone off during manual edits via keyboard or mouse. While Dragon does support a keyboard hotkey to toggle the mic off, we saw that as a extra first step before editing. So we used a programmable Logitech G300S mouse to set the mic toggle to one of its extra buttons. The idea being that the mouse would likely be used in edting anyway. We are also testing a software solution that allows press to talk emulation like the Nuance PowerMic does. We found a free utility called MicMute that runs at startup and does just that."
You can also use a USB footswitch to accomplish the same.
Regards,
Jason
Posted : May 8, 2017 4:05 am
we also have this problem and are on cps 12.0.12. the 12.2 release is SUPPOSED to fix this according to the release notes. We have not done that upgrade yet so I cant confirm
Posted : May 28, 2017 11:09 am
