Anyone have a microphone/software package for dictating from home?

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RustedFox

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Title says it all.
If anyone uses software/mic for dictation from home (or say, a mobile office), let me know what you think and how much is a smart amount to spend.

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I use Dragon Medical Practice Edition with a SpeechMike SMP4000 wireless microphone. I take my laptop to work and dictate with it since I'm not a fan of M*Modal that the hospital pays for. We have to use our phones as microphones at the hospital.

Unfortunately, Nuance no longer sells DMPE. They shifted to their cloud-based service (DragonMedicalOne), which is absolutely horrible from my limited experience with it. Maybe it's improved, but I don't think it's worth $99/month plus all the setup fees.
 
Title says it all.
If anyone uses software/mic for dictation from home (or say, a mobile office), let me know what you think and how much is a smart amount to spend.
For what kind of work? Newer editions of microsoft word have a dictation feature that I've found to be better than some versions of dragon i've worked with.

I use Dragon Medical Practice Edition with a SpeechMike SMP4000 wireless microphone. I take my laptop to work and dictate with it since I'm not a fan of M*Modal that the hospital pays for. We have to use our phones as microphones at the hospital.

Unfortunately, Nuance no longer sells DMPE. They shifted to their cloud-based service (DragonMedicalOne), which is absolutely horrible from my limited experience with it. Maybe it's improved, but I don't think it's worth $99/month plus all the setup fees.
If you didn't have to use your phone, what would you think of m-modal? I'm on a wait list to get this from my hospital, but wondering if I should just commit to something like your combo.
 
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@southerndoc

Yeah; I'm hoping that I can "teach" the software to type the specific words that I want (example: latissimus dorsi) the old way by typing them, then speaking them 7x into the mic.

Yeah: M-Modal is trash; so it makes sense why Envision would embrace it.
 
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For what kind of work? Newer editions of microsoft word have a dictation feature that I've found to be better than some versions of dragon i've worked with.


If you didn't have to use your phone, what would you think of m-modal? I'm on a wait list to get this from my hospital, but wondering if I should just commit to something like your combo.

For dictating, silly.

I'll get into the type of work if I can get my ideas up and off of the ground.
Otherwise, I'm not getting too excited.
 
I'm working with IT to hopefully be able to use the SpeechMike microphones with M*Modal. We're having trouble because all of the computers in our department are "headless" (they don't have a CPU, it's basically a glorified monitor that runs processes off a server).
 
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I'm working with IT to hopefully be able to use the SpeechMike microphones with M*Modal. We're having trouble because all of the computers in our department are "headless" (they don't have a CPU, it's basically a glorified monitor that runs processes off a server).

This; this is the mistake that even a middle-school kid could tell you is a huge, fatal, mistake.
 
For dictating, silly.

I'll get into the type of work if I can get my ideas up and off of the ground.
Otherwise, I'm not getting too excited.
Lots of different kinds of dictation tasks...I would have very different recommendations for someone looking for a program to dictate emails v clinical notes directly into an EMR (and those recommendations can differ further depending on the specific EMR). Other considerations would be do you need a dictation system with in-program templates, smart phrase features, etc...
 
I have dragon powermic mobile app, that works with dragon software installed on EPIC at our hospital system. Works great.
 
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Lots of different kinds of dictation tasks...I would have very different recommendations for someone looking for a program to dictate emails v clinical notes directly into an EMR (and those recommendations can differ further depending on the specific EMR). Other considerations would be do you need a dictation system with in-program templates, smart phrase features, etc...

I gotcha.

Basically dictating clinical notes directly into an EMR. Smart phrase features would be great.
 
(DragonMedicalOne), which is absolutely horrible from my limited experience with it. Maybe it's improved, but I don't think it's worth $99/month plus all the setup fees.
I certainly wouldn't pay that fee myself, but my hospital pays for DMO and I find your experience to run contrary to my own. I absolutely can not imagine charting without Dragon and find that it works as intended 95+% of the time.

department are "headless" (they don't have a CPU, it's basically a glorified monitor that runs processes off a server).

Random nitpick from a tech geek. A headless machine is one which does not have a monitor. E.g. my media server which hosts my movies/tv shows does not have a monitor attached to the actual box. I can access it remotely via terminal or a remote desktop situation.

You are likely describing a virtual machine, where your computer has a minimally powered CPU and streams a virtual environment from a host server onto your monitor. None of the work you're doing actually takes place on the little box connected to the monitor, it takes place on the server.
 
I have a personal set up that I use both at home and at work. I oftentimes bring in a laptop and dictate at work as my employer-provided solution is suboptimal.

I run Dragon professional 15 that I have trained for medical vocabulary. The training process consisted of finding a number of emergency medicine related texts (e.g. I found PDF copies of common textbooks, as well as a few thousand emergency medicine focused care notes) and trained the software on these files. This got me pretty close to an acceptable solution, the final touch was training words that Dragon struggled to recognize for whatever reason.

I chose Dragon Professional as it allows for macros and Power Mic usage. It's also worked well with other headsets and microphones.

Since I used to do lots of locums with a variety of EMRs, I have grown used to dictating into notepad or a Word document and then copying and pasting into the EMR. However Dragon professional 15 will allow me to dictate directly into the EMR (e.g. when I am dictating the indication for an imaging study).

To facilitate template usage, I use a free piece of software called phrase express. This works very well and allows me to begin typing a phrase shortcut, and auto complete menu appears and if I hit "tab" an entire block of text is inserted into my document.

Lastly, if that is not sufficiently nerdy, a final piece of software (Octopus USB) allows me to program Dragon shortcuts to be activated by keys on the keyboard. This allows me to use the function keys to jump through template fields, clear defaults, or perform other functions. I've also use this to program a Logitech gaming mouse so that the extra mouse keys will jump through a template and provide faster navigation. The approach above is the final embodiment of a sad but true observation that in attending made when I was in medical school - "medicine is a computer game interrupted by talking to people".

Happy to answer any questions that people might have!
 
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I use M-Modal for my inpatient notes and I wonder if the version isn't different, because I have created all sorts of smart phrases. I can't for the life of me get it to say "COVID" and it substitutes COBRA. But other than that, it's better than the last DragonOne I used. (Edited to add that I'm not paying for it - it's my system's thing - so not really what you were asking...)
 
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I use the dragon powermic mobile app. Hospital buys us all licenses. Functions as a dragon mic but from your cell phone.
I actually find the mobile mic more accurate then the physical mic attached to the desktops.
 
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See; this is another perfect example of why we don't need admins.
We can fix our own problems better, kthxbye.
Very true. Most hospitals are pretty bad. When I was a 1099 for a large CMG working within large hospital systems, I would find the basics to be missing.

Ultrasound - broken. Bring your own if you'd like one. It's 3 am, there's a young women w/ low abdominal pain and a BP of 95/60. Is that her normal? Is it an ectopic? A urine or blood HCG will take at least 45 minutes, calling in the US tech will take 2+ hours, and OB won't come in without more information. I'd really like a working ultrasound machine!

Dragon - no account for me to use, no site license, etc.

Chair - if they ever had one they were stolen by nursing.

Access to PACS? Nope, look at the portable monitor or walk to radiology and look over their shoulder.

A computer to work at? Unavailable during shift change. Why? The powers that only had enough workstations for the scheduled staff to have one.

Being a locums type doc, I figured it was my job to provide solutions to their problems, not create more. I came on shift with a laptop, portable ultrasound, a small airway roll, and good attitude. I made money, fewer people died, and I then left as soon as possible. That festering cesspool of a hospital is probably still killing people. But it's ok because they're poor disenfranchised brown people. I'm no woke SJW (my politics are somewhere on the Venn Diagram between Dems, Republicans, and Libertarians), but shoddy corporate medicine isn't what I went to medical school for.
 
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So I love Dragon Medical One. I think it is much better than previous editions of dragon. I'm kind of a tech nerd as well. Never used M-modal. I however don't use the powermic mobile app. On most of these softwares there should be an option to use whatever mic you want. I would imagine that is true for M-modal as well. I would consider paying the fee for DMO if I didn't have it provided but I also have all of my MDMs/procedures/DC instructions, etc... loaded in so all I have to say is "insert..." I guess it is how much you value have speech-to-text and how much time you want to put into setting it all up. I have a $20 desk mic that I plug in and set the on/off to be the "-" on the number pad. Works well for me.
 
So I love Dragon Medical One. I think it is much better than previous editions of dragon. I'm kind of a tech nerd as well. Never used M-modal. I however don't use the powermic mobile app. On most of these softwares there should be an option to use whatever mic you want. I would imagine that is true for M-modal as well. I would consider paying the fee for DMO if I didn't have it provided but I also have all of my MDMs/procedures/DC instructions, etc... loaded in so all I have to say is "insert..." I guess it is how much you value have speech-to-text and how much time you want to put into setting it all up. I have a $20 desk mic that I plug in and set the on/off to be the "-" on the number pad. Works well for me.
Do you have occasional Dragon hiccups? My only complaint with DMO is that I will sometimes be dictating, and in the middle of a sentence it will simply not register 5 or 6 words that I said. It doesn't get them wrong, it's as if the mic just stopped listening for 2 seconds. I also use a toggle on/off button like you, so it isn't like the mic is actually off during that window. I don't know if this is a nuance mic issue or a software issue. I assume the latter, but it might be worth a $20 experiment to get a new mic like you suggested.
 
Do you have occasional Dragon hiccups? My only complaint with DMO is that I will sometimes be dictating, and in the middle of a sentence it will simply not register 5 or 6 words that I said. It doesn't get them wrong, it's as if the mic just stopped listening for 2 seconds. I also use a toggle on/off button like you, so it isn't like the mic is actually off during that window. I don't know if this is a nuance mic issue or a software issue. I assume the latter, but it might be worth a $20 experiment to get a new mic like you suggested.
I have had this issue with the dication microphones we have installed with our computers. Never had this issue with the power mic app using my phone.
 
Do you have occasional Dragon hiccups? My only complaint with DMO is that I will sometimes be dictating, and in the middle of a sentence it will simply not register 5 or 6 words that I said. It doesn't get them wrong, it's as if the mic just stopped listening for 2 seconds. I also use a toggle on/off button like you, so it isn't like the mic is actually off during that window. I don't know if this is a nuance mic issue or a software issue. I assume the latter, but it might be worth a $20 experiment to get a new mic like you suggested.
Maybe once or twice? No more than any other random computer glitches. I'm sure it does happen more often but I probably don't catch it. I'll have to look out for it.
 
I used to own a personal version of Dragon Dictate that I used to chart from home but I didn't use it enough to justify the expense. However, it worked just fine. I used my phone as a mic. Currently, we use MModal for EPIC and I typically have found much better results with my phone, using the IOS app. It seems to make fewer mistakes than the hand held mic. I also use it at home. I probably dictate 50% of the time and type the rest.
 
I have a personal set up that I use both at home and at work. I oftentimes bring in a laptop and dictate at work as my employer-provided solution is suboptimal.

I run Dragon professional 15 that I have trained for medical vocabulary. The training process consisted of finding a number of emergency medicine related texts (e.g. I found PDF copies of common textbooks, as well as a few thousand emergency medicine focused care notes) and trained the software on these files. This got me pretty close to an acceptable solution, the final touch was training words that Dragon struggled to recognize for whatever reason.

I chose Dragon Professional as it allows for macros and Power Mic usage. It's also worked well with other headsets and microphones.

Since I used to do lots of locums with a variety of EMRs, I have grown used to dictating into notepad or a Word document and then copying and pasting into the EMR. However Dragon professional 15 will allow me to dictate directly into the EMR (e.g. when I am dictating the indication for an imaging study).

To facilitate template usage, I use a free piece of software called phrase express. This works very well and allows me to begin typing a phrase shortcut, and auto complete menu appears and if I hit "tab" an entire block of text is inserted into my document.

Lastly, if that is not sufficiently nerdy, a final piece of software (Octopus USB) allows me to program Dragon shortcuts to be activated by keys on the keyboard. This allows me to use the function keys to jump through template fields, clear defaults, or perform other functions. I've also use this to program a Logitech gaming mouse so that the extra mouse keys will jump through a template and provide faster navigation. The approach above is the final embodiment of a sad but true observation that in attending made when I was in medical school - "medicine is a computer game interrupted by talking to people".

Happy to answer any questions that people might have!
This is an older post, but I felt deserved recognition. You are an absolute god. I just graduated fellowship, and am taking over a prior doc's solo practice in a small, rural area. He has Dragon Professional 15 which has been terrible thus far, far worse than Dragon Medical One that I used to use in residency/fellowship. I've really not wanted to pay the extra fee, but figured I may have to...until I read your post.

If you can say, did you have any issues with Dragon Professional and really severe spelling errors for basic english - things like "fiix" or "cleearlly?"
 
This is an older post, but I felt deserved recognition. You are an absolute god. I just graduated fellowship, and am taking over a prior doc's solo practice in a small, rural area. He has Dragon Professional 15 which has been terrible thus far, far worse than Dragon Medical One that I used to use in residency/fellowship. I've really not wanted to pay the extra fee, but figured I may have to...until I read your post.

If you can say, did you have any issues with Dragon Professional and really severe spelling errors for basic english - things like "fiix" or "cleearlly?"
No real issues, but for some reason I can't get it to dictate "procalcitonin" correctly, I always get "Pro calcitonin".
 
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No real issues, but for some reason I can't get it to dictate "procalcitonin" correctly, I always get "Pro calcitonin".
Maybe this is a sign to stop ordering procalcitonins.

I kid I kid

Kind of
 
Hah! Probably correct, but it has helped a few times and the hospitalist really seems to like them, so I order them!
Maybe this is a sign to stop ordering procalcitonins.

I kid I kid

Kind of
 
I couldn’t justify spending the premium for a dragon mic or speechmike. Bought a samson q9u that also sounds great for meetings or if iburnout and try to become an asmr influencer. I use windows 11 dictation which is comparable to the best dragon ive used… now that microsoft has bought nuance i am excited to see how much better it might get
Mmodal provided by my system is so error prone I can’t even compare it to writing, let alone typing.
 
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I couldn’t justify spending the premium for a dragon mic or speechmike. Bought a samson q9u that also sounds great for meetings or if iburnout and try to become an asmr influencer. I use windows 11 dictation which is comparable to the best dragon ive used… now that microsoft has bought nuance i am excited to see how much better it might get
Mmodal provided by my system is so error prone I can’t even compare it to writing, let alone typing.

Really surprised to hear that mModal was a bust for you.
At my current shop, its solidly reliable. I give it 4/5 stars.
That being said, reading the PLP's charts (when they use it) sounds like a deranged methhead.
 
Really surprised to hear that mModal was a bust for you.
At my current shop, its solidly reliable. I give it 4/5 stars.
That being said, reading the PLP's charts (when they use it) sounds like a deranged methhead.
Not sure the deranged part is due to the software
 
Really surprised to hear that mModal was a bust for you.
At my current shop, its solidly reliable. I give it 4/5 stars.
That being said, reading the PLP's charts (when they use it) sounds like a deranged methhead.
I’m not sure why it doesn’t work well. Guess it depends on the implementation.
I am involved in rolling out the “AI” enhanced version of mmodal at my shop…it has been in development hell for years. There is ONE sample paragraph the rep uses to test everything and the dictation has an average 15% percent error rate… on their own sample phrase! Doesnt inspire confidence.
 
I think I've said it before (too lazy to look), but Dragon Medical Practice Edition is no more. You can't buy it. Those that have it can continue using it, but Nuance isn't supporting it. I'm not updating to Windows 11 because I don't want DMPE to break. It's much much better for me than M*modal. With DMPE, I have a ton of macros saved and have automated tasks that make me able to complete a chart super quickly.

Nuance markets Dragon Medical One, but M*modal is way better than DMO.
 
I think I've said it before (too lazy to look), but Dragon Medical Practice Edition is no more. You can't buy it. Those that have it can continue using it, but Nuance isn't supporting it. I'm not updating to Windows 11 because I don't want DMPE to break. It's much much better for me than M*modal. With DMPE, I have a ton of macros saved and have automated tasks that make me able to complete a chart super quickly.

Nuance markets Dragon Medical One, but M*modal is way better than DMO.

So, what we need is an *ahem* hacker to liberate DMPE.

I mean, it takes minimum effort to find free Photoshop, etc on teh internetz.

And before anyone asks, I'm not skilled in this area. My knowledge of such ended with the warez scene of the late 90s.
 
I wish my procalcitonins was Pro calcitonin.

I once dictated “Vagina breath.” I have no idea what I said, but it was nothing regarding front or back bottoms.
My infamous Dragonism was "patient was prepped and raped in the usual sterile fashion." Of course I didn't catch it, signed the note, and got a lot of teasing from the ICU docs I'm friends with.

Also had a patient once who had a history of "eating hemorrhoids."

@RustedFox Unfortunately you can't hack it. DMPE will only run so many times without phoning home to authorize its use. Nuance hasn't shut down that part yet. You can't even install it on multiple computers. DMPE is really good, but unfortunately all good things eventually come to an end.
 
My infamous Dragonism was "patient was prepped and raped in the usual sterile fashion." Of course I didn't catch it, signed the note, and got a lot of teasing from the ICU docs I'm friends with.

Also had a patient once who had a history of "eating hemorrhoids."

@RustedFox Unfortunately you can't hack it. DMPE will only run so many times without phoning home to authorize its use. Nuance hasn't shut down that part yet. You can't even install it on multiple computers. DMPE is really good, but unfortunately all good things eventually come to an end.

I'm certain that some mouthbreather out there can "hack" it, even with it phoning home.

Unfortunately for us, there's no motivation for the virgins that live in their parents' basements to do so.
 
I couldn’t justify spending the premium for a dragon mic or speechmike. Bought a samson q9u that also sounds great for meetings or if iburnout and try to become an asmr influencer. I use windows 11 dictation which is comparable to the best dragon ive used… now that microsoft has bought nuance i am excited to see how much better it might get
Mmodal provided by my system is so error prone I can’t even compare it to writing, let alone typing.

I’ve had decent experience using Siri on my laptop. It seems to work pretty well too. Just curious - what kind of microphone do you use?
 
I’ve had decent experience using Siri on my laptop. It seems to work pretty well too. Just curious - what kind of microphone do you use?

I use a samson q9u at home- great for dictating and meetings. I used to use windows 11 dictation the latest update (22h2) has greatly reduced accuracy, so i use dragon medical one supplied by a locums job.

I do some nursing home work too and use an android tablet with google dictation, which works great- better than dmo for non medical stuff.
 
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