How to Use Dragon Medical in Your EHR

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Dragon Speech for Your Electronic Health Record

In this article, we will address questions you may have about using Dragon Medical speech recognition software within your Electronic Health Record (EHR); specifically, Dragon features that pertain directly to Electronic Medical Records (EMR). We’ll include tips on how to make dictation easier, both with application functions and microphones, and address a common question about using Dragon directly within your medical record.   

My Computer and Dragon

This article is specifically written for healthcare professionals using the Windows-based Dragon voice recognition system with their EMRs. . Since we’re talking about Dragon in a healthcare environment—and only for Windows computers—the application we’re using today is called Dragon Medical One. If you are using this software, be sure you are fully up to date, as that can affect your ability to dictate into your EHR. The information in this article may apply to any EHR that can use Dragon Medical, including: 

  • Allscripts
  • CureMD™
  • eClinicalWorks
  • Cerner
  • Practice Fusion
  • Epic
  • athenaClinicals®

Your EMR may be locally installed or hosted on a server and deployed over a remote connection. The deployment method will also factor in on how Dragon voice recognition works. 

Dragon Medical Only

Non-medical Dragon editions are not intended for use in healthcare, and likely will not provide any voice dictation functionality in your electronic record.   

How Dragon Works With Your EHR

For Dragon to be able to print your words inside of your medical record, it needs to be compatible with the edit controls of the text field you are using. Any field in your EHR that you can type text into has these edit controls. They essentially encode the field for text input. When Dragon is compatible with the edit controls of a text field in your EMR, and your deployment method doesn’t interrupt this compatibility, you should have speech-to-text functionality there. If the edit controls are incompatible, you won’t be able to dictate. We will discuss what you can do in these scenarios.  

What Is Full-Text Control?

Essentially, when we say that Dragon Medical has full text control in a text field, it means that Dragon can do everything that it does under normal circumstances. If you want to know if a field in your EMR has full-text control, click your mouse in the field. The green checkmark on your DragonBar should be lit up. If it is not, you may lose some or all of your Dragon dictation functionality in that field. You may also hear this functionality referred to as “dictate at the cursor.” This term is similar to full-text control but actually refers only to the ability to dictate wherever you click your mouse. Consider it a subset of full-text control. To address these issues, click on the hyperlink to restore dictate at the cursor and/or full-text control in your EHR. If these don’t work for you, there are three other approaches you might take. 

1) Use the Dictation Box

The Dictation Box, included with Dragon Medical, is designed to enable you to dictate into windows where you don’t have full-text control. In effect, it acts as a bridge between Dragon and the field where you need to dictate. We recommend setting up the Dictation Box in Hidden Mode, to enable full Dragon speech-to-text functionality without having to switch between windows. If you have a Nuance PowerMic, you can program it to make using the Dictation Box even simpler

2) Change Your Deployment

Changing your deployment means changing where you have an application installed and how you deliver it. It’s very possible that Dragon could have full text control in your EHR, but your EHR is coming to you over a remote connection. In many cases, these kinds of local-virtual relationships cut off full-text control. 

Locally Installed

An application that is installed locally is on your workstation. It is not coming over Citrix or Remote Desktop to get to you. If Dragon is installed locally, and you can install your EHR locally as well, consider working with your IT team to see if this is an option. Please note that it’s possible your EHR may not natively support Dragon full-text control, regardless of your deployment strategy. For instance, your EHR may already be installed locally. In this case, use the Dictation Box. 

VDI and Remote Connections

If your EHR is coming to you over Remote Desktop or Citrix, you may have the option to install Dragon Medical on the server where your EHR is installed. While you’ll need to check with your IT team/EHR vendor before proceeding, Dragon Medical does support this scenario. There are specific configurations that need to be made for this to work, but it is the supported method for deploying Dragon when working with virtualization. Again, be sure to verify that your EHR natively supports Dragon full-text control before proceeding.

3) Dragon Software Developer Kit (SDK)

If your clinic, hospital, or EHR vendor wants to incorporate Dragon Medical functionality within your electronic health record, you can also purchase the Dragon SDK. This kit will allow your development team to bring Dragon functionality into your EHR natively. Do note that this is a high-cost investment, and will require programming expertise to implement.   

Using Dragon Templates

Instead of dictating full reports into your EHR, you should consider creating Dragon templates. These pre-configured reports can be pasted right into your EHR, and then filled in with the specific patient information. Fillable fields can be added, which allow you to move between them with a voice command… or the press of a button.   

Programmable Microphones

Dragon speech-to-text has all sorts of voice commands that allow you to control it and other applications. You can even control your computer, to some extent. If you have a programmable microphone, like the Nuance PowerMic or the Philips SpeechMike, you can assign some of these commands to buttons. Imagine, instead of using voice commands or your keyboard and mouse, you can program your microphone buttons to: 

  • Turn the Dragon microphone on/off
  • Call up one of your templates
  • Move between fields in your report or your EHR
  • Press hotkeys that your EHR uses
  • Open the Dictation Box
  • Transfer text from the Dictation Box to your EHR
  • Open a program
  • Train words, add words, add commands, and more.