Desktop Application - Installation and Administration Guide

Desktop

Application

Installation and Administration Guide

Dragon Medical One Desktop Application 2020.1

- 2 -

Table of contents

Getting started 6

Setting up a working system 6

Setting up Dragon Medical Advisor 6

Customizing the system to your needs 6

Software and hardware requirements 8

Deploying Dragon Medical One 10

The Windows Installer 10

XCOPY deployment 11

Deploying Dragon Medical One in a virtualized environment 13

Supported virtualized environments 13

Edit control visibility 14

Nuance virtual extensions 15

Server runtime requirements 16

Deployment options 17

Logging 17

Coherence mode 18

Scenario 18

Prerequisites 18

Procedure 18

Results 19

Running both instances 19

PowerMic Mobile 19

Using Dragon Medical One with Mac 20

Accessing Dragon Medical One as a published virtual application 20

Running Windows on macOS 20

Running Windows in native mode on Mac hardware 20

Google Chrome 21

Architecture 21

Installation 21

Configuring Dragon Medical One 23

Configuring the organization token 23

Providing different configurations for a single stand-alone deployment 23

Configuring the default settings 23

Dragon Medical One Desktop Application 2020.1

- 3 -

Enabling basic text controls 29

Configuring timeout for end users 31

Configuring Dragon Medical Advisor 31

Disabling PowerMic Mobile support 32

Configuring the speech recognition topic/specialty 32

Configuring microphones 33

Disabling the crash dump notification to end users 33

Enabling the troubleshooting data collection for end users 33

Disabling registration of the Microsoft Word add-in 34

Customizing the splash screen 34

Configuring the user interface color theme 35

Dragon Medical One command line 36

Starting Dragon Medical One from the command line 36

Logging off and closing Dragon Medical One from the command line 37

Enabling and disabling WPF support from the command line 37

User authentication 39

No authentication 39

Native authentication 39

LDAP authentication 40

NMS call forwarder/local authenticator 40

On-premise NMS 41

Trusted authentication 42

Single sign-on (SSO) authentication 42

Logging 44

Log file location 44

Setting the logging level 44

Nuance Management Center - overview 45

Prerequisites for running NMC 45

Launching NMC 45

Licensing 45

Groups 45

Speech recognition settings: Auto-texts 47

Defining an auto-text in NMC 47

Configuring the auto-text filter 48

Setting an auto-text filter in NMC 48

Dragon Medical One Desktop Application 2020.1

- 4 -

Speech recognition settings:Voice commands 50

Speech recognition settings:Managing the vocabulary 51

Adding a word in NMC 51

Speech recognition settings:Dragon Medical Connect 52

Dragon Medical One Desktop Application 52

DragonMedical Network Edition 52

Third-party applications only 53

Nuance Healthcare ID 54

Registering the Nuance Healthcare ID 54

Activating the Nuance Healthcare IDfor an app 54

Dragon Medical Advisor overview 56

Advice types 56

Coding Assistant 56

Content packs 57

System requirements 57

Dragon Medical Advisor licensing 58

Installing licenses 58

Granting licenses to users 59

Using Dragon Medical Advisor without speech recognition 59

Configuring Dragon Medical Advisor in NMC 60

Connecting to the Advisor Service 60

Configuring the patient context 60

Configuring the healthcare setting for a site 61

Dragon Medical Advisor:Advice filters 62

Overview 62

Enabling and disabling advice 62

Working with advice filter groups 63

Dragon Medical Advisor:HCC filters 65

Overview 65

Enabling and disabling HCCcategories 65

Working with HCC filter groups 66

Documentation 68

System administrators 68

End users 68

Supported languages 69

Dragon Medical One Desktop Application 2020.1

- 5 -

Troubleshooting 70

Dragon Medical One Desktop Application 2020.1

- 6 -

Getting started

Welcome to the

Dragon Medical One Desktop Application Installation and Administration Guide

Setting up a working system

The following steps are required to set up a working Dragon Medical One system:

1. Make sure you fulfill all software and hardware requirements. For more information, see: Software and

hardware requirements and Deploying in a virtual environment.

Dragon Medical One requires access to Dragon Medical Server (nsa.nuancehdp.com) via port 443; make

sure your firewall does not block this port.

Dragon Medical One requires access to the Nuance Management Server (nms.nuancehdp.com) via port

443; make sure your firewall does not block this port.

If your system is set up to use the PowerMic Mobile feature, Dragon Medical One requires access to the

PowerMic Mobile Server (https://pmm.nuancehdp.com) via port 443; make sure your firewall does not

block this port.

If you are deploying Dragon Medical Advisor or QRA, make sure Dragon Medical One has access to the

Advisor Service (https://<organization-specific prefix>.nuanceunderstanding.com) via port 443; your

firewall must not block this port.

Deploy Dragon Medical One. The following options are available:

Deploy Dragon Medical One using the Windows Installer (MSI package).

Deploy Dragon Medical One via XCOPY deployment (manually copy the package to the destination

path).

7. Configure the organization token in the SoD.exe.config file.

Setting up Dragon Medical Advisor

Dragon Medical Advisor is accessed via Dragon Medical One;a speech recognition license is not required. To

set up Dragon Medical One with Dragon Medical Advisor, follow the steps for setting up a working system, then

import the required Dragon Medical Advisor and content pack licenses and configure your organization via the

Nuance Management Center (NMC).

For more information, see:Dragon Medical Advisor - overview

Customizing the system to your needs

Dragon Medical One offers a wide range of options to customize the system to your users' needs. The following

customization options are available:

Customizing the application (all users)

Providing different configurations for a single stand-alone deployment

Disabling the crash dump notification to end users

Configuring the user authentication

Dragon Medical One Desktop Application 2020.1

- 7 -

Customizing the splash screen

Starting Dragon Medical One from the command line

Configuring logging

Customizing the system for speech recognition users

Configuring the speech recognition topic

Configuring microphones

Disabling registration of the Microsoft Word add-in

Disabling PowerMic Mobile support

Defining auto-texts and configuring auto-text filters

Configuring step-by-step commands

Customizing the system for Dragon Medical Advisor users

Application settings for Dragon Medical Advisor

Configuring Dragon Medical Advisor

Configuring advice filters

HCCGuidance only:Configuring HCCfilters

Dragon Medical One Desktop Application 2020.1

- 8 -

Software and hardware requirements

Dragon Medical One supports the following hardware and software.

Be aware that not all configurations have been tested. For more information, contact Nuance Healthcare

technical support or your Nuance account executive.

Operating systems

n 32-bit: Microsoft Windows 7, Windows 8.1 and Windows 10. Make sure that the latest service pack is always

applied.

n 64-bit: Microsoft Windows 7, Windows 8.1, Windows 10, Windows Server 2012 R2, Windows Server 2016

and Windows Server 2019. Make sure that the latest service pack is always applied.

Microsoft .NET Framework 4.5.2 (or higher) is required.

In Microsoft Windows 8.1 and 10, you can only use Dragon Medical One in the desktop environment, the

Microsoft design language-based user interface (Start screen) is not supported.

Processor speed

n Minimum: 1.7 Ghz

n Recommended: 2.8 Ghz

RAM

n Minimum: 512 MB

n Recommended: 2 GB

Display

If you are deploying Dragon Medical Advisor we recommend a minimum of 1280 x 1024 pixels;Dragon Medical

One does not otherwise have a minimum display resolution requirement.

Microphones

Any microphone that can record audio data in 16 kHz, 16 bit mono format.

To work with Dragon Medical One in hands-free mode, using a foot pedal in combination with a microphone, you

must make changes to the Registry on your workstation. If you are working in a virtual environment, you must

modify the registry settings on the virtual server for every Windows user that will be used to run Dragon Medical

One. For more information, contact Nuance Technical Support.

Web browsers

For access to Nuance Management Center (NMC):

n Microsoft Internet Explorer, Microsoft Edge, Google Chrome, Apple Safari

For the ClickOnce installer:

n Microsoft Internet Explorer

For the personalization and help window:

Microsoft Internet Explorer 11. In the Internet Options, make sure that cookies are enabled.

Dragon Medical One Desktop Application 2020.1

- 9 -

Text editors

The following text editors are supported for speech recognition and for basic Dragon Medical Advisor

functionality without patient context:

n TX Text Control 12 to 25, .NET

n Microsoft Word 2007, 2010, 2013 and 2016

n Microsoft Rich Text controls (including .NET Forms)

n Ter32, Ter13-Ter17 and Ter21-Ter23

n TEdit (for 32-bit applications), TMemo (for 32-bit applications) and TRichEdit (for 32-bit and 64-bit

applications)

n Dragon Medical One Dictation Box

n WPF standard text controls

Restrictions: Speech focus anchoring is not supported.

Dragon Medical Advisor - supported EHR systems

Dragon Medical Advisor provides patient context support for the following EHRs:

n Epic HyperSpace

n Cerner Millenium

n Allscripts TouchWorks

n Allscripts SCM

n AthenaHealth AthenaClinicals

n Meditech Expanse

Patient context support is required for the full Dragon Medical Advisor feature set. Dragon Medical Advisor works

with other text editors and with text in the Dictation Box, but with a reduced feature set.

Virtualized environments

For information on supported virtualized environments, see: Deploying Dragon Medical One Desktop

Application in a virtualized environment.

End-of-life: Third-party environments

Support for third-party environments is only valid as long as they are supported by the corresponding vendor and

might be subject to other restrictions. Contact Nuance Technical Support for details. For more information, see

the documentation delivered with the third-party product and supporting Nuance documentation.

When standard support by the vendor has stopped, Nuance will continue support if an issue is specific to the

Nuance solution, within the limitations of the vendor’s standard end-of-life and Nuance's policy. This means that

issues that are a combination of the vendor’s component and the Nuance solution cannot be supported.

Dragon Medical One Desktop Application 2020.1

- 10 -

Deploying Dragon Medical One

The following options are available to deploy Dragon Medical One:

Deploy Dragon Medical One using the Windows Installer (MSI package).

Deploy Dragon Medical One via XCOPY deployment (manually copy the package to the destination path).

We recommend deploying Dragon Medical One to a local folder. During runtime, Dragon Medical One frequently

accesses files that are part of the deployment; loading those files from a network share would have a severe

impact on performance.

For information on how to deploy Dragon Medical One in a virtual desktop/application environment, see:

Deploying in a virtual environment.

The Windows Installer

The MSI package provided is command line-only; no installation wizard is available.

To customize the installation, set all mandatory parameters and any optional parameters you want, or use the

CONFIGTEMPLATE parameter to deploy a configuration file containing all relevant settings (this is the

recommended option). Values for parameters must be in double quotes.

Application binaries are by default installed to the following location: C:\Program Files

(x86)\Nuance\Dragon Medical One

To support uninstallation, an entry is created in the Control Panel, Programs and Features window.

Mandatory parameters

SERVERURL

The full URL of the Nuance-hosted Dragon Medical Server: "https://nsa.nuancehdp.com/basic"

ORGANIZATIONTOKEN

The organization token assigned to the organization you are deploying to.

SUPPORTEDLANGUAGES

Currently only English (IETF language tag: en-US) is supported. For more information, see: Supported

languages.

SUPPORTEDTOPICS

A list of speech recognition topics that the end user can select from on the startup screen. Separate values

with the pipe character: |

For more information, see: Configuring the speech recognition topic.

Optional parameters

CONFIGTEMPLATE

The full path to the configuration file containing all relevant settings. If this parameter is specified, all other

command line parameters provided by Dragon Medical One are ignored (you can still use OEMSPLASHSCREEN

and INSTALLDIR).

For more information, see Configuring Dragon Medical One.

INSTALLDIR

Dragon Medical One Desktop Application 2020.1

- 11 -

The deployment location. If this parameter is not set, the default location is used.

OEMSPLASHSCREEN

The custom splash screen overlay. The specified file is copied to the deployment location. Required size:

320x130 pixels; required format: PNG.

AUTHENTICATION

The user authentication type; for more information, see: User authentication.

LOGFILEPATH

The location of the log file. To prevent environment variables from being expanded when the setup is

executed, the percent sign must be escaped by the ^ character and no quotes must be used; for example,

^%APPDATA^%.

For more information, see: Logging.

LOGLEVEL

The log level; for more information, see: Logging.

ALLOWEDMICS

A list of microphones the end user is allowed to use. Separate values with the pipe character: |

For more information, see: Configuring Dragon Medical One.

POWERMICMOBILE

Enables/disables the PowerMic Mobile feature. Possible values: Yes, No. If this parameter is not set, the

feature is enabled by default.

WPFSUPPORT

Enables/disables support for standard WPF text controls. Possible values: Yes, No. If this parameter is not

set, the feature is disabled by default.

For more information, see: Enabling and disabling WPF support from the command line.

Examples

msiexec /i Standalone.msi SERVERURL="https://nsa.nuancehdp.com/basic"

ORGANIZATIONTOKEN="your_organization_token" SUPPORTEDLANGUAGES="en-US"

SUPPORTEDTOPICS="GeneralMedicine|ClinicalAdministration|Cardiology|Emergency|InternalMedi

trics|Surgery"

msiexec /i Standalone.msi CONFIGTEMPLATE="C:\<path>\SoD.exe.config"

OEMSPLASHSCREEN=".\SoD.OEM.png"

XCOPY deployment

To deploy Dragon Medical One using XCOPY, do the following:

Download the installation package.

Depending on your Group Policy security settings, Microsoft Windows marks downloaded files as unsafe.

Unblock the downloaded ZIP file, if necessary, to allow .NET to execute properly when the application is

started: Right-click the ZIP file and select Properties; on the General tab, click Unblock and Apply.

Extract all files.

Dragon Medical One Desktop Application 2020.1

- 12 -

Customize the SoD.exe.config file template to configure the Dragon Medical One application. For more

information, see: Configuring Dragon Medical One.

5. Make the Standalone folder available to your end users.

Upgrading using XCOPY

When an upgrade package is available, be sure to make it available to your end users.

Make sure you save the existing application configuration file before the upgrade to keep your customized

settings.

Dragon Medical One Desktop Application 2020.1

- 13 -

Deploying Dragon Medical One in a virtualized

environment

Dragon Medical One can be deployed as a virtualized application or on a virtual desktop. The speech recognition

is performed in secure Nuance data centers; Dragon Medical One has a small resource footprint on the

application/desktop virtualization server.

Supported virtualized environments

Citrix XenApp/XenDesktop

Citrix server

n One of the following operating systems:

Microsoft Windows Server 2012 R2

Microsoft Windows Server 2016

Microsoft Windows Server 2019

n One of the following Citrix virtualization environments:

Citrix XenApp 7.15

Citrix XenDesktop 7.15 (latest version tested: Citrix Virtual Apps and Desktops 1909)

Client PC

n One of the following operating systems:

Microsoft Windows 7

Microsoft Windows Embedded Standard 7

Microsoft Windows 8.1

Microsoft Windows 10

For information on supported Linux operating systems, see: Thin clients.

n Citrix Receiver 4.9 or higher (latest version tested: Citrix Workspace app 1909 for Windows)

Microsoft Remote Desktop Services (RDS)

Terminal Server

Dragon Medical One Desktop Application 2020.1

- 14 -

n One of the following operating systems:

Microsoft Windows Server 2012 R2

Microsoft Windows Server 2016

Microsoft Windows Server 2019

Client PC

n One of the following operating systems:

Microsoft Windows 7

Microsoft Windows Embedded Standard 7

Microsoft Windows 8.1

Microsoft Windows 10

n Microsoft Remote Desktop Client using Remote Desktop Protocol (RDP) 7.x or higher

For Nuance RDS Audio Extension and Nuance PowerMic RDS Client Extension the User Datagram

Protocol (UDP) transport must be disabled on RDP 8.1 and RDP 10 clients. RDP 8.1 is preinstalled on

Windows 8.1 and installed by Microsoft Update on Windows 7 and 8. RDP 10 is preinstalled on Windows

10.

To disable UDP transport, add the following registry keys and value to the Microsoft Remote Desktop

Client, then restart the PC:

Keys:

HKEY_LOCAL_MACHINE\Software\Microsoft\Terminal Server Client

HKEY_LOCAL_MACHINE\Software\Wow6432Node\Microsoft\Terminal Server Client

DWORD Value:

DisableUDPTransport = 1

VMware Horizon View/RDSH

VMware Horizon View/RDSH server

n VMware Horizon View 7.6 or higher

Client PC

n One of the following operating systems:

Microsoft Windows 7

Microsoft Windows Embedded Standard 7

Microsoft Windows 8.1

Microsoft Windows 10

Microsoft Windows Server 2012 R2

Microsoft Windows Server 2016

Microsoft Windows Server 2019

n VMware Horizon View Client 4.9 or higher

Edit control visibility

To write recognized text directly in the target application (instead of the Dictation Box) or for Dragon Medical

Advisor/QRA to provide advice based on the user's documentation, Dragon Medical One must be able to directly

access the application's edit controls. To enable this, Dragon Medical One must be co-installed and published

with the target application.

This means the following:

Dragon Medical One Desktop Application 2020.1

- 15 -

n If you are using a virtual desktop solution, where all target applications are installed and run locally in the

virtual desktop, Dragon Medical One must be installed in the virtual desktop image.

n If you are virtualizing applications that are accessed by a viewer or remote desktop application on a local

workstation, make sure that Dragon Medical One and the virtualized applications will be launched in the

same remote session.

Nuance virtual extensions

High quality audio is required for accurate speech recognition. Regardless of the virtualization technology and

architecture, you must be able to deliver audio from the client workstation/terminal to the Dragon Medical One

application in the virtual environment.

The Nuance virtual extensions package provides custom audio channels to reduce the audio bandwidth

requirements between the client end point and the virtualized application. The custom audio channels require 28

kbit/s for each user while they are dictating (native audio channels often require up to 1.4 Mbit/s).

VMware environments:Dragon Medical One already integrates the server/virtual desktop component of the

VMware audio channel. Install only the Nuance VMware Client Audio Extension on the client PC.

Microsoft RDS environments:Dragon Medical One already integrates the server/virtual desktop component

of the RDS audio channel. Install only the Nuance RDS Client Audio Extension on the client PC.

Citrix environments:Dragon Medical One already integrates the server/virtual desktop component of the Citrix

audio channel.Install only the Nuance Citrix Client Audio Extension on the client PC.

Note: If the Nuance VMware Server & Virtual Desktop Audio Extension or the Nuance RDS Server & Virtual

Desktop Audio Extension is installed, we recommend you uninstall it unless it is still used by another product.

For more information, see the Docs & Guidelines folder of the Nuance virtual extensions package.

Thin clients

To use the custom audio channel in a thin client environment, the client component of the corresponding Nuance

virtual extension must be installed on the thin client. The following thin clients are supported:

Virtualization

infrastructure

Model/manufacturer Operating system/firmware requirements

Citrix Various Microsoft Windows Embedded Standard 7

Citrix IGEL For information on the IGEL thin clients supported, search for

Nuance compatibility

in the

IGEL Knowledge Base

Citrix Fujitsu Futro

S520/S700/S720

eLux RP 5.1.x (Philips SpeechMike button controls have not been

tested - Philips Speech Drivers for Citrix are not included in this

firmware version.)

Backward compatibility

The server/virtual desktop components of the Nuance virtual extensions are integrated in Dragon Medical One.

The Nuance virtual extensions are designed to be backward compatible from Dragon Medical One to the client

end point. This means that you can run newer versions of Dragon Medical One in your virtual environment and

they will work with older versions of the corresponding client end point extension with the following restrictions:

Dragon Medical One Desktop Application 2020.1

- 16 -

n New versions of Dragon Medical One are backward compatible with the corresponding end point virtual

extensions for up to one year.

n It is recommended to upgrade the client end point extension to the latest version.

Microphone controls

The Nuance virtual extensions package provides custom PowerMic control channels to redirect PowerMic button

presses to the virtualized Dragon Medical One instance.

Citrix, RDS and VMware environments:Dragon Medical One already integrates the server/virtual desktop

component of the PowerMic button channel. Install the corresponding client component on the client PC.

Note: If the Nuance PowerMic Citrix Server & Virtual Desktop Extension is installed, we recommend you

uninstall it unless it is still used by another product.

Redistributable packages for Philips, Grundig and Olympus devices are also available.

For more information, see the Docs & Guidelines folder of the Nuance virtual extensions package.

Server runtime requirements

Bandwidth

Audio transmission between the end point and the virtualized application/virtual desktop: If the Nuance custom

audio channel is used, expect 28 kbit/s per active user; if the native virtual audio channel is used, expect up to

1.4 Mbit/s per active user.

Audio transmission between the virtualized application/virtual desktop and the Dragon Medical system: Expect

80 kbit/s per active user.

Latency

Network latency between the client PC and the virtualized application/virtual desktop must not exceed 50 ms.

Network latency between the virtualized application/virtual desktop and the Dragon Medical system must not

exceed 200 ms.

Memory

The Dragon application’s memory usage, when in use, will fluctuate (increase and decrease based on user

behavior and Microsoft Windows memory management behavior). For sizing and planning purposes we estimate

memory utilization of 220 MB (full working set), of which approximately 70 MB (shared working set) are shared

Dragon Medical One Desktop Application 2020.1

- 17 -

between all instances of the SoD.exe process on the same machine – the real physical memory impact therefore

is approximately 150 MB per instance.

CPU

Due to the many factors that can have an impact on CPU usage (processor speed, number of cores assigned to

a given virtual instance, etc.), exact guidelines cannot be given. In general, the CPU requirements for the

virtualized sod.exe executable are very low. As Dragon Medical One leverages Nuance’s cloud-based speech

recognition services, the local client performs very light-weight duties such as streaming speech and inserting

recognition results.

With modern multi-core CPU architecture and provided that a given virtual session has been assigned at least

one core, Dragon Medical One consumes between 1% and 3% of the available CPU per user session while the

user is dictating.

Deployment options

The following options are available to deploy Dragon Medical One in a virtual desktop/application environment:

Deploy Dragon Medical One using the Windows Installer (MSI package).

Deploy Dragon Medical One via XCOPY deployment (manually copy the package to the destination path).

Logging

In a virtual desktop/application environment, we recommend configuring a user-specific folder as the log file

location; for example, %APPDATA%.

If you deploy Dragon Medical One using the Windows Installer, you can specify the location of the log file via the

LOGFILEPATH parameter. For more information, see: Windows Installer.

If you deploy Dragon Medical One via XCOPY deployment, you can specify the location of the log file in the

log4net section of the SoD.exe.config file (use the following syntax to specify environment variables:

${APPDATA}):

For more information, see: Logging.

Dragon Medical One Desktop Application 2020.1

- 18 -

Coherence mode

Dragon Medical One Desktop Application is designed to work in a virtualized environment; which significantly

lowers administration overhead for installation and maintenance. Additionally, virtual deployments increase the

availability of the application as users can access Dragon Medical One from any secure end point (office, clinic or

home).

Dragon Medical One can also be installed locally on a Windows desktop using either an XCOPY installer or a

traditional MSI. This is necessary when users need to record into locally installed applications such as Microsoft

Word, Microsoft Outlook or an EMR that is deployed as a "fat" client.

Occasionally, users want to work both locally and virtually. They use a published version of Dragon Medical One

to record into a published EMR and a local version of Dragon Medical One to dictate into local applications.

This chapter describes how to set up this workflow.

Note: Coherence mode is only supported in Citrix virtualization environments.

Scenario

The user wants to record into the primary virtual EMR application and into applications that are published locally.

Prerequisites

n The primary EMR is hosted as a virtual application or published as a virtual application.

n Dragon Medical One is published in the same way as the primary EMR (as a virtual application or as part of

the virtual desktop image).

n The end point used to access the virtual applications is a desktop machine running a supported Microsoft

Windows operating system (for information on supported operating systems, see: Software and hardware

requirements).

Procedure

Install Dragon Medical One on the server.

Install the technology-specific custom audio and microphone channels on the server.

Install the corresponding technology-specific custom audio and microphone channels on all client end points.

Install Dragon Medical One on the local workstation, using either the XCOPY or MSI installation package.

Remarks

n We do not recommend using the ClickOnce package; it could result in the local installation being newer than

the virtual instance. Using the XCOPY or MSI installation method enables you to keep both versions of the

application synchronized.

n Local installations do not use the custom audio or microphone drivers, therefore there is no conflict.

Dragon Medical One Desktop Application 2020.1

- 19 -

Results

Dragon Medical Connect ensures users have an identical speech experience, regardless of whether they are

using the local application or the published instance. All the auto-texts, commands, custom words and

application configuration parameters will be consistent across both instances.

Note: For performance reasons, each instance of Dragon Medical One maintains a cache of auto-texts,

custom words and commands. If a user adds a word, auto-text or command in one instance, it will be

available in the second instance when that cache is refreshed (by closing and running that instance).

When a user only has one instance of Dragon Medical One running at a particular moment, a local instance or a

virtual instance, but not both at the same time, there are no usability concerns.

Running both instances

If a user is running both the local and published instances concurrently and wants to dictate into local and

published applications, consider the following good practice:

To visually differentiate the local and virtual instances of Dragon Medical One, we recommend setting a

different color theme for each instance.

To switch the audio and device button focus between instances, users must click the icon on the

corresponding DragonBar. Once an instance has the audio focus, users can continue to use their hardware

microphone to control the application as normal.

Note: When using Nuance PowerMic II or PowerMic III as an input device, users can automatically switch

the audio and device button focus from a local instance to a published one by placing the cursor in the

corresponding local or published application.

PowerMic Mobile

When using PowerMic Mobile as an input device, users need to switch audio focus by pairing the mobile app

with their preferred instance of Dragon Medical One.

We recommend enabling the following PowerMic Mobile features:

Targets: The user can browse a list of available targets and switch the pairing from one instance to another

without exiting the mobile app or logging out of Dragon Medical One.

Favorites: The user can save a personal list of pairing targets that they use regularly.

Note: These features are disabled by default in PowerMic Mobile; contact Nuance support if you would like

these features enabled.

Dragon Medical One Desktop Application 2020.1

- 20 -

Using Dragon Medical One with Mac

Dragon Medical One Desktop Application is a native Windows application; it cannot be installed and used

directly on a macOS-based computer. Dragon Medical One can be configured for use with macOS.

Accessing Dragon Medical One as a published virtual application

Dragon Medical One can be published as a server-based virtual application using virtualization technology such

as Citrix XenApp. A macOS-based computer can be used as an end point to access the published virtual

instance of Dragon Medical One. A virtualization client such as Citrix Receiver must be installed on the macOS-

based computer to view and interact with Dragon Medical One and other published applications.

Audio input devices

n Supported: PowerMic Mobile. For more information, see the documentation delivered with the product.

n Not supported: Nuance PowerMic II, Nuance PowerMic III and third-party microphones and headsets.

Running Windows on macOS

A user can run a full instance of a Windows operating system on a macOS-based computer via virtual machine

solutions such as Parallels Desktops for Mac or VMware Fusion. These solutions allow using Windows and

macOS applications side-by-side.

Dragon Medical One must be installed on a Windows virtual machine. This configuration is identical to Dragon

Medical One installed on a native Windows machine and provides full functionality with the following conditions:

n Dictation at the cursor is not supported in native macOS applications. To fully support this functionality,

Dragon Medical One requires a deep integration with target applications; this level of integration is not

possible with native macOS applications. Dictating into the Dictation Box and then transferring text in target

macOS applications might be possible; however, this configuration is not officially supported by Nuance.

n Hardware microphone "pass-through" must be supported by the virtualization solution. This allows the

hardware device to be recognized by the Windows operating system and made available to Dragon Medical

One.

n Nuance will officially test and support PowerMic II and PowerMic III hardware microphones. For issues

specific to third-party microphones, contact the device vendor.

n PowerMic Mobile is fully supported. For more information, see the documentation delivered with the

product.

Running Windows in native mode on Mac hardware

A user can run a Windows operating system on a macOS-based computer via Boot Camp. Boot Camp

eliminates the virtual machine layer introduced by virtual machine solutions such as Parallels. If a user is running

Windows in native mode on a macOS-based computer, there are no additional requirements or restrictions in

using PowerMic Mobile with this configuration.

Dragon Medical One Desktop Application 2020.1

- 21 -

Google Chrome

Dragon Medical One supports dictation at the cursor in standard text controls (these include text input, text area

and standard content-editable controls) hosted in the Google Chrome browser.

To support text controls and dictation at the cursor, in Google Chrome-based applications, you must install the

DragonMedical One Web Extension.

Architecture

Dragon Medical One and the DragonMedical One Web Extension use a dedicated process (sodria_

nmhost.exe) for communication between Dragon Medical One and Google Chrome. This process is delivered

with Dragon Medical One and is started by Google Chrome. Google Chrome and Dragon Medical One rely on a

registry key (HKEY_CURRENT_

USER\Software\Google\Chrome\NativeMesssagingHosts\com.nuance.sodria) to connect the two

applications. Dragon Medical One automatically creates and updates the registry key to connect the two

processes while starting; this is usually only needed once per deployment and operating system user.

Installation

DragonMedical One Web Extension must be installed for each machine and operating system user using

Google Chrome. Once the extension is installed, the browser must be restarted (or tabs reloaded). The user is

informed if the browser needs to be restarted.

Installing DragonMedical One Web Extension via Google Chrome web store

To install manually, do the following:

Dragon Medical One Desktop Application 2020.1

- 22 -

Browse for the DragonMedical One Web Extension web store link:

https://chrome.google.com/webstore/detail/dragon-medical-one-web-

ex/feolagkacappiaieohahjkeaikhjjcfa

2. Click Add to Chrome.

In Google Chrome settings, make sure that the DragonMedical One Web Extension is enabled.

Restart the Google Chrome browser.

Installing DragonMedical One Web Extension via Google Chrome policies

To install automatically, do the following:

Open the LOCAL_MACHINE registry hive.

Add the following to the registry:

Key: HKEY_LOCAL_MACHINE\SOFTWARE\Policies\Google\Chrome\ExtensionInstallForcelist\1

Value: feolagkacappiaieohahjkeaikhjjcfa;https://clients2.google.com/service/update2/crx

Restart the Google Chrome browser.

For more information on automatic installation, see Google Chrome policy documentation.

Enabling dictation at the cursor in local HTML pages

To enable dictation at the cursor in HTML pages stored in the local file system, do the following:

1. In the Google Chrome menu, expand More tools and click Extensions.

2. Search for DragonMedical One Web Extension and select Allow access to file URLs.

Dragon Medical One Desktop Application 2020.1

- 23 -

Configuring Dragon Medical One

Configuring the organization token

To set the organization token for Dragon Medical One, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, OrganizationToken setting, specify the organization token.

Providing different configurations for a single stand-alone deployment

To provide a single stand-alone package of Dragon Medical One to different user groups using different

configuration settings, do the following:

1. Deploy Dragon Medical One using the Windows Installer (MSI package) or via XCOPY deployment.

Create a new XML file containing only the configuration settings that are different from the settings in the

SoD.exe.config file.

3. Start Dragon Medical One from the command line and use the config parameter to specify the path to this

XML file. The settings in this file will override the settings specified in the SoD.exe.config file.

Remarks

For a list of setting elements you can specify, see the SoD.Settings section in the SoD.exe.config file. The

elements must be stated exactly as they are in the SoD.exe.config file.

The setting elements that you add to the SoD.DefaultOptions section will override the default settings.

For example (mandatory XML elements and structure in bold):

<?xml version="1.0" encoding="utf-8" ?>

<SoD.Settings>

<value>native</value>

</setting>

</SoD.Settings>

<SoD.DefaultOptions>

<value>Toggle</value>

</setting>

</SoD.DefaultOptions>

</applicationSettings>

n Dragon Medical One will access the XML file during startup; hosting the file on a network share can impact

startup performance.

Configuring the default settings

Dragon Medical One enables you to configure the default settings that the user logs on with. By default, the user

can change all settings in the Options dialog box; you can lock specific settings to prevent the user from

Dragon Medical One Desktop Application 2020.1

- 24 -

changing them.

Proceed as follows:

Open the SoD.exe.config file.

2. In the SoD.DefaultOptions section, configure the default options:

Specify the setting elements that you want to customize. For a list of setting identifiers and their

corresponding values, see the table below.

In the setting elements that you want to lock, add the isLocked attribute and set the value to True.

Example:

<value>CtrlALTW</value>

</setting>

<value>CtrlALTQ</value>

</setting>

<value>PressAndHold</value>

</setting>

The following table lists the setting identifiers, their descriptions, possible values and the default values the

application is delivered with (the setting identifier has the following

format:OptionCategory.IdentifierName):

Dragon Medical One Desktop Application 2020.1

- 25 -

Setting identifier Setting description

General.AnchorSpeechFocusRecStarted

Decides if the speech focus should be anchored

when recording is started.

Values: True, False (default)

General.VisualFeedbackVoiceCommandsRecognized

Decides if visual feedback should be provided when

a voice command is recognized and specifies where

the voice command bubble should be anchored.

Values: None, DragonBar (default), Mouse, Text,

SystemTray

General.AudioFeedbackVoiceCommandsRecognized

Decides if audio feedback should be provided when

a voice command is recognized.

Values: True, False (default)

General.EnableHandsFree

Decides if the wake word feature is enabled so the

user can switch between dictation and standby

mode. For more information on the wake word

feature, see the end user help.

Values: True (default), False

General.StartInStandbyMode

Decides if the application starts in standby mode

when the user logs on. For more information on the

wake word feature, see the end user help.

Values: True (default), False

General.LeftFieldDelimiters

Configures the left embedded field delimiter.

Values: [ (default)

General.RightFieldDelimiters

Configures the right embedded field delimiter.

Values: ] (default)

General.OptimizeForRapidNavigation

Decides if the text should be inserted at the current

cursor position when the position of the cursor is

changed manually during recording.

Values: True, False (default)

DictationBox.TransferMethod

Configures the text transfer method.

Values: ShiftInsert (default), CtrlV,

WindowsPaste, SimulateKeystrokes

DictationBox.TransferRecStopped

Decides if the text should be transferred from the

Dictation Box when recording is stopped.

Values: True, False (default)

Dragon Medical One Desktop Application 2020.1

- 26 -

Setting identifier Setting description

DictationBox.ClearAfterTransfer

Decides if the transferred text should be cleared

from the Dictation Box.

Values: True (default), False

DictationBox.KeepTextClipboardAfterTransfer

Decides if the transferred text should be kept on the

clipboard.

Values: True, False (default)

DictationBox.AddTextFromTargetApp

Decides if the text selected in the target application

should be added to the Dictation Box.

Values: True, False (default)

DictationBox.ShowWhenDragonMinimized

Decides if the Dictation Box should be shown when

the DragonBar is minimized.

Values: True (default), False

DictationBox.AudioAlertWhenOpens

Decides if an audio alert should be played when the

Dictation Box opens automatically.

Values: True, False (default)

DictationBox.TextAppearance

Configures the text appearance.

Values: Plain (default), Formatted

DictationBox.FontType

Configures the font type.

Default value: Arial

DictationBox.FontSize

Configures the font size.

Default value: 10

Hotkeys.ShowHideDragonBar

Configures the hotkeys used to show/hide the

DragonBar.

Default value: CtrlALTH

Hotkeys.StartStopRecording

Configures the hotkeys used to start/stop recording.

Default value: NUM-Add

Hotkeys.AnchorReleaseSpeechFocus

Configures the hotkeys used to anchor/release the

speech focus.

Default value: CtrlALTA

Hotkeys.ShowHideDictationBox

Configures the hotkeys used to show/hide the

Dictation Box.

Default value: CtrlALTD

Hotkeys.TransferText

Configures the hotkeys used to transfer the text

from the Dictation Box.

Default value: CtrlALTT

Dragon Medical One Desktop Application 2020.1

- 27 -

Setting identifier Setting description

Hotkeys.ClearDictationBox

Configures the hotkeys used to clear the Dictation

Box.

Default value: none

Hotkeys.RecallText

Configures the hotkeys used to recall the text.

Default value: none

Hotkeys.PreviousField

Configures the hotkeys used to navigate to the

previous field in an auto-text.

Default value: none

Hotkeys.NextField

Configures the hotkeys used to navigate to the next

field in an auto-text.

Default value: none

Hotkeys.FieldComplete

Configures the hotkeys used to accept a field’s

default text.

Default value: none

Hotkeys.AcceptDefaults

Configures the hotkeys used to accept the default

text in all fields.

Default value: none

Hotkeys.OpenDMA

Configures the hotkeys used to open Dragon

Medical Advisor.

Default value: none

Hotkeys.CloseDMA

Configures the hotkeys used to close Dragon

Medical Advisor.

Default value: none

Microphone.Record

Configures the Record button's behavior.

Values: Toggle, PressAndHold (default)

Microphone.Transcribe

Configures the Transcribe button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText (default),

AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField, AcceptDefaults,

FieldComplete, PressHotkey, OpenDMAWindow,

CloseDMAWindow

Dragon Medical One Desktop Application 2020.1

- 28 -

Setting identifier Setting description

Microphone.EnterSelect

Configures the Enter/Select button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField, AcceptDefaults

(default), FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Microphone.CustomRight

Configures the Custom Right button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox

(default), NextField, PreviousField,

AcceptDefaults, FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Microphone.CustomLeft

Configures the Custom Left button's behavior.

Values: none (default), ClearDictationBox,

RecallText, TransferText,

AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField, AcceptDefaults,

FieldComplete, PressHotkey, OpenDMAWindow,

CloseDMAWindow

Microphone.TabBackward

Configures the Tab Backward button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField (default),

AcceptDefaults, FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Microphone.TabForward

Configures the Tab Forward button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField (default), PreviousField,

AcceptDefaults, FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Dragon Medical One Desktop Application 2020.1

- 29 -

Setting identifier Setting description

Microphone.PlayStop

Configures the Play/Stop button's behavior.

Values: none (default), ClearDictationBox,

RecallText, TransferText,

AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField, AcceptDefaults,

FieldComplete, PressHotkey, OpenDMAWindow,

CloseDMAWindow

Microphone.FastForward

Configures the Fast Forward button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField (default), PreviousField,

AcceptDefaults, FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Microphone.FastRewind

Configures the Fast Rewind button's behavior.

Values: none, ClearDictationBox, RecallText,

TransferText, AnchorReleaseSpeechFocus,

ShowHideDragonBar, ShowHideDictationBox,

NextField, PreviousField (default),

AcceptDefaults, FieldComplete, PressHotkey,

OpenDMAWindow, CloseDMAWindow

Remarks

n A hotkey value can be specified as a sequence of keys, either separated by spaces and/or plus signs or

joined; for example, Ctrl + ALT + H, Ctrl ALT H or CtrlALTH.

To define a hotkey as the default value of a microphone button, specify the corresponding setting element

and set the value to PressHotKey (KeySequence).

Example:

<value>PressHotkey (CtrlShiftAltA)</value>

</setting>

Enabling basic text controls

Basic text controls are applications and text editors which are not fully supported by Dragon Medical One. By

default, if a user is working with a text control that Dragon Medical One cannot directly write the text in, the

Dictation Box opens automatically and the text is written there. To enable dictation at the cursor in basic text

controls, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, BasicTextControls setting, specify all basic text controls the user can work with.

Dragon Medical One Desktop Application 2020.1

- 30 -

A basic text control is defined as a WindowClass element specific to a process. If you don't define

WindowClass elements for a process, all window classes of that process are used as basic text controls. If you

define a wildcard character (*) for a process, all specified WindowClass elements are used as basic text

controls, independent of the process.

Example (by default, the BasicTextControls setting is empty):

<value>

<WindowClass>Sample_class_1</WindowClass>

</ProcessName>

</ProcessName>

<WindowClass>Sample_class_2</WindowClass>

<WindowClass>Sample_class_3</WindowClass>

</ProcessName>

</BasicTextControls>

</value>

</setting>

Configuring the text transfer method for basic text controls

By default, the text is inserted in the basic text controls via SimulateKeystrokes; other possible text transfer

methods are ShiftInsert, CtrlV and WindowsPaste. Dragon Medical One enables you to configure the text

transfer method for all the basic text controls of a process or for specific basic text controls.

Proceed as follows:

Open the SoD.exe.config file.

2. In the SoD.Settings, BasicTextControls setting, configure the text transfer method:

To apply the setting to all window classes of the process, add the textTransferMethod attribute in the

ProcessName element and set the value.

To apply the setting on a window class level, add the textTransferMethod attribute in the

WindowClass element and set the value. The attribute that you set in the WindowClass element will

override the ProcessName text transfer method.

Example:

<value>

<WindowClass textTransferMethod="SimulateKeystrokes">Sample_class_

2</WindowClass>

<WindowClass>Sample_class_3</WindowClass>

</ProcessName>

Dragon Medical One Desktop Application 2020.1

- 31 -

<WindowClass textTransferMethod="CtrlV">Sample_class_1</WindowClass>

</ProcessName>

</BasicTextControls>

</value>

</setting>

Configuring timeout for end users

You can configure Dragon Medical One to automatically log a user off, if they have not worked with the

application for the specified period of time. When a user is logged off automatically any unsaved changes are

lost.

By default, this setting is empty and a user is never logged off automatically, no matter how long they do not use

Dragon Medical One.

Proceed as follows:

Open the SoD.exe.config file.

2. In the SoD.Settings, AutoLogOffTimeout setting, set the time period in minutes. Range: 5-120 minutes.

Example:

</setting>

If the user does not work with Dragon Medical One for more than 10 minutes, they are logged off.

Configuring Dragon Medical Advisor

Dragon Medical Advisor analyzes clinicians' documentation in real time and display additional information to

help make the documentation more complete and accurate. Although users access the advisor window via

Dragon Medical One,a speech recognition license is not needed.

For more information on Dragon Medical Advisor, see:Dragon Medical Advisor - overview.

Make sure Dragon Medical One has access to the server running the Advisor Service (https://<organization-

specific prefix>.nuanceunderstanding.com) via port 443; your firewall must not block this port.

Disabling Dragon Medical Advisor

To disable Dragon Medical Advisor completely, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, add the setting EnableAdvisor and specify as follows:

<value>False</value>

</setting>

Dragon Medical One Desktop Application 2020.1

- 32 -

Configuring the Advisor window to open automatically

You can configure Dragon Medical One to automatically open the Advisor window once per day or once per

session, the first time advice is generated via auto-processing. Auto-processing must be enabled and Dragon

Medical One must be able to capture the patient context from the EHR. You can also specify the number of days

this behavior is applied for.

Note: If Dragon Medical One is not configured to open the Advisor window automatically or the number of days

set via DMA.AutoOpenDays is reached, the user can open it via the advice icon or via the run Advisor voice

command.

Proceed as follows:

Open the SoD.exe.config file.

2. In the SoD.DefaultOptions section, configure the behavior of the Advisor window:

Add the setting DMA.AutoOpen and specify if the Advisor window will automatically open once per day

(value:1) or once per logon session (value:2). To disable the automatic opening of the Advisor window,

set the value to 0.

Add the setting DMA.AutoOpenDays and specify the number of days the Advisor window will

automatically open.

Example:

<SoD.DefaultOptions>

</setting>

</setting>

</SoD.DefaultOptions>

Disabling PowerMic Mobile support

The PowerMic Mobile feature enables users to use their mobile devices as a microphone. If your system is set

up to use this feature, users can select PowerMic Mobile from the list of available microphones during logon. To

hide PowerMic Mobile from the list, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, EnablePowerMicMobile setting, set the value to False.

Note: This setting will only disable the installation-free PowerMic Mobile feature. If a user has installed the

corresponding components of PowerMic Mobile on their mobile device and on the desktop, their device will

still be available in the list.

Configuring the speech recognition topic/specialty

To configure the speech recognition topic for Dragon Medical One, do the following:

Dragon Medical One Desktop Application 2020.1

- 33 -

Open the SoD.exe.config file.

2. In the SoD.Settings, SupportedTopics setting, specify the speech recognition topic.

If you want to present a list of available speech recognition topics to the end user, specify all supported speech

recognition topics in the setting and separate them with the pipe (|) character (for example,

GeneralMedicine|Surgery). The end user is then able to choose a topic when they start the application.

Supported speech recognition topics

GeneralMedicine, ClinicalAdministration, Cardiology, Emergency, InternalMedicine,

MentalHealth, Neurology, ObstetricsAndGynecology, Oncology, Orthopaedics, Pathology,

Pediatrics, Surgery.

Configuring microphones

To configure the microphones the end user is allowed to use in Dragon Medical One, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, AllowedMicrophones setting, specify all microphones the end user is allowed to use

and separate them with the pipe (|) character.

When the end user starts the application, the list of connected microphones is filtered based on this setting. If

you do not configure this setting, the end user can choose from all connected microphones.

Note: Unless PowerMic Mobile support has been disabled, PowerMic Mobile devices are always available

regardless of this setting.

Disabling the crash dump notification to end users

When Dragon Medical One shuts down unexpectedly, crash dump information is saved. The next time the user

starts the application, they are informed that log files containing information about the crash are available and

can be sent to their system administrator for analysis.

We recommend that you ask your users to send crash dump files to you; send the files, along with an error report

if possible, to Nuance Technical Support for further analysis.

If you do not want your users to receive this crash dump notification, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, EnableCrashNotification setting, set the value to False.

Note: The crash dump notification interacts with the troubleshooting data collection feature. For more

information, see Interaction with crash dump notification.

Enabling the troubleshooting data collection for end users

You can enable Dragon Medical One to automatically collect and send troubleshooting data (minidump and log

files containing information about a crash) to Nuance for further analysis.

If you want to enable the troubleshooting data collection for your users, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, EnableTroubleshootingDataCollection setting, set the value to True.

Dragon Medical One Desktop Application 2020.1

- 34 -

When the troubleshooting data is available, the user will be asked if they want to send it to Nuance; the user can

change this setting via the Data Collection pane in the Options dialog box.

Interaction with crash dump notification

If the EnableTroubleshootingDataCollection and EnableCrashNotification settings are set to True, a

message asking the user if they want to send the troubleshooting data to Nuance will be displayed.

If the EnableTroubleshootingDataCollection setting is set to True and the EnableCrashNotification

setting is set to False, no message will be displayed to the user and the troubleshooting data will be

automatically sent to Nuance.

If the EnableTroubleshootingDataCollection setting is set to False and the EnableCrashNotification

setting is set to True, a crash dump notification will be displayed to the user and the troubleshooting data

will not be sent to Nuance.

If the EnableTroubleshootingDataCollection and EnableCrashNotification settings are set to False,

no message will be displayed to the user and the troubleshooting data will not be sent to Nuance.

Disabling registration of the Microsoft Word add-in

When starting Dragon Medical One calls the regsvr32.exe executable to register the Microsoft Word add-in. To

disable registration of the Microsoft Word add-in, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, add the setting RegisterWordAddIn and specify as follows:

<value>False</value>

</setting>

Note: This configuration setting is optional.

Registering the Microsoft Word add-in for individual users

If registration of the Microsoft Word add-in is disabled, you can enable it for an individual user. Log on to the

corresponding user account and run the following command:

regsvr32.exe /s SoD.WordAddin.dll

If a user works with a 64-bit version of Microsoft Word, run the following command:

regsvr32.exe /s SoD.WordAddin_x64.dll

Note: If you update Dragon Medical One, you must run the corresponding command again.

Customizing the splash screen

You can lay a custom image over the Dragon Medical One splash screen; the overlay image will be placed in the

lower left corner of the splash screen.

Requirements:

Size: 320x130 pixels

Format: PNG

File name: SoD.OEM.png

Dragon Medical One Desktop Application 2020.1

- 35 -

Location:

ClickOnce: The deployment location (same location as the application package)

Stand-alone: The application directory (same location as the configuration file)

Configuring the user interface color theme

By default this setting is empty and the Blue (default theme) is used. To configure the color theme for Dragon

Medical One, do the following:

Open the SoD.exe.config file.

2. In the SoD.Settings, DefaultTheme setting, specify the theme identifier (Blue, Light, Dark):

</setting>

Dragon Medical One Desktop Application 2020.1

- 36 -

Dragon Medical One command line

Starting Dragon Medical One from the command line

You can configure the stand-alone Dragon Medical One package so that your users do not need to log on

separately to the application. By starting Dragon Medical One with the mandatory parameters specified, the

logon dialog box will not be shown and any logged on user will be automatically logged off.

Note: Make sure you specify the full path to the application; using the short 8.3 form of the path will cause

problems.

Example

Dr. Chris Smith speaks with an American English accent, works in the field of general medicine and records

using a SpeechMike III.

SoD.exe -user "chrissmith" -lang "en-US" -topic "GeneralMedicine" -mic "SpeechMike III"

When Dr. Smith logs on to a PC, Dragon Medical One is available, in the notification area, with their preferred

settings applied.

Parameters

user

The speech recognition user profile name.

This parameter is mandatory; you must specify the user before any of the other parameters are applied.

If trusted authentication is enabled, Dragon Medical One will ignore this parameter.

lang

The speech recognition language.

This parameter is mandatory; you must specify the language as an IETF language tag. For more

information, see: Supported languages. Currently only English (IETF language tag: en-US) is supported.

topic

The speech recognition topic (medical specialty). For a list of available topic names, see: Configuring the

speech recognition topic.

If only one topic is specified in the configuration file and this parameter is not set, this topic will be selected

automatically and Dragon Medical One will start without displaying the logon dialog box.

If more than one topic is specified in the configuration file and this parameter is not set, Dragon Medical One

will start without displaying the logon dialog box and will use the topic the user last logged on with. If the user

has not logged on successfully before, or if the topic the user last logged on with is no longer available, the

logon dialog box is opened and the user must select a topic manually.

mic

The microphone identifier.

This parameter is mandatory. If you do not know the exact microphone identifier, you can specify part of the

name, for example, "SpeechMike". If only one connected microphone contains the specified string in its

name, this microphone will be used. If no connected microphone or more than one connected microphone

contains the specified string in its name, the logon dialog box is opened and the user must select a

microphone.

Dragon Medical One Desktop Application 2020.1

- 37 -

If you have configured a list of allowed microphones, the mic parameter is optional. Dragon Medical One

will go through the allowed microphones, in the order that you listed them, and use the first specified

microphone it finds that is connected. If you specify the mic parameter, this microphone must be included in

the list of allowed microphones.

password

The user's password.

If trusted authentication is enabled, Dragon Medical One will ignore this parameter.

nologo

Disables the splash screen.

config

The path to the XML file containing custom configuration settings. For more information, see: Configuring

Dragon Medical One.

Logging off and closing Dragon Medical One from the command line

You can configure the stand-alone Dragon Medical One package so that your users do not need to log off or

close the application manually.

Parameters

logoff

Logs off the currently logged on user. This parameter is exclusive and cannot be used together with other

parameters.

If trusted authentication is enabled, this parameter is ignored by Dragon Medical One.

shutdown

Shuts down the currently running instance of Dragon Medical One. This parameter is exclusive and cannot

be used together with other parameters.

Enabling and disabling WPF support from the command line

Dragon Medical One provides built-in support for applications based on Windows Presentation Foundation

(WPF) TextBox class text controls. You need to enable WPF only if your users cannot dictate at the cursor in

these applications.

You can enable/disable WPF support, for a specific machine, in the stand-alone Dragon Medical One package.

By enabling/disabling WPF support, you will register/deregister a Microsoft Text Services Framework plugin on

the machine that you have deployed to. This operation requires administration rights on that machine. To

perform the registration, Dragon Medical One will attempt to elevate rights; if the rights cannot be elevated you

cannot proceed.

Note: regsvr32.exe will be invoked for this operation.

These parameters are mutually exclusive and will override any other parameters passed to the SoD.exe process

during start-up. For example, passing the parameters during standard logon procedure is not supported and will

cause Dragon Medical One to shut down after registration/deregistration.

Parameters

enableWPF

Dragon Medical One Desktop Application 2020.1

- 38 -

Registers the Text Services Framework (TSF) plugin. To perform the registration, the SoD.exe process will

be started, and once this operation is performed, it will shut down.

You only need to enable WPF support once per deployment or if you change the deployment location.

disableWPF

Deregisters the Text Services Framework (TSF) plugin. To perform the deregistration, the SoD.exe process

will be started, and once this operation is performed, it will shut down.

Dragon Medical One Desktop Application 2020.1

- 39 -

User authentication

The following options for user authentication when Dragon Medical One is started are available:

No authentication: The user enters a unique user name to log on and must always use this name.

Native authentication: The user must enter a user name and password provided by the administrator when

logging on. The credentials are checked via the Nuance Management Server (NMS).

LDAP authentication: The user must enter a user name and password to log on. The credentials are

checked via an LDAP server.

Trusted authentication: The user, logged on to Microsoft Windows with the Active Directory user name and

password, is automatically logged on to the application. The credentials are checked via the Nuance

Management Server (NMS).

SSO authentication: The user is redirected to your corporate identity provider for authentication. If the user

is not logged on to the corporate identity provider domain, they are prompted for credentials. The credentials

are validated, the user is redirected and logged on to Dragon Medical One. If the user is already logged on to

the corporate identity provider domain, they are redirected and logged on to Dragon Medical One without

being prompted for credentials.

No authentication

This is the default configuration for authentication. When this type is used, the application prompts the user to

enter a new user name when logging on. A password is not required and it is not possible to use one. NMS loads

the user settings associated with the user name or automatically creates a user profile if a profile for the user

name does not yet exist. The user is granted access to Dragon Medical One and a license is assigned.

Procedure

In the SoD.exe.config file, SoD.Settings, Authentication setting, specify: <value>none</value>.

When a user logs on to Dragon Medical One, they must enter a new user name and always use this name.

Native authentication

Native authentication sends the user credentials to NMS to authenticate and grant or deny access to Dragon

Medical One. You must create a user account in NMC before the user can log on to Dragon Medical One. This

means that users cannot specify their own user names and passwords.

Procedure

In the SoD.exe.config file, SoD.Settings, Authentication setting, specify: <value>native</value>.

When a user logs on to Dragon Medical One, they must enter a user name and password that correspond to an

existing user account in NMS.

Configuring password settings

You can define password expiration and complexity criteria via NMC for users of an organization logging on to

Dragon Medical One via native authentication.

Proceed as follows:

Dragon Medical One Desktop Application 2020.1

- 40 -

1. Search for the organization, right-click it and select Organization details.

2. On the Products tab, open the General tab and expand Password Settings.

Define the criteria.

4. Select Password must meet complexity requirements and click Save.

LDAP authentication

LDAP authentication sends the user credentials to NMS to authenticate the user against an LDAP server hosted

in your organization and grant or deny access to Dragon Medical One. To successfully authenticate against an

LDAP server, NMS must be hosted in the same organization domain. You can host a full NMS instance or

facilitate an NMS call forwarder or local authenticator to connect Dragon Medical One to NMS.

Using the local authenticator instead of the call forwarder improves performance. All calls from Dragon Medical

One to NMS go through the call forwarder; the local authenticator enables local clients to authenticate against

an LDAP server while all other calls go directly to NMS.

NMS call forwarder/local authenticator

Deploying an NMS call forwarder/local authenticator

To deploy the NMS call forwarder/local authenticator, you must create an organization token connecting the call

forwarder/local authenticator to your NMS organization. Proceed as follows:

Browse for the organization details of your organization.

2. Open the Organization Tokens tab and add a new token.

To deploy the on-premise NMS call forwarder/local authenticator (providing this organization token), do the

following:

Install the call forwarder/local authenticator using the organization token generated above.

In the SoD.exe.config file, check that the NMS organization token and the NMS URL are correct.

Configuring Dragon Medical One

In the SoD.exe.config file, SoD.Settings, Authentication setting, specify <value>ldap</value> if you use

the NMS call forwarder, or <value>ldaplocal</value> if you use the NMS local authenticator.

Configuring your NMS organization (in the Nuance-hosted NMC)

To connect Dragon Medical One with your on-premise call forwarder/local authenticator, do the following:

Browse for the organization details of your organization.

2. Open the Products tab and expand Dragon Medical Server.

3. In the NMS on-premise server URL field, enter the URL of the on-premise NMS call forwarder/local

authenticator including the port that hosts the authentication interface on the call forwarder/local

authenticator: <http://nms.organization.com:8731>, and click Save.

4. Open the Domains tab, click Add and enter the name and the LDAP Active Directory connection string, and

click Save.

To configure a user account, do the following:

Dragon Medical One Desktop Application 2020.1

- 41 -

1. Search for the user account, right-click it and select User Account Details.

2. Open the Credentials tab.

3. On the NTLM tab, click Add; the User name and Organization Name already filled out.

4. From the Domain list, select the domain added above.

5. In the Login field, enter the LDAP login ID.

6. Click Save.

Note: If users already exist in NMS with a different NMS login ID, the Active Directory login ID and NMS

Active Directory login ID.

On-premise NMS

This procedure assumes that you have set up a full NMS instance in your organization. It guides you through

connecting the NMS instance to your LDAP server.

Configuring your NMS organization (in your on-premise NMC)

To connect your on-premise NMS instance to the LDAP server, do the following:

1. Search for the organization, right-click it and select Organization details.

2. Open the Domains tab and click Add.

Enter the domain name and the Active Directory connection string.

4. Click Save.

To configure a user account, do the following:

1. Search for the user account, right-click it and select User Account Details.

2. Open the Credentials tab.

3. On the NTLM tab, click Add; the User name and Organization Name already filled out.

4. From the Domain list, select the user's domain.

5. In the Login field, enter the LDAP login ID.

6. Click Save.

Note: If users already exist in NMS with a different NMS login ID, the Active Directory login ID and NMS

Active Directory login ID.

Configuring your Nuance organization (in the Nuance-hosted NMC)

To connect Dragon Medical One with your on-premise NMS instance, do the following:

Browse for the organization details of your organization.

2. Open the Products tab and expand Dragon Medical Server.

Enter the URL of the on-premise NMS instance including the port that hosts the authentication interface, for

example, <http://nms.organization.com> and click OK.

Dragon Medical One Desktop Application 2020.1

- 42 -

Configuring Dragon Medical One

In the SoD.exe.config file, SoD.Settings, Authentication setting, specify: <value>ldap</value>.

Trusted authentication

Trusted authentication sends the Active Directory credentials of the currently logged on user to NMS to

authenticate and grant/deny access to Dragon Medical One. The user can work with Dragon Medical One

without entering a user name and password; the logon dialog box is not displayed.

The local authenticator is required to enable local clients to authenticate against an LDAP server. The

authentication calls from Dragon Medical One to NMS go through the local authenticator. For information on

how to deploy the NMS local authenticator and configure your NMS organization, see LDAP authentication.

Configuring Dragon Medical One

In the SoD.exe.config file, SoD.Settings, Authentication setting, specify: <value>trusted</value>.

NMC

You must configure the user account in NMC to authenticate the user in the Active Directory.

Proceed as follows:

1. Search for the user account, right-click it and select User Account Details.

2. Open the Credentials tab.

3. On the NTLM tab, click Add; the User name and Organization Name already filled out.

4. From the Domain list, select the user's domain.

5. In the Login field, enter the Active Directory login ID.

6. Click Save.

Single sign-on (SSO) authentication

SSO authentication enables a user to log on to Dragon Medical One using their corporate identity (for example,

Windows Active Directory credentials). The authentication is performed via a Central Authentication Service,

which interacts with your corporate identity provider to validate the user's credentials. The Central Authentication

Service passes a secure token to NMS, which then grants access to Dragon Medical One. When a user logs on

to Dragon Medical One, they are redirected to the corporate identity provider. If the user is not logged on to the

corporate identity provider domain, they will be prompted for credentials. If the user is logged on to the domain,

they will be automatically granted access to Dragon Medical One, without being prompted for credentials.

Enabling SSO authentication

Open the SoD.exe.config file.

2. In the SoD.Settings, Authentication setting, specify: <value>sso</value>.

Configuring Dragon Medical One for SSO authentication

Open the SoD.exe.config file.

2. In the SoD.Settings, Domain setting, specify: <value>nuancehdp.auth0.com</value>.

Dragon Medical One Desktop Application 2020.1

- 43 -

3. In the SoD.Settings, ClientId setting, specify: <value>rtsoCXxRETvN3a0SavF6B5srHn3CXbwa</value>.

4. In the SoD.Settings, Connection setting, specify the connection name provided by your Nuance technical

contact.

5. In the SoD.Settings, RedirectUri setting, specify:

<value>https://nuancehdpdev.auth0.com/mobile</value>.

Dragon Medical One Desktop Application 2020.1

- 44 -

Logging

Dragon Medical One creates log files that can help Nuance to analyze issues reported by end users or

administrators. Log files are uploaded to Dragon Medical Server, and a limited amount of information is written

to the local file system of the client PC. The information written to the local file system does not contain any

sensitive data; the amount of data kept on the local PC can be configured and usually spans data for the last few

days.

Log file location

Dragon Medical Server

Dragon Medical Server log file: \\<server_name>\<share>\Logs\<year_month>\<day>\

Dragon Medical SpeechKit log file: \\<server_name>\<share>\Logs\<year_month>\<day>\

Local PC

Local log file (does not contain sensitive data):

Dragon Medical One ClickOnce directory (C:\Users\<User_Name>\AppData\Local\Apps\...)

Dragon Medical One stand-alone directory

Crash dump:

%APPDATA%\Nuance\SoD\

Virtual desktop/application environment

For information on logging in a virtual desktop/application environment, see: Logging in a virtual environment.

Setting the logging level

The log level is set in the log4net section of the SoD.exe.config file. The log level should be set for both logger

names specified in the configuration section:

The default log level is ERROR which creates the least amount of data. You can change the logging level to one of

the following (amount of data collected in descending order):

DEBUG

INFO

WARN

ERROR

Dragon Medical One Desktop Application 2020.1

- 45 -

Nuance Management Center - overview

The Nuance Management Center (NMC) is the central administration component for Dragon Medical One. NMC

enables you to perform a variety of administration tasks, such as licensing and managing auto-texts, users,

groups and organizations.

For information on how to define auto-texts and set auto-text filters in NMC, see: Auto-texts.

For more information on NMC, see the documentation delivered with the product and the Dragon Medical Server

documentation.

Note: NMC requires HTTPS access to https://nmc-hc-prod-us.nuancehdp.com (port 443); make sure your

firewall does not block this port. This port must be accessible from the workstations used to access NMC.

Prerequisites for running NMC

n Microsoft Internet Explorer, Microsoft Edge, Google Chrome, Apple Safari

Launching NMC

To access NMC, browse to: https://nmc-hc-prod-us.nuancehdp.com.

To log on for the first time, use the credentials in your welcome kit.

Note: To change your password, click and select Change password.

Licensing

To monitor licenses, open the Licensing ribbon, click View Licenses and search for the license type. You can

see a summary of license information.

If you need to free licenses, select a row, click Revoke and select user accounts.

Groups

When you first log on to NMC the following groups are available:

NMC Administration: For users performing administration tasks in NMC.

Speech Recognition: For users accessing speech recognition.

Note: The Speech Recognition group does not exist until the first end user connects via a Dragon Medical

One client; the group is then automatically created.

Groups are useful for the following:

n Groups can be used to assign the rights to create auto-texts and custom commands to specific users.

n Groups can be used to make certain auto-texts and custom commands available to specific users. To assign

an auto-text or custom command to a group make sure that the Group level is selected when you create an

auto-text or create a custom command.

Dragon Medical One Desktop Application 2020.1

- 46 -

Working with groups

To group users who have rights to create auto-texts/custom commands, do the following:

Log on to NMC with your administration credentials.

2. Open the Groups ribbon and click Add.

Select the new group's organization.

4. In the Role field, select NMC Administrator.

5. Base the new group on the existing NMC Administration group and click OK.

6. Enter a Group name and make sure the correct Site is selected.

7. In the Privileges list, select Product Manage Dragon Medical Server.

8. Click Save.

9. Open the Groups ribbon and click Search.

10.

Enter the name of the group you just created and select it in the list of search results.

11. Click Add User Account to Group in the Membership ribbon.

12. To add a user account to the group, enable the check box in the Member column in the corresponding row.

13. Click Save.

To group users of auto-texts/custom commands, do the following:

Log on to NMC with your administration credentials.

2. Open the Groups ribbon and click Add.

Select the new group's organization.

4. In the Role field, select Speech Recognition User and click OK.

5. Enter a Group name and make sure the correct Site is selected.

6. Click Save.

7. Open the Groups ribbon and click Search.

Enter the name of the group you just created and select it in the list of search results.

9. Click Add User Account to Group in the Membership ribbon.

10. To add a user account to the group, enable the check box in the Member column in the corresponding row.

11. Click Save.

Dragon Medical One Desktop Application 2020.1

- 47 -

Speech recognition settings: Auto-texts

The auto-text feature enables you to define standard blocks of text (also called 'normals' or 'canned text') that

Dragon Medical One users can insert into their document with a short voice command. Using auto-texts reduces

the time the user needs to dictate and improves the consistency of documentation. Available auto-texts are

displayed to end users on the What You Can Say page. You define auto-texts in the Nuance Management

Center (NMC). Users can create their own auto-texts in Dragon Medical One in the Manage Auto-texts dialog

box.

Defining an auto-text in NMC

Scenario

Your users often speak to their patients about the dangers of smoking. In the report, they will say The

patient was advised to quit smoking and counseled on effective smoking cessation strategies.

You define an auto-text called

Quit smoking

that contains this information.

A doctor says the voice command insert quit smoking to insert the information.

Procedure

1. Open the Speech Recognition tab on the ribbon.

2. Click Manage.

3. Select your Organization.

4. In the Auto-texts tree view, select the level you want to create the auto-text for (site, group or user).

5. In the Auto-text group on the ribbon, click Add.

6. Enter a Name (

Quit smoking

), a Description (optional) and select a Language.

7. Optional: change the Spoken Phrase.

In the contents section, enter:

The patient was advised to quit smoking and counseled on effective smoking cessation strategies.

9. Click Save.

Remarks

n To make the auto-text available for all users, make sure to select the corresponding site or group in the tree

view.

n A keyword is what the user says to tell the system that an auto-text is to be processed. The default keyword

is insert; you can change it in NMC. For more information, see the

Dragon Medical Server Administration

Guide

The Name field contains the title of the auto-text (this is generally what users must say to insert the auto-

text); make sure it is unambiguous and easy to pronounce. It is strongly recommended that you give the

auto-text a distinctive name that cannot be misinterpreted as speech to be recognized. This helps to ensure

that it is correctly inserted.

By default, the Spoken Phrase is the same as the Name. If how the auto-text name is written and how it is

pronounced are very different, change the Spoken Phrase (how it is pronounced). You can only use

Dragon Medical One Desktop Application 2020.1

- 48 -

alphabetic characters in spoken phrases. For acronyms that are spelled out use capital letters, separated by

spaces.

For spoken phrases do not use:

Very short phrases (such as one syllable only)

Capital letters (except for acronyms, for example, C I A)

Abbreviations

Digits (use 'twelve' and not '12')

Punctuation marks (for example, ", !, ?, etc.)

Symbols (for example, +, -, &, $, etc.)

If you want to give your users more than one way to insert an auto-text, click and enter another Spoken

Phrase.

Activate Display all levels to list the auto-texts for the level selected in the tree view and its higher levels.

n Auto-texts can contain fields. Fields are gaps in the auto-text where users can enter specific text, for

example, patient data. To add a field to an auto-text, enter [] in the relevant place of the auto-text's

contents; you can enter any text between the field delimiters as default content, for example, CBC results

[within normal limits], vital signs [within normal limits]. When users insert the auto-text, they can decide

whether they want to replace the default values with specific text or use the default values.

n By default, fields are indicated by square brackets. Users can change the characters used as field delimiters

in Dragon Medical One on the General pane of the Options dialog box; any previously defined fields using

different delimiters will then no longer work.

Configuring the auto-text filter

A system with many auto-texts can be complex for users; they might have difficulty remembering all the names

and which ones are relevant for them.

Filtering is set up in the SoD.exe.config file and then set in NMC.

In the configuration file, enter the filter key/value pairs you need. For example:

</filter>

</filterSettings>

Remarks

n You can configure as many key/value filter pairs as you want.

Use the | character to separate multiple values for a key.

Setting an auto-text filter in NMC

You can filter specific auto-texts to be active for specific forms.

Dragon Medical One Desktop Application 2020.1

- 49 -

Scenario

n Dragon Medical One supports an auto-text filter with the key 'modality' and values 'X-ray', 'CT' and 'MRI' and

it will set this filter for all radiology reports.

n You want to set the 'normal chest' auto-text to be active for x-rays only.

Procedure

Search for the 'Normal chest' auto-text.

2. Open the Meta Data tab.

3. In the Name field enter

modality

and in the Value field enter

X-ray

4. Click OK and then Save.

Remarks

n By default, auto-texts are always active. Be aware that:

If no auto-text filter has been set for a document or form, all auto-texts that have been defined in the system

will be active.

All auto-texts that you do not define meta data entries for will always be active.

If an auto-text filter with a specific name has been set for a document or form but no corresponding meta

data entry with this name has been applied to an auto-text, then this auto-text will always be active.

n An auto-text is deactivated (filtered out) for a specific document or form only if:

The application has defined an auto-text filter with a specific name and value for the document or form.

You have set a meta data entry for the auto-text with this name but with a different value.

Dragon Medical One Desktop Application 2020.1

- 50 -

Speech recognition settings:Voice commands

Voice commands enable Dragon Medical One users to say a word or phrase that initiates an action and control

the application without using the mouse or the keyboard. This reduces the time the user needs to complete their

work.

The custom command feature in Dragon Medical One was extended to enable users to create more feature-rich

commands and are now called step-by-step commands. Users define step-by-step commands in the Manage

Step-by-step Commands dialog box and they are displayed on the What You Can Say page; for more

information, see the end user help.

Existing user-level custom commands created in the Nuance Management Center will be automatically migrated

to step-by-step commands.

Dragon Medical One Desktop Application 2020.1

- 51 -

Speech recognition settings:Managing the

vocabulary

Managing the vocabulary your users are using enables you to improve speech recognition by explicitly tailoring

the system to your requirements. This might be necessary if words or phrases are repeatedly misrecognized.

In the Nuance Management Center (NMC), you can add words and phrases to the vocabulary and delete words

from it.

Adding a word in NMC

Scenario

Your users frequently prescribe the drug

Xanax

and recognition has been problematic.

Procedure

1. Open the Speech Recognition tab on the ribbon.

2. In the Word group, click Manage.

3. In the Words tree view, select the level you want to associate the word with (site, group or user).

4. In the Word group on the ribbon, click Add.

5. Enter a Written form (

Xanax

) and, if necessary, a Spoken form (

zanacks

6. Select the Language you want to associate the word with.

7. Click Save.

Remarks

n To make the word available for all Dragon Medical One users, make sure to select the corresponding site or

group in the tree view.

n The spoken form is optional. If how the word is written and how it is pronounced are very different, enter a

spoken form (how it is pronounced) and define a Written form (how it is inserted into the document). You

can only use alphabetic characters in spoken form; special characters are not allowed. For acronyms that are

spelled out use capital letters, separated by spaces.

For spoken phrases do not use:

Very short phrases (such as one syllable only)

Capital letters (except for acronyms, for example, C I A)

Abbreviations

Digits (use 'twelve' and not '12')

Punctuation marks (for example, ", !, ?, etc.)

Symbols (for example, +, -, &, $, etc.)

Activate Display all levels to list the words that have been added for the level selected in the tree view and

its higher levels.

Dragon Medical One Desktop Application 2020.1

- 52 -

Speech recognition settings:Dragon Medical

Connect

Dragon Medical Connect is a powerful feature that allows all speech-enabled, cloud-based applications -

(Nuance-branded and third-party partner applications) - to share a single cloud-based user profile. The single-

profile architecture means that any changes a user makes to custom words, auto-texts or commands are

immediately available, to that user, in any application, on any device - anytime and anywhere. From a user's

perspective, this feature provides a consistently superior experience when using Dragon Medical One Desktop

Application, DragonMedical Network Edition or any one of the speech-enabled, third-party applications that

leverage Nuance's cloud-based platform.

Dragon Medical Connect is built into all Nuance and partner cloud-enabled products and does not require

additional licensing or configuration. However, given the breadth and depth of the Nuance partner ecosystem, it

is important to understand how this feature works in the context of the applications you use.

Dragon Medical One Desktop Application

When using Dragon Medical One the following profile sharing features and functions are available:

n Dragon Medical One: Users can add their own custom words, auto-texts and commands via the application

menu. Words and auto-texts are shared with any other cloud connected product including third-party

applications. Step-by-step commands are proprietary to and can only be shared with the Nuance products

Dragon Medical One and DragonMedical Network Edition.

n DragonMedical Network Edition (with Nuance-hosted Nuance Management Server): Users can add their

own custom words, auto-texts and commands via Dragon command and vocabulary editors. Words and

auto-texts are shared with any other cloud-connected products including third-party applications. Step-by-

step commands are proprietary to and can only be shared with the Nuance products Dragon Medical One

and DragonMedical Network Edition.

n Third-party applications: Users can add their own custom words and auto-texts via the Nuance

personalization and help window. To create auto-texts in mobile applications the user must have a Dragon

Medical One license. Words and auto-texts are shared with any cloud-connected product including other

third-party applications.

n Nuance Management Center (NMC): Administrators can add words or auto-texts at the site, group or user

level. Words and auto-texts defined in NMC are shared with any cloud-connected product, including third-

party applications.

DragonMedical Network Edition

Nuance-hosted Nuance Management Server

If your facility is using DragonMedical Network Edition with a Nuance-hosted NMS, and Dragon Medical One is

not yet licensed, the following profile sharing features and functions are available:

n DragonMedical Network Edition: Users can add their own custom words, auto-texts and commands via

Dragon command and vocabulary editors. Words and auto-texts are shared with other cloud-connected

products including third-party applications. Step-by-step commands are proprietary to and can only be

shared with the Nuance products Dragon Medical One and DragonMedical Network Edition.

Dragon Medical One Desktop Application 2020.1

- 53 -

n Third-party applications: Users can add their own custom words and auto-texts via the Nuance

personalization and help window. To create auto-texts in mobile applications the user must have a Dragon

Medical One license. Words and auto-texts are shared with any cloud-connected product including other

third-party applications.

n Nuance Management Center (NMC): Administrators can add words or auto-texts at the site, group or user

level. Words and auto-texts defined in NMC are shared with any cloud-connected product include third-party

applications.

On-premise Nuance Management Server

All cloud enabled offerings, including third-party applications, use a Nuance-hosted instance of NMS for a

transparent single profile experience. If you are using DragonMedical Network Edition but have not yet migrated

your NMS instance to the Nuance cloud, your profile sharing options are limited. The only option available is to

periodically export custom words and auto-texts from your on-premise NMS instance and import them into the

Nuance-hosted NMS instance. Be aware that this approach is labor intensive and does not deliver a true single

user profile experience.

You are strongly encouraged to migrate your on-premise NMS instance to the Nuance cloud or consider moving

to Dragon Medical One.

Third-party applications only

If you are using one or more cloud-enabled third-party applications, but not a Nuance solution, you can still

benefit from a single user profile.

n Third-party applications: Users can add their own custom words and auto-texts via the Nuance

personalization and help window. To create auto-texts in mobile applications the user must have a Dragon

Medical One license. Words and auto-texts are shared with any cloud-connected product including other

third-party applications.

n NMC: Administrators can add words or auto-texts at the site, group or user level. Words and auto-texts

defined in NMC are shared with any cloud-connected product.

Dragon Medical One Desktop Application 2020.1

- 54 -

Nuance Healthcare ID

The Nuance Healthcare ID is a unique identifier that enables clinicians to personalize their Dragon Medical One

experience and access their personal speech profile and speech-enabled products in a selection of mobile apps.

Registering the Nuance Healthcare ID

Your users can register their Nuance Healthcare ID when they first log on to Dragon Medical One Desktop

Application or later via the Nuance Healthcare ID option on the DragonBar menu.

Procedure for the end user

Start Dragon Medical One Desktop Application.

2. On the DragonBar menu, select Nuance Healthcare ID.

3. Complete the registration form and click Submit.

You will receive a confirmation email; click the link in this email to complete the registration.

Remarks

n Nuance Healthcare ID registration is optional. Users register once.

n Registration can only be done individually by each Dragon Medical One Desktop Application user;batch

registration is not possible.

n During registration, the user specifies their Nuance Healthcare ID user name (a personal email address) and

password; these are needed to activate it.

n After registration, the user activates the Nuance Healthcare ID separately for each app to speech-enable

that app.

The

My Nuance Healthcare ID

website lists all available mobile apps where users can activate their Dragon

Medical speech recognition profile and access speech-enabled products.

There is no additional cost for Dragon Medical in the mobile apps listed on the

My Nuance Healthcare ID

website but you must have an app installed on your mobile device, and have a license/rights to access it,

before you activate your Nuance Healthcare ID.

Activating the Nuance Healthcare IDfor an app

Once a user has registered for their Nuance Healthcare ID, they can access the

My Nuance Healthcare ID

website via Dragon Medical One Desktop Application or via a web browser.

Procedure for the end user

Via Dragon Medical One Desktop Application

On your desktop/laptop, start Dragon Medical One Desktop Application.

2. On the DragonBar menu, select Nuance Healthcare ID; the

My Nuance Healthcare ID

website opens.

Browse for the available mobile apps.

4. For the app you want, click Activate NHID; you will receive an activation link via email.

On your mobile device, make sure the app is installed.

Dragon Medical One Desktop Application 2020.1

- 55 -

On your mobile device, open the email you received and click the activation link; Dragon Medical is activated

for this app.

Via web browser on your mobile device

1. Open your web browser and go to healthcareid.nuance.com.

Log on using your Nuance Healthcare ID user name and password.

Browse for the available mobile apps.

On your mobile device, make sure the app is installed.

5. On the

My Nuance Healthcare ID

website, select the app and tap Activate NHID; Dragon Medical is

activated for this app.

Via web browser on your desktop/laptop

1. Open your web browser and go to healthcareid.nuance.com.

Log on using your Nuance Healthcare ID user name and password.

Browse for the available mobile apps.

4. For the app you want, click Activate NHID; you will receive an activation link via email.

On your mobile device, make sure the app is installed.

On your mobile device, open the email you received and click the activation link; Dragon Medical is activated

for this app.

Remarks

When users access the

My Nuance Healthcare ID

website via Dragon Medical One Desktop Application

they do not need to log on.

When users access the

My Nuance Healthcare ID

website via healthcareid.nuance.com, they must log on

with their Nuance Healthcare ID user name and password.

Dragon Medical One Desktop Application 2020.1

- 56 -

Dragon Medical Advisor overview

Dragon Medical Advisor analyzes clinicians' documentation in real time and displays additional information to

help make the documentation more complete and accurate. Information is displayed to the user via the Advisor

window in Dragon Medical One.

Note:Although clinicians access Dragon Medical Advisor via Dragon Medical One;a speech recognition license

is not needed.

Manage licenses and configure organization-level settings via NMC. For more information, see:Configuring

Dragon Medical Advisor in NMC.

Configure application-level settings via the Dragon Medical One configuration file (sod.exe.config). For more

information, see: Configuring Dragon Medical One.

For information on filtering advice for specific conditions at the user and group level, see:Advice filters.

Advice types

Depending on your license and the EHRyou are using, Dragon Medical Advisor provides recommendations in

the following categories:

Specificity

To improve documentation completeness and coding compliance, Dragon Medical Advisor checks the

documented diagnoses and provides advice if a diagnosis could be more specific. For example, if the user

documents

acute renal failure

without specifiers, the advisor will display an Acute Renal Failure pane with a

list of specificity recommendations.In this case it will recommend adding the cause, injury site, setting, lab

support and POAstatus.

Potential missing diagnoses

If Dragon Medical Advisor finds important symptoms, treatments or lab results that are not explained by the

diagnoses in the documentation, the Advisor window lists the clinical evidence and prompts the clinician to add

diagnoses as required.

To enable this feature, install the Clinical Evidence Content Pack license. Patient context support must be

available for your EHR.

Opportunities to document HCCdiagnoses

When a patient has been flagged for potential HCCdiagnoses, Dragon Medical Advisor will notify the clinician.

The clinician can review the evidence and accept or reject the diagnoses.

To enable this feature, install the HCCTalix license.

Coding Assistant

When this feature is enabled, the clinician can open the Coding Assistant window, which displays ICD-10

diagnosis codes and Intelligent Medical Objects (IMO) descriptions for diagnoses in the documentation. The

user can copy the descriptions into the EHR or charge capture system. Additionally, the clinician can refine the

codes and find new codes via the IMO natural language search capabilities.

Dragon Medical One Desktop Application 2020.1

- 57 -

To enable this feature, install the HCCTalix license or the Dragon Medical Advisor license together with the

Code Extractor license.

Content packs

Content packs provide specific Dragon Medical Advisor features;for example a set of diagnoses for which

specificity advice is available, or an advice type in the Advisor window. To enable a content pack for an

organization, install the corresponding license in NMC and grant the license to users.

Base content pack

Specificity recommendations for the core set of conditions and specifiers.

Pediatric content pack

Specificity recommendations for pediatric conditions and specifiers.

HCC content pack

Specificity recommendations for Hierarchical Condition Category diagnoses.

Clinical Evidence content pack

Enables Potential missing diagnoses advice.

System requirements

Dragon Medical Advisor provides patient context support for the following EHRs:

n Epic HyperSpace

n Cerner Millenium

n Allscripts TouchWorks

n Allscripts SCM

n AthenaHealth AthenaClinicals

n Meditech Expanse

Patient context support is required for the full Dragon Medical Advisor feature set. Dragon Medical Advisor works

with other text editors and with text in the Dictation Box, but with a reduced feature set.

Make sure Dragon Medical One has access to the Advisor Service (https://<organization-specific

prefix>.nuanceunderstanding.com) via port 443; your firewall must not block this port.

Recommended minimum display size:1280 x 1024 pixels.

Dragon Medical One Desktop Application 2020.1

- 58 -

Dragon Medical Advisor licensing

To be able to Advisor window, the user must have either the Dragon Medical Advisor license or the HCCTalix

license assigned.

Some features are enabled by default when either of these two licenses are assigned; some features require

additional licenses. The following tables indicate the licenses required by each feature, with the license names

as displayed by NMC.

Advisor window

The user can select the Advisor tab or the Coding Assistant tab.

Feature Required licenses

Advisor window

Dragon Medical Advisor OR HCCTalix

Coding Assistant

Dragon Medical Advisor + Code Extractor OR HCCTalix

Advice types

The Advisor window displays the following advice types as expandable panes.

Feature Required licenses

Specificity

Dragon Medical Advisor OR HCCTalix

Potential missing diagnoses

Dragon Medical Advisor + Clinical

Evidence Content Pack

OR HCCTalix + Clinical

Evidence Content Pack

Opportunities to document

HCCdiagnoses

HCCTalix

Content packs for specificity advice

The following content packs enable specificity advice for a set of diagnoses and specifiers.

Feature Required licenses

Base content pack

Dragon Medical Advisor OR HCCTalix

HCC content pack

Dragon Medical Advisor OR HCCTalix

Pediatric content pack

Dragon Medical Advisor OR HCCTalix

Installing licenses

Proceed as follows:

1. In NMC, open the Licensing ribbon and click Import License Key.

2. Paste in a valid license key for your organization and click Show Information.

Dragon Medical One Desktop Application 2020.1

- 59 -

3. Click Import.

Log out of NMC and log in again.

Granting licenses to users

An organization-level Dragon Medical Advisor license enables 5000 user licenses.

Granting and revoking licenses

To grant or revoke a license to/from a user, do the following:

1. Open the Licensing ribbon and click View Licenses, then click Search.

2. Right-click the license and select Grant Licenses or Revoke Licenses.

3. Click > to move users from Available Users to Selected Users and click OK.

Repeat steps 2 to 4 for your content pack licenses.

Using Dragon Medical Advisor without speech recognition

If a user has a Dragon Medical Advisor or HCCTalix license but no speech recognition license, they can log on to

Dragon Medical One to use only Dragon Medical Advisor functionality. Speech recognition and voice commands

will not be available, but Dragon Medical One can read the text and patient context from supported EHRs and

the user can click the advice icon on the Dragon bar to open the Advisor window.

Dragon Medical One Desktop Application 2020.1

- 60 -

Configuring Dragon Medical Advisor in NMC

Depending on your Dragon Medical Advisor features and EHR, you might to perform the following configuration

settings in NMC:

Connecting to the Advisor Service

Configuring Clinical Guidance

Configuring the patient context

Configuring the healthcare setting for a site

Additional settings are available in the Dragon Medical One configuration file;for more information, see

Configuring Dragon Medical Advisor.

Connecting to the Advisor Service

This setting is a prerequisite for Dragon Medical Advisor. Proceed as follows:

1. Open the Sites ribbon and click Details.

2. Open the Products tab and select Dragon Medical Advisor from the left panel.

3. Enter the Advisor token and the Advisor Service URL. These values are unique to each organization. If

you do not know your Advisor token or your Advisor Service URL, contact Nuance technical support or your

Nuance account executive.

Configuring the patient context

Note:Nuance typically performs this configuration for customer organizations. For more information, contact

Nuance Healthcare technical support or your Nuance account executive.

About patient context

Dragon Medical Advisor captures patient and visit information from the EHR (patient name, MRN, visit ID,

encounter ID). This enables the following:

n The Advisor Service does not repeat the same advice multiple times in one document, even if the

documentation is divided between multiple text controls. If the user enters a specific diagnosis into one form

field, when the user then refers to the same condition in another form field, the Advisor Service can suppress

the duplicate advice.

n The Advisor Service does not repeat the same advice multiple times in one patient encounter (from

admission to discharge), even if several providers recorded the documentation.

n Auto-processing takes place as soon as the EHR has the focus;the user does not need to open the Advisor

window.

n Dragon Medical One can open the Advisor window automatically when the EHR has the focus. To enable

this, update your Dragon Medical One configuration file, sod.exe.config.

Configuring patient context via an EHR interface (Epic HyperSpace only)

1. Open the Sites ribbon and click Details.

2. Open the Products tab and select Dragon Medical Advisor from the left panel.

Dragon Medical One Desktop Application 2020.1

- 61 -

3. Enter the EHR interface adapter, EDServiceDescriptor and EnvironmentID. These settings depend

on the specific Epic HyperSpace system used by the organization.

Configuring patient context via screen capture

1. Open the Sites ribbon and click Details.

2. Open the Products tab and select Dragon Medical Advisor from the left panel.

For Cerner Millenium, Allscripts TouchWorks, Allscripts SCM, AthenaHealth AthenaClinicals and Meditech

Expanse, upload a Patient context configuration JSON file. The file contains screen capture rules to find

the patient information and visit ID in the application window.

Epic HyperSpace:If an EHR interface is available, the required settings can also be encoded in the JSON

file.

Group-level EHR interface settings

You can also configure the EHR interface parameters for Epic HyperSpace at the group level. Proceed as

follows:

1. Open the Groups ribbon and click Search.

2. Select your organization from the drop-down list and click Search.

3. Right-click the group and select Group Details.

4. Open the Dragon Medical Advisor tab and enter the EHR interface adapter, EDServiceDescriptor

and EnvironmentID values.

5. Click Save.

Remarks:

The EHR interface adapter, EDServiceDescriptor and EnvironmentID settings have priority over the

patient context configuration file if any settings overlap.

Group-level settings for EHR interface adapter, EDServiceDescriptor and EnvironmentID have priority

over organization-level settings.

n If Dragon Medical Advisor cannot retrieve a valid patient context configuration from NMS, it will display

advice based on individual text controls and not based on the patient encounter.

Configuring the healthcare setting for a site

In large organizations it can be useful to identify sites by healthcare setting; this helps with analyzing Dragon

Medical Advisor usage.

To define a site's healthcare setting, do the following:

1. In NMC, open the Sites ribbon and click Organization Overview.

2. In the left pane, right-click a site and select Details. The Site Details screen opens.

3. Open the Dragon Medical Advisor tab.

4. Select the site Healthcare type;for example: Acute Inpatient Care or Long-term Care Center.

Note:Leave the EHRlocation identifiers list empty;this is for a future release.

Dragon Medical One Desktop Application 2020.1

- 62 -

Dragon Medical Advisor:Advice filters

Overview

Use the Manage Advice Filters screen in NMC to control how much advice Dragon Medical One displays to

your users. This can be useful if users find the large amount of advice they receive distracting, or if users find that

not all the advice they receive is relevant to their documentation.

When you introduce Dragon Medical Advisor to your organization it is recommended to configure advice filters so

that only the most relevant conditions and specifiers are enabled. You can enable more conditions and specifiers

subsequently, based on user feedback and observed usage patterns in your organization.

If you have a Clinical Evidence Content Pack license, you can also filter the Potential missing diagnoses

advice on this screen. The Diagnosis detail for this advice type is always displayed as Diagnosis.

Note: Although some of the NMC user interface elements refer to speech recognition, advice filters do not

require a speech recognition license.

Enabling and disabling advice

Example 1:Enabling specificity advice for asthma at the organization level

Proceed as follows:

1. Open the Speech Recognition ribbon and click Manage Advice Filters.

2. In the left panel (tree view) select your organization. In the right panel, open the Specificity tab. The right

panel lists all diagnoses and specifiers included in the organization's content pack licenses.

3. Scroll down to Asthma in the Advice column. In the base content pack, asthma is listed with two

specifiers:Severity and Smoking status.

4. Activate the Display check box for both specifiers.

5. Click Save.

Specificity advice is now enabled for asthma (severity) and asthma (smoking status) for all sites, groups and

users in the organization, and the corresponding Display check boxes are activated at those levels.

Example 2:Disabling specificity advice for asthma at the group level

Prerequisite:Asthma (severity) and asthma (smoking status) have been enabled at the organization level,

following example 1.

Proceed as follows

1. Open the Speech Recognition ribbon and click Manage Advice Filters.

In the left panel (tree view) expand your organization and site and select a group. In the right panel, open the

Specificity tab. The right panel lists all diagnoses and specifiers included in the content pack licenses

assigned to any users in that group.

3. Scroll down to Asthma in the Advice column. Because asthma advice was enabled at the organization level

for example 1, theDisplay check box is also activated for Severity and Smoking status at the group level.

4. Clear the Display check box for both specifiers.

5. Click Save.

Dragon Medical One Desktop Application 2020.1

- 63 -

Specificity advice is now disabled for asthma (severity) and asthma (smoking status) for this group and for all

users in this group. At the user level, the cleared state of the Display check box for the two asthma specifiers is

now inherited from this group and not from the organization level. The asthma advice is still enabled for users

that are not assigned to this group.

Remarks

Activating the Mandatory check box for a diagnosis/specifier at the organization, site or group level means

the corresponding Display check box cannot be cleared at lower levels (site, group or user).

n By default, all check boxes are cleared for new organizations.

To activate the Display check box for all diagnoses and specifiers, click Select All.

To clear the Display check box for all diagnoses and specifiers, click Clear All, then click OK.

Working with advice filter groups

An efficient way to manage advice filters for a large number of users is to create groups corresponding to their

specialties and enable/disable advice at the group level.

To enable/disable advice at the user level, assign users to these groups.

Creating an advice filter group

To create an advice filter group (for example, for cardiologists), do the following:

1. Open the Groups ribbon and click Add.

Select the new group's organization from the drop-down list.

3. In the Role field, select Speech recognition user and click OK.

4. In the Sites field, select the new group's site from the drop-down list.

5. Enter a group name; for example:

Cardiology advice filters

6. Click Save.

7. Open the Speech Recognition ribbon and click Manage Advice Filters.

8. In the left panel (tree view) expand your organization and site and select the new Cardiology advice filters

group.

9. Activate the Display check box for each diagnosis and specifier relevant to your cardiologists and clear the

Display check box for each diagnosis and specifier that they are less likely to document.

10. Click Save.

Assigning multiple users to a group

Proceed as follows:

1. Open the Groups ribbon and click Search.

Enter search criteria. If you do not enter search criteria, all your groups are listed.

3. Select a group and click Add User Account to Group (on the Membership ribbon). All users in the group's

site are listed.

Dragon Medical One Desktop Application 2020.1

- 64 -

4. To add user accounts to the group, activate the corresponding Member check boxes.

5. Click Save.

Assigning a user to multiple groups

Proceed as follows:

1. Open the Sites ribbon and click Organization Overview.

In the left panel (tree view) select your organization;all the organization's users are listed.

3. Right-click the user whose group assignments you want to edit and select Details.

4. Open the Group Memberships tab.

Select one or more of the available groups and click to move it to the Selected Groups list.

In the Selected Groups list, select a group and click or to make its priority higher or lower.

7. Click Save.

Remarks

When a user is assigned to multiple groups, groups higher up the Selected Groups list have higher priority.

For example:

Asthma (severity) advice has been enabled for

Group A

but disabled for

Group B

The user

Chis Smith

has been assigned to both groups.

In Chris Smith's Selected Groups list, Group B is higher than Group A.

When asthma appears in Chris Smith's documentation, the Advisor window will not prompt Chris Smith

for the severity specifier.

Dragon Medical One Desktop Application 2020.1

- 65 -

Dragon Medical Advisor:HCC filters

Overview

Use the Manage HCC Filters screen in NMC to control which HCCcategories Dragon Medical One displays to

your users. This can be useful in scenarios where the HCCs that have been flagged for a patient are not relevant

to a site, group or specific provider's specialty.

Remarks

n NMC enables filtering by HCC categories but not by specific HCC codes.

n By default, all HCC groups are enabled for all users.

n Although some of the NMC user interface elements refer to speech recognition, HCC filters do not require a

speech recognition license.

Enabling and disabling HCCcategories

Example 1:Hiding HCCs for hypertension at the organization level

Proceed as follows:

1. Open the Speech Recognition ribbon and click Manage HCC Filters.

In the left panel (tree view) select your organization. The right panel lists all available HCC categories.

3. Click the HCCName column heading to sort the list alphabetically.

4. Scroll down to Hypertension and clear the corresponding check box.

5. Click Save.

Hypertension HCCs are no longer listed in Dragon Medical One's Advisor window for any users in your

organization.

Example 2:Enabling HCCs for hypertension at the group level

Prerequisite:Hypertension has been disabled at the organization level, following example 1.

Proceed as follows:

1. Open the Speech Recognition ribbon and click Manage Advice Filters.

In the left panel (tree view) expand your organization and site and select a group. The right panel lists all

available HCC categories.

3. Click the HCCName column heading to sort the list alphabetically.

4. Scroll down to Hypertension; because hypertension was disabled at the organization level for example 1,

theDisplay check box is also cleared at the group level.

5. Activate the Display check box.

6. Click Save.

Where hypertension HCCs have been flagged for review, they will now be listed in Dragon Medical One's Advisor

window for all users in this group. At the user level, the activated state of the Display check box for hypertension

Dragon Medical One Desktop Application 2020.1

- 66 -

is now inherited from this group and not from the organization level. Hypertension HCCs are still hidden for users

who are not assigned to this group.

Remarks

Activating the Mandatory check box for an HCC category at the organization, site or group level means the

corresponding Display check box cannot be cleared at lower levels (site, group or user).

To activate the Display check box for all HCC categories, click Select All.

To clear the Display check box for all HCC categories, click Clear All, then click OK.

The Source column indicates the level from which the current display setting is inherited (organization, site,

group).

The Average RAF Score column indicates the average Risk Adjustment Factor of the diagnoses within an

HCC category.

Working with HCC filter groups

An efficient way to manage HCC filters for a large number of users is to create groups corresponding to their

specialties and enable/disable HCC categories at the group level.

To enable/disable HCC categories at the user level, assign users to these groups.

Creating an HCC filter group

To create an advice filter group (for example, for cardiologists), do the following:

1. Open the Groups ribbon and click Add.

Select the new group's organization from the drop-down list.

3. In the Role field, select Speech recognition user and click OK.

4. In the Sites field, select the new group's site from the drop-down list.

5. Enter a group name; for example:

Cardiology HCC filters

6. Click Save.

7. Open the Speech Recognition ribbon and click Manage HCC Filters.

8. In the left panel (tree view) expand your organization and site and select the new Cardiology HCC filters

group.

9. Activate the Display check box for each HCC category that your cardiologists would review and clear the

Display check box for each HCC category that they do not need listed.

10. Click Save.

Assigning multiple users to a group

Proceed as follows:

1. Open the Groups ribbon and click Search.

Enter search criteria. If you do not enter search criteria, all your groups are listed.

3. Select a group and click Add User Account to Group (on the Membership ribbon). All users in the group's

site are listed.

Dragon Medical One Desktop Application 2020.1

- 67 -

4. To add user accounts to the group, activate the corresponding Member check boxes.

5. Click Save.

Assigning a user to multiple groups

Proceed as follows:

1. Open the Sites ribbon and click Organization Overview.

In the left panel (tree view) select your organization;all the organization's users are listed.

3. Right-click the user whose group assignments you want to edit and select Details.

4. Open the Group Memberships tab.

Select one or more of the available groups and click to move it to the Selected Groups list.

In the Selected Groups list, select a group and click or to make its priority higher or lower.

7. Click Save.

Remarks

When a user is assigned to multiple groups, groups higher up the Selected Groups list have higher priority.

For example:

Hypertension has been enabled for

Group A

but disabled for

Group B

The user

Chis Smith

has been assigned to both groups.

In Chris Smith's Selected Groups list, Group B is higher than Group A.

When Chris Smith's patient has been flagged for a hypertension HCC, the Advisor window will not list

this HCC.

Dragon Medical One Desktop Application 2020.1

- 68 -

Documentation

Dragon Medical One is delivered with documentation for system administrators and end users.

System administrators

The

Dragon Medical One Installation and Administration Guide

describes the installation and system

configuration procedures. This guide also covers information on the Nuance Management Center.

End users

Users access the end user help by saying launch help or by clicking Help on the DragonBar menu. The Dragon

Help tab of the personalization and help window contains information on how to use the application features (for

example, anchoring the speech focus); the Speech Recognition Help tab contains information on speech

recognition features and how to use them.

The What You Can Say page contains a list of all available voice commands and auto-texts. Users can open it

by saying what can I say or clicking What You Can Say on the DragonBar menu.

Dragon Medical One Desktop Application 2020.1

- 69 -

Supported languages

The speech recognition language is the language the user records in and that Dragon Medical One recognizes.

Currently only English (IETF language tag: en-US) is supported.

The user interface language is the language in which Dragon Medical One displays menus, help files, error

messages and dialog boxes. Currently only English (IETF language tag: en-US) is supported.

Dragon Medical One Desktop Application 2020.1

- 70 -

Troubleshooting

n A client cache error is displayed after installing the ClickOnce package, and the application won't run.

Delete the ClickOnce application cache in the user's AppData directory (Windows 7: "C:\Users\<user

name>\AppData\Local\Apps\2.0").

After Dragon Medical One has been deployed via XCOPY deployment, the application does not start and an

exception is thrown: "System.Configuration.ConfigurationErrorsException: Insufficient permissions for

setting the configuration section 'defaultProxy'. ---> System.Security.SecurityException: Request for the

permission of type 'System.Net.WebPermission, System, Version=4.0.0.0, Culture=neutral,

PublicKeyToken=b77a5c561934e089' failed."

Depending on your Group Policy security settings, Microsoft Windows marks downloaded files as

unsafe. This prevents .NET from executing properly, which causes the exception.

Unblock the downloaded ZIP file before you extract it; for more information, see: XCOPY deployment.

n Dragon Medical One crashes when the application is started.

Check the configuration file and the log file for configuration-related issues.

Make sure that your system conforms to the software and hardware requirements.

Make sure you followed all steps required to set up a working system.

An error occurs when Dragon Medical One is started: An error has occurred, it is not possible to use the

application. Please contact your administrator. The specified server URL cannot be reached,

check your network connection.

Check the network connection to Dragon Medical Server.

n The automatic gain control (AGC) of the recording device or the device driver/sound card driver interferes

with the automatic audio adjustment feature of Dragon Medical One.

Disable the interfering AGC.

An error occurs when the user starts recording: Speech recognition is temporarily not available in this

application because there are no licenses available.

If auto-provisioning of users is not enabled for your organization in NMC, make sure that the user exists

in NMC and the user name is spelled correctly (user names are case sensitive), and that the user's token

credentials (User Account Details dialog box, Credentials tab, Token tab) are the same as the user

name or empty.

In NMC, check if your organization has run out of licenses. For more information, see Licensing.

n Dragon Medical One inserts text in the wrong place in a Microsoft Word document.

This might be caused by a version incompatibility. Make sure you use a Microsoft Word version officially

supported by Dragon Medical One. For more information, see: Software and hardware requirements.

n The text cursor and/or elements of the document flicker when the user dictates in a Microsoft Word 2013

document.

Follow the instructions in the Microsoft Knowledge Base article: https://support.microsoft.com/en-

us/kb/2768648.

The user changed their settings in the Options dialog box, but the changes are not saved.

Make sure that Dragon Medical One can communicate with the Nuance Management Server; for

information on the ports Dragon Medical One requires access to, see: Setting up a working system.

Dragon Medical One Desktop Application 2020.1

- 71 -

An error occurs when Dragon Medical One is started: No supported audio device is available. To start

Dragon, connect a device and click Refresh.

Connect a microphone the end user is allowed to use, and click Refresh.

In a virtual desktop/application environment, make sure the connected microphone is set as the default

device in Microsoft Windows on the end point.

In a virtual desktop/application environment, make sure the Nuance custom audio channel has been

deployed on the client end point and on the virtual server hosting the application.

n Dragon Medical One shuts down unexpectedly; no error message is displayed.

Collect the crash dump (location: %APPDATA%\Nuance\SoD\) and send it, along with an error report if

possible, to Nuance Technical Support for analysis.

n The ClickOnce deployment of Dragon Medical One does not update automatically when pinned to and

launched from the task bar.

Launch the ClickOnce Dragon Medical One application from the Windows Start menu.

Make sure you do not start the ClickOnce Dragon Medical One application by running SoD.exe.

A message is displayed when the user opens the personalization and help window:The help needs to be

refreshed. Please close and open it again.

In the Internet Options, make sure that cookies are enabled for the corresponding users/machines. If

your organization works in virtualized environments, this setting must be applied to the virtual server.

n The user cannot dictate at the cursor in applications based on Windows Presentation Foundation (WPF)

TextBox class text controls.

Make sure to enable WPF support from the command line. For more information, see: Enabling and

disabling WPF support from the command line.

n The user cannot switch the speech focus between applications running at the same time in a Citrix

environment.

Launch the FarmTWIHelper - Seamless Configuration Helper Tool on the Citrix server where the issue

occurs and make sure to deselect all the settings (do not change the Disable Active Accessibility

Hook (0x4) setting). Restart the server before starting Dragon Medical One. For more information on

how to use the helper tool, see https://support.citrix.com/article/CTX115146

n Dragon Medical One is no longer in standby mode when a user, working in a Citrix environment, locks and

unlocks the screen.

Make sure that the latest version of the Nuance custom audio channel has been installed on the client

end point.