"Dragon Medical Practice Edition speech recognition software provides for more efficiency, higher quality documentation and more profitable medical care. Dragon Medical Practice Edition gives you the ability to dictate directly into your electronic medical record allowing doctors and clinicians to freely document care in their own words in EHR sections such as History of Present Illness, Review of Systems, Physicals Examination and Assessment and Plan...."

so the "spiel" goes.

I recently got the upgrade for Dragon (I'm going to leave off Medical Practice Edition mostly for the rest of this article). This article will discuss how Dragon interacts with McKesson Practice Partner Patient Records (I currently have version 9.5.2 SP1). I was presently suprised that the "spiel" plays out well in real use.

When I use Dragon, I really count on it to get things done. Let me explain further. My use is primarily for free text entry when templates and quicktext/FASText don't "cut the mustard". Dragon is also a useful tool when, at the end of the day, I may be a little tired of typing. It's nice to just dictate. I really don't use the Navigation and Command features in Practice Partner (i.e. "Open chart", etc) that much. Again, I really just use my mouse to navigate and primarily dictate in the progress note section.

Dragon has a robust macro feature that can be triggered with a simple trigger word (i.e. "Normal Exam"). Hardware is so important and having adequate disk space and memory along with a good sound card (or motherboard) and microphone make the difference. At the practice, I usually just dictate in my office at my PC which has 4gig of RAM, Intel Core2 Quad CPU @ 2.66GHz with Windows XP SP3. At home, I have a custom PC with Windows 7 Ultimate 64bit, 8 gigs of RAM and Raid 0 750MBWD SATA hard-drives. The mic I use in the office is a SAMSON Airline 77 wireless mic which gives me freedom to shuffle paper with both hands, etc. I use a USB mic at home. Don't skimp on hardware, you'll pay for it in impoverished accuracy which will slow you up and waste your time.

I have found KNOWBRAINER to be a good site which offers upgrades, etc at reasonable rates. They even have add-on software which allows for even more "out of the box" commands once installed. They offer support after installation in an inital time period for free. Their website is If interested, go to the Nuance Website ( where you can be directed to other resellers.

I have been upgrading Dragon since 1995 and starting using it at the office since 1997 when the first version of Dragon included the medical vocabulary. It was pretty good then, it is now even better.

What is supposed to be new (or different) in Dragon Medical Practice Edition as opposed to Dragon 10+?

  1. BETTER ACCURACY - yes, noticed this right off the bat. But, it is so important to correct errors as they occur. I've notices upgrades working really well intially but then with "drift" (as I call it), the recognition accuracy drops off at times. I will say that I seemed to notice that it ignored background noice/talk better than in previous versions. Recognition of medical terms is stellar and this is why you SHOULDN'T get any other version of Dragon.
  2. SMART CONFIGURATION RECOGNITION - although already configured, I did readjust the audio settings on my mic at home and it was very quick.
  3. ANALYTICS RECOGNITION - what? OK, the software always was robust in analyzing voice so maybe this is better.
  4. SPEED ACCURACY TUNING - supposedly this is a nice feature - which is run when you aren't using the program but it really 'fine tunes' the recognition to fit your speech.
  5. SMART CORRECTIONS - this seemed to work faster. The graphical user interface is different but easy to get used to.
  6. NEW DRAGON SIDEBAR - just window dressing, perhaps there was some reason to do this. Was easy to adjust to.
  7. PROFILE CREATION WIZARD - didn't need to do this although I went through re-training on my office PC and mic. It seems to recognize faster. On upgrading, it spent some time processing the user profile so make sure you go get a cup of coffee (or two)!
  8. HELP SYSTEM AND TUTORIALS - haven't really used them but on quick glance looks to be improved.
  9. IMPROVED NAVIGATION - I guess but I don't really use this much.
  10. PLAYBACK INITIAL TRAINING - no experience here.
  11. TIME REDUCED FOR DIGITAL RECORDING DEVICES - if true this'll be handy for those who may carry a digital recorder on rounds, etc.
  12. ENHANCED PROFILE-OPENING USER DIALOG - OK, don't really feel it's that much better but maybe so.

Other thoughts:

It seems to work well in Practice Partner with little to no real changes. Losing focus of the cursor used to happen but I haven't seen this (so far) with the new version of Dragon. When I'm home, I dictate directly into the chart using GoToMyPC as the VPN software. Some of the commands still don't work in this environment. However, the way I use it, I really don't need most of these anyway. Since I may dictate in several parts of a progress note (usually, Subjective and Plan but occasionally Objective), using the Dragon Box (Text editor box you can call up) and then pasting into the chart would not be that efficient for me. However, my use of Dragon is needed less and less over the years which is now about 20% of the progress notes (these are already mostly complete notes with use of template, etc.). Even with these ever shrinking percentages, I find that the increased accuracy does make a difference none-the-less.

So, all-in-all, I would have to say it is probably worth the nearly $600 upgrade. McKesson Practice Partner will resell Dragon and if you want their support, that may be the way to go. McKesson may tell you that they don't support this newest version, which is understandable. However, Dragon seems to work well with this newest version.

At Skyline Family Practice, we've always been of the mind that IF some process or some equipment will shave seconds of a step each day that is done multiple times, THEN it is probably worth the cost or time to develop the process. I think the upgrade price is a little steep but I'll probably forget about that since the accuracy is improved and therefore, I will save a lot of time accumulated over a year!

At the end of this article are two videos on Dragon (from Nuance) that may show you more of how much better this version is from version 10. Also, in the file sharing part of the EMR village (under 'Add-ons...:) you will find the New Cheat Sheet for DNS 11 Commands.


 Video on DNS 11 - Features
Video on DNS 11 - Demo 
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  •  Tripp_Bradd: 

    I have been upgrading DNS for the past couple of versions from KnowBrainer.  Nuance seems to like folks going to resellers for the actual upgrades.


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  •  Rick_Herrington: 

    Helpful post Tripp. Thank you. Did you get from KB, Nuance, MPP?

    Uninstall prior version first? Save/ re add commands and words??

    Cost was ~$600 where?



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4 votes