Review: Nuance's Dragon 10 Medical
Originally published in GP magazine .
Written for GP magazine around 2009. This is the version I submitted - the published article may have been edited.
I was excited to be asked to review Nuance’s Dragon 10 Medical voice recognition software. My copy arrived with a Philips SpeechMike Pro microphone, which costs a couple of hundred quid extra and is meant to give a higher quality sound.
Things didn’t start well when I installed it and it corrupted my roaming profile. I’m prepared to believe this might be my machine, as it could probably do with a clean-up. I then went through the training and learning module, where it makes you read out a passage of your choice - one is a medical report - and it scans your hard drive for emails to learn your vocabulary and style. Nuance missed a trick here, and this is the first sign that although it is touted as a medical version it doesn’t really understand GP computing. I must have thousands of referral letters stored in my clinical system but it doesn’t seem to know about them.
Dragon 10 is advertised as being 99% accurate out of the box. After using it solidly for a week I was getting high 90s, but I still found there was always at least one correction I had to make. Making corrections sometimes seemed to take longer than typing it myself, which brings me to my next point. Training in using it is vital. I constantly felt that I wasn’t getting the most out of it.
Although it would dictate into EMIS directly, it wouldn’t correct well and I found it very hard to make it part of my workflow. Instead of putting things in under different headings I found I was speaking a lot of text in the comment box, and I still had to go into a template to Read code data. Although a couple of resellers are meant to specialise in working with medical clinical systems including EMIS, I didn’t get to speak to them so was left floundering.
The retail copy of Dragon 10 costs £150, the medical version around £650, though this is the price off their website and doesn’t take into account bulk purchase deals - but then it doesn’t include training or installation. The professional version has lots of enterprise features. It also has a higher level of customisation built in and you can create all sorts of custom scripts that allow you to get the best out of your existing software. It also includes specialised dictionaries. I think it’s a lot extra to pay for the professional version when it doesn’t integrate that well, on what I have seen.
The one feature where you would think it would come into its own, dictating referral letters, it fails. We, like a lot of practices near us, now use a digital dictation system and there is no easy (read cheap) way of integrating speech recognition. I could create the letters myself in Word and email them over to the secretaries, but that then means me doing more work not less and wastes the existing investment.
To be fair - and this review runs the risk of coming over as too negative - when it works it is quite simply stunning. I have found it most useful in emails, particularly ones that need a lot of text. It is amazing how it keeps up with you.
My advice would be that this is a very complex product that I don’t think has been properly integrated into general practice workflow or existing software. If you are interested, speak to a specialist reseller - be prepared to do a lot of work setting it up and training both it and yourself. It could be great - I’m just not convinced the benefits are currently worth the time, trouble and cost.