Inexpevsive and easy to use ERMs for small practices

[Tennessee Redneck]

I did not realize the expense of EMR packages but have recently been enlightened to the fact that they often cost three to five thousand dollars (WOW!!!). With this in mind I thought I’d mention this product. I am a speech recognition expert with minimal EMR experience but I do know a bit about TexTALK as its creator is one of our partners. I corresponded with several physicians and they seemed to be especially happy with ease of use. It is simple, easy and cost efficient. It has state-of-the-art speech recognition technology. Intuitive speech commands automate complex tasks. It has a user-friendly interface that is easy to learn and simple to use with little or no computer knowledge. There are customized templates for each physician that look and flow like the practice's current charting system. Support for Tablet PCs. Documents, such as current charts, labs, x-rays and consults can be scanned directly into a patient chart.

Our NaturallySpeaking customers that use TexTALK have expressed that the two mesh well together. Here are some features and benefits.


 State-of-the-art speech recognition technology to ensure a high level of accuracy while dictating notes.

 Customized Medical Language Models.
 Automatic insertion of patient demographics.

 Intuitive speech commands that automate complex tasks, such as filling out forms and inserting boilerplate text.

 Deferred Dictation and Correction.

 Use of special hand-held recorders for later playback and transcription by the computer. An assistant can correct and proof read.

 User-friendly interface that is easy to learn and simple to use with little or no computer knowledge.

 Customized templates for each physician that will look and flow like the current charting system.
 Allows to "clone" documents based on previous documents.

 Patient charts can be faxed to referring physicians and insurance companies.

 Scanning Module allows documents such as current charts, labs, x-rays and consults to be scanned directly into TexTALK MD Enterprise. Outside documentation can be scanned directly into a patient note for quick reference.
 Built in security features to provide secure charts and private physician notes.
Support for Tablet PC.

The cost of this product is still very significant but seems to be very competitive with its offerings.

We built our company on tech-support and our Speech Recognition Forum where we answer hundreds of questions. We choose not to sell any product that we can’t provide proper support for. The tech-support for TexTALK comes from the developer who as I mentioned is one of our partners. He also assembled the code for KnowBrainer 2006 that adds the ability to create your own advanced macros in NaturallySpeaking Preferred as well as other features that level the playing field between Preferred and Professional.

Most of our medical clients choose to purchase directly from us because it’s $ 300.00 less than purchasing directly from Alma Information Systems. Either way Alma Information Systems provides the technical support.

[Tennessee Redneck]

We are now offering a special on TextTALK by giving our clients a choice of freely adding one of the following 4 items: Philips Speech Mic USB microphone, Revolabs xTag wireless lapel microphone, Olympus DS-50 digital recorder or KnowBrainer 2007 command software. At KnowBrainer we believe one can never have too many Gadgets.

[techguy]

What type of accuracy do you get from the speech recognition you use? Do your doctors have to go back and correct things after the transcription is complete?

[Tennessee Redneck]

John,

I tend to get about 97 % accuracy with NaturallySpeaking Pro 9.5. My business partner tends to achieve 99 % accuracy but he has dictated thousands of posts on our Speech Recognition forum. He has also been working with the software since the birth of the original product called Dragon dictate created by DragonSystems and developed the KnowBrainer command software add-on for NarurallySpeaking Preferred, Professional, Medical and Legal.

Our physician clients tend achieve 96 to 99 % accuracy with most of them landing around the 97 % mark. There are a few that stay around 96 % and a few that reach 99 %. We feel that 95 % or below is simply not worth bothering with because clients come to us for productivity gains and we see 96 % as the cutoff point. All of our customers including doctors, lawyers, court reporters, transcriptionists, writers, professional business people and people with physical disabilities all seem to average 97% accuracy. I believe this is because they take advantage of our Speech Recognition / support forum, the manuals that we create for most everything that we carry (especially all forms of DNS, KnowBrainer or Univoice) and our 30 days of set up / tech support. For some customers that need extra support we assist them through Go To Meeting where we can virtually take over their computer and install / fix problems and assist with training issues.


Many end users fall into simply avoided pitfalls such as not enough RAM, an inferior soundcard / microphone which can be inexpensively cured, or not having a proper support platform. In closing as long as you don’t have any weak links in speech recognition chain the software should give you a 25 % increase in productivity.

Also feel free to browse our forum linked below for addition information as you can never have too many different sources of information for different topics. I will also continue to answer different types of questions and offer reviews on this forum. I almost forgot to mention I visited your blog and found it very professional and well formatted.

[techguy]

Thanks for the information. I'm glad you mentioned a quality microphone. That was my next step was to find some high quality microphones. Do you have a link to the best microphones?

[Tennessee Redneck]

John,

This is actually quite a complex question. There are many factors to consider. Do no always sit next to your computer or do you tend to get up and pace a bit during dictation? Is the environment you intend to dictate within a quiet one or a noisy one? Are you going to use your mic on a desktop,a tablet, or a laptop computer? Are you going to work in a constant stop and go dictation style or will you be dictating for long periods of time? These are some of the questions we tend to ask clients when helping them choose the mic that’s the best fit for their work style. The microphone people choose is very crucial because it affects the performance of NaturallySpeaking and therefore affects their overall experience with the software.

The Sennheiser ME3(modified for speech recognition) was the original Mercedes mic for speech recognition several years ago but since then there have been some additions although it still places in the top six. Here are the top five in order.

1. Hybrid Samson Airline 77 wireless microphone – The highest accuracy and best noise cancellation on any mic we’ve ever tested. Here is a review. Samson Airline 77 Review

2. Revolabs xTag wireless lapel microphone - This mic placed second in accuracy and is incredibly comfortable as it is a lapel mic. It’s Achilles heal is its noise cancellation so it needs to used in more quite environments.

3. Hybrid Plantronics CS55 wireless telephone/microphone – Third in accuracy with great noise cancellation and the unique phone to computer application.

4. Plantronics CS50-USB wireless microphone – Fourth in accuracy with its sound device built in. A slight bit less accurate than the CS55 due to the sound device being a bit gritty compared to the VXI or Andrea external soundcards used with the CS55.

5.theBoom V4 microphone & theBoom “O” microphone – The only wired mics currently that best the Sennheiser. Very good noise cancellation and accuracy with the v4 being an ear clip style mic and the “O” being a traditional style headset. These mics can also be used with cell phones or cordless landline phones.

The KnowBrainer Hands Free (or Sennheiser knock off) is an exellent and economical choice offering good accuracy and noise cancellation.

Several months ago one of our forum members mentioned that he uses an Olympus ME52W lapel mic with NaturallySpeaking. I told him that mic certainly would produce less than acceptable results. We sell that mic as an add on to our endorsed digital recorders and would never sell it for direct dictation. The seed was planted and after a few trials.............the ME52W actually did very well at $30.00. The accuracy was comparable to our other 2nd tier wired mics such as the TalkPro Express, ANC 700/750 or NC 9100. Unique to this mic is the fact it's a lapel mic and only carries the weight of a quarter. Noise cancellation was not at all acceptable so I would only suggest using this mic in a very quiet environments only. I also suggest if anyone wants to take this route add a 1/2 duplex USB Pod (external soundcard) and a 6 ft extension cord (adding to the site soon) as the ME52W only has a three foot cord. The mic,soundcard and cord will cost you only 76.00 and the mic by itself has became the most inexpensive mic that we have ever accidentally found acceptable for NaturallySpeeking.

For the last 4 weeks we’ve been testing the Sennheiser BW900 and have found it to be a jack of all trades. Our test results and review are about finalized and I’ll post them here upon completion.

You can compare all of our mics and how they size up against each other on the microphone Microphone Comparison Matrix.

[Tennessee Redneck]

Senneheiser BW 900 review

We have been using the new Hybrid Senneheiser BW 900 wireless microphone for the last 30 days. Several of us have collaborated on testing this microphone and we are in agreement over the following:

We found the BW 900 to be exceptionally good with NaturallySpeaking after adding the proprietary PC Switch/Cabling device that we use to convert the Plantronics CS55 and Plantronics CS70N microphones into speech recognition mics. This microphone exhibits exceptionally high accuracy and noise cancellation. From an accuracy point of view we found the BW 900 equivalent to the Hybrid Plantronics CS55 and Hybrid Plantronics CS70N (available around January 4). The BW 900 surpasses the CS55 in noise cancellation and is equivalent CS70N which falls just below the Hybrid Samson Airline 77.

One of our favorite aspects of the BW 900 is the auto-level control. Auto-level control is commonly used on digital and analog recorders but we've never seen it incorporated into a microphone. Many end users, including ourselves, tend to run the Audio Setup Wizard at a slightly lower volume level than we should because we are reading. When free-form dictating we tend get a little excited (especially when writing reviews); not to mention occasionally frustrated, which results in raising our voice. Raising your voice on a typical microphone will have drastic effects on NaturallySpeaking's accuracy but the BW 900s built-in auto-level control catches volume increases and decreases seemingly instantly which translates directly into higher accuracy. The only other microphone we've tested with a similar feature is the Samson Airline 77 which can handle even more drastic volume changes but it incorporates a noise gate which is better but can take up to 2 seconds to register. The BW 900 auto-level control can't handle extreme volume input changes but it is literally instantaneous. When you factor in slight volume changes that go on throughout the day, we consider this invaluable.

Additional perks include the best Bluetooth microphone we've ever used with a cell phone. It seems like we have tested every Bluetooth cell phone microphone on the market and there have always been pairing issues and dropped connections. We gave up on using Bluetooth cell phone microphones until the BW 900. It's easy to pair, has no problem establishing a connection and is very easy to change the volume level on those hard to hear calls when driving our Jeep Wrangler, which is about as noisy as a dune buggy. This microphone is also good in the wind where even a slight breeze will render most other Bluetooth microphones useless.

The BW 900 works exceptionally well with standard landline telephones as well as cell phones and although you can add an optional hydraulic telephone handset lifter, you may not find it practical for use with dictation because every time you turn on your microphone, the lifter will pick up your telephone headset. We like the hydraulic lifter so we just unplug it while dictating into NaturallySpeaking.

Unfortunately not all the news is good. The BW 900 has a 300 foot range but the included rechargeable battery only lasts about 4.5 hours and takes up to 3 hours to acquire a full charge. Fortunately the unit is capable of simultaneously charging a 2nd battery in the base station. If you plan on using this microphone half as much as much as we do, it would be highly advisable to purchase a 2nd inexpensive battery and even if your battery goes dead while you are on the phone, you can change it out without losing the connection. Changing the battery couldn't be easier. It's just slides in and out.

The Achilles heel of the BW 900 is the headset itself. Like other Bluetooth headsets, it basically clips to your ear with a clever hinged speaker that pinches the interior of your ear canal against the back of the headset which rests on the back of your ear. We are not saying that it's overwhelmingly uncomfortable but because this microphone is clearly designed to handle all your cell phone and landline needs along with your speech recognition requirements, you could easily be wearing it continuously throughout the workday and in today's workplace, you could even wind up wearing it through lunch and dinner too. The speaker includes 3 spacers and although the medium-sized spacer is the default ring, we suspect everyone will be a little more comfortable using the smallest ring which is how we will be shipping our units.

Final Thoughts: Although the Senneheiser BW 900 isn't quite as accurate or noise canceling at the Samson Airline 77, it is far more universal in that it doubles as a wireless very accurate very noise canceling Bluetooth cellphone headset, landline headset and speech recognition microphone. We would like to see the Bluetooth portion of the microphone work for speech recognition software but it currently doesn't fulfill this need. That is why we will be including our pc switching device. Senneheiser will hopefully work on this issue but in the meantime we will try to find a Bluetooth dongle to support tablet computers. Our PC switch works fine on desktop computers and notebooks which are typically used in one place but is not well-suited for mobile professionals or tablet computers. To help take care of our customers who need more portability, we'll be including a free KnowBrainer Hands-free microphone with every BW 900 we sell.

[Tennessee Redneck]

Plantronics CS70N Test Results for January 1, 2008

I have been using the new Hybrid Plantronics CS70N microphone for the last couple of weeks. Several of us have collaborated on testing this microphone and we are in agreement over the following:

We found the CS70N to be exceptionally good with NaturallySpeaking after adding the specialized PC Switch/Cabling device that we use to convert the Hybrid Plantronics CS55 and the Hybrid Senneheiser BW 900 microphones into speech recognition mics. This microphone exhibits exceptionally high accuracy and noise cancellation. From an accuracy point of view we found the CS70N equivalent to the CS55 and BW 900. From a noise cancelation point of view the CS70N falls just shy of the Hybrid Samson Airline 77 but doubles as a wireless telephone headset; like the CS55.

Unfortunately the optional hydraulic telephone handset lifter, isn’t practical for use with dictation because every time you turn on the microphone, the lifter will pick up your telephone headset so we recommend against purchasing the lifter.

Bottom Line: Although we found the unique headset to be very comfortable it may not be for everyone because the headset isn’t worn in a traditional headset manner. It is worn around your ear, like the Plantronics Voyager 510 (which we don’t recommend for speech recognition usage). The CS70N also inserts the headset speaker slightly into your ear cannel. We found this microphone to be very comfortable and it works great with most land line phones. If you want a more traditional headset we recommend the CS55 but if you don’t want to mess your hair (ladies) and you need excellent noise cancellation (which is the CS55’s Achilles Heal) the CS70N would be our recommendation.