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Dragon vs. Macros

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  • Dragon vs. Macros

    My office partner is pushing hard for us to get Dragon and I've never used dictation software before. I'm a bit of an EMR power-user, and I've always just used macros to close out my charts by 5. On the other hand, he is very slow and "needs it to be efficient". We split overhead 50/50. I'm having a hard time justifying the expense - is there even remotely a chance this will allow me to see patients faster if I use it?

  • #2
    Some of our clinicians use the speak function on their macbooks. Works the same per them. I must say, for the last 2 weeks, I've been using EMR for the first time in 20 years. It's fun. I'm not as fast, but it gamefies documenting.

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    • #3
      You can use dragon with macros. But it wouldn't be any faster I don't think

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      • #4
        As far as I know you can use dragon with any electronic health record system. There is no reason you cannot use both macros and dragon. And as has been pointed out you can use voice macros within dragon.

        Note that the entire text body of this post was written in Dragon.

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        • #5
          Dragon has macros. You would only get it if you wanted the ability to use the voice recognition feature. If you already have an extensive list of macros you won’t go any faster unless you are typing a lot of your notes.

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          • #6
            I used to use Dragon but find it faster to use macros now that I have built up enough of a supply that I can dot-phrase most of every note. It's absolutely a YMMV kind of question.

            Frankly if your partner hasn't managed to get fast with what he has available then I doubt adding a new toy is going to make him faster.

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            • #7
              Seems clunky. But then again I type way faster than I speak. We recently switched to the worst EMR I've ever used, eClinicalWorks. It's very mouse-intensive and I have to use a program called autohotkey to get around the worst of it. I created a bunch of keyboard shortcuts that create mouse clicks in specific areas so I don't have to constantly work through point and click menus and switch between mouse and keyboard.

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              • #8
                Originally posted by funkmstr47 View Post
                My office partner is pushing hard for us to get Dragon and I've never used dictation software before. I'm a bit of an EMR power-user, and I've always just used macros to close out my charts by 5. On the other hand, he is very slow and "needs it to be efficient". We split overhead 50/50. I'm having a hard time justifying the expense - is there even remotely a chance this will allow me to see patients faster if I use it?
                The question is "Is Dragon a legitimate tool for the office?" Like any productivity too, it is up to the individual using it. Is this a single user license? $1599.99

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                • #9
                  I use dragon and I like it quite a bit. However I cannot type well so it really does increase my efficiency. I also started using dragon and do not use a bunch of macros so it's hard to say which way would be faster.

                  I will say from a personalized note standpoint the person who types out their plan and HPI either through typing or dictating is going to be much better off than somebody who plops in a bunch of template garbage. But I have seen templated notes that do look and sound genuine so a lot is up to the user and how much they care.

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                  • #10
                    I have used a combination of macros and Dragon for years. I could not even imaging doing notes with out them. After a while you get good at speaking and then typing a macro in between. Before Dragon I used macros a lot. The problem I had when I go back and reread a note made by macros , it becomes generic gobbly gook which really does not mean any thing. You can use the macro function of Dragon which works well for canned speech.

                    I can usually dictate around 120 wpm, I cant type nearly as quick.

                    A few dictated lines from Dragon becomes much more descriptive and meaningful for me to keep track of problems and my thoughts at the time of the visit.

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                    • #11
                      Originally posted by Lordosis View Post
                      I use dragon and I like it quite a bit. However I cannot type well so it really does increase my efficiency. I also started using dragon and do not use a bunch of macros so it's hard to say which way would be faster.

                      I will say from a personalized note standpoint the person who types out their plan and HPI either through typing or dictating is going to be much better off than somebody who plops in a bunch of template garbage. But I have seen templated notes that do look and sound genuine so a lot is up to the user and how much they care.
                      As a radiologist, I use a combo of templates and dictation. I read a lot of notes too. There was a particular PA who I can only assume used macros and his notes were basically useless. I could never tell what was actually going on with the patient or why he ordered an MRI.

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                      • #12
                        You can do a whole paragraph with dragon ie HPI or MDM in a few seconds. I use a dragon step by step command to fill out the other fields of my chart activated by a push of the button on the dragon remote, and then specific dot phrases for all the common procedures and billable things we do in the ER. Most charts take around 1-2 minutes. I don't think I could go back to any other way. Dragon allows you to be verbose and actually talk through nuance without getting carpal tunnel or being excessively brief but activating macros via dragon is too difficult to remember (ie should I say "Instert LP Note" or "LP Note" or "Lumbar puncture note" etc). Instead dot dot L brings up all the options for macro for me.

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                        • #13
                          I started using dragon in 2000 and from a voice recognition standpoint it has improved substantially. I can dictate much quicker than I can type and I would like to think my notes made sense to anyone else that would need to read them.
                          Be aware that any non-medical version of dragon will detect that it is being used in an electronic medical record and automatically shut down.
                          If I recall, the standalone version of dragon medical (which is installed locally on the hard drive) is being discontinued and nuance is only going to be offering dragon medical one which is a cloud-based monthly subscription. Fortunately my company still allows me access for when I work once or twice a month.

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                          • #14
                            I switched to using Fluency direct by 3M. I think it is $85 / month. I use smart phrases in the program. I.e. “insert physical exam”. I found that my EMR was very mouse and click intensive. Basically by using the dictate feature I put almost everything in the HPI section of my note. It eliminates having to click through every physical exam that required about 25 clicks to do it properly. Essentially, it doesn’t matter what part of the note contains the information (physical exam, plan, etc). It just has to be there. Plus, if someone picked up my note to read it’s all on the first 2 pages and not buried in the EMR nonsense.

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                            • #15
                              Originally posted by burritos View Post
                              Some of our clinicians use the speak function on their macbooks. Works the same per them. I must say, for the last 2 weeks, I've been using EMR for the first time in 20 years. It's fun. I'm not as fast, but it gamefies documenting.
                              My Mac speech is not nearly as good with medical terminology compared to dragon. I use dragon in the hospital and type in the office. We do not have a practice subscription to dragon.

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