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EMR and Vista speech

Printed From: MSSpeech-Forum
Category: Windows™ Speech Recognition Forums
Forum Name: Medical Professionals
Forum Description: Discussion group for physicians and other medical professionals
URL: https://www.msspeech-forum.com/forum_posts.asp?TID=27
Printed Date: 28/Mar/2024 at 7:40am
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Topic: EMR and Vista speech
Posted By: jgan
Subject: EMR and Vista speech
Date Posted: 27/Sep/2008 at 2:42pm
Hi, I don't know if anyone is doing this as of yet, but I would love to hear about any experiences that include an EMR usage with Vista speech.  Now that Dragon requires medical version for use with an emr  it should open the door to users with Vista.



Replies:
Posted By: cmwilkerson
Date Posted: 06/Oct/2008 at 10:16am
I'm going to look into this. The native Vista Speech appears to work very well. If it had a way to easily import a medical vocabulary, it would reach new limits.

-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: Guests
Date Posted: 06/Oct/2008 at 1:03pm
Originally posted by cmwilkerson cmwilkerson wrote:

I'm going to look into this. The native Vista Speech appears to work very well. If it had a way to easily import a medical vocabulary, it would reach new limits.


Dr. Wilkerson,

Would it be possible to provide your medical vocabulary in the context of other words, that is dictations, letters, procedure notes, etc... rather than just the "raw" speciality words?  If so, the WSRToolkit's "Add From File" feature will do wonders.  Actually, this is Microsoft's preferred way to add large amounts of specialty words as they have also said that more than about 1,000 individual words or phrases in your personal dictionary will cause performance problems.  The Toolkit will also allow you to add words or phrases to your personal dictionary but we deliberatly limited this ability to one word at a time.  We may change this in the next release, however.

Brad


Posted By: Wes7373
Date Posted: 06/Oct/2008 at 6:39pm
We have eClinicalworks, and I have been using Vista speech recognition for a few months.  Works reasonably well, definitely faster than typing for the most part and definitely cheaper than dictating.  I usually dictate the HPI and the treatment plan, type most of the other stuff, put in a physical exam template (I am a subspecialist and tend to use the same general exam frequently).  I am pleased with the setup, training wasn't onerous.  It still occasionally drives me crazy, of course, but it's not bad.

Issues:  You need to be in a quiet space for it to work.  Ambient noise is a significant issue.
There are a few words that I use frequently that it refuses to learn, so I've learned to just type those (posterior = post your ear).  It locks up once in a while, but usually doesn't cause a loss of data.

Overall, a good experience. 

wes


Posted By: cmwilkerson
Date Posted: 07/Oct/2008 at 10:13am
Originally posted by wrote:

Originally posted by cmwilkerson cmwilkerson wrote:

I'm going to look into this. The native Vista Speech appears to work very well. If it had a way to easily import a medical vocabulary, it would reach new limits.


Dr. Wilkerson,

Would it be possible to provide your medical vocabulary in the context of other words, that is dictations, letters, procedure notes, etc... rather than just the "raw" speciality words?  If so, the WSRToolkit's "Add From File" feature will do wonders.  Actually, this is Microsoft's preferred way to add large amounts of specialty words as they have also said that more than about 1,000 individual words or phrases in your personal dictionary will cause performance problems.  The Toolkit will also allow you to add words or phrases to your personal dictionary but we deliberatly limited this ability to one word at a time.  We may change this in the next release, however.

Brad
 
I have used the WSRToolkit to import medical charts and exams in MS Doc formats using, "Add From File." . I also took a medical vocabulary list of thousands of words, converted it to a doc file and imported it, using the toolkits, "Add From File."
 
I also tried to add a list of words, left formatted one word per line, to the Add to Dictionary section of the toolkit. This was not workable for me,  as I pasted hundreds of words, and the program wanted me to deal with and verify each entry, one at a time.
 
I've done the above, at home, on a 2.8 Imac with 2 gigs of ram,  dual booting to Vista. I'm using the iMacs built in mic but will try a better mic.  (I have a 3.2 quad 4 at work with 4 gigs of ram that is better suited for this but I have more time at home to experiment).
 
I have discovered that my EMR at work, ( http://www.writepad.com - www.writepad.com ) does not like Vista Voice in my charting section. Vista Voice will pop up with numbered choices ONLY in my EMR? DNS Medical Pro 9.5 works fine in this same application, and Vista Voice works in other applications. Not sure what that is all about but presently this prohibits my using Vista Voice in my EMR, which is my main goal.
 
 
 


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: mmarkoe
Date Posted: 08/Oct/2008 at 11:47am
Originally posted by Wes7373 Wes7373 wrote:

We have eClinicalworks, and I have been using Vista speech recognition for a few months.  Works reasonably well, definitely faster than typing for the most part and definitely cheaper than dictating.  I usually dictate the HPI and the treatment plan, type most of the other stuff, put in a physical exam template (I am a subspecialist and tend to use the same general exam frequently).  I am pleased with the setup, training wasn't onerous.  It still occasionally drives me crazy, of course, but it's not bad.
Great to hear you are using WSR productively.

Quote Issues:  You need to be in a quiet space for it to work.  Ambient noise is a significant issue.
I cannot over emphasize the importance of having a good microphone. A good microphone with excellent noise canceling ability will outperform almost any other microphone even in a quiet environment. However, in a noisy environment it is invaluable. We have six microphones (two wired, two wireless, and two handheld/desktop mounted) which will give you top-notch accuracy and noise canceling. These range in price from $90 (Samson Q7) to well over $400 (Sennheiser MD431II) depending on the model and style.

Quote There are a few words that I use frequently that it refuses to learn, so I've learned to just type those (posterior = post your ear). 
 
Have you used the, "Add new word" feature?
1. If you have the http://www.mymsspeech.com/microphones/prod_details.asp?prodID=228 - WSRToolkit just click on or say, "Add to Dictionary."
2. If you do not have the WSRToolkit, just say, "Open the speech dictionary" and then, "Add a new word."
 
For example, no matter how many times a I said and or corrected "a bad" as in a bad soundcard, it would interpret it as, "a bed." Adding, "a bad" to the Speech Dictionary allows that phrase to be recognized correctly every time now.
 
 
Quote It locks up once in a while, but usually doesn't cause a loss of data.
Overall, a good experience. 
 
Locking up is not an experience we have had or heard of in our over two years of using Windows Speech Recognition in Vista. What exactly happens? You have to reboot the computer? Do you have a reasonably fast computer, a dual core with 3 GB of RAM minimum?


-------------
Marty Markoe, MVP
Microsoft Valued Partner
See us at: http://www.mymsspeech.com


Posted By: mmarkoe
Date Posted: 08/Oct/2008 at 12:28pm
Originally posted by cmwilkerson cmwilkerson wrote:

I have used the WSRToolkit to import medical charts and exams in MS Doc formats using, "Add From File." . I also took a medical vocabulary list of thousands of words, converted it to a doc file and imported it, using the toolkits, "Add From File."
The Add From File description (right on the page) specifically says it is not meant for adding lists of words. Its purpose is to recognize a specific style of speaking based on the context of how you use words. It will update your speech model to reflect your style and usage and not add specific words.
 
Quote I also tried to add a list of words, left formatted one word per line, to the Add to Dictionary section of the toolkit. This was not workable for me,  as I pasted hundreds of words, and the program wanted me to deal with and verify each entry, one at a time.
I could not get Windows Speech Recognition to recognize, "a bad" as in a bad microphone and sound card. It constantly came up with, "a bed." Just adding it to the dictionary one time along with its pronunciation solved the problem.
 
The description for the Add to Dictionary feature describes its purpose for improving the recognition of difficult to understand words. It does this by not only adding the word (it helps if you use the word within a short phrase) but also record a pronunciation associated with it.
 
You can add hundreds of words, but as you found out, this will work best if you add a pronunciation for each one.  Most words, even medical words are already in the speech dictionary. Usually, correcting a word one or two times in context will mean it will be recognized from then on.
 
Quote I've done the above, at home, on a 2.8 Imac with 2 gigs of ram,  dual booting to Vista. I'm using the iMacs built in mic but will try a better mic.  (I have a 3.2 quad 4 at work with 4 gigs of ram that is better suited for this but I have more time at home to experiment).
There is certainly nothing shabby about your system specifications. However, and accurate/noise canceling microphone will mean that the software will understand your words and commands with much higher frequency than a built-in microphone or commodity microphone purchased in a retail store.
 
[/quote]I have discovered that my EMR at work, ( http://www.writepad.com - www.writepad.com ) does not like Vista Voice in my charting section. Vista Voice will pop up with numbered choices ONLY in my EMR? DNS Medical Pro 9.5 works fine in this same application, and Vista Voice works in other applications. Not sure what that is all about but presently this prohibits my using Vista Voice in my EMR, which is my main goal.[/quote]
Right-click on the microphone icon on the Windows Speech Recognition Speech Bar. Choose Options, and make sure there is a checkmark next to, "Enable dictation everywhere."


-------------
Marty Markoe, MVP
Microsoft Valued Partner
See us at: http://www.mymsspeech.com


Posted By: cmwilkerson
Date Posted: 08/Oct/2008 at 12:44pm
Originally posted by mmarkoe mmarkoe wrote:

Originally posted by cmwilkerson cmwilkerson wrote:

I have used the WSRToolkit to import medical charts and exams in MS Doc formats using, "Add From File." . I also took a medical vocabulary list of thousands of words, converted it to a doc file and imported it, using the toolkits, "Add From File."
The Add From File description (right on the page) specifically says it is not meant for adding lists of words. Its purpose is to recognize a specific style of speaking based on the context of how you use words. It will update your speech model to reflect your style and usage and not add specific words.
 
Quote I also tried to add a list of words, left formatted one word per line, to the Add to Dictionary section of the toolkit. This was not workable for me,  as I pasted hundreds of words, and the program wanted me to deal with and verify each entry, one at a time.
I could not get Windows Speech Recognition to recognize, "a bad" as in a bad microphone and sound card. It constantly came up with, "a bed." Just adding it to the dictionary one time along with its pronunciation solved the problem.
 
The description for the Add to Dictionary feature describes its purpose for improving the recognition of difficult to understand words. It does this by not only adding the word (it helps if you use the word within a short phrase) but also record a pronunciation associated with it.
 
You can add hundreds of words, but as you found out, this will work best if you add a pronunciation for each one.  Most words, even medical words are already in the speech dictionary. Usually, correcting a word one or two times in context will mean it will be recognized from then on.
 
Quote I've done the above, at home, on a 2.8 Imac with 2 gigs of ram,  dual booting to Vista. I'm using the iMacs built in mic but will try a better mic.  (I have a 3.2 quad 4 at work with 4 gigs of ram that is better suited for this but I have more time at home to experiment).
There is certainly nothing shabby about your system specifications. However, and accurate/noise canceling microphone will mean that the software will understand your words and commands with much higher frequency than a built-in microphone or commodity microphone purchased in a retail store.
 
I have discovered that my EMR at work, ( http://www.writepad.com - www.writepad.com ) does not like Vista Voice in my charting section. Vista Voice will pop up with numbered choices ONLY in my EMR? DNS Medical Pro 9.5 works fine in this same application, and Vista Voice works in other applications. Not sure what that is all about but presently this prohibits my using Vista Voice in my EMR, which is my main goal.[/quote]
Right-click on the microphone icon on the Windows Speech Recognition Speech Bar. Choose Options, and make sure there is a checkmark next to, "Enable dictation everywhere."
[/QUOTE]
 
Thanks for the answers.  I hope I did not make things worse with my making a document out of thousands of individual medical words and then adding them as a file! I don't believe Vista Voice allows one to restart a profile like DNS does.
 
With respect to "Enable dictation everywhere," I do in fact have this enabled at all times but I still get the, "Altnerates Panel," virtually everytime I dictate in my chart note which is an .rtf format. Because of this, I cannot dictate into my EMR with Vista Voice.


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: cmwilkerson
Date Posted: 09/Oct/2008 at 1:06pm
I'm sitting here with DNS 9.5 enabled and dictating supplemental text into my EMR chart.
When I turn off DNS and switch to Vista Voice, dictating the exact same words (or any words) results in the Alternates Panel showing up and giving me a choice of numbered answers. This does not occur in Notepad or Word, with Vista VR. Both of these applications work just fine and the dicataion below is perfect. I'm at a loss. I assume this Alternates Panel ONLY appears when recognition is failing?
 
Here is the exact text I am dictating: "The patient presents today with a follow up examination, with respect to a diagnosis of Cervical radiculitis."
The Alternates Panel pops up even with dicating only, "The patient presents."


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 09/Oct/2008 at 2:04pm
Originally posted by cmwilkerson cmwilkerson wrote:

I'm sitting here with DNS 9.5 enabled and dictating supplemental text into my EMR chart.
When I turn off DNS and switch to Vista Voice, dictating the exact same words (or any words) results in the Alternates Panel showing up and giving me a choice of numbered answers. This does not occur in Notepad or Word, with Vista VR. Both of these applications work just fine and the dicataion below is perfect. I'm at a loss. I assume this Alternates Panel ONLY appears when recognition is failing?
 
Here is the exact text I am dictating: "The patient presents today with a follow up examination, with respect to a diagnosis of Cervical radiculitis."
The Alternates Panel pops up even with dicating only, "The patient presents."


I may have an idea about bypassing the Alternates Panel while you're dictating into your EMR chart.  The concept is for a speech macro to determine when the EMR chart application is active then do a little fancy footwork (via <sendKeys>) to bypass the Alternates Panel.

First we'll need to determine what is the exact name of your EMR chart application.  If you're not sure, with it loaded, go to Windows Task Manager (CTRL-SHIFT-ESC).  On the 'Processes' tab you should find the exact .EXE name of your app.  Let me know this and I'll craft a simple macro for you to try.

Brad


Posted By: cmwilkerson
Date Posted: 09/Oct/2008 at 2:10pm
Hi BRad,
 
I'm open for any ideas. Smile
 
My EMR executable is writepad.exe.


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 09/Oct/2008 at 6:28pm
Originally posted by cmwilkerson cmwilkerson wrote:

Hi BRad,
 
I'm open for any ideas. Smile
 
My EMR executable is writepad.exe.


Well darn.  After having played around with what I thought would work, it's turning out to be quite a kludgy workaround (You have to preface every group of words with the phrase "EMR dictate".  Confused  Guess it's time for Plan B.  But anyway, here's the macro... 

You'll first need to make sure you have WSRMacros loaded and running ( http://www.msspeech-forum.com/forum_posts.asp?TID=29&PID=110#110 - see other post ) then copy/paste this macro into notepad then save it in your Speech Macros directory.

<speechMacros>
<command>
<appIsInForeground processName="writepad.exe"/>
<listenFor>E M R dictate [...]</listenFor>
<sendKeys>{[...]}{250 WAIT}{u+0020}</sendKeys>
</command>
</speechMacros>

Brad


Posted By: cmwilkerson
Date Posted: 09/Oct/2008 at 10:17pm
Originally posted by BradT BradT wrote:

Originally posted by cmwilkerson cmwilkerson wrote:

Hi BRad,
 
I'm open for any ideas. Smile
 
My EMR executable is writepad.exe.


Well darn.  After having played around with what I thought would work, it's turning out to be quite a kludgy workaround (You have to preface every group of words with the phrase "EMR dictate".  Confused  Guess it's time for Plan B.  But anyway, here's the macro... 

You'll first need to make sure you have WSRMacros loaded and running ( http://www.msspeech-forum.com/forum_posts.asp?TID=29&PID=110#110 - see other post ) then copy/paste this macro into notepad then save it in your Speech Macros directory.

<speechMacros>
<command>
<appIsInForeground processName="writepad.exe"/>
<listenFor>E M R dictate [...]</listenFor>
<sendKeys>{[...]}{250 WAIT}{u+0020}</sendKeys>
</command>
</speechMacros>

Brad
 
Notepad? Don't you mean the Macro Editor of the Toolkit, which autosaves in appropriate directory, and proper extension .wsrmac), which in my case appears to be C:\Users\Chris\Documents\MacroBuilder
 
I assume I can call it whatever I want. What is this macro going to do? Delay the Alternative Choices in hopes of dictating into the note? Remember, my EMR is already open and running. I just want to add supplemental text to the existing note.
 
Thanks for your help Brad!


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: mmarkoe
Date Posted: 10/Oct/2008 at 11:06am
Originally posted by cmwilkerson cmwilkerson wrote:

Notepad? Don't you mean the Macro Editor of the Toolkit, which autosaves in appropriate directory, and proper extension .wsrmac), which in my case appears to be C:\Users\Chris\Documents\MacroBuilder
I agree, using the Macro Editor of the http://www.emicrophones.com/microphones/prod_details.asp?prodID=228 - WSRToolkit is easier for you or I. Brad as a skilled programmer uses Notepad for creation/editing.
 
 

Quote I assume I can call it whatever I want. What is this macro going to do? Delay the Alternative Choices in hopes of dictating into the note? Remember, my EMR is already open and running. I just want to add supplemental text to the existing note.
The line with listenFor as in:
<listenFor>E M R dictate [...]</listenFor>
is called the trigger word(s) command. You can change E M R dictate to whatever you feel comfortable calling macro.

Marty


-------------
Marty Markoe, MVP
Microsoft Valued Partner
See us at: http://www.mymsspeech.com


Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 11:42am
Brad,
 
How do I know my macros are working?
 
Verbalizing, "EMR dictate," does nothing but open the Alternatives panel.
 
As you probably remember, there is a question whether my macros are working at all given the error in opening the WSRTookit and my installed path of C:\Users\Chris\Documents\MacroBuilder
 


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 10/Oct/2008 at 3:41pm
Originally posted by cmwilkerson cmwilkerson wrote:

Brad,
 
How do I know my macros are working?
 
Verbalizing, "EMR dictate," does nothing but open the Alternatives panel.
 
As you probably remember, there is a question whether my macros are working at all given the error in opening the WSRTookit and my installed path of C:\Users\Chris\Documents\MacroBuilder
 


At this point I don't believe macros are working for you... and it sounds like WSRMacros hasn't actually installed.  Here are some things to check:

Is there a WSRMacros.exe file on your HD?  Assuming you have 32-bit Vista (not 64-bit) it should be in this folder: "C:\Program Files\WSRMacros".

If you do have that folder and .exe file, does it put the WSRMacros icon in the system tray when you run it?  The WSRMacros icon looks like this:

file:///C:%5CUsers%5CBrad%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_filelist.xml - file:///C:%5CUsers%5CBrad%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_preview.wmf - file:///C:%5CUsers%5CBrad%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_editdata.mso - file:///C:%5CUsers%5CBrad%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_themedata.thmx - file:///C:%5CUsers%5CBrad%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_colorschememapping.xml">


If not, we need to figure out when and where the WSRMacros.msi install program is failing...

Try downloading a fresh copy of WSRMacros.msi from http://download.speechmacros.com/ then run that file.  Post what types of messages and screens you see during the install...

Brad

# -




Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 4:00pm
Brad,
 
I found the problem and it is with me. I assumed, erroneously that when I started your WSRToolkit that the macros would be loaded. Not the case. So now I start the Windows macros program separately from the run command.
 
Having said that, I am still at a loss for how to start your EMR dictate macro which I made in the Toolkit??


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 10/Oct/2008 at 4:42pm
Originally posted by cmwilkerson cmwilkerson wrote:

Brad,
 
I found the problem and it is with me. I assumed, erroneously that when I started your WSRToolkit that the macros would be loaded. Not the case. So now I start the Windows macros program separately from the run command.
 
Having said that, I am still at a loss for how to start your EMR dictate macro which I made in the Toolkit??


The WSRToolkit will automatically run WSRMacros.exe if it's in the C:\Program Files\WSRMacros directory.  I'm still not convinced that WSRMacros is running on your PC.  There are two folders involved in a successful install of WSRMacros.  The executable file will reside in C:\Programs Files\WSRMacros and all macros must reside in C:\Users\Chris\Documents\Speech Macros.  Without the Speech Macros directory, WSRMacros won't function properly. 

When it runs, WSRToolkit looks for  this Speech Macros directory.  If it doesn't exist, WSRToolkit creates a "safe" directory C:\Users\Chris\Documents\MacroBuilder to hold macros created before WSRMacros is installed.  Once WSRMacros is installed, you have to manually copy the macros in the MacroBuilder folder  to the Speech Macros directory. 

The mystery is, where is the Speech Macros directory on your PC? 

If you're certain WSRMacros is running, create the folder C:\Users\Documents\Speech Macros and copy the EMR Dictate macro to that folder.  Then try opening your EMR app (writepad) and say "E M R dictate this is a test".

Brad



Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 5:10pm
Originally posted by BradT BradT wrote:

Originally posted by cmwilkerson cmwilkerson wrote:

Brad,
 
I found the problem and it is with me. I assumed, erroneously that when I started your WSRToolkit that the macros would be loaded. Not the case. So now I start the Windows macros program separately from the run command.
 
Having said that, I am still at a loss for how to start your EMR dictate macro which I made in the Toolkit??


The WSRToolkit will automatically run WSRMacros.exe if it's in the C:\Program Files\WSRMacros directory.  I'm still not convinced that WSRMacros is running on your PC.  There are two folders involved in a successful install of WSRMacros.  The executable file will reside in C:\Programs Files\WSRMacros and all macros must reside in C:\Users\Chris\Documents\Speech Macros.  Without the Speech Macros directory, WSRMacros won't function properly. 

When it runs, WSRToolkit looks for  this Speech Macros directory.  If it doesn't exist, WSRToolkit creates a "safe" directory C:\Users\Chris\Documents\MacroBuilder to hold macros created before WSRMacros is installed.  Once WSRMacros is installed, you have to manually copy the macros in the MacroBuilder folder  to the Speech Macros directory. 

The mystery is, where is the Speech Macros directory on your PC? 

If you're certain WSRMacros is running, create the folder C:\Users\Documents\Speech Macros and copy the EMR Dictate macro to that folder.  Then try opening your EMR app (writepad) and say "E M R dictate this is a test".

Brad

 
I know have all three below and the macros are in the last folder.
C:\Program Files\WSRMacros
C:\Users\Chris\Documents\MacroBuilder
C:\Users\Documents\Speech Macros
 
I have the toolkit open, my emr open and the windows macros program open.
When I dictate "E M R dictate this is a test" the Alternates Panel pops up.
The emr.WSRMac that I made in the toolkit sits in C:\Users\Documents\Speech Macros
 
Here is a jpg of my desktop with pertinent folders open and programs running.
 
http://www.digital-doc.com/speech.jpg - http://www.digital-doc.com/speech.jpg


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 10/Oct/2008 at 5:48pm
Quote
Here is a jpg of my desktop that will appropriate folders open and running.
 
http://www.digital-doc.com/speech.jpg - http://www.digital-doc.com/speech.jpg


Good idea on the screen shot.  It looks like the WSRMacros program is showing as a window but not loading in the system tray.  Here's a snapshot of yours:



I'm certain there's something amiss with WSRMacros... but the question is 'what'.

One thing that comes to mind, the folders you described:

C:\Program Files\WSRMacros
C:\Users\Chris\Documents\MacroBuilder
C:\Users\Documents\Speech Macros

If you're signed on as 'Chris', WSRMacros might not be looking in C:\Users\Documents\Speech Macros.


Brad


Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 6:05pm
Brad, its open look at the blue window, which is the windows macros.
 
Let me know if you want to do a logmein session sometime, VPN, Hamachi etc.
I can call you or we can Skype. etc.
 
I'd like to get Vista Speech working with my EMR at work,  because that is where I would have an excuse to use it in a medical environment.
 


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 10/Oct/2008 at 6:12pm
Originally posted by cmwilkerson cmwilkerson wrote:

Hi BRad,
 
I'm open for any ideas. Smile
 
My EMR executable is writepad.exe.


Another thing to try:

How about having notepad open along side of writepad, dictate into notepad.  We can craft a simple macro that will allow you to say "copy to EMR" (or whatever you'd like to say) and it will automatically copy everything in notepad, make writepad the active application and paste it at the current cursor location. 

Brad


Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 6:17pm
Let's just make a macro that works.
 
Now I am getting another error when I open the windows macros: "no signature was present in the subject."
 
This error appears to be related to the macro you made for me as when I remove the macro, no error. When I place it back, the error occurs.
 
Write now, in my EMR I can use DNS 9.5 Medical Pro with no problems and 98% accuracy.
I can say the same for Vista, using Word or Notepad but NOT my EMR where I need to use it. Dead


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 10/Oct/2008 at 6:31pm
Originally posted by cmwilkerson cmwilkerson wrote:

Let's just make a macro that works. 


Aw, come on, where's your sense of adventure!  Smile

Originally posted by cmwilkerson cmwilkerson wrote:


Now I am getting another error when I open the windows macros: "no signature was present in the subject."
 
This error appears to be related to the macro you made for me as when I remove the macro, no error. When I place it back, the error occurs.


Now we're getting somewhere!  While experimenting (and tweaking) your macros, it's recommended to set macro security to 'Low'.  Right-click the WSRMacros icon in the system tray and choose 'Security -> Set Security Level -> Low'.  That will get rid of the error messages for now.  Once things settle down a bit, you can always go back and resign your macros if worried about malicious programs.

Brad


Posted By: cmwilkerson
Date Posted: 10/Oct/2008 at 7:13pm
>>Now we're getting somewhere!  While experimenting (and tweaking) your macros, it's recommended to set macro security to 'Low'.  Right-click the WSRMacros icon in the system tray and choose 'Security -> Set Security Level -> Low'.  That will get rid of the error messages for now.  Once things settle down a bit, you can always go back and resign your macros if worried about malicious programs.<<
 
Macros work in EMR now.  However text still a no go, unless I want to use the Alternate Panel in my EMR.


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 11/Oct/2008 at 10:25am
Originally posted by cmwilkerson cmwilkerson wrote:

 
Still all I get is the  Alternate Panel in my EMR.


I think we're wrestling with two issues:

1. Dictation doesn't work (without the Alternate Panel) with WSR in your EMR software
2. WSRMacros isn't functioning properly.

#1 is the result of some software not adhering to "standards" (apparently set by Microsoft) and therefore pops up the Alternate Panel for you to verify what you said before inserting.

Focusing on #2 may provide the most benefit, if we can get this going you might be able to come up with a workable macro that will ease the problem of #1.

Since the WSRToolkit may be pointing to the wrong directory, copy/paste this macro into your Speech Macros directory (using notepad), saving it with the .WSRMac extension.  It's very simple, but will allow verification of properly functioning Speech Macros.

<speechMacros>
<command>
<listenFor>hello</listenFor>
<setTextFeedback>Hello, it's working</setTextFeedback>
<speak>Hello, it's working</speak>
<insertText>Hello, it's working</insertText>
</command>
</speechMacros>

You shouldn't get any error messages after the copy/paste/save.  Open notepad and say "hello".  You should hear a voice, the Speech Recognition Bar should display a message and words will appear in notepad as well.  Let me know and we can go from here...

Brad


Posted By: cmwilkerson
Date Posted: 11/Oct/2008 at 10:32am

Did exactly as instructed and macro is present under Speech Macros folder but the macro text is not being inserted in Notepad, only the word hello.

It appears my macros are still not working!


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: cmwilkerson
Date Posted: 11/Oct/2008 at 10:37am
 
Wait a minute!
 
I just navigated to my C:\Program Files\WSRMacros\wsmacros.exe and changed the properties to open as adminstrator and your macro worked!!!!!!!!!!!!!!!!!!!!
 
My Macro issue is solved!
 
FYI: I use Vista Ultimate on all 3 computers that had the same problem. Maybe others without this problem are not on ultimate?
 
Darn, now I am at home and my EMR is at work so I will have to wait till Monday to fix and try,  unless WVR works over a VPN.


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 11/Oct/2008 at 11:05am
Originally posted by cmwilkerson cmwilkerson wrote:

 
Wait a minute!
 
I just navigated to my C:\Program Files\WSRMacros\wsmacros.exe and changed the properties to open as adminstrator and your macro worked!!!!!!!!!!!!!!!!!!!!
 
My Macro issue is solved!
 
FYI: I use Vista Ultimate on all 3 computers that had the same problem. Maybe others without this problem are not on ultimate?
 
Darn, now I am at home and my EMR is at work so I will have to wait till Monday to fix and try,  unless WVR works over a VPN.


Woo-hooo!  Thanks for posting that.  I had no idea...

Brad


Posted By: BradT
Date Posted: 14/Oct/2008 at 11:38am
Originally posted by BradT BradT wrote:

[QUOTE=cmwilkerson] 
Still all I get is the  Alternate Panel in my EMR.


Here's a macro that will allow you to dictate (indirectly) into applications that pop-up the Alternates Panel.  This macro will open Notepad when you say "begin emr dictation", you then proceed to dictate as normal.  When complete just say "post emr dictation" and it will automatically select/copy all text within Notepad, switch to your EMR application (writepad.exe) and paste the text at the current cursor location.  I believe this is similar to the way Dragon NaturallySpeaking works with the "show dictation box" command.

<speechMacros>

<!-- begin emr dictation -->
<command>

<listenFor>begin e m r dictation</listenFor>
<run command="notepad.exe" params=""/>

</command>
 
<!-- post emr dictation -->
<command>

<listenFor>post e m r dictation</listenFor>

<sendKeys>{{CTRL}}a</sendKeys>
<waitFor seconds=".25"/>
<sendKeys>{{CTRL}}c</sendKeys>
<waitFor seconds=".25"/>
<switchToApp windowTitleContains="WritePad"/>
<waitFor seconds=".5"/>
<sendKeys>{{CTRL}}v</sendKeys>

</command>

</speechMacros>


Posted By: BradT
Date Posted: 20/Oct/2008 at 11:03am
I've been thinking about this macro a little more and have made some refinements.  It will now automatically switch back to notepad and delete the previous dictated text after posting it into the EMR application.  Pretty cool! Cool

(one prerequisite: create a text file named 'ShowDictationWindow.txt' and change the path within the <run> tag to point to this file.  As you can see, this is required so the <switchToApp> tag can have a specific windowTitleContains name to switch back to. )

<speechMacros>

<!-- begin dictation -->
<command>

<listenFor>begin e m r dictation</listenFor>
<run command="notepad.exe" params="C:\Users\Brad\Documents\ShowDictationWindow.txt"/>

</command>
 
<!-- post dictation -->
<command>

<listenFor>post e m r dictation</listenFor>

<sendKeys>{{CTRL}}a</sendKeys>
<waitFor seconds=".25"/>
<sendKeys>{{CTRL}}c</sendKeys>
<waitFor seconds=".25"/>
<switchToApp windowTitleContains="WritePad.exe"/>
<waitFor seconds=".5"/>
<sendKeys>{{CTRL}}v</sendKeys>
<waitFor seconds=".25"/>
<!-- switch back and clear -->
<switchToApp windowTitleContains="ShowDictationWindow.txt"/>
<waitFor seconds=".5"/>
<sendKeys>{{CTRL}}a{250 WAIT}{DELETE}</sendKeys>


</command>

</speechMacros>


Posted By: cmwilkerson
Date Posted: 16/Nov/2008 at 4:03pm

Can anyone confirm that:

WSR uses the Vocabulary of the Tablet Input Panel? (TIP)

If this is true, then with a powertoy from MS (dictionarytool.exe), I can import a medical vocabulary into TIP that will be utilized by WSR.



-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 17/Nov/2008 at 12:34pm
Originally posted by cmwilkerson cmwilkerson wrote:

Can anyone confirm that:

WSR uses the Vocabulary of the Tablet Input Panel? (TIP)

If this is true, then with a powertoy from MS (dictionarytool.exe), I can import a medical vocabulary into TIP that will be utilized by WSR.


According to a reliable source at Microsoft:

"No, WSR and the handwriting recognizer use different vocabularies.  They're not compatible at all."

Unhappy



Posted By: robch_ms
Date Posted: 18/Nov/2008 at 9:49am
Sorry... Sometimes the wrong information gets out of MS... Actually, the two systems are very very linked.
 
I can confirm that the two sub-systems (both Handwriting and Windows Speech Recognition) do indeed use the same underlying store for supplemental vocabularies.

It's kind of funny, in fact... After finishing up the re-write of the Speech platform back in the late 90s in the speech team, I left that team, and landed in the Tablet PC team, where I led about half the platform development team for handwriting platform features (in addition to the very early implementations of Speech Recognition on Tablet PC).

The Handwriting team needed a system to enable the same types of features for a dictionary that we had developed for the Speech Recognizer but instead for the Handwriting Recognizer. So ... Instead of duplicating the speech dictionary code, or building something new, we just use the exact same store (for lexical entries). Not only was it easier to develop (because it was already done), it's a great end user sharing feature as well.

In addition, both correction experiences are tied together. For example, if you were to dictate something to the speech recognizer, and then select it for correction with the handwriting recognizer, you'll see the speech alternatives in the handwriting UI. Same is true in reverse. If you handwrite something and insert it into the document, you can select it with the pen and say "Correct that", and you'll see the handwriting alternatives in the speech correction UI.



Posted By: mmarkoe
Date Posted: 18/Nov/2008 at 10:11am
Originally posted by robch_ms robch_ms wrote:

Sorry... Sometimes the wrong information gets out of MS... Actually, the two systems are very very linked.
Thank you for letting us know of your new take on the initial question.
 
I would like some further clarification. It seems that Dr. Wilkerson is calling this a vocabulary. It seems to me that this is just a matter of adding words? This is not a true language model which includes the context associations as well as the pronunciations?
 
Marty


-------------
Marty Markoe, MVP
Microsoft Valued Partner
See us at: http://www.mymsspeech.com


Posted By: robch_ms
Date Posted: 18/Nov/2008 at 10:47am
Sorry, Marty. I tried to make that clear in my previous post.
 
For Speech, there are 2 things:
1.) Lexicon - This the list of words that can be used. Each word has an optional pronuncation. If a pronuncation isn't specified we'll use LTS (letter to sound) rules to "guess" a pronuncation.
2.) Language Model - This is the relative frequency of occurrence of words in the context of other words.
 
The DictionaryTool that Dr. Wilkerson mentioned is simply adding items to the lexicon (without specified pronuncations). He's calling that a vocabulary. That's a reasonable thing to call it, although, it's not what we call it in Vista for speech. We call it a dictionary, sort of like a dictionary that you'd pick up at a local bookstore. It has words, their spellings, and their pronuncations in it.
 
--rob


Posted By: cmwilkerson
Date Posted: 20/Nov/2008 at 8:56am
Thanks for the explanation Rob!
 
So the trick to optimizing WSR with Medical is:
1. Import a pertinent dictionary-Lexicon
2. Scan prior medical documents into WSR so the words can be seen in their overall frequency of occurrence within the context of other words. (words often related to other words).


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: BradT
Date Posted: 20/Nov/2008 at 9:10am
Originally posted by cmwilkerson cmwilkerson wrote:

Thanks for the explanation Rob!
 
So the trick to optimizing WSR with Medical is:
1. Import a pertinent dictionary-Lexicon
2. Scan prior medical documents into WSR so the words can be seen in their overall frequency of occurrence within the context of other words. (words often related to other words).


Maybe Rob will validate this, but I believe the best way with WSR is to:

1. Scan prior medical documents into WSR so the words can be seen in their overall frequency of occurrence within the context of other words. (words often related to other words).

Then, after certain words/phrases fail repeatedly, add them to the lexicon.

I have been told that performance will begin to suffer around about 1,000 words in the lexicon but the addition of words to the language model (context) is unlimited.




Posted By: cmwilkerson
Date Posted: 20/Nov/2008 at 9:19am

"I have been told that performance will begin to suffer around about 1,000 words in the lexicon but the addition of words to the language model (context) is unlimited."
 
In my experience, there can be an inverse recognition to medical and lay recognition. In other words, if you fill your dictionary with medical words, the lay output can suffer. Perhaps this subjective experience is because of, "Overload." Or it may be brain fatigue on my part?
 
Is there any way to delete an entire profile or dictionary?
 
Knowing what I know now, I would be much more discretionary about what I import and scan.


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: robch_ms
Date Posted: 20/Nov/2008 at 9:26am
You can delete your profile (and/or create a new one) in the Advanced Speech Control Panel. Say, "Show Speech Options", "Configuration", "Open Speech Control Panel", "Advanced Speech Options". Then, you can use "New" to create a new profile, or "Delete" to delete the selected profile.
 
If you want to remove words from you user lexicon, you can export the speech dictionary with the "Speech Dictionary.wsrMac" macro on http://code.msdn.microsoft.com/wsrmacros - http://code.msdn.microsoft.com/wsrmacros .
 
--rob


Posted By: cmwilkerson
Date Posted: 20/Nov/2008 at 9:33am
Originally posted by robch_ms robch_ms wrote:

You can delete your profile (and/or create a new one) in the Advanced Speech Control Panel. Say, "Show Speech Options", "Configuration", "Open Speech Control Panel", "Advanced Speech Options". Then, you can use "New" to create a new profile, or "Delete" to delete the selected profile.
 
If you want to remove words from you user lexicon, you can export the speech dictionary with the "Speech Dictionary.wsrMac" macro on http://code.msdn.microsoft.com/wsrmacros - http://code.msdn.microsoft.com/wsrmacros .
 
--rob
 
0utstanding! Thanks so much! Guess I lost sight of the forest through the trees. Smile


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: cmwilkerson
Date Posted: 09/May/2009 at 11:33am

I'm using WSR on Windows 7 with a Lenovo Tabletpc with internal array mic and 4 gigs of RAM. It works great but needs a medical lexicon. For example, the word, "radiculitis," is seen as "ridiculous." Using the TabletDictionary's import tool, I imported a 1000 medical words.

After the import, radiculitis is found, as are every medical word present in my import!!!
You can read about it here: http://www.medicaltabletpc.com/ - http://www.medicaltabletpc.com/


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com



Posted By: cmwilkerson
Date Posted: 10/May/2009 at 1:40pm
>>However text still a no go, unless I want to use the Alternate Panel in my EMR.<<
 
No longer an issue with Windows 7 WSR. Thumbs Up


-------------
Dr. Chris Wilkerson
Carson Doctors Group
MVP TabletPC
www.MedicalTabletPC.com
www.Digital-Doc.com




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