Important information

Handling of Speech recognition and UI language

Starting with Dragon Medical One 3.4 the Dragon Medical One UI language will be selected based on the speech recognition language; it is no longer possible to specify the UI language separately. As a consequence, the following changes were applied

The UserInterfaceLanguage configuration setting is no longer evaluated and Dragon Medical One will always use the selected speech recognition language as its UI language
The UILANGUAGE MSI parameter is no longer evaluated or supported

Internet Explorer

Dragon Medical One requires Microsoft Internet Explorer 11 to render functionality presented in the personalization and help window - organizations deploying earlier versions of Internet Explorer will not be able to access all personalization and help window functionality.

Intel USB driver incompatibilities

When utilizing the Intel(R) USB 3.0 eXtensible Host Controller and using Nuance PowerMic as the audio input device, Dragon Medical One or the virtual server session might become unresponsive during recording or when starting Dragon Medical One. To solve the issue, update your host controller drivers to version 4.0.6.60 or higher.

Citrix virtual audio extension

Starting with Dragon Medical One 3.3, Dragon Medical One provides built-in functionality to replace the Nuance Citrix virtual audio extension on the Citrix server; from this version, administrators are no longer required to install the Nuance Citrix virtual audio extensions on the Citrix server. To get the latest version of the custom audio channel deployed to the Citrix server, update the Dragon Medical One application on the Citrix server. Note that the Nuance Citrix virtual audio extension on the end-point is still required and needs to be deployed to end-points and virtual extensions providing support for microphone device buttons still require deploying the virtual extension on the Citrix server and end-points.

Improvements

Support for TX text control version TX for .NET X14

Starting with Dragon Medical One 3.5, dictation into applications integrating TX text controls in version TX for .NET X14 is now supported.

Copying auto-texts and step-by-step commands

Starting with Dragon Medical One 3.5, end users can copy auto-texts and step-by-step commands in Dragon Medical One via the Manage Auto-texts/Manage Step-by-step Commands dialog boxes:

Right-click and select Copy.
Click the Copy button on the user interface.

Configuring default options

Starting with Dragon Medical One 3.5, administrators can define default options for users in the configuration file: Administrators can restrict end users from changing specific settings or allowing them to override the defaults in the Dragon Medical One Options dialog box. See below for the full list of supported default options and their values.

Documentation of default option configuration

Specifying a default option

In the configuration file, for each option to define add a child element to the SoD.DefaultOptions element in the configuration file. For example, for the microphone device record button behavior and default hotkeys to navigate to the next and previous embedded auto-text field, in the SoD.DefaultOptions element, add the following child elements to the configuration file.

		
...
<SoD.DefaultOptions>
  <setting name="Microphone.Record" serializeAs="String">
    <value>PressAndHold</value>
  </setting>
  <setting name="Hotkeys.NextField" serializeAs="String">
    <value>CtrlAltW</value>
  </setting>
  <setting name="Hotkeys.PreviousField" serializeAs="String">
    <value>CtrlAltQ</value>
  </setting>
</SoD.DefaultOptions>
...

Preventing end users from changing a specific default in the Options dialog box

To prevent end users from changing a specific default option, add the isLocked attribute to the setting element for the default option you defined in the configuration file and set its value to True. For example, to prevent the end user from changing the default option defined for the microphone device record button, specify the default as follows

...  
  <setting name="Microphone.Record" serializeAs="String" isLocked="True">
    <value>PressAndHold</value>
  </setting>
...

Full list of default options and values

Available default option identifiers and values

Solved Issues

General

SOD-10291 [Reproduction]
Fixed an issue that could lead to incorrect insertion positions for utterances in the Dictation Box when multiple utterances are dictated in quick succession and utterances are processed and queued for insertion before the first utterance has been inserted into the Dictation Box. This issue was introduced in Dragon Medical One 3.5.100.2622 and was resolved in Dragon Medical One 3.5.101.2632.
1. Have an application or text control that is not supported by Dragon Medical Direct and put the focus into the text control, making sure that the Dictation Box is closed.
2. Speak a sentence and ensure that you pause long enough to generate a second utterance.
3. Without waiting for the first sentence to be inserted into the Dictation Box, speak another sentence.
SOD-10290 [Reproduction]
Dragon Medical One no longer requires end users to use modifier keys (Ctrl, Alt or Shift) for key presses in the step-by-step command step type "Press Hotkey." This issue was introduced in Dragon Medical One 3.5.100.2622 and was resolved in Dragon Medical One 3.5.101.2632.
1. Create a new step-by-step command and enter a valid name for the new command.
2. Create a new step of type "Press Hotkey".
3. Focus the content text field and press a key, for example "Enter", without pressing any modifier keys.
4. Save the step-by-step command.
SOD-9846 [Reproduction]
Addressed an issue that resulted in increased memory consumption in applications hosted in Internet Explorer when using speech recognition to document and opening and closing reports. The issue will only affect applications that run in docmode 10 or higher.
1. Have an application hosted in Internet Explorer and run in docmode 10 or higher
2. Open a new report in your application and focus a text editor
3. Say a sentence
4. Repeatedly, close the report, open a new report and use speech recognition
SOD-9694 Dragon Medical One will no longer fail to authenticate the end user when using the trusted authentication method if the LDAP/AD server of the organization is hosted in a different network than the Nuance Management Server. Note that for successful authentication in such scenarios, a properly configured Nuance Management Server Local Authenticator is required to facilitate the authentication channel between Dragon Medical One and the Nuance Management Server. For more information, see how to configure Dragon Medical One for the trusted authentication method in the installation and administration guide.
SOD-9804 [Reproduction]
Dragon Medical One no longer sometimes terminates when hiding the DragonBar (using a voice command or the GUI element) while the Dictation Box is open.
1. Start Dragon Medical One and log on
2. Open the Dictation Box
3. Hide the DragonBar by clicking minimize on the DragonBar
SOD-9840, SOD-9841 [Reproduction]
Dragon Medical One no longer terminates when attempting to show the DragonBar after it was minimized, if Dragon Medical One was started from the command line using the "-nologo" command line parameter and all required parameters have been passed to Dragon so the logon screen will not be shown to the end user.
1. Start Dragon Medical One from the command line, passing all required parameters for Dragon to start up without showing the logon screen and using the "-nologo" parameter
2. Hide the DragonBar by clicking minimize on the DragonBar
3. Start recording and say "show Dragon"
SOD-8931 [Reproduction]
Fixed an issue that could lead to incorrect insertion positions for utterances in the Dictation Box when dictating two utterances in quick succession and the second utterance processed and queued for insertion prior to the first utterance having been inserted into the Dictation Box
1. Have an application or text control that is not supported by Dragon Medical One and put the focus into the text control
2. Speak a sentence and ensure that you pause long enough to generate a second utterance
3. Without waiting for the first sentence to have been inserted into the dictation box, speak another sentence

Application support

SOD-7677 [Reproduction]
Dragon Medical One will no longer duplicate text when users dictate into the comment text boxes (for example, "Boolean Comment" or "Suggested Comment") in Allscripts Sunrise Clinical Manager. See the “Known issues” section for remaining issues that may occur when dictating into these comment boxes.
1. Open a comment box in the Allscripts SCM application
2. Speak a sentence
SOD-9801 Dragon Medical One will no longer cause the Epic Hyperspace application to sometimes terminate when using speech recognition in HTML-based text controls and switching between text controls or notes.
SOD-9442 Dragon Medical One will no longer consider behaviour implemented to change the number of white spaces for recognized or typed text at the insertion position in the Athena Streamline application as manual and intentional user correction behaviour and update the insertion position correctly to avoid inserting recognition results at the previous insertion position.
SOD-8794 [Reproduction]
Dragon Medical One will no longer allow an end user to dictate into standard HTML text controls that are marked read-only; the Dictation Box will now open in this case.
1. Have a standard HTML text control (Text Input or Text Area) that is marked as read-only (e.g. using the "readonly" attribute)
2. Focus the text control
3. Start recording and say a sentence

Known Issues

Allscripts Sunrise Clinical Manager becoming unresponsive when dictating into comment boxes

When deploying Dragon Medical One 3.5 with Allscripts Sunrise Clinical Manager, one or both applications may become unresponsive after dictating into a comment text box (for example, "Boolean Comment" or "Suggested Comment"). Furthermore, selection voice commands are not available in the comment boxes, and new line spacing may fail. If you are unsure whether to upgrade to Dragon Medical One 3.5 due to these issues, please contact Nuance Technical Support.

Epic Hyperspace and Dragon Medical One becoming unresponsive

When deploying Dragon Medical One with Epic Hyperspace 2015 and later, both applications may sometimes become unresponsive during documentation or when navigating the Epic Hyperspace application after documentation. While Epic and Nuance are working on a resolution to the issue, a workaround can be implemented should your end users be affected by the issue.

Workaround configuration file changes

Add the SoD.Development and IEComponent.Settings configuration sections

Add the SoD.Development section group and IEComponent.Settings configuration section as a child element to the existing <sectionGroup>...</sectionGroup> element; the order within the sectionGroup does not matter, you can add it as the first child element

<configSections>
...
   <sectionGroup name="SoD.Development" type="System.Configuration.ApplicationSettingsGroup, System, Version=2.0.0.0, Culture=neutral, PublicKeyToken=b77a5c561934e089" >
      <section name="IEComponent.Settings" type="System.Configuration.ClientSettingsSection, System, Version=2.0.0.0, Culture=neutral, PublicKeyToken=b77a5c561934e089" requirePermission="false"/>
   </sectionGroup>
...
</configSections>

Add the SoD.Development and IEComponent.Settings configuration elements

Add the SoD.Development and IEComponent.Settings elements as a child element to the existing <applicationSettings>...</applicationSettings> element. The order within the applicationSettings element does not matter, you can add it as the first child element.

<applicationSettings>
   <SoD.Development>
      <IEComponent.Settings>

      </IEComponent.Settings>
   </SoD.Development>
   ...
</applicationSettings>

Add the forcemode setting

Add the forcemode setting to the IEComponent.Settings element and set the value to "native"

	
...
<applicationSettings>
  <SoD.Development>
    <IEComponent.Settings>
      <setting name="forcemode" serializeAs="String">
        <value>native</value>
      </setting>
    </IEComponent.Settings>
  </SoD.Development>
</applicationSettings>

Infrastructure

For more information on supported infrastructure and text control support, see the Dragon Medical One Installation and Administration Guide.

System requirements

Operating systems: Windows 7, Windows 8, Windows 8.1, Windows 10, Windows Server 2008 R2, Windows Server 2012 R2
Internet Explorer: Internet Explorer 11
Runtime: Microsoft .NET 4.5

Virtual environments

Virtualized environments: Citrix XenApp 6.5 or later - Citrix Receiver 4.3 or later, VMware Horizon 4.3.0 or later
Virtualized server operating systems: Windows Server 2008 R2, Windows Server 2012 R2
Internet Explorer: Internet Explorer 11
Runtime: Microsoft .NET 4.5, Nuance Virtual Extensions 28.2.2.0

Dragon Medical Server

Dragon Medical Server 3.0 or later
Nuance Management Server 5.4 or later

End-of-life: Third party environments

Support for third party environments is only valid as long as they are supported by the corresponding vendor and might be subject to other restrictions. Please contact Nuance Technical Support for details. For more information, see the documentation delivered with the third party product and supporting Nuance documentation.

When support by the vendor has stopped, Nuance will continue support if an issue is specific to the Nuance solution, within the limitations of the vendor’s and Nuance's end-of-life policy. This means that issues that are a combination of the vendor’s component and the Nuance solution cannot be supported.

Dragon Medical One 3.4 SR1 (3.4.101.2436)

Improvements

Internet Explorer legacy mode support

Starting with Dragon Medical One 3.4 SR1, dictation at the cursor in text fields hosted in legacy Microsoft Internet Explorer versions or running in legacy docmodes (docmodes 9 and below) is supported. Dragon Medical One will decide at run-time, at the point in time the end user starts dictation into a text control, whether to communicate with the text control using the latest communication channel or whether to fall back to the legacy mode communication channel. Note that if Dragon Medical One falls back to the legacy mode communication channel, the end user experience might be diminished due to known issues; which cannot be resolved due to technical limitations. Nuance recommends to update your organizations environment and applications to utilize the latest versions of Internet Explorer. Note that Dragon Medical One Internet Explorer legacy mode support has an effect on speech recognition functionality only and does not remove the requirement to deploy Internet Explorer 11 for full Dragon Medical One personalization and help window functionality.

Citrix Nuance Audio Virtual Extension - automatic updates

Starting with Dragon Medical One 3.4 SR1, the Nuance Citrix virtual extension for audio supports automatic updates of the virtual client extension deployed on Citrix endpoints; future updates to the endpoint extensions will be deployed automatically and no longer require manual deployment of the extension to the Citrix endpoint. To benefit from the change and enable automatic updates for future releases, manually deploy and update your Citrix endpoints to the latest audio virtual extension. Note that the Nuance Citrix audio virtual extension on the Citrix endpoint still requires manual deployment when updating or re-installing the Citrix Receiver on an endpoint.

Authentication - Trusted authentication mode

Starting with Dragon Medical One 3.4 SR1, administrators can choose to allow end users to log on to Dragon Medical One using the credentials of the currently logged on Microsoft Windows operating system user and have Dragon Medical One automatically authenticate the end user without the need to enter a user name or password. For more information on how to enable and configure trusted authentication mode, see the "Trusted authentication" chapter in the Dragon Medical One Installation and Administration Guide.

Enabling Microsoft WPF text control support in MSI installer

Starting with Dragon Medical One 3.4 SR1, administrators can enable support for Microsoft WPF-based text controls when deploying Dragon Medical One using the MSI installation package. To do so, use the WPFSUPPORT parameter and specify "Yes" or "No" as values; if the parameter is not passed, support for WPF will not be enabled. For more information, see the "Deploying Dragon Medical One" chapter in the Dragon Medical One Installation and Administration Guide.

Solved Issues

General

SOD-8563 Dragon Medical One will no longer overwrite customizations to the Dragon Medical One options applied by the end user if Dragon Medical One fails to download the user settings at application start-up. Note that if Dragon Medical One fails to download the user settings from the Nuance Management Server, the end user will still get the default options assigned for the current Dragon Medical One session.
SOD-6834 [Reproduction]
Dragon Medical One will no longer fail to execute the -logoff and -shutdown command line actions when configured to use an external configuration file while not having mandatory configuration settings stated in the main configuration file.
1. Have a deployment using a custom external configuration file, stating the OrganizatinToken and a main configuration file with empty OrganizationToken setting.
2. Start Dragon Medical One using the command line and point to an external configuration file using the -config parameter.
3. Shut down the running instance of Dragon Medical One by using the command line option -shutdown without stating the -config parameter.
SOD-9110 [Reproduction]
Dragon Medical One will no longer prevent end users from logging on when having opted into Dragon Medical One automatically applying profile settings (like speech recognition topic) during logon and having selected an invalid or unsupported topic in previous versions of Dragon Medical Direct.
1. Have a deployment of Dragon Medical Direct 2.x with either native or LDAP/AD authentication enabled and a topic configuration of "Invalid" specified in the configuration file.
2. Have the end user log on and opt into Dragon Medical Direct to remember the profile selection for the next log on.
3. Update your deployment to Dragon Medical One.
4. Have the end user log on to Dragon Medical One.
SOD-8432 [Reproduction]
Dragon Medical One will now properly minimize and allow end users to restore the Dragon Medical One application UI again in Citrix environments hosted on Microsoft Windows Server 2008 R2 or Windows Server 2012 that have certain seamless mode flags configured. If Dragon Medical One is deployed to a Citrix environment hosted on MS Windows 2008 R2 or MS Windows Server 2012 with Citrix seamless mode configured with the flags DISABLE CLIENT INFO SYNC EXCEPT WORKAREA 0x80000, Dragon Medical One will change the application UI mode and properly minimize and restore. Note that as a side-effect, Dragon Medical One might display a black border around its application main UI in such environments. This change is disabled by default and requires changes to the configuration file to be enabled - to enable, add the following section to the configuration file
```
<SoD.Development>
	<MainWindow.Settings>
		<setting name="MainWidnowSetAllowsTransparency" serializeAs="String">
			<value>true</value>
		</setting>
	</MainWindow.Settings>
</SoD.Development>		
				
```
1. Have an environment running Citrix on Microsoft Windows 2008 R2 or MS Windows Server 2012 with the seamless mode flags set to include DISABLE CLIENT INFO SYNC EXCEPT WORKAREA 0x80000.
2. Start Dragon Medical One.
3. Minimize Dragon Medical One .
SOD-9160 [Reproduction]
Dragon Medical One will no longer shut down unexpectedly when started after upgrading from Dragon Medical One 3.3 using the MSI installer.
1. Have an installation of Dragon Medical One 3.3 which was deployed using the MSI installer.
2. Upgrade Dragon Medical One to version 3.4 using the MSI installer.
3. Start Dragon Medical One.

Application support

SOD-8741 [Reproduction]
Dragon Medical One will now properly insert dictated text into Cerner mPages IView after switching patient records and having dictated into one of the table cells before.
1. Open a patient record and double click into one of the table cells.
2. Say "The patient presents today".
3. Open another, different patient record and double click on the same table cell.
4. Say "The patient presents today".
SOD-9354 [Reproduction]
Dragon Medical One will now no longer sometimes cause the Epic Hyperspace application to terminate when dictating into some Internet Explorer based text controls within the application.
1. Open a form and place the cursor in either of the ED Course, Family Comments or Specialty Comments text fields.
2. Say "The patient presents today".
3. Open another, different form.
4. Say "The patient presents today".
SOD-8575 [Reproduction]
Dragon Medical One will no longer sometimes fail to properly execute step-by-step commands that insert new notes in the Notes section in the Epic Hyperspace application, sometimes opening the Dictation Box. Note that depending on user behavior, the step-by-step command may still fail to properly execute due to the Microsoft Windows input focus not being in the Epic Hyperspace application.
1. Have a step-by-step command "Insert new note" that presses the hotkey associated with inserting a new note in the Notes section.
2. Navigate to the Notes section.
3. Say "Insert new note".
SOD-9208 [Reproduction]
Dragon Medical One will no longer open the Dictation Box when starting to speak in a non-editable Microsoft Internet Explorer-based web application section - the Dictation Box will now only open for non-editable sections if dictation results need to be inserted into the non-editable section.
1. Have an Internet Explorer-based web application.
2. Focus the web application without focusing a text control inside.
3. Say a voice command or non-speech utterance like "uhm".

Dragon Medical One 3.4 (3.4.100.2276)

Improvements

Dragon Medical Advisor

GUI improvements - The Dragon Medical Advisor window now allows end users to dock the window to the left or right side of their screen and have the advisor window always open there. To dock the window, use the window placement UI elements on the advisor window. Note that docking the advisor window is not supported if Dragon Medical One is deployed as a published Citrix application.

Authentication: Native authentication password policies

Administrators are now able to manage password guidelines in NMC and have Dragon Medical One honor those when using the native authentication method. User accounts can be managed to Require passwords that follow an organization wide complexity policy Require changing after a set period of time Get locked after a set number of failed logon attempts for a specific period of time Management of the guidelines is done through NMC for a specific organization. For more details, see the Installation and Administration guide and NMC documentation.

Microphone record button behavior - customize default behavior

Administrators are now able to manage the behavior of the microphone record button for their end users by customizing the button behavior in the Dragon Medical One configuration file, overriding the built-in default behavior to either Toggle or Press-and-hold and additionally decide whether their end users may change the option in the Dragon Medial One options options dialog. To override the built-in default behavior, add the settings outlined below to the "SoD.DefaultOptions" section in the configuration file. Note that the latest version of the configuration file is required to override the built-in defaults.

To override the microphone record button behavior to either Toggle or Press-and-hold, add the following setting to the Dragon Medical One configuration file and set the value to either "Toggle" or "PressAndHold"

<SoD.DefaultOptions>
	<setting name="Microphone.Record" serializeAs="String">
		<value>[Toggle|PressAndHold]</value>
	</setting>
</SoD.DefaultOptions>

To override the microphone record button behavior to either Toggle or Press-and-hold and preventing end users from changing the option in the Dragon Medical One options, add the isLocked attribute to the setting in the Dragon Medical One configuration file

<SoD.DefaultOptions>
	<setting name="Microphone.Record" serializeAs="String" isLocked="True">
		<value>[Toggle|PressAndHold]</value>
	</setting>
</SoD.DefaultOptions>

UI Language support

Starting with Dragon Medical One 3.4 all supported speech recognition languages were added as supported UI languages. Dragon Medical One will now use the speech recognition language as the UI language in all cases.

Solved Issues

Dragon Medical One 3.4 is an accumulative improvement on Dragon Medical One 3.3 SR2 and includes all improvements and solutions delivered in previous versions - please see the Dragon Medical One 3.3 SR2 release notes for solutions not listed in this release note.

General

SOD-8582, CAVE-1956 When trying to stop recording, Dragon Medical One no longer sometimes fails to change the recording state and appear to be unresponsive when deployed in virtualized environments.
SOD-8319 [Reproduction]
Step-by-step commands that type text or press keys will now enter text using the casing that is stated in the step-by-step command independent on the state of the CAPSLOCK key; the CAPSLOCK key will be temporarily cleared while the step-by-step command is played back
1. Have a step by step command "Type hello" that types "Hello World"
2. Open notepad and put the cursor into notepad
3. Toggle CAPSLOCK on
4. Start recording
5. Say "Type hello"

Deployment

SOD-8523 The MSI installer now accepts and properly applies the "ldaplocal" authentication method as value of the AUTHENTICATION parameter

Dragon Medical Advisor

SOD-7981 Dragon Medical One will now properly insert recognized text into the focused text control when Dragon Medical Advisor is active and the end user previously dictated into an Internet Explorer based application and will no longer either insert text at the wrong position or not insert the text at all
SOD-8762 Dragon Medical One will no longer close unexpectedly when logging off and keeping the Dragon Medical One logon dialog visible for a short amount of time if the Dragon Medical Advisor back-end infrastructure cannot be reached
SOD-8766 [Reproduction]
Dragon Medical One will no longer close unexpectedly when starting dictation into an Internet Explorer based application without focusing a text control, while using the Dragon Medical One GUI record button to start and stop recording
1. Have an Internet Explorer based application
2. Focus the Internet Explorer based application without focusing a text control
3. Start recording using the GUI button
4. Say a word
5. Stop recording using the GUI button
6. Repeat starting and stopping recording repeatedly

Application support

SOD-7881 [Reproduction]
Dragon Medical One will no longer sometimes get into a state where window focus is rapidly passed between the Dragon Medical One and Epic Hyperspace application when having started to record in Dragon Medical One using the GUI record button and interacting with the Epic Hyperspace GUI.
1. Open an Epic note text field and put focus into the field
2. Start recording using the GUI record button and speak into the note text field
3. Stop recording and type into the same note text field
4. Cancel and discard the note text field
5. Open an Epic note text field and put focus into the field
6. Start recording using the GUI record button, Stop recording using the GUI record button and repeat starting and stopping to record using the GUI button
SOD-8824 [Reproduction]
Dragon Medical One will no longer sometimes get into a state where window focus is rapidly passed between the Dragon Medical One and Epic Hyperspace application when having started Dragon Medical One but not logging on and hiding the logon window behind other running applications.
1. Open Epic Hyperspace
2. Open Dragon Medical One but do not log on
3. Bring Epic Hyperspace to the foreground, hiding the Dragon Medical One logon window
4. Bring Dragon Medical One to the foreground
5. Repeat steps 3 and 4
SOD-8592 [Reproduction]
Dragon Medical One will now properly transfer text from the Dragon Medical One Dictation box into the Epic Hyperspace application when using the GUI transfer text button. Additionally, Dragon Medical One will no longer remove the window focus, preventing the end user from typing into an Epic Hyperspace text control when recording was started using the GUI record button. Dragon Medical One will no longer sometimes become unresponsive for more than 10 seconds when changing the recording state using the record GUI button after having dictated into an Epic Hyperspace text control before.
1. Put focus into unsupported Epic text control
2. Start recording and dictate into the dictation box
3. Stop recording
4. Transfer text using the dictation box GUI transfer button without explicitly focusing the unsupported text control
SOD-8825 [Reproduction]
Dragon Medical One will no longer open the dictation box after inserting the text into custom content editable or built-in CKEdior based elements in Cerner Dynamic Documentation when dictating multiple sentences ending with new line characters while having to remove a previously inserted new line character as part of formatting the recognition result.
1. Have an empty content editable text control
2. Say "1. this is a sample dictation new line"
3. Say "2. this is a sample dictation new line"
4. Say "3. this is a sample dictation new line"
SOD-7644, SOD-8528 Dragon Medical One will no longer sometimes become unresponsive when attempting to interact with an application that is not responsive or is not responding to Dragon Medical One in time