Dragon Medical One is now available in the Epic electronic medical records system for prescribers across Johns Hopkins Medicine. Early reviews have been positive for the voice recognition tool, introduced as part of the Joy at Johns Hopkins Medicine initiative. 

The system, available since Nov. 14, adds text in Epic when the user speaks into a microphone on a mobile device. Clinicians are using it to take notes during their patient encounters, providing the double benefit of letting patients hear the notes, while reducing the time spent adding and editing them — time that might otherwise be required during evenings and weekends.

“Dragon Medical One in Epic permits real-time, quality transcription,” says internist Joseph Cofrancesco Jr. “I can close my note after seeing a patient and not have this hanging over me.”  

Providers will see the Dragon icon on the Epic tool bar, as well as a Learning link that takes users to the Learning Dashboard with more Dragon Medical One resources.

To use Dragon Medical One, clinicians can speak through the headset attached to the clinical workstation, or use their smartphone by installing the PowerMic Mobile app to their mobile device, using either Workplace ONE Intelligent Hub or the Microsoft Intune Company Portal. In areas with a lot of background noise, such as emergency departments or intensive care units, a microphone or headset attached to the clinical workstation may work better than the PowerMic Mobile app.

“I have been incredibly impressed by how accurate the dictation is,” says Nestoras Mathioudakis, clinical director for endocrinology, diabetes and metabolism. “It recognizes the medical terms and the names of the medications that I use.”  

Below are some Dragon Medical One tips provided by Michelle Campbell, administrator for ambulatory operations for Johns Hopkins University School of Medicine, and Danny Lee, chief medical informatics officer at Johns Hopkins Community Physicians.

1. Use the microphone wisely. The microphone on your phone works best when it’s about 1 to 3 inches from your mouth and off to the side. Press and hold the microphone button for a half-second before talking. Speak directly into the microphone, not across it.
2. Speak naturally. Talk clearly, at a normal pace and using complete sentences. Dictate commands and punctuation, for example saying the words “colon,” “new paragraph” or “end sentence.” Pause briefly before and after a command. For a list of commands, ask, “What can I say?”  ​
3. Use the auto-texts feature for frequently used language. To create an auto text, say, “Manage auto texts” or navigate there through the Dragon Medical One button. When the dialogue box opens, click + and enter what you want to say to access the material, such as, “Insert pain medication instructions.” In the “content” box, write the material that you want to appear when you say the word. Special characters are not allowed, and acronyms must be in all capital letters, with spaces between. Then click “apply all” and close. Tip: You don’t need to fill in the description field.
4. Try the speech focus feature. This lets users dictate in one application while opening and closing others. To access it, click the blue Dragon Medical One button and go to options, then general, then check the box that says “anchor the speech focus when recording is started.” Click “apply all” and close. 
5. Add words you commonly use. It’s easy to add words to your vocabulary list — for example, teaching Dragon Medical One that when you say “jay hock” it should write JHOC. Either say, “Manage vocabulary” or navigate there through the Dragon Medical One button. Click + and enter the desired word in the dialogue box that pops up. Click the microphone button to record the word, then click “confirm” and close the box. You can also correct text by highlighting the word, which will open a corrections box.
6. Log out at the end of your session. You do not want another provider to use Dragon Medical One and mess up the voice recognition it has developed for you.
7. Don’t get intimidated. You don’t need to use every feature and shortcut right away. Just get started, and over time make the changes you want.