Softnet Systems, Inc. Speech Recognition Specialists

"Nuance Introduces Nuance® Dragon® Medical Practice Edition 2"

June 20, 2013 Review

Nuance Dragon Medical Practice Edition 2 includes many new features. Many of these were introduced into the Dragon NaturallySpeaking Professional 12 and Legal 12 products that became available in September 2012. Others are unique to this release. We have only used the product for a couple of days so will likely update this review again late this week.

Changes of Significant Value to Many Physicians

Changes of Minor Value to Most Physicians

Changes Related to Microphones (e.g. they probably won't matter if you don't have specific devices but could be important if you have specific devices)

Business Reasons to Upgrade to Nuance Dragon Medical Practice Edition 2 (Hint: These are as compelling as the technical reasons for many readers)

Cautions (no show-stoppers)

Nuance Information Details from the manufacturer perspective

Buy it Now Yes, we are in business and we appreciate your business! Plus you get $100 off if you buy prior to June 30, 2013

System RequirementsToo slow of a system and you'll not be happy. The largest benefits of this release go to upper-end/new systems.

Significant Value to Physicians

  • Better reliability.

    This is particularly the case for those moving from Release DMPE to DMPE 2. A major problem on DMPE

  • Better accuracy for most persons.

    Nuance claims an average of 22% fewer errors, that is consistent with what I have observed with my Professional 12 customers who have newer PC's. But this is an average, and some report more errors while some claim over 50% fewer errors with Release 12. Your mileage will vary! (If moving from Release 10 or earlier, expect more significant improvements in accuracy!)

  • A Transparent Dictation Box

    Many have to use the Dictation Box, particularly for dictating into Citrix or Terminal Services sessions but also for some EMR's. The transparent dictation box allows less interference with other material on the screen.

  • Better use of multiple processors.

    Most new PC's have at least 2 processors/CPU's. Now Dragon can use more than one at a time to speed up its algorithms, allowing it to more completely analyze your speech which typically leads to fewer errors.

  • Better handling of recorders.

    This has been steadily improving. The recorder manufacturers haven't been sitting back either, recorders such as the Olympus DS-7000 and Philips 9600 are now working well with Dragon, at least when the dictation is done in a fairly quiet environment.

  • Better training material, of significant value to new users of Nuance Dragon Medical Practice Edition 2
  • Support of Windows 8, Office 2013, Internet Explorer 10
  • Reduction in "latency" problems. One of the more common problems with Dragon Medical Practice Edition was a delay putting words onto the screen. This didn't happen to all users, but was a common problem. If you have this problem, then the upgrade to NuanceDragon Medical Practice Edition 2 is likely beneficial.

Minor Value

(e.g. either applies to a small market segment or is a minor improvement for all users)

  • Use a smartphone on Wi-Fi as a microphone
    This works, but is likely to be useful mainly as a backup microphone.
  • Ability to export/import word properties of custom words.
  • Enhanced recovery of user profiles.


Changes Related to Audio Devices

  • Use an iPhone or Android smartphone on a Wi-Fi network as a microphone. This has limitations, but is at a minimum a good backup for many physicians.
  • Enhanced Bluetooth Support

Business Reasons to Upgrade

Users of Dragon Medical 10 and Dragon Medical 10 Small Practice Edition need to upgrade, else they are likely to have to buy a full-copy product next release. Normally Nuance only allows upgrades for either one or two releases. Nuance Dragon Medical Practice Edition 2 is for practices with 24 or fewer physicians.

If your practice has 25+ physicians (M.D.'s + D.O.'s) and is looking to upgrade Dragon Medical and/or Dragon Medical Small Practice licenses, please contact us for guidance.


Installation support will be more important on this release than other recent releases. The Nuance algorithms for choosing the BestMatch V vs. BestMatch IV seem out of line, opting for BestMatch V many times when BestMatch IV would be significantly better. Look for detailed instructions and analysis from your vendor, but give them a little slack as there is no specific formula for determining the proper choice.

A slowdown in command execution while using BestMatch IV is a sign that BestMatch V is inappropriate for your situation. We expect that certain EMR's will not work well with BestMatch V. If using a Tablet-PC, start with BestMatch IV, not BestMatch V regardless of the Nuance default selection.

Because of these issues, we are writing more extensive installation instructions than normal. If you order from us and don't receive them, ask us to send them! Or arrange for a flat-rate $75 remote installation/upgrade service (single system). This will often take over an hour elapsed time, but most of that time is waiting for files to be copied.

There are also new options for dealing with commands, the Dictation Box, and Smart Formatting where custom choices will be needed. If you are a long-term user, expect some temporary frustrations with this release.

There are a few custom macros that need to be changed due to some minor changes between Releases 10 and Nuance Dragon Medical Practice Edition 2. Timing of command execution has changed, so commands that used "Wait" statements are particularly vulnerable. Some of these are Windows 7/Windows 8 issues, don't blame all of this on Dragon.

When adding vocabulary/phrases, quit using punctuation in the "spoken form." Our advice over the years to use "A." in the spoken forms is now reversed -- do not use periods, if you wish to specify a "spoken form" for an acronym not in the vocabulary then just use the capital letter without a period. Don't worry, Dragon will tell you if you forget to do this!

We recommend new user profiles for users migrating from Release 10. We don't know yet if we will make the same recommendation for those moving from DMPE 1.

Nuance Information

Nuance has their own detailed comparison of Dragon Medical Practice Edition and Nuance Dragon Medical Practice Edition 2. I've got my own initial assessment of these differences and how they may impact users.

Nuance Comparison: DMPE 1/DMPE 2 Feature Comparison

Softnet Analysis: DMPE 1/DMPE 2 Feature Analysis

For other details directly from Nuance, the following PDF files are available:


DMPE 2 Features and Specifications

DMPE 2 Vocabulary Specialties

Buy it Now

Call or email us if you are looking for other options, over 5 licenses, etc.

Nuance Dragon Medical Practice Edition 2 $1599.99
Upgrade from Dragon Medical 10 or Dragon Medical Practice Edition to Nuance Dragon Medical Practice Edition 2.
This product will be shipped by the next business day after receipt of order.

The above prices include limited phone/email support from Nuance plus email support for installation problems from Softnet Systems, Inc.

System Requirements

CPU: Upper-end i5 or i7 systems if in the Intel 3xxx series are recommended.

There are many CPU models, we suggest using the Passmark score as a general guide at 8000 or more is best and will allow use of BestMatch V unless you have many macros. 6000 or more and you'll be OK. 4000-5999 and the CPU will be workable but you will experience more lag time and will not be able to use BestMatch V.

L2 cache is important, we suggest 6MB or more.

RAM: For Windows XP, 32-bit, 2GB is minimum but 4GB is recommended. For Vista, Windows 7, or Windows 8 4GB is minimum and 8GB or more is recommended.

BestMatch V takes over 1GB by itself. We've seen up to 1.4GB under some situations. BestMatch IV or BestMatch III are not nearly so memory-intensive.

Sound/Audio System: For USB microphone users, it doesn't matter. Most sound systems today are good on new systems if you use a headset microphones. Built-in microphones are seldom good but may be useable if you accept lower accuracy.

Hard Drive Space: If using a Solid State Hard Drive (SSD) then you may lack the 4GB normally needed for installation. You can reduce that to about 2GB if you do a custom install. Most systems easily have the needed 4GB hard drive space, all of which is needed on the C: drive.

OS: Windows XP 32-bit, SP3; Windows Vista SP2, Windows 7, Windows 8



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