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Fluency Direct User`s Guide

1. 28 ADD NEV COMMAN pm 28 zB EN OSEE o a o i eel he aa ae de 31 DELETE COMMAND inicias ee chu d A a ee ea 31 PUBLISHED GROUPS AND COMMANDS 2 ccceccceccecceceeceeeceeceeceeceecueceecuecuecuecueceesueauesseseeeaees 31 SEARGII stessa Ru en o M E is mU DM E 31 FOBNATTIN O r FE 32 MEDICAL SPECIAL TY ae entia te at E dud i tri CIE Coe M Le RE ped DU 35 a 1 Ete RR A A DIETE EE 35 DICTATION ME CIMA 36 ERROR CORRECTION cr teda 37 ISISEINEECORIREGQJTIQODNI s nttiitebecemi m ctas Sunt e den Du Pb tete oco tuuc dune ae 37 ERROR CORREC HON WINDOW 5 535 f sel t cias 38 SPEECH COMMAND OS irsaxkn COfts KxuVEvEE Vw SeEExFFa CuVbS FUMER CER da 40 STANDARD SPEECH COMMANDS 4 eoi ssiude vent diee seed debo ped Uer Eni dnetd dui idis e sodas 40 ADDITIONAL SPEECH COMMANDS ti een tepido Seed ine e eo seca epu o Odds 40 PUNCTUATION SYMBOLS SPEECH COMMANDS sse eene ee rere rner hn rne rre rer rns nns 40 SPEECHBOXX a ie ose or fta die hint nada etu de ev dc dr ul ld c ela aad vat Da oa dt eMe Ra C SUE 41 UNDERSTANDING SPEECH BOX e tae e E m dob E e Pr te a E e is casu 41 SPEBRCEIBOXNODIES seven Uu ME LE MU Me d o ie Ets 41 STANDARD S cnim eMule dd M eee Error Bookmark not defined EEOATINO GL Lo M E HM i M MM t M et 41 OPENING THE SPEECH BOK ettet amu eat e at stata
2. Fluency Direct User s Guide 29 COMMAND ACTIONS TEXT This option can be used to create text snippets or to create templates that offer field support Text Snippet A text snippet is a piece of text that you insert into your document during dictation There are two methods to creating a text snippet from the Commands window or by dictation To add a text snippet select the Text action In the text box provided enter the desired text that you wish to use Text Snippet from Selection If you have a selection of text available you can use the command Save this Text to create a new command Alternate commands include Create Text Snippet or Create Macro The Command window will appear with your selected text You will then enter the Command Name assign it to a Command Group and if desired add additional actions to the command Click OK to save NOTE When inserting a text snippet they are inserted using the current font attributes of the target text area You cannot retain formatting from the original document used to create the Text Snippet Template Fields Creating a command using template fields allows you to create a reusable template which can be inserted and quickly completed by navigating through the fields When creating a template you insert brackets to denote a field Using the Next Field Previous Field commands which can be mapped to a SpeechMike button if desired you can move through the fields
3. User s Guide 7 PROFILE TRAINING M Madal Fluency Direct Personalization Train your profile Profile training will both introduce you to various features of M Modal Fluency Direct and train the system to better recognize your unique speech patterns COMPLETE Once you have finished your profile training you will have completed the Initial Personalization Wizard and can begin using Fluency Direct M Madal Fluency Direct Personalization You re done M Modal Fluency Direct s settings can be adjusted at any time and it will learn more about your speech patterns as you dictate If you have any questions please refer to the User Manual Fluency Direct User s Guide 8 FLUENCY DIRECT WORKSPACE THE CONTROL BAR After opening the Fluency Direct application the Control Bar will appear on the desktop You can drag the Control Bar to any location on the screen or you can dock it on any edge of the screen that you prefer To dock the Control Bar click and drag to a screen edge the screen edge will become highlighted when you near it Drop it where you want the Control Bar to be docked Fluency Direct will remember the location of the Control Bar and will open in the same position each time you log in From the Control Bar s drop down menu you can access Fluency Direct personalization tools You can also access the Help Menu for User Guides and Help open the Editor and Change your Password Sign Out or Quit
4. select next Select the next instance of the currently selected text Can be used with Sentence List Item select next one Paragraph or Line This command next one requires the use of Select Current lt x gt first select previous Select the previous instance of the currently selected Can be used with Sentence List Item select previous one text Paragraph or LineThis command previous one requires the use of Select Current lt x gt first select next lt n gt words Select the number of words between 2 and 9 including Cannot use the Next One commands punctuation to the right of the cursor in conjunction with this command The cursor must be at the beginning or end of a word to use this command properly select previous lt n gt words Select the number of words between 2 and 9 including Cannot use the Previous One punctuation to the left of the cursor commands in conjunction with this command The cursor must be at the beginning or end of a word to use this command properly save this text Brings up a selection box that allows the user toadda There is no limit to how many text new text snippet command snippets can be created There is a large limit 32 766 characters for a single text snippet Larger text snippets may see a minor delay when pasting into the target application Fluency Direct User s Guide 48 CLEAR SELECTION SAY THIS TO DO THIS clear selection Clear the selected te
5. Places cursor after the given word in insert mode insert after word sequence Places cursor after the given word sequence in insert mode insert before word Places cursor before the given word in insert mode insert before word sequence Places cursor before the given word in insert mode go to lt start begin beginning gt of Places cursor at the beginning of the current sentence paragraph or list lt sentence paragraph gt move to lt start begin beginning gt of Places cursor at the beginning of the current sentence line paragraph or list lt sentence line paragraph gt go to lt end ending gt of Places cursor at the end of the current sentence line paragraph or list lt sentence line paragraph gt move to lt end ending gt of Places cursor at the end of the current sentence line paragraph or list lt sentence line paragraph gt next field Moves to the next field in the document If at the end of the document saying Next Field will loop around to the first field in the document previous field Moves to the previous field in the document If at the beginning of the document saying Previous Field will loop around to the last field in the document COPYING TEXT SAY THIS TO DO THIS Insert Fluency Inserts text from the Fluency Editor to the current Recommended use Editor application at the point of the cursor Insert Fluency Inserts text from the Fluency Editor to the current Editor Here application at the
6. This unique proprietary technology combines best in class speech recognition with a powerful Natural Language Understanding NLU capability for improved accuracy by pairing language models and the context of words Speech Understanding allows clinicians to speak to clinical applications in conversational tones a new paradigm M Modal refers to as Conversational Documentation The system continually learns based on previous dictation and can even benefit from historically dictated and transcribed reports to accelerate the system s learning and adoption process User and facility level customizations and trained author profiles are hosted over the Internet in M Modal s data centers making easy access to trained author profiles from the office clinic nursing unit and home This server based model for speech processing allows for the frequent and seamless upgrade of the technology The system is not an install once and upgrade every three years type of system The back end speech processing engine is updated and improved frequently BENEFITS Ready to use in minutes Physicians can speak in conversational tones Instant conversion of dictation into medical reports Coverage across all specialties Continuous Learning for Continuous improvement Can be used with third party software such as MS Outlook Word and EMRs Ability to define voice enabled commands to automate frequent tasks and normal text Ability to add new custo
7. application where the cursor was previously located This mode prevents the user from moving the cursor focus to any other window including those from other applications This ensures that dictated text in the Speech Box could safely be transferred into the text editor where it was launched from FLOATING For some users the ability to be able to access other applications or launch different windows in the existing one while the Speech Box is open is important This is when you would use the Floating Speech Box When using the Floating Speech Box it will always be the topmost window and will be auto set as the dictation target When the user transfers the dictated text it will transfer to the text editor that has focus AT THAT TIME This is important because if you are switching between multiple applications you need to be sure you have focus on the correct application before transferring the text FLOATING DICTATION TARGET While the Speech Box is Floating and set as the dictation target a message is shown stating that all text will be inserted into it regardless of focus The Fluency Direct Control Bar Dictation Target will also shows Speech Box as the current target of dictation You can cancel the dictation target by clicking the X on the control bar or clicking on the cancel dictation target link on the Speech Box The dictation target will also be cleared after the Speech Box is closed and text has been transferred OPENING
8. it will use that word as the first word delete previous n words Delete a specified number between 2 and 10 words including If the cursor is positioned within a word punctuation of words to the left of the cursor position it will use that word as the first word undo that Undoes the last utterance or command spoken It is important to note that not all undo last commands can be undone specifically undo last command commands concerning selection or navigation CAPITALIZING SAY THIS TO DO THIS lowercase no caps selection Turns current selection into lowercased text lowercase no caps next n words Lowercases the sequence of n tokens to the left Can select between 2 and 10 words of the current cursor position including punctuation lowercase no caps previous n words Lowercases the sequence of n tokens to the Can select between 2 and 10 words right of the current cursor position including punctuation uppercase all caps selection Turns current selection into uppercased text uppercase all caps next n words Uppercases the sequence of n tokens to the left Can select between 2 and 10 words of the current cursor position including punctuation uppercase all caps previous n words Uppercases the sequence of n tokens to the Can select between 2 and 10 words right of the current cursor position including punctuation all caps on Dictation following this command will be capitalized until turned off all caps off This comm
9. Using the Active Window option will automatically make whatever window has the focus be your dictation target EDITOR Selecting Editor allows you to only dictate in Editor while selecting other windows When this option is selected there will be a notification above the Control Bar OTHER WINDOW Selecting Other allows you to choose a specific window as your dictation target When using this option available targets will become highlighted as you select them Fluency Direct User s Guide 37 ERROR CORRECTION There are two ways to perform error correction with Fluency Direct In Line Correction using the phrase Select lt text gt or using the phrase Correct lt text gt to open the Error Correction Window IN LINE CORRECTION In line correction only makes a change to the text in the current documentation On occasion Fluency Direct might misrecognize a spoken word or phrase This misrecognition is not necessarily because a word or phrase is missing from the underlying vocabulary domain or user dictionary but could be because of other factors such as background noise or spoken tone To perform in line error correction you can select the text that you want to correct and then speak over the text EXAMPLE Dictate your text see the error EN Fluency Editor M 7B zu This is a 78 year old white female with multiple complaints she has a history of chronic sinusitis a fibroma type syndrome and depression Spea
10. down to the correct order Delete this step x DELETE ACTION To remove an action from the Commands Details click on the x in the specific action that you want to remove Fluency Direct User s Guide 31 EDIT COMMAND To edit an existing command double click on the command and the Edit command windows will open You can make changes and click OK or Apply to save your changes DELETE COMMAND To delete an existing command select the command you wish to delete and click the delete icon on the far right Lion button and Delete this command i ick the PUBLISHED GROUPS AND COMMANDS Published Groups and or Commands are those groups or commands that have been published by an administrator for use across a company or facility These items will be available in the Commands dialog but will contain a lock symbol to the right of them When a Group or Command has been published it is locked from both editing and deleting Only an administrator can remove published items SEARCH The search option is available for you to search through your dictionary terms including categories As you type in the search term the dictionary will automatically filter out the terms that don t match As the filter is applied if your search term is not available in a category that category is also filtered out Cp m 3eadrcr Fluency Direct User s Guide 32 FORMATTING The Formatting option provides addit
11. ei E me e M co n E e eta e Ld Dra 41 TRANSFER TES d cuui Mx iul iu Mul E uU ele 42 EDOR M C e ed 43 EDITORSVORISSEAGE utet e e e E eeu M LEE sg Ces 43 CONTE XF ME NU S eem ceros Mo e LR M m e ee al lo e a ps ao el o oe 44 EDITOR SREPLECHECRER e de a e M at e a o ll A5 S PEEL CHECK CORRECTION is A5 AUTOCOMBEETE e e e e eee ban A5 Kao A veut cor A a a cans cunaaei nals uveesefotaeeeeannaam ese A 46 EDITOR DICTATION COMMAND Saad 47 alzflcft TT a O A 47 SELEC TINGAND CORREC DING resora aa aa a a a a a apu he aia aa anias 47 FOLLOW UP SELECTION Mur 47 PES recta cae A 48 LINE AND PARAGRAPH ss 4 inicistnttesaetteie A dose diste AAA uias m recat 48 UNBOING ANDDECETIN Sicario ta 48 S ADI CAICMMEE 48 EDITING AND FORMATTING TEXT ooooooooccccccccnnnnnocccncccnnnnnanccnnnncnnnnnnnnncnnnnnnnnnnnrrnnncnnnnnnnnnccnnncnnnnnne 48 NAVIGATING THE DOCUMENT sssseesseseeeeeeneeenennnn hh hhnn nsn ee nah hn nnne nsns enhn nnne nsn enar n nis 49 9 anita IA DES 49 MICROPHONE BUTTON MAPPING So eec ctoa near po ii a e E qan EE S ex Y po x REY Hera ae 50 INTRODUCTION MUI e 50 WORKING WITH THE CONFIG FILE ivi a ri a aea Pe arb ene 50 TROUBLESHOOTIN Gantt dos 53 Fluency Direct User s Guide 1 WELCOME OVERVIEW Fluency Direct is a desktop solution for free form dictations of medical reports into windows and web based Electronic Medical Records EMRs The core of Fluency Direct is the power of Speech Understanding
12. in the template dictating as you go along The Next Previous field commands will wrap around to beginning end of text when the current cursor is beyond the last or first field in the text For example if you are at the end of the document you can click Next to go to the first field in the document It is also possible to set via a configuration setting to automatically remove brackets on a field when a user advances off a given field with next field previous field or to retain the brackets The default is to retain the brackets This can be changed by the following config entry add key FieldCommandsRemoveSelectedFieldBrackets value True gt SIMULATE KEY PRESSES This option will capture your keystrokes and record them as the command You can enter a single key press or a string of key presses depicted below Key Press Single Fluency Direct User s Guide 30 4 Simulate pressing Ctrl P Clear Key Press String m z Simulate pressing shift Enter Ctrl P PrintScreen Clear To clear a keystroke you can select the entire key press by double clicking and then entering a new key press or you can click the Clear link at the end of the key press field to remove all key presses If you wish to change a single key press in a string of key presses you can highlight the specific key press that you wish to remove and then enter a new key press or press the delete key to remove that key press WAIT This
13. necessary The configuration settings below will support both Philips SpeechMikes and Olympus DirectRec Microphones CommandShortcuts SpeechMike keys support the mapping to existing commands The KeyPressShortcuts SpeechMIke keys support Simulated key presses It is possible to sequence multiple commands with a single button press by delimiting them with a comma lt appsettings gt lt add key CommandShortcuts SpeechMike Record value RECORD gt lt add key CommandShortcuts SpeechMike EOL value SHOW_SPEECH_BOX gt lt add key CommandShortcuts SpeechMike Overwrite value DELETE_CURRENT_SENTENCE gt lt add key CommandShortcuts SpeechMike RwdStart value SELECT_PREVIOUS_FIELD gt lt add key CommandShortcuts SpeechMike PlayStopToggle value SELECT_NEXT_FIELD gt lt add key CommandShortcuts SpeechMike FwdStart value REMOVE ALL FIELDS TRANSFER TEXT lt add key CommandShortcuts SpeechMike F1 value CORRECT_SELECTION gt lt add key CommandShortcuts SpeechMike F2 value SHOW_FLUENCY_EDITOR gt lt add key CommandShortcuts SpeechMike F3 value gt lt add key KeyPressShortcuts SpeechMike F4 value TAB gt lt appSettings gt All CommandShortcuts options include CORRECT SELECTION Displays the correction dialog for a currently highlighted word or phrase DELETE CURRENT SENTENCE Deletes the previous sentence to the left of the cursor or the sentence surrounding the cursor Fluenc
14. nodal COLLABORATIVE INTELLIGENCE Fluency Direct User s Guide Version 7 85 1710 Murray Avenue Pittsburgh PA 412 422 2002 solutions mmodal com CONFIDENTIALITY DISCLAIMER All information methods and concepts contained in or disclosed by this document is confidential and proprietary to Multimodal Technologies Inc By accepting this material the recipient agrees that this material as well as the information and concepts contained therein will be held in confidence and will not be reproduced in whole or in part without express written permission from Multimodal Technologies Inc Client use of M Modal tools or information excluding any services or tools provided to the Client that are covered under a separate written agreement is subject to the terms of a legal agreement between the Client and M Modal Inquiries regarding permission for use of material contained in this document should be addressed to communications mmodal com CONTACT INFORMATION BUSINESS M Modal Corporate 9009 Carothers Parkway Ste C 2 Franklin TN 37067 SUPPORT 888 290 2001 Monday Friday 6 00am 9 00pm EST Languages Supported English Table of CONIENIS CONFIDENTIALITY DISCLAIMER siria naaa AR inci dcir 2 CONTACGTINFORMATI N cocinan 2 pes AA A AP 1 A Ae nn A 1 PA A a e o A 1 aid ES APA Po AA lt P a 1 ABOUT TAI CUIDE renee ar aemennrer ere erent eee fare ane eer re eae er eee ee ee ee 2 GU
15. only appear the first time that you use the Dictionary i Dictionary Po X Manage Dictionary Categories Names Add Locations Hospitals regions etc Medications Click Add to add a name Ex temazepam Procedures Ex hysterectomy Diagnoses Ex retinoblastom Others Words that don t fit elsewhere Excluded Words you don t want recognized Fluency Direct User s Guide 19 MANAGING YOUR DICTIONARY After you have populated your dictionary when you open it it will open to the screen below From here you can select your category and add or edit your dictionary as needed Dictionary Manage Dictionary Search Categories Names Carly Jacks Locations Cassadine Hospital ions etc ospitals regions etc Corinthos Medications Ex temazepam Jacks Procedures Jasper Jacks Ex hysterectomy Diagnoses McCall Ex retinoblastom l sonny Corinthos Others Words that don t fit elsewhere Spinelli Excluded f Webb Words you don t want recognized seas ADDING A DICTIONARY ENTRY To add a dictionary entry you can select the category and click the Add button in the top right The Add a New word window will appear Fluency Direct User s Guide 20 Add a new word Enter a word Pronunciation Press to record pronunciation Category Names Medications Diagnoses Locations Procedures Others 1 Enter the word to be added to the dictionary Cli
16. option will cause the system to wait for a specified amount of time before proceeding to the next action SCRIPT The script step in a command is for advanced functionality it is possible to use a script as a command step in one of two ways 1 Specify a Javascript method name When interacting with an EHR hosted in Internet Explorer M Modal Fluency Direct can use javascript injection to call a javascript method available on the currently displayed web page This allows M Modal Fluency Direct to call methods exposed by the application for UI interaction The javascript method runs in the context of the web browser 2 Itis possible to create scripts in a number of different programming languages to do complex actions such as interact with low level APIs and manipulate data from other sources A script can be written in the VBScript JavaScript C or VB net languages and runs in the context of M Modal Fluency Direct Typically this type of scripting needs to be created by someone with extensive knowledge of computer programming languages Before import a script needs to be properly signed by a command line tool provided by M Modal Please contact M Modal support for more information on scripting s practical limitations how they can be used to automate certain tasks and information on how they can be signed for import MOVING ACTIONS Actions can be reordered after they have been set To reorder actions simply click and drag the action up or
17. point of the cursor Insert Scratch Pad Inserts text from the Fluency Editor to the current Previously known as Scratch Pad the Scratch Pad application at the point of the cursor command will still apply Insert Scratch Pad Inserts text from the Fluency Editor to the current Previously known as Scratch Pad the Scratch Pad Here application at the point of the cursor command will still apply Fluency Direct User s Guide 50 MICROPHONE BUTTON MAPPINGS INTRODUCTION Customizing your Microphone buttons via mappings can be daunting but is an efficient tool for improving dictation practice You can customize your SpeechMike button to work in specific applications Fluency Editor perform specific actions such as opening the Speech Box or to perform a series of multiple commands even Removing all fields Transferring Text Please note that if you customize any microphone buttons you need to also define recording behavior Users will no longer be able to customize the Record Dictation Only and Command only buttons via the Microphone Setup dialog It will still be possible to change recording attributes for headsets whenever opeechMike buttons are mapped to recording through the config file WORKING WITH THE CONFIG FILE To begin make a copy of FluencyDirect exe config found in the client folder This should be copied from a successfully working version of Fluency Direct that is already configured Modify FluencyDirect exe config as
18. s Guide 4 SIGN IN If you are signing in for the first time or if you have signed out the Control Bar will be available for you to sign in Enter your Login Name and Password and click the Sign In button to access Fluency Direct _ UN Please sign in User Name Password When logging in for the first time or if you have requested a password change you will receive the following notification and the application will prompt you to change your password This does not apply to all users and is dependent on your configuration Your can only use this password 2 more times until it expires Please change your password as soon as possible 9 signing in The Control Bar will notify users of the application status Error Messages will appear above or below the Control Bar depending upon the position of the Control Bar on the desktop Error messages will be displayed for a short time before fading away Error Message Example Unable to sign in Please check your user name and password 8 Please sign in p P Fluency Direct User s Guide 5 INITIAL EXPERIENCE When signing into Fluency Direct for the first time users will be prompted to perform the Initial Experience process To begin the Initial Experience click the Begin button Users can choose to return to the Initial Experience Wizard at a later time if desired The entire Initial Experience should take less than five minutes to comple
19. the logs are located e C Documents and Settings Windows user namelLocal Settings Application Data MModal DesktopDictationClient logs Sending my feedback to M Modal and Help Desk If you want to know if there is a more efficient way to do something have a question or are experiencing a technical issue there is a way to provide feedback directly to M Modal Click on the control bar on your name gt Help gt Feedback This feature tracks the last several words and commands you have said and allows you to select where exactly you experienced the issue One or multiple utterances can be selected by holding down the Ctrl key while clicking your selections The text box below it lets you explain the issue and or ask your question
20. Fluency Direct Fluency Editor Toolbar docked on the left side pz 118 Cari Becker Mr Microphone Setup Personalization Dictionary Editor Abbreviations Dictation Target Commands Help Formatting Change Password Medical Specialty Sign Out Profile Training Quit MICROPHONE SETUP This option allows you to select your microphone set your recording hot key and recording mode as well as calibrate your microphone This should be completed during the Initial Personalization phase as well as any time you need to change your microphone PERSONALIZATION DICTIONARY Allows you to customize your Dictionary specifying categories for Names Locations Medications Procedures Diagnoses Others words that don t fit into the other categories and Excluded Words words that you don t want to see recognized ever ABBREVIATIONS Allows you to add abbreviations that you use regularly Here you can create a list of abbreviations using the spoken form what you dictate and the outcome what you want to appear in your report COMMANDS Fluency Direct offers the ability to create commands to which can be used to insert snippets of text perform keyboard shortcuts and more Fluency Direct User s Guide 9 FORMATTING Fluency Direct offers the ability to define formatting for measurements dates times and more MEDICAL SPECIALTY Fluency Direct uses vocabularies optimized for the physician s medical specialty Selecti
21. IDE CONVENTIONS iua isa tio tains nera iia tens gee 2 GETTING STARTED rana ti 3 OPENING FLUENCY DIRECT a cccociocinicii sinesansrarincateiani oia iria iio je 3 A o Pu 4 INITIAL isziisc 5 A A E E E E E N E E O 5 188012410 6 N89 uc9cm 6 RECORD BUTTON 6 RECORDING BEHAVIOR 6 ams LLO PA q o saci 6 xz CI CcH 7 COMPR CE ee ee T FLUENCY DIHECT WORKSPACE societaria 8 THE CONTROL BAR rt X 8 MICROPHONE SETUP srt pi pides 8 RERSONALIZATION ooo 8 EDITOR A 9 DISTAMON TARGE Essen escollera 9 a AP O er ere ee ee ee eee eee 9 CHANGE PASSWORRD ssssssseessinehheeees eee ss snnnh eee rris inen n irr n nsn nnn annt nnns 10 ANOT 11 210 EE lt P 11 EDITOR A A q ocean EEE 11 MICROPHONE STATUS cc cece eee ee ee eee ee eee eee eee eee nn nn nn eens ease aaa eee ee eeaaaaaaeees 11 PREPAR
22. ING TO DIGTATE naar 12 MIGROPHONE Se UP sentando dro pois 12 PROFILE TRAINING nersini a 14 SUGGESTED DICTATION HABITS cisne iia 16 PERSONALIZA TION ossi od 17 Bey se od rerne ec sss oa E E ea E EEE EEEE 18 FIRST TINE USE unete E E to 18 MANAGING YOUR DICTIONARY csioionosiaailis aida 19 ADDING A DICTIONARY ENTRY assistant rhe tenerae ede canes 19 EDIT OIC TIONAR CENT seo islotes 20 MOVE DICTIONARY ENTRY cassette 20 DELETE DICTIONARY ENTR esperarte ip edd UU 21 O LsueADe ALIE E LL HE t DES eL M CL ME E E DE 21 ABBREVIATIONS caeno ia ide xmi ecstistassmtisale ad cul ca se e um a iUd LET 22 PIR SE PIME U ETT 22 MANAGING YOUR ABBREVIATIONS c cccccccecceccecceeceeceeceecuecuececuecaecaecueceecuecuecaececaesaeeaeeaeeceeaeens 23 ADDSABISEVDATION e t ee dee ed a eM LL 23 EDIT ABB REVIA TON 2 it as ola tene E e les E een 24 DELETE ABBREVIA TON a es e Ledo a sse ad do dee 24 PUBLISHED ABBREVIATIONS 45 2 2 tv E RE ELA EM A ds 24 SEARCH A t E DERI EL ARM D em E LE 24 CONMAND Sa aes tee oM a IP RAI RT UE ALIAD IAE ILE EI cies 25 FIRST TIME U E escudo Ria MUR E IEEE ELLA EIE ME LA E EAE ELM 25 MANAGING YOUR COMMANDS sssseseeem eI II II men rene rere nnns 26 GROUP PP P E ME A aM EI 26 ADD NEW OROU P us teeter renee ee ern ne UU Idae ee MEE EE 26 zENECIOS M 27 DELETE EROS nenas ted esci c e uuu M M RARE erattu Et EM 27 CONMAND c
23. NAGING YOUR ABBREVIATIONS After you have populated your dictionary when you open it it will open to the screen below From here you can select your category and add or edit your Abbreviations as needed Abbreviations Search Spoken Form Outcome Add Afib atrial fibrillation b i d twice a day CHF congestive heart failure q d everyday q i d four times a day q o d every other day tid three times a day I URI upper respiratory infection z Cancel Apply ADD ABREVIATION To add an abbreviation click on the ADD button towards the top right The following screen will appear enter the Spoken Form and the expected Outcome click Save to save the abbreviation To add additional abbreviations just click the Add Button again Fluency Direct User s Guide 24 i Add new abbreviation Spoken form Outcome Ex Congestive heart failure Cancel EDIT ABBREVIATION Abbreviation entries can be edited by double clicking on the item to open it Make your changes and click OK to save and close the dialog DELETE ABBREVIATION To delete an abbreviation entry select the word and click the Delete icon to the far right Delete this abbreviation PUBLISHED ABBREVIATIONS Published Abbreviations are those abbreviations that have been published by an administrator for use across a company or facility These items will be available in the Abbreviations dialog but will conta
24. OPHONE SETUP Microphone setup should be performed during the Initial Personalization wizard But a microphone can be setup at any time for any reason If you are changing microphones you will need to perform the Microphone Setup again Select Microphone Setup from the Control Bar Menu The Microphone Setup window will appear Microphone Setup CEN A Set up your microphone Microphone select the microphone you want to use for dictation Microphone 4 SpeechMikel v Record button Record click to change A choose a microphone button or keyboard key to start and stop recording ge a li vi _ A T gt hh _ Recording behavior Tee z specify how the record button will work SS Calibration l E Calibrate calibrate the microphone to your voice and surroundings Advanced ee JL em Microphone If you have not installed a microphone at this time you can connect it now If you have a microphone installed you can select it from the drop down menu Record Button Select the microphone button or keyboard key that you wish to use to start and stop recording Click the X to remove the selection Recording Behavior This option will define how the record button will work Select Hold to Talk or Toggle to Talk as desired e Hold to Talk Use this option when you will be using the microphone sporadically and you wish to use the push button to activate the microphone Fluency Direct User s Gui
25. SpeechMikell Once you have finished calibrating the microphone you can click OK to close this window Fluency Direct User s Guide 14 PROFILE TRAINING Training your voice profile or enrollment is a simple process Once you login as a new user you have the option to complete the enrollment process after you have selected and calibrated your microphone during the Initial Personalization Wizard This is recommended for best recognition results but is not required to run the program Training your profile should take only a few minutes to complete Profile Training Train your profile Profile training will both introduce you to various features of M Modal Fluency Direct and train the system to better recognize your unique speech patterns Please click Begin hold down the Record button on your microphone and dictate the series of short paragraphs that will be presented to you Fluency Direct User s Guide 15 Once you are ready to train your profile click the Begin button The Profile Training screen will display a series of paragraphs for you to read As you complete each paragraph the system will move to the next one You can also click OK to move on Train your protile Fluency Direct is a solution for all free form dictation needs whether it is dictating portions of text into an EHR full medical documents or even emails Here are some tips for using Fluency Direct in the most efficient way Once com
26. THE SPEECH BOX There are several ways to access the Speech Box These configurations can be used for defining how to open Speech Box in either mode as well Fluency Direct User s Guide 42 CONFIG FILE You can define the Speech Box to auto launch when record is activated while the focus is on a defined text editor For example you can define it to activate whenever a user attempts to dictate into NotePad SPEECHMIKE BUTTON You can map a specific button on your SpeechMike to open the Speech Box The first button press will open Speech Box in Modal Mode Double pressing will convert it to Floating Mode NOTE If you open the Speech Box in In Line mode and dictate then press the Speech Box button again the Floating mode will become active and the dictated text will still be available SPEECH COMMAND You can say Show Speech Box to open the In Line mode or say Show Floating Speech Box to open in Floating mode This will most likely be used by headset users TRANSFER TEXT The Transfer Text command will transfer the dictated text captured by the Speech Box into the target editor When using In Line Mode the text is inserted in the last location of the cursor When using Floating Mode the text is inserted at the location you have selected The Speech Box will close automatically after the text has been transferred TO TRANSFER TEXT YOU CAN e Say Transfer Text e Click the Transfer Text button in the Speech Box e M
27. and will turn off the All Caps On command EDITING AND FORMATTING TEXT SAY THIS TO DO THIS Fluency Direct User s Guide 49 SAY THIS TO DO THIS boldface selection Turns current selection into boldfaced text boldface next n Boldfaces the sequence of n tokens to the left of the Can select between 2 and 10 words words current cursor position including punctuation boldface previous n Boldfaces the sequence of n tokens to the right of the Can select between 2 and 10 words words current cursor position including punctuation italicize selection Turns current selection into italicized text italicize next n words Italicizes the sequence of n tokens to the right of the Can select between 2 and 10 words current cursor position including punctuation italicize previous n Italicizes the sequence of n tokens to the left of the current Can select between 2 and 10 words words cursor position including punctuation underline selection Turns current selection into underlined text underline next n Underlines the sequence of n tokens to the left of the Can select between 2 and 10 words words current cursor position including punctuation underline previous n Underlines the sequence of n tokens to the right of the Can select between 2 and 10 words words current cursor position including punctuation NAVIGATING THE DOCUMENT scroll up Scrolls up scroll down Scrolls down insert after word
28. ap a SpeechMike button to the command Transfer Text Fluency Direct User s Guide 43 EDITOR The Fluency Editor is an integrated application that allows you to dictate into create text snippets copy paste and edit The benefit of Fluency Editor over the standard text note pad is that Fluency Editor can also respond to a pre defined set of voice commands EN Fluency Editor EDITOR WORKSPACE TOOLBAR O y B 7 ult I I The toolbar offers quick access through icons to the most commonly used functions in the Format menu FUNCTION SHORTCUT DESCRIPTION Section CTRL N This function will create a sectionfor the selected text or from where the cursor is placed List CTRL L This function will create a list for the selected text or from where the cursor is placed Bookmark CTRL SHIFT This function will insert a highlighted bookmark of the selected text for QA This bookmark can be F5 typed freeform as opposed to the pre defined bookmarks located under the Insert menu Bold CTRL B This function will make the selected text Bold Italic CTRL This function will make the selected text Italicized Underline CTRL U This function will make the selected text Underlined Decrease CTRL SHIFT This function will decrease the indent of a listed item Indent M Increase CTRL M This function will increase the indent of a listed item Indent Fluency Direct User s Guide CONTEXT MENU You can access the Context menu
29. ated your commands when you open it it will open to the screen below From here you can select your group and add or edit your commands as needed AS Manage commands Search Next Field Previous Field TE Go to Home Page Internet Explorer Word Word GROUPS ADD NEW GROUP Click the Add button arrow to create a new Command Group Next Field Fluency Direct User s Guide 27 The Add a Group dialog window will appear Add a Group Group name Type in the name of your group E I Available everywhere Availability Type in a window title to limit the accessibility of tems in this group to that window Save Cancel 1 Enter the Group Name 2 Select Availability a Available Everywhere This option means this group of commands will be available in any application that you use to dictate b Availability Enter the window title to limit the availability to an active title window containing that title in its title bar For example Microsoft will work in any Microsoft application while Microsoft Word will only work in the Microsoft Word application weet ft tl tf PLA PNA EDIT GROUP To edit an existing group select the group you want to edit and click the Edit Group icon to the right Add IE Edit this group Previous Field DELETE GROUP To delete an existing group select the group you want to delete and click SIELLA IUS the Dele
30. ble in the Dictionary dialog but will contain a lock symbol to the right of them Published Dictionary terms CAN be recorded for pronunciation Double click on the term and record the pronunciation by clicking the Record button in the dialog The Name field and the Category buttons will be disabled for editing When a dictionary term word etc has been published it is locked from both editing and deleting Only an administrator can remove published items SEARCH The search option is available for you to search through your dictionary terms including categories As you type in the search term the dictionary will automatically filter out the terms that don t match As the filter is applied if your search term is not available in a category that category is also filtered out A T earch Fluency Direct User s Guide 22 ABBREVIATIONS Fluency Direct also allows users to create a collection of abbreviations This is a list of words or phrases that you use repeatedly but abbreviate when speaking FIRST TIME USE The first time you open the Abbreviations dialog the screen will appear like the one below To begin using the Abbreviations you will click the Add button that the arrow is pointing at This window will only appear the first time that you use the Abbreviations Abbreviations Abbreviations Sea rch Add Click Add to add an abbreviation Fluency Direct User s Guide 23 MA
31. by right clicking on any text the Fluency Editor workspace The Context menu will provide you with available spelling options if the cursor is placed in a misspelled word 44 Additional spelling options allow you to Ignore Ignore All Correction this will open the spelling Correction dialog Undo Cut Copy Paste Delete Select All or Lookup Lookup option will allow you to search the word online f Fluency Editor i Bru The patient underwent a coloonosco colonoscope colo anoscopy colo otoscopy Ignore Ignore All Add to dictionary Correction Undo Delete Select All Look up Fluency Direct User s Guide 45 EDITOR SPELLCHECKER SPELL CHECK CORRECTION The Fluency Editor offers a built in spell check correction that you can access spell check by right clicking on the word and selecting Correction The following window will appear lanare II Caloanascapu Ignore all Change unknown word Cancel Suggestions Colonosco n Colonoscope From here you can select the correct word from the Suggestions box choose to Ignore a single word or All instances of a word or you can enter a new spelling and click Change AUTOCOMPLETE The Fluency Editor offers an auto complete option when typing words As you are typing the word suggestions will appear Click TAB to select the word shown or SHIFT TAB to see a selection of available w
32. cements are derived from a list of words detected with a phonetic similarity and in a similar context Over time information is gathered regarding the specific speech patterns of the dictator as well the context of words previously spoken In this way the system learns not only from annunciations but also learns from the historical context of words used by the document author If none of the suggestions meet your needs you can type in the correction dialog using the keyboard As you make changes to the word or phrase and that word or phrase is not available in the current vocabulary domain you will be given an option to record the pronunciation to improve recognition Selecting the category of the term will also improve future recognition Say Save or click the Save button to finish Fluency Direct User s Guide 40 SPEECH COMMANDS STANDARD SPEECH COMMANDS The following is the list of commands supported in Microsoft Word and Fluency Editor SAY THIS TO DO THIS select lt word sequence gt Select a word or group of words 5 word limit including punctuation Correct lt that gt Correct a selected word or phrase Boldface lt that gt Apply boldface formatting to a selected word or phrase Copy lt that gt Copy a selected word or phrase Paste lt that gt Paste a selected word or phrase Delete lt that gt Delete a selected word or phrase Undo lt that gt Undo the previous action Uppercase lt that gt Apply Upp
33. ck the Record button in the dialog not on your speechmike to record the pronunciation This button will activate your handheld microphone record button for you 3 If you selected the category before clicking Add then the correct category will be chosen If you want to assign it to a different category select the category here 4 Click Save to finish EXCLUDED WORDS The excluded words will not appear in the categories for Adding a New Word Excluded Words are words that the user has specified to never appear in the dictation for a variety of reasons To add an excluded word you MUST select the Excluded Words category and then click the Add button i Exclude a word Enter the word that you wish to exclude and click OK EDIT DICTIONARY ENTRY Dictionary entries can be edited by double clicking on the item to open it Make your changes and click OK to save and close the dialog MOVE DICTIONARY ENTRY If you have created a dictionary entry and discovered that it is in the wrong category you can click the dictionary entry and drag it to the correct category Fluency Direct User s Guide 21 DELETE DICTIONARY ENTRY To delete a dictionary entry select the word and click the Delete icon to the far right Delete this Name PUBLISHED DICTIONARY Published Dictionary terms are those words or terms that have been published by an administrator for use across a company or facility These items will be availa
34. de 13 e Toggle to Talk This option allows you to select a key press which will begin your recording session used with Toggle to Talk mode and headsets Calibration The calibration process is a single screen that will calibrate your microphone to your specific voice and surroundings You will be prompted to read a paragraph to complete this process Microphone calibration will control the volume level of the input source which has a direct effect on recognition quality This is not the same as the volume slider which controls the volume level of speakers Microphone calibration will stay with your profile regardless of what computer you are using as long as you are using the same type of microphone New microphones will require a new calibration The calibration process will adjust automatically as you read the paragraph included on the wizard It will require a minimum of 20 seconds of audio to adjust the gain properly Calibrate the microphone to your surroundings Hold down the Record button on your microphone and dictate this text I am speaking into the microphone The microphone is at the side of my mouth so that I don t breathe directly into it While l m reading this paragraph my profile is being adjusted for better speech recognitian I speak in a natural voice as if I m talking to a friend After the profile adjustment is complete the OK button will become enabled and I will be able to proceed Microphone 4
35. e button is the equivalent to using SHOW FLOATING SPEECH BOX This will allow the user to have a single button that can be used to cycle the Speech Box window to be either modal or non modal SHOW FLOATING SPEECH BOX Shows the speech box and a non modal window SHOW FLUENCY EDITOR Show the Fluency Direct Editor TRANSFER TEXT Transfer text from the Speech Box back into the text at the previous location of the cursor Various Keyboard Shortcuts can be supported via KeyPressShortcuts using TAB Fluency Direct User s Guide 52 PGDN F1 F12 TAB IZ Alt z z Shift z Az Control z I z Alt Shift z TAB Alt Tab Once the configuration file is tested you can place it into the Client folder of the installer When the application is installed the FluencyDirect exe config file will automatically be copied as part of the install If you are automating an install in another way then you will need to automate this copy step after the MSI install is completed Fluency Direct User s Guide 53 TROUBLESHOOTING What information do need if need to report an error e Timestamp of issue error Error or warning message if applicable Unexpected expected behavior Applications running such as EPIC Word etc Description of issue error Local session log How to obtain local session logs e Windows the logs are located e CAUsers Windows username AppData Local MModal DesktopDictationClient logs e XP
36. ect Quit from the Control Bar menu EDITOR The Editor is an integrated application that allows you to dictate into create text snippets copy paste and edit The benefit of Editor over the standard text note pad is that Editor can also respond to a pre defined set of voice commands MICROPHONE STATUS The Control Bar will display Red Green or Yellow depending on the microphone status This is a quick visual cue for the user to know when to begin speaking or if there is an issue with the microphone This will occur when the user is not logged in is signing in or if a The Microphone Status will display RED when the user cannot dictate de Signing in microphone is not detected warning for the user This will most likely be that the recognition The Microphone Status will display YELLOW when there is a critical O Full Name Here quality is affected by low resources Bar light up GREEN A green bar will show around the bottom of the Control Bar moving left to right to display an indication of the microphone volume Once you begin recording you will see the microphone on the Control pini d Ae ps O Full Name Here Fluency Direct User s Guide 12 PREPARING TO DICTATE Before you can start dictating there are a few steps to perform To begin with you will need to configure your microphone In addition you will need to set your hotkeys for recording if desired as well as perform enrollment optional MICR
37. ercase formatting to a selected word or phrase Lowercase lt that gt Apply lowercase formatting to a selected word or phrase New Line Paragraph Start selected text on a new line paragraph or create a new line paragraph at the current cursor position Next Line Paragraph Move to the next line paragraph following the current line paragraph Insert Line Paragraph Insert a new line paragraph from the cursor position Insert Fluency Editor Inserts the text from the Editor previously known as ScratchPad into the current application Insert Fluency Editor here Insert Scratch Pad Insert Scratch Pad here Show Speech Box This command will open the Speech Box for dictation ADDITIONAL SPEECH COMMANDS The following is a list of commands supported in Epic Allscripts McKesson and Practice Partner SAY THIS TO DO THIS select word Select a word or group of words 5 word limit including punctuation sequence gt Correct lt that gt Correct a selected word or phrase Correct Correct a selected word or phrase selection Copy lt that gt Copy a selected word or phrase Paste lt that gt Paste a selected word or phrase Delete lt that gt Delete a selected word or phrase Undo lt that gt Undo the previous action Save This Text Brings up a selection box that allows the user to add a new text snippet command There is no limit to how many text snippets can be created There is a large limit 32 766 characters for a single text sn
38. fore month 2 January 2009 Alphanumeric Ordinal Day No comma January 2nd 2009 Numeric Separated by Slashes 4 digit yrs 01 02 2009 Numeric Separated by Slashes 2 digit yrs 01 02 09 Alphanumeric Short Jan 2 2009 Alphanumeric Long January 2 2009 Alphanumeric Short form no comma Jan 2 2009 Alphanumeric Long form no comma January 2 2009 TIME FORMAT Select the format that you wish to see times appear in your dictation You can choose 12hr or 24hr format Example As Dictated ANY FORMAT Numeric 12h HH MM AM PM 1 00 PM Numeric 24h HH MM 13 00 Military time HHMM hours 1300 hours PERCENT Choose to display the percent symbol or the text percent Example Use Percentage Symbol 3096 Use Text Format 30 percent 33 Fluency Direct User s Guide 34 TEMPERATURE Choose to display the degree symbol 11 5 or the text degree Example Dictated Phrases A temperature is ninety six B temperature is ninety six degrees Textual if dictated A temperature is 96 B temperature is 96 degrees oymbolic if dictated A temperature is 96 B temperature is 96 Textual word degrees A temperature is 96 degrees B temperature is 96 degrees oymbolic degree symbol Always Add degree symbol even if not dictated A temperature is 96 B temperature is 96 PARAGRAPH SPACING Set the number of Return key presses that will be inserted when you say New paragraph Default
39. in ALL CAPS For example Press ENTER to submit your password Screen prompts menu and window names fields buttons boxes etc appear in bold type The syntax used to demonstrate accessing a palette or submenu is Menu Submenu Messages in text are shown in italics as follows No Information Found This indicates that the words No Information Found are displayed in the application This manual uses the following format to indicate that you must press two keyboard keys simultaneously to perform the specified task SHIFT F5 This indicates that you must press and hold the SHIFT key and then press the F5 key on the keyboard to perform the specified task When you need to follow steps in a specific order it will have numbers next to each step as shown here 1 Do this first 2 Next you have to do this o Information Tips and Notes contain helpful advice and other information that makes the software easier and more enjoyable to use A CAUTION Cautions warn of potential problems that you will want to avoid Fluency Direct User s Guide 3 GETTING STARTED OPENING FLUENCY DIRECT Once you have successfully installed Fluency Direct you can open Fluency Direct by going to Windows Start gt MModal gt Fluency Direct The Fluency Direct application will open you will see the Splash screen appear while the application loads ms amp mocdal DE Sh Fluency Direct Fluency Direct User
40. in a lock symbol to the right of them 3 When an abbreviation has been published it is locked from both editing and deleting Only an adminstrator can remove published items SEARCH The search option is available for you to search through your dictionary terms As you type in the search term the dictionary will automatically filter out the terms that don t match T Tag 3 amp eadrc ra Fluency Direct User s Guide COMMANDS Fluency Direct offers the ability to create commands to which can be used to insert snippets of text perform keyboard shortcuts and more Commands are organized by Groups Go to Personalization gt Commands to bring up the Commands screen FIRST TIME USE The first time you open the commands dialog the screen will appear like the one below To begin using the commands you will click the Add button that the arrow is pointing at This window will only appear the first time that you use the commands All users will have a default group available to them when they open the Commands dialog This group will be called User Name Commands and can be populated with your custom commands 25 Commands ro X Manage commands o Groups Add Cari Becker s Commands Add Click Add to add a command to this group ical ACA ectetur Aen ER eo HR CARE cH beca hee ce Aen eA rca Hh EN CEN c JL aes Fluency Direct User s Guide 26 MANAGING YOUR COMMANDS After you have popul
41. ional options related to the display and rendering of the dictation and draft text More options may be added in the future Formatting x b Adjust formatting Measurements cm ml ft in Ordinal format Ist 2nd 3rd Numerical Ranges 1 10 s Date format las dictated x Time format 1 00 PM Percent 36 sign E Temperature E symbol m Paragraph spacing double E MEASUREMENTS Select Abbreviated cm or Expanded centimeters for how measurement abbreviations should be displayed Example Dictated phrase 8 millimeters Abbreviated 8 mm Spelled out 8 millimeters Fluency Direct User s Guide ORDINAL FORMAT Choose 1st 2nd 3rd or first second third Note if used at the beginning of a sentence it will be spelled out and capitalized Example Dictated phrase A two hundred fifty thousand fifty five B three thousand Abbreviated 1st 2nd 3rd Spelled Out First Second Third NUMERICAL RANGE Select the display of numerical ranges 1 10 1 to 10 or one to ten Example Dictated Phrase She drank eight to ten cups of coffee per day oymbolic 8 10 Written Spelled Out eight to ten Written Numeric 8 to 10 DATE FORMAT Select the format that you wish to see dates appear in your dictation Example Dictated Phrases January second two thousand nine As Dictated January 2 2009 Alphanumeric Ordinal Day January 2nd 2009 Alphanumeric Long form day comes be
42. ippet Larger text snippets may see a minor delay when pasting into the target application PUNCTUATION SYMBOLS SPEECH COMMANDS The following is the list of commands for dictating punctuation and symbols SAY THIS TO DO THIS colon Insert a colon in the dictation semi colon Insert a semi colon in the dictation open parentheses Insert the open parentheses in the dictation Closed parentheses Insert the closed parentheses in the dictation Opening quotation Insert the opening quotation marks in the dictation Closing quotation Insert the closing quotation marks in the dictation Period Insert a period in the dictation Slash Insert a slash in the dictation Fluency Direct User s Guide 41 SAY THIS TO DO THIS Question mark Insert a question mark in the dictation Exclamation mark Insert an exclamation mark in the dictation point Insert a period for temperatures ex 98 6 say ninety eight point six SPEECHBOX UNDERSTANDING SPEECH BOX SPEECH BOX MODES The Speech Box is an integrated application that allows you to dictate into and then transfer the text to any application Speech Box provides a standard dictation environment with a pre defined set of commands There are two modes to the Speech Box In Line and Floating Depending on how you dictate will determine the best method for you IN LINE In this mode the Speech Box will capture dictated text and then transfer the dictated text into the
43. k Select Fibroma or use the keyboard and mouse to highlight text May Fluency Editor f RE TT Tit May Fluency Editor F1 ABU This is a 78 year old white female with multiple complaints she has a history of chronic sinusitis a fibromyalgia type syndrome and depression Fluency Direct User s Guide 38 ERROR CORRECTION WINDOW Dictate your text see the error co Fluency Editor 1i B r y This is a 78 year old white female with multiple complaints she has a history of chronic sinusitis a fibroma type syndrome and depression Speak Select Fibroma or use the keyboard and mouse to highlight text Vin Fluency Editor lite female with multiple complaints she has a history type syndrome and depression C Fluency Editor iic pa B a pes This is a 78 year old white female with multiple complaints she has a history of chronic sinusitis a jes type syndrome and depression Say choose followed by a number E fibramas fibroid fibrous fibro Xibrom A SA e REUNIR Reco rd Pronunciatian Name Medication Diagnosis Location Procedures Other Save Cancel Fluency Direct will display suggestions based on the word being corrected From here you can select a replacement option suggested by saying Choose 1 Choose 2 Choose 3 and so on Fluency Direct User s Guide 39 The suggested repla
44. led you can select it from the drop down menu RECORD BUTTON Select the microphone button or keyboard key that you wish to use to start and stop recording Click the X to remove the selection RECORDING BEHAVIOR This option will define how the record button will work Select Hold to Talk or Toggle to Talk as desired CALIBRATION The calibration process is a single screen that will calibrate your microphone to your specific voice and surroundings You will be prompted to read a paragraph to complete this process Microphone calibration will control Calibrate the microphone to your surroundings the volume level of the input source which has a direct effect Hold down the Record button on your microphone and dictate this text on recognition quality This is not the same as the volume slider I am speaking into the microphone The microphone is at the side of which controls the volume level of my mouth so that I don t breathe directly into it While I m reading this speakers paragraph my profile is being adjusted for better speech recognition The calibration process will adjust I speak in a natural voice as if I m talking to a friend After the profile automatically as you read the adjustment is complete the OK button will become enabled and I will paragraph included on the wizard be able to proceed It will require a minimum of 20 seconds of audio to adjust the gain properly Microphone 4 SpeechMikell Fluency Direct
45. m vocabulary REQUIREMENTS Microsoft amp Windows XP or higher Windows OS Processor Intel Core 2 CPU 1 5 GHz 2GB recommended for Local Recognition Processor Intel Core 2 CPU 1 5 GHz 1GB recommended for Remote Recognition Microsoft Internet Explorer Version 6 SP1 or higher Net Framework 4 0 For dictation support into Java based applications JRE 1 7 u6 32 bit or higher needs to be installed on the computer before Fluency Direct is installed e For Citrix XenApp support with the Fluency Connector you must have already installed the Citrix Client 10 11 12 or the Citrix Receiver in advance of installing Fluency Direct as well as have the Connector configured on the Citrix Server Fluency Direct User s Guide 2 ABOUT THIS GUIDE The Clinician s Users Guide is written for the clinical users of Fluency Direct physicians physician s assistants radiologist amp imaging specialists and other clinical professionals that dictate patient information This guide contains instructions regarding the use of Fluency Editor along with a complete list of dictation commands for supported applications GUIDE CONVENTIONS File names Commands and Prompts III DA Pressing keys simultaneously Ordered Procedures Information Tips and Notes Cautions amp Warnings This manual uses bold text to indicate file names This manual uses bold text to indicate user input A specific key on the keyboard is indicated
46. ng the specialty that best applies to you will ensure the best recognition possible PROFILE TRAINING While Profile Training is not required to use Fluency Direct it is highly reccomended Fluency Direct learns your speech habits and nuances based on the amount of dictation that you present Therefore as you continually dictate Fluency Direct will continually learn Perofroming the Profile Training will give you a head start on recognition issues and ensure that Fluency Direct returns the most accurate results to you EDITOR The Editor is an integrated application that allows you to dictate into create text snippets copy paste and edit The benefit of Editor over the standard text note pad is that Editor can also respond to a pre defined set of voice commands DICTATION TARGET Fluency Direct allows you to define the Dictation Target as the Active Window Editor or another window HELP F1 Press F1 from any location in the Fluency Direct application to bring up Fluency Direct Help In addition to instructions and images the Fluency Direct Help also offers a variety of Video Tutorials for users to watch directly from the section that you are trying to learn more about VIDEO TUTORIALS Fluency Direct Help also offers Video Tutorials directly from the help file menu To access the video library click F1 from anywhere in the Fluency Direct application from the Help menu click Help Video Tutorials USER MANUAL The Fluency Di
47. ords ABBREVIATIONS Create a collection of abbreviations This is a list of words or phrases that you use repeatedly but abbreviate when speaking COMMANDS Create commands to which can be used to insert snippets of text perform keyboard shortcuts and more FORMATTING Define specific options related to the display and rendering of the dictation and draft text including dates times measurements and spacing MEDICAL SPECIALTY Fluency Direct focuses on the physician s medical specialty select your specialty here to ensure improved recognition PROFILE TRAINING Training your voice profile or enrollment is a simple process Once you login as a new user you have the option to complete the enrollment process after you have selected and calibrated your microphone This is recommended for best recognition results but is not required to run the program Fluency Direct User s Guide 18 DICTIONARY The Fluency Direct Dictionary allows you to create a custom dictionary of Names Locations Medications Procedures Diagnoses and Excluded Words that you use often to ensure recognition each time To open the Dictionary go to Personalization Dictionary in the Control Bar drop down menu The Dictionary window will appear FIRST TIME USE The first time you open the Dictionary dialog the screen will appear like the one below To begin using the dictionary you will click the Add button that the arrow is pointing at This window will
48. ords You can select a word using the arrow keys and pressing ENTER Col Colo Colonoscopy Colon Color Colonic Colostomy Fluency Direct User s Guide 46 LOOK UP The look up option allows you to check medications obtain a definition or verify correct spelling from a list of online resources Look up RxList Wikipedia Wiktionary The Free Dictionary Right click the word and select your online source from the Look up option Fluency Direct User s Guide 47 EDITOR DICTATION COMMANDS The following speech commands are supported in the M Modal Fluency Editor There is variable functionality within other word process editors and applications HELP Click F1 from the Fluency Direct application to access the context sensitive help SELECTING AND CORRECTING TO DO THIS select lt word sequence gt Select a word or group of words 5 word limit including CDS Live will find exact matches as punctuation well as any related match It will select the first available instance after the cursor correct lt word sequence gt Correct a word or group of words select lt word gt through lt word gt Select the text beginning with the first word spoken through to the last word spoken correct lt word gt through lt word gt Correct the text beginning with the first word spoken through to the last word spoken select all Select all text in the entire document FOLLOW UP SELECTION TO DO THIS
49. plete you will be notified that you have completed your profile training and you can click the Finish button to exit Profile Training Train your profile M Modal Fluency Direct profile training is now complete Please make sure your microphone is off As you use the system going forward it will continue to learn more about your speech patterns Fluency Direct User s Guide 16 SUGGESTED DICTATION HABITS e f using a handheld dictation device place in the palm of your hand with the thumb on the 4 position switch and your index finger across the trigger underneath e When dictating hold the device approximately 1 inch from your mouth When turning your head please remember to move keep the microphone near your mouth e When using the Push To Talk mode pause slightly before speaking when starting your recorder and pause briefly before stopping recording This prevents words from being clipped y For improved performance review the Fluency Direct Best Practices Fluency Direct User s Guide 17 PERSONALIZATION Fluency Direct offers a variety of tools to help you personalize your experience and daily use t3 Cari Becker Microphone Setup Personalization Dictionary Editor Abbreviations Dictation Target Commands Help Formatting Medical Specialty Change Password Sign Out Profile Training Quit DICTIONARY Create a custom dictionary of Names Locations Medications Procedures Diagnoses and Excluded W
50. rect User Guide is a comprehensive Clinician Guide for using Fluency Direct Note To access the PDF files you must have Adobe Reader installed SUBMIT FEEDBACK This option will allow you to send an email to our Product Development Group offering specific feedback and comments regarding the applications features functionalities and overall use This option is not to be used for support or service ABOUT This option will display the Fluency Direct SplashScreen which provides information regarding the current installation and version number which is required for support tickets CHANGE PASSWORD The Change Password button will allow users to change their password as desired Enter your current password then the new password You will need to confirm the new password as well Once the new password has been confirmed and the length is between the required 4 20 characters the green checkmarks will appear and the Apply button will be highlighted Fluency Direct User s Guide 10 Change your password Current Password Mew Password Confirm New Password New password confirmed Length between 4 and 20 characters isa Fluency Direct User s Guide 11 SIGN OUT Sign out from the Fluency Direct application using this option this option will not exit the application it will remain running on your desktop QUIT To exit the application completely the Control bar will no longer be available on your desktop sel
51. te M Madal Fluency Direct Personalization A Welcome to M Modal Fluency Direct During the next few minutes you will be guided through a few steps to help optimize M Modal Fluency Direct for your voice SPECIALTY At this point users will be prompted to select their medical specialty Previously users selected a domain which focused on the type of document being produced Fluency Direct now focuses on the physician s medical specialty which offers improved recognition Click Next to continue M Modal Fluency Direct Personalization NETS 4 Select your medical specialty Critical Care Medicine i Dermatology Ear Mose and Throat Emergency Medicine Endocrinology e Family General Practice ls Back la Cancel Fluency Direct User s Guide 6 MICROPHONE Users will next be prompted to Set up their Microphone M Madal Fluency Direct Personalization Set up your microphone Microphone select the microphone you want to use for dictation Microphone 4 SpeechMikell Record button Record click to ch X choose a microphone button or keyboard key to start and stop recording il il RES Recording behavior Hold to talk E specify how the record button will work Calibration mm calibrate the microphone to your voice and surroundings a Advanced mJ cons MICROPHONE If you have not installed a microphone at this time you can connect it now If you have a microphone instal
52. te Group icon to the far right Add IE Delete this group Previous Field Fluency Direct User s Guide 28 COMMANDS ADD NEW COMMAND To add a new command click on the Add button in the top right corner The Add Commands window will appear Commands A AUN Command details Name Group Print Word T Simulate pressing x Text Ctrl P PrintScreen Clear Key Q Wait Script Name your command The Command Name is an important step because this is the speech command that will activate the command details inserted text key presses wait time or scripts Do not choose a name that is complicated to pronounce or too long to be recognized easily Keep your names simple and relative to the command actions results In addition try to follow these best practices e Capitalize the first letter of each word in the command name e Spell out numbers rather than using the numerals i e Four Two Five instead of 425 e Use an action verb at the beginning of each command name i e Insert Print etc Select the Group that you want the command to appear in The Group will default to your custom commands group or to the selected group Add Actions Using the buttons add Text Keystroke Wait time or a Script to the command See Actions below for more information Save the Command Click OK to save the command clicking Apply will save the command and keep the Command Details window open
53. value is double 2 blank lines between paragraphs Single will insert one blank line between paragraphs Fluency Direct User s Guide 35 MEDICAL SPECIALTY Users can select their medical specialty to optimize the vocabulary for the types of documents you will be dictating Select your specialty by scrolling through the options or searching in the search bar Once selected click OK to save and exit Specialty Select your medical specialty Colon amp Rectal Surgery Critical Care Medicine Dermatology Ear Nose and Throat Emergency Medicine Endocrinology SEARCH The search option is available for you to search through the available medical specialties As you type in the search term the list will automatically filter out the specialties that don t match Search Fluency Direct User s Guide 36 DICTATION TARGET Fluency Direct allows you to select the dictation target from the Control Bar menu Setting a dictation target allows you complete control over your screen By utilizing this feature you can keep your EMR image viewer etc front and center covering the actual report This allows you to focus on detailed patient information without having to move the report on the screen Cari Becker e Microphone Setup Personalization Editor Dictation Target k v Active Window default Help F Editor Change Password Other Window Sign Out Quit ACTIVE WINDOW DEFAULT
54. xt Cursor will be positioned at the end of the selection once cleared unselect text Deselect the selected text unselect that Deselect the selected text LIST SAY THIS TO DO THIS item n word sequence Begin a list at the current cursor position with the Continue with Item n until complete first list item item number n word sequence Begin a list at the current cursor position with the Continue with Item Number n until first list item complete word sequence next item word Begin a list at the current cursor position with the Next Item command continues the list sequence first list item LINE AND PARAGRAPH new line paragraph Start selected text on a new line paragraph or create a new line paragraph at the current cursor position next line paragraph Move to the next line paragraph following the current line paragraph select current sentence paragraph Select the current sentence paragraph in which the cursor is currently positioned UNDOING AND DELETING delete selection Delete the currently selected text All delete commands ensure proper delete current selection spacing and case at the location of the deletion delete current sentence Deletes the entire sentence in which the cursor is currently positioned delete next n words Delete a specified number between 2 and 10 words including If the cursor is positioned within a word punctuation of words to the right of the cursor position
55. y Direct User s Guide 51 RECORD User can Dictate and use Commands RECORD COMMANDS ONLY User can only use commands Dictation will not be recognized RECORD DICTATION ONLY User can only dictate Commands only will be recognized REMOVE ALL FIELDS Removes all from the current text SELECT NEXT When used after a select XYZ command will find the next XYZ instance in the text SELECT PREV When used after a select XYZ command will find the previous XYZ instance in the text SELECT NEXT FIELD Will find the next instance of a bracketed field in the text SELECT PREVIOUS FIELD Will find the previous instance of a bracketed field in the text SELECT FIRST FIELD Will find the first instance of a bracketed field in the text SELECT LAST FIELD Will find the last instance of a bracketed field in the text SELECT CURRENT SENTENCE Selects the sentence surrounding the cursor SELECT NEXT SENTENCE Selects the next sentence to the right of the cursor SELECT PREVIOUS SENTENCE Selects the previous sentence to the left of the cursor SELECT CURRENT PARAGRAPH Selects the paragraph surrounding the cursor SELECT NEXT PARAGRAPH Selects the next paragraph to the right of the cursor SELECT PREVIOUS PARAGRAPH Selects the previous sentence to the left of the cursor SHOW SPEECH BOX Shows the speech box as a modal window When this value is set A single press of the button places the dialog in a modal state The second press of th

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