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1 EditScript MT Student Guide V9 Software Version 9.0 Document Version 1.0 August 2009 escription

2 Acknowledgments Developed by Joanne Vaccaro, escription Training and Documentation Please send comments to Trademarks EditScript MT, EditScript-QA, EMon, IntelliScript, AutoScript, and NetScript are trademarks of Nuance Communications, Inc. All other company and product names are the trademarks or registered trademarks of their respective companies. Copyright Notice Copyright 2009 Nuance Communications, Inc. Nuance Communications authorizes you to copy this document or documents published by escription on the World Wide Web for non-commercial uses within your organization only. Contact Nuance Communications, Inc 1 Wayside Road Burlington, MA phone fax Confidential Information Nuance. All Rights Reserved.

3 Overview of escription 3 Table of Contents 1: OVERVIEW OF ESCRIPTION 5 Dictation Workflow...6 The Voice Model...8 Importance of the Style Guide...9 Exercise 1 - Summary Questions : GETTING STARTED 11 Logging in to EditScript MT...12 Using EditScript MT...13 Getting Work...14 Exercise 2 Log in to EditScript MT and Get Work...15 Changing Options ALT+O...16 Audio Tools...18 Exercise 3 Adjusting Audio Controls and Transcribing...19 The Header Patient Demographics...20 Editing the Header...21 Searching for Patient Information...22 Changing Fields with Drop-Down Menus...25 Changing Work Type...26 Modifying Date Fields...27 Hiding the Header...29 Exercise 4 Modifying the Header and Transcribing...30 CCs...31 Adding a CC...32 Deleting a CC...34 Adding a New Contact...35 Exercise 5 Modifying the Header and Transcribing...37 Inserting a Contact Name into a Dictation...38 Taking a Break and Logging Out...39 ALT+SHIFT+U and EXIT...39 Exercise 6 Taking a Break and Logging Out : USING WORD TOOLS 41 How Word Shortcuts Work...42 Exercise 7 Word Shortcut Key Tutorial...43 Essential Word Shortcut Keys...44

4 4 Overview of escription Using AutoCorrect...45 Exercise 8 Practice AutoCorrect : EDITING IN EDITSCRIPT MT 47 Multiple Cursors...48 Using ALT+K...49 Exercise 9 Jumping to a Word using ALT+K...50 Exercise 10 Fixing a Word using ALT+K...51 Using ALT+SHIFT+K...52 Exercise 11 Practice...53 Correction Macro ALT+. (PERIOD)...54 Using ALT+K with ALT+. (period)...54 Exercise 12 Using ALT+. (Period)...55 Correction Macro ALT+SHIFT+: (COLON)...56 Exercise 13 Using ALT+SHIFT+: (Colon)...57 Exercise 14 - Practice Dictations : EDITSCRIPT TOOLS 59 Pending Dictations...60 Exercise 15 Pend a Dictation...63 Inserting and Using Templates...64 Exercise 16 Insert a Template...68 Splitting Dictations...69 Exercise 17 Split a Dictation : MANAGING YOUR WORKFLOW 71 Workflow Best Practices...72 Viewing Dictations in Your Work Queue...72 Exercise 18 Workflow Best Practices...76 Viewing and Printing Metrics...77 EditScript MT Features...79 Searching for Previous Reports...80 EditScript MT Review Questions...83 APPENDIX 85 Appendix A: MT Instructions...86 Appendix B - EditScript MT Certification...87 Appendix C Amending Dictations...90 Appendix D Creating a Document without Audio...93 Appendix E EditScript Commands...94 Confidential Information Nuance. All Rights Reserved.

5 Overview of escription 5 1: Overview of escription Objectives Upon completion of this module, you will be able to: Describe the Dictation Workflow in EditScript Explain Voice Models Explain the Importance of the Style Guide

6 6 Overview of escription Dictation Workflow The workflow of a dictation in escription: IntelliScript voice capture AutoScript speech recognition EditScript Server dictation workflow management EditScript MT dictation transcription and editing NetScript/EditScript Online web access to dictations and reports Confidential Information Nuance. All Rights Reserved.

7 Overview of escription 7 What is IntelliScript? IntelliScript is the server located at your institution that records high-quality, digital audio dictations. Clinicians call IntelliScript and enter their ID and identifying information such as patient medical record number and work type. Using IntelliScript, clinicians dictate, review, edit or add to their dictations. What is AutoScript? AutoScript is the program that performs speech recognition. AutoScript learns how a physician speaks, develops a voice model and creates a voice recognized draft of each dictation. What is the EditScript Server? The EditScript Server manages the workflow of a dictation as it transitions from an audio recording, to a draft document, to a completed and distributed document. What is EditScript MT? EditScript MT is the software that MTs use to transcribe or edit reports. Connected to the internet, MTs download dictations, edit or transcribe them, and upload completed work. EditScript MT is integrated with Microsoft Word and uses many familiar word shortcuts.

8 8 Overview of escription The Voice Model Voice models process what the clinician says to produce a draft document. Here is how it works: The clinician dictates and the MT transcribes. AutoScript analyzes the dictation and compares it to the final written report. After approximately 1.5 hours of audio and 50 reports, AutoScript develops a voice model per clinician and work type. Based on each voice model, voice recognized drafts are produced. Voice recognized drafts are not perfect and always need some editing. Voice models recognize sounds and strings them into words and phrases. Using complex formulas, they put these words into context and format the report based on the requirements of your institution. This is done by work type since each work type has its own terminology and possibly its own report format. AutoScript does not produce a draft of a report if the quality is such that it would be faster to transcribe the entire report. The goal is to make the job of the MT easier. Examples of How the Voice Model Learns You may work with a cardiologist who uses the phrase 'no rhythm' for 'normal rhythm'. The MTs at your institution know this cardiologist and always change the phrase to 'normal rhythm'. AutoScript learns that 'no rhythm' should be recognized as 'normal rhythm' for that particular cardiologist. Soon the voice recognized drafts have the correct phrase, thereby eliminating the need to edit that phrase in the draft. Dr. Smith may use the word 'basically' repeatedly and inappropriately throughout his dictations. The MTs at your institution consistently omit 'basically' from Dr. Smith's reports. In time, AutoScript learns to eliminate the word 'basically' from Dr. Smith's reports even though he continues to use the word in his reports. Some clinicians may not be voice recognized. Clinicians who are not organized speakers or who speak inconsistently may never be recognized. As such, their reports will require standard transcription. If a clinician is an organized speaker and has a thick accent or does not speak clearly, he may be voice recognized. Confidential Information Nuance. All Rights Reserved.

9 Overview of escription 9 Importance of the Style Guide Consistency in typing and editing is important to the development of voice models since AutoScript analyzes the dictation and compares it to the final written report. In order to ensure consistency, each institution creates a Style Guide that defines what the final reports will look like. Style Guide Requirements Style Guide requirements can include: how dates are formatted (e.g. 03/03/2008 or March 3, 2008) when Arabic or Roman numerals (e.g. Arabic numerals for 'types' of conditions and Roman numerals for 'grades' of conditions) how many dashes and spaces are used in specific situations (e.g. hyphens without a space between two numeric values, 3-4 months) These elements and many others are defined and communicated to you so that all MTs who work in your system type and edit reports consistently. Recognition improves when the clinician speaks consistently, and MTs type and edit the spoken word consistently.

10 10 Overview of escription Exercise 1 - Summary Questions Please circle T for True or F for False for each of the following summary questions. 1. There is no need to follow the Style Guide for consistency in formatting. T/F 2. Clinicians are voice recognized by work type. T/F 3. It takes at least 6 hours of dictation before a clinician is recognized e.g. an editable draft is created. T/F 4. The speed at which dictations are downloaded is related to the speed of the MTs internet connection. T/F 5. The MT 'trains' the Voice Model to recognize a clinician and work type which is why consistency while transcribing and editing is so important. T/F Confidential Information Nuance. All Rights Reserved.

11 Getting Started in EditScript MT 11 2: Getting Started Objectives Upon completion of this module, you will be able to: Log in to EditScript MT Download Dictations Show Audio Dialog Modify Pedal Bounce-back Adjust Audio Speed and Volume Enter and Modify Patient Demographics Search for Patient Information Add CCs Add a New Contact Log out of EditScript MT

12 12 Getting Started in EditScript MT Logging in to EditScript MT To begin working in EditScript MT, log in to the application. 1. Double click the EditScript MT_9 icon on your Desktop. 2. In the EditScript MT - Login dialog box enter the following: 1) Login ID: (this is case sensitive) 2) Password: (this is case sensitive) 3) Institution: your institution name or acronym 4) System: Test (during training) Production (after Go-Live) 3. Press ENTER or press ALT+O for Ok. Confidential Information Nuance. All Rights Reserved.

13 Getting Started in EditScript MT 13 Using EditScript MT EditScript MT looks familiar because it is integrated with Microsoft Word. In addition to the Word Toolbar, there is also an EditScript MT toolbar. EditScript MT Toolbar Status Bar The Status bar at the bottom of screen provides appropriate messages and commands based on the screen that is open. The messages in the Status Bar change as the screen you are on changes.

14 14 Getting Started in EditScript MT Getting Work ALT+U To download a new dictation to your screen, press ALT+U. The Status bar reads, 'Downloading your next dictation. Please wait'. The first time you press ALT+U, EditScript MT downloads several dictations to your computer and displays the first one on your screen. If the dictation is voice recognized, you will see text. If it is not, you will have a blank screen. When you complete a dictation, press ALT+U. EditScript uploads that dictation and displays the next one from your queue. While you are editing, EditScript downloads another dictation to your queue. This way, there are always dictations in your queue (as long as there are available dictations in the system). Dictations are automatically assigned and downloaded to you based on priority. Confidential Information Nuance. All Rights Reserved.

15 Getting Started in EditScript MT 15 Exercise 2 Log in to EditScript MT and Get Work Please follow the steps below. After using your mouse to launch EditScript MT by clicking on the icon, try to complete these tasks without using your mouse. Enter the required information in each field and then tab to the next field. Press Enter for OK. 1. Log in to EditScript MT using the Login ID and Password assigned by the instructor. 2. Download the first dictation and wait for further instructions. The system downloads one dictation onto your screen and downloads two reports into your queue.

16 16 Getting Started in EditScript MT Changing Options ALT+O Always Display Audio Dialog ALT+O opens the EditScript MT Profile Settings screen. Here you can choose to always display the audio tool bar and to set your pedal bounce back. Always displaying the audio tool bar makes it easy for you to see the duration of the current dictation and to ensure that you listen to the entire dictation prior to uploading. 1. Click the Transcription Tab. 2. Check the box next to Always Display Audio Dialog. After you select this option, you must log out and log in again in order for the change to take effect. Confidential Information Nuance. All Rights Reserved.

17 Getting Started in EditScript MT 17 Changing Foot Pedal Bounce-back Pedal Bounce-back is what happens when you lift your foot off of the play pedal and then press the play pedal again. The audio will rewind for a few seconds before it plays. You determine how far back to rewind by setting the foot pedal Bounce-back. Once the Bounce-back is set, you only need to change it if your preferences change. 1. Click the Foot Pedal Tab. 2. Change the value in the Pedal Bounce-back field by entering the appropriate number in seconds. Pedal Bounce-back is indicated in seconds. You can enter a fraction of a second in the form of a decimal. 3. Press ALT+O for Ok when finished.

18 18 Getting Started in EditScript MT Audio Tools There are several keyboard commands that control the speed and volume of the dictation. They are: ALT+1 Decrease Speed ALT+2 Increase Speed ALT+3 Decrease Volume ALT+4 Increase Volume Using any one of these commands opens the Audio Control Toolbar. 1. Press any one of these commands, ALT+1, ALT+2, ALT+3 or ALT+4, to open the Audio Control toolbar. 2. Hold down the ALT key and repeatedly type 1, 2, 3 or 4 to increase or decrease the audio speed or volume. Audio Control The Audio Control toolbar displays the Current Position of the audio and the Total Duration of the dictation. To return the speed to the default position, use ALT+Z. Press ALT+5 to hide the Audio Control toolbar. Confidential Information Nuance. All Rights Reserved.

19 Getting Started in EditScript MT 19 Exercise 3 Adjusting Audio Controls and Transcribing Start from the beginning of the current dictation. 1. Modify and transcribe the dictation as required. 2. Adjust speed and volume as needed. 3. When finished, remove your headset and wait for further instructions.

20 20 Getting Started in EditScript MT The Header Patient Demographics Your first responsibility when typing or editing a dictation is to verify the patient information. In EditScript MT this information resides at the top of the screen in the Header. Many of the field names in the Header have a letter that is underlined. Press the ALT key and the underlined letter to jump the cursor to that field. The Header pre-populates based on the information the clinician provides when she dictates the report. The actual fields in the Header vary depending on your institution. All Headers have patient name, medical record number (MRN), dictation information and a Visit Grid. The Visit Grid automatically shows recent visits associated with the patient's MRN. Patient Information Dictation Information Visit Grid Confidential Information Nuance. All Rights Reserved.

21 Getting Started in EditScript MT 21 Editing the Header ALT+E 1. To access the Header for editing, press ALT+E. This places the cursor in the Patient Last Name field (or places the cursor in the last header field that it was in.) The Status bar at the bottom of the screen identifies ALT+E as the toggle between the Header and the Work area where the dictation text is displayed. The system defaults a check mark next to the most recent visit for the patient named. If this is not the correct visit and the visit is shown in the Visit Grid, you must select the correct visit. 2. To select the correct visit, press ALT+V to jump the cursor to the Visit Grid. 3. Press the Up and Down Arrow keys to select the correct visit based on the information provided by the clinician. 4. Press the Spacebar to put a checkmark next to the highlighted visit. To check the T for a temporary visit in the visit grid, press CTRL+T. 5. Press ALT+O to Save (Confirm).

22 22 Getting Started in EditScript MT Searching for Patient Information In some instances, you must search for the correct patient and visit. In this example, the search for the correct patient is by Patient Last Name. If you change the patient name or MRN by simply typing in either field, the system will pend the dictation. 1. With the cursor in the Header, press ALT+P to jump the cursor to the Patient Last Name field. EditScript MT automatically copies the search value from the field in which you cursor is located when you press ALT+S. For example, if your cursor is in the MRN field in the Header, the MRN is copied to the search screen. 2. Press ALT+S to search. This opens the search screen. EditScript MT copies the last name from the header onto the search screen. If the Patient Name and MRN fields are yellow at your institution, typing in either field will automatically take you to the search screen. Start to enter either the Patient Name or MRN and the application automatically moves your cursor to that field on the search screen. 3. Type over the highlighted default value to enter a new Patient Last Name. Confidential Information Nuance. All Rights Reserved.

23 Getting Started in EditScript MT Press ALT+S to perform the search based on the new Patient Last Name. The Search Results appear. The fields in the Search Results can be sorted by clicking CTRL+ the number at the top of the field. The Status bar also explains this. 5. Press the Up and Down Arrow keys to select the correct result.

24 24 Getting Started in EditScript MT 6. Press the Spacebar to put a checkmark next to the correct result. 7. Press ALT+O for OK and to return to the Header. 8. Press ALT+O again to Confirm changes. You can see that you have saved changes to the Header when the Confirm button is grayed out. Confidential Information Nuance. All Rights Reserved.

25 Getting Started in EditScript MT 25 Changing Fields with Drop-Down Menus Several fields in the Header can be changed by typing the first couple of letters of the required value. These fields include Worktype and Speaker. To illustrate this, the Speaker is changed to Dr. Collins. 1. With your cursor in the Header, press ALT+K to jump the cursor to the Speaker field. 2. Type Co to change the speaker to one that begins with Co, in this example, Collins. This opens the Drop-down menu. 3. Use the Up and Down Arrow keys to find the correct selection in the Drop-down menu. 4. Press Enter when the required name is highlighted. This changes the entry to the highlighted one. Any fields in the Header that have a Drop-down menu can be changed in the same way (Steps 2-4). When you are finished making changes to the Header, type ALT+O to confirm or save changes. This moves your text cursor back to the body of the report

26 26 Getting Started in EditScript MT Changing Work Type At many institutions, the work type field represents the different document types. Different document types may require different information in the Header. When you change the work type field, you must next press ALT+O to confirm or save that change. The saved change in work type may prompt a change in the header, requiring you to enter additional information. Like other fields in the Header that have drop-down menus, you can change the work type by typing the first couple of letters of the new work type and selecting it from the menu. 1. Type rad to change the work type to radiology. 2. Press Enter when the required work type is highlighted. 3. Type ALT+O to Confirm changes. This may prompt the following message: 4. Press Enter or type ALT+Y for Yes. Make any necessary changes in the new Header and press ALT+O to save. Confidential Information Nuance. All Rights Reserved.

27 Getting Started in EditScript MT 27 Modifying Date Fields The Header may include date fields such as Service Date and Procedure Date. The date fields are divided into 3 sections, month/day/year. Use your Arrow keys right (or left) to move from one section to the next in order to modify the date. Use your Up and Down Arrow keys to increase or decrease the number. Press t to enter 'today's' date. In this example, the Procedure Date is changed from 11/27/2007 to 11/29/ Press ALT+D to jump the cursor to the Procedure Date field. 2. Press the Right Arrow to highlight Press the Up Arrow twice to change 27 to 29. To delete the date or a value in most fields in the Header, press F3. This does not apply to fields that cannot be blank. 4. After completing all changes in the Header, press ALT+O to confirm the changes. The cursor returns to the Work area of the dictation. If you do not save changes by pressing ALT+O, the system will prompt you to do so prior to uploading the completed dictation.

28 28 Getting Started in EditScript MT There is a calendar associated with each date field that can be accessed by using ALT+ Down Arrow. Use Right or Left Arrow to highlight the required date. Then press Enter to select the date and close the calendar. If you do not want to save any of the changes made in the Header, press ALT+R to Reset the Header to the original values. Confidential Information Nuance. All Rights Reserved.

29 Getting Started in EditScript MT 29 Hiding the Header ALT+SHIFT+E The Header can be hidden to provide more work space. Press ALT+SHIFT+E to hide the header. The full Header can be restored by typing ALT+E.

30 30 Getting Started in EditScript MT Exercise 4 Modifying the Header and Transcribing 1. Listen to the dictation that is on your screen. 2. Modify the Header based on the information dictated. 3. Transcribe the dictation. 4. When finished, remove your headsets and wait for further instructions. Confidential Information Nuance. All Rights Reserved.

31 Getting Started in EditScript MT 31 CCs ALT+C To send a report to other physicians or clinics automatically, the appropriate name must appear in the CC field. In EditScript MT, CCs are entered and viewed in the same area as the Header. ALT+C opens the CC dialog box. CC

32 32 Getting Started in EditScript MT Adding a CC 1. Press ALT+C. The Header changes to the Contact List view. Your cursor defaults to the Enter name field. You can find the correct CC based on Name, Speciality and/or Location. You can sort Contacts Found by typing CTRL + the column number. 2. Type the first few letters of the clinic or clinician's last name. For example, type gr for Gray. The list automatically scrolls to match the letters typed. If multiple results start with the same letters, use the Down (or Up) Arrow keys to highlight the correct entry. 3. Press Enter to select the highlighted name. The name appears in the Currently Selected Contacts box. Confidential Information Nuance. All Rights Reserved.

33 Getting Started in EditScript MT Press ALT+O for OK. The CC appears in the CC field. The CC field in the Header is hidden if there is not a CC selected.

34 34 Getting Started in EditScript MT Deleting a CC 1. Press ALT+C to open the CC dialog. 2. Press ALT+D to jump your cursor to the Currently Selected Contacts box. 3. Highlight the entry to be deleted. 4. Press ALT+D to delete the contact. 5. Press ALT+O for OK to save the change. Confidential Information Nuance. All Rights Reserved.

35 Getting Started in EditScript MT 35 Adding a New Contact If the name of the clinician or institution to be added in the CC is not in the list, you can add that clinician or institution. Depending on your institution, this may automatically pend the dictation. If the dictation pends, an administrator will add the complete contact information and decide whether or not to make it available for future dictations. 1. Press ALT+R to open the Create new contact entry dialog. 2. Enter all information known about the new contact here. First Name and Last Name are the only required fields when adding a new contact. 3. Press ALT+O for OK.

36 36 Getting Started in EditScript MT In the CC list, the new contact appears in the Currently Selected Contacts box. 4. Press ALT+O for OK when you finish modifying the CCs. Confidential Information Nuance. All Rights Reserved.

37 Getting Started in EditScript MT 37 Exercise 5 Modifying the Header and Transcribing 1. Listen to the dictation that is on your screen. 2. Modify the Header based on the information dictated. 3. Transcribe the dictation. 4. Modify the CC field based on the information dictated. 5. When finished, remove your headset and wait for further instructions.

38 38 Getting Started in EditScript MT Inserting a Contact Name into a Dictation ALT+I In the text of a dictation, you may need to add the name of a clinician. You can type the name or EditScript MT can insert the name in the body of the dictation at the location of your cursor. This is helpful when you are unfamiliar with the spelling of the contact to be inserted. 1. With your cursor in the body of dictation at the location where the contact is named, Press ALT+I. This opens the same dialog box used for CCs. 2. Select the Contact and press ALT+O or Enter for OK. EditScript MT inserts the contact s name into the dictation without the address. Confidential Information Nuance. All Rights Reserved.

39 Getting Started in EditScript MT 39 Taking a Break and Logging Out ALT+SHIFT+U At the end of the day or prior to taking a break, you want to upload the completed dictation without downloading another dictation onto your screen. As long as there is an open dictation on your screen, the lines per hour clock continues to track your time for that open dictation. ALT+SHIFT+U uploads the current dictation, but does not download another onto your screen. However, dictations remain in your queue until you exit from EditScript MT. Use ALT+SHIFT+U if you have completed a dictation and want to take a short break or end work for the day (prior to logging out of EditScript MT). ALT+SHIFT+U and EXIT ALT+SHIFT+U uploads your completed dictation without putting another dictation from your queue onto your screen. However, dictations remain in your queue and other MTs do not have direct access to those dictations. To release those dictations from the queue, you must log out of EditScript MT. To log out of EditScript MT, click the X in the upper right corner of your screen. This removes all dictations from your queue, puts them back in the general queue and makes them available to other MTs. Always complete the dictation that is downloaded on your screen prior to taking a break or logging out for the day.

40 Using Word Tools 40 Exercise 6 Taking a Break and Logging Out 1. Upload the dictation that is currently on your desktop but do not download another. 2. Log out of EditScript MT. 3. Give yourself a break!

41 Using Word Tools 41 3: Using Word Tools Objectives Upon completion of this module, you will be able to: Explain how Word Shortcuts Work Use Essential Word Shortcuts Set up AutoCorrect

42 42 Using Word Tools How Word Shortcuts Work Shortcuts are a set of keys which, when used in combination, perform common tasks that otherwise would require you to use the mouse or to use multiple key strokes. Since EditScript MT is integrated with Microsoft Word, shortcuts that you use in Word, can also be used in EditScript MT. Shortcuts allow you to navigate quickly through dictations. Shortcuts also allow you to keep your fingers on the home keys of the keyboard, thereby reducing physical stress. Best practice is to transcribe and edit mouse free by using keyboard shortcuts. The most common keys that Word uses as shortcuts are SHIFT and CTRL. These keys change or enhance the actions of other keys. When using SHIFT or CTRL, hold the key down and press the other key that is required to complete the shortcut. Confidential Information Nuance. All Rights Reserved.

43 Using Word Tools 43 Exercise 7 Word Shortcut Key Tutorial There is a Word file named wskt.doc on your computer desktop. 1. Open the file and perform the actions described. 2. Close the file when finished and return to EditScript MT.

44 44 Using Word Tools Essential Word Shortcut Keys Word has numerous shortcuts to make your work easier. Focus on one at a time until it becomes routine, then learn another. Below are the Word shortcuts that are most helpful: CTRL + CTRL + Jumps word-by-word to the left Jumps word-by-word to the right CTRL + CTRL + Jumps by paragraph up Jumps by paragraph down CTRL + SHIFT + CTRL + SHIFT + Highlights text, word-by-word, to the left Highlights text, word-by-word, to the right CTRL + SHIFT + CTRL + SHIFT + Highlights and jumps by paragraph up Highlights and jumps by paragraph down CTRL + BACKSPACE Deletes word-by-word to the left CTRL + DELETE Deletes word-by-word to the right HOME END Jumps to the beginning of the line Jumps to the end of the line CTRL + C CTRL + X CTRL + V Copies the selected text to the clipboard Cuts the selected text and holds it on the clipboard Pastes the text from the clipboard to the current cursor position CTRL + Z SHIFT + F3 CTRL + F Undoes the last change made Changes case from Title, to UPPER, to lower Opens Find and Replace dialog Confidential Information Nuance. All Rights Reserved.

45 Using Word Tools 45 Using AutoCorrect AutoCorrect is Microsoft Word's built in utility that automatically recognizes misspellings or abbreviations and corrects them as you type. It allows you to type just a few characters instead of the full word. For example, you can type tp for the patient. This tool is a tremendous time-saver. In this example, htn is added for hypertension. 1. Click the Tools item in the menu bar (or press ALT+ T, then A and skip the next step) 2. Click AutoCorrect on the dropdown menu. 3. The AutoCorrect dialog box opens. Replace box With box 4. In the Replace box, type htn. 5. Tab to the With box, and type hypertension. 6. Press ENTER to accept this entry and to close AutoCorrect (or press ALT+A to select the Add button), and then press ALT+O to click OK. 7. Test your AutoCorrect entry. In an open Word document, type the abbreviation, htn. The first space bar, punctuation or return that you press after that last letter, "n", causes the abbreviation to expand to hypertension.

46 46 Using Word Tools Exercise 8 Practice AutoCorrect In this exercise, create your own set of shortcuts for Auto Correct. Then complete the exercise using Auto Correct. The words that require shortcuts are listed, please enter them into AutoCorrect. EXERCISE 8A 1. Identify the following: replace htn with hypertension HISTORY OF PRESENT ILLNESS REVIEW OF SYSTEMS temperature round and reactive full range of motion -year-old 2. Open Auto Correct and enter the above shortcuts (replace with). EXERCISE 8B 1. Get the next dictation. 2. Transcribe the dictation. 3. Use your AutoCorrect shortcuts when appropriate. 4. When finished, remove your headset and wait for further instructions. Confidential Information Nuance. All Rights Reserved.

47 Editing in EditScript MT 47 4: Editing in EditScript MT Objectives Upon completion of this module, you will be able to: Explain and Use Multiple Cursors Explain and Use EditScript MT Punctuation Commands

48 48 Editing in EditScript MT Multiple Cursors As voice models are developed, the system generates voice recognized drafts of reports that require editing. To make editing easier, EditScript MT has a voice cursor that follows the dictation and highlights each word as the clinician speaks it. The voice cursor acts as a visual queue of what you are listening to in the report. EditScript MT has two cursors: Text cursor - MS Word's cursor that indicates where you are typing Voice cursor red box, in the editable draft, that moves with the dictation that you are listening to; aids in locating of errors The two cursors can work together to locate errors and to make editing easier and faster. Text Cursor Voice Cursor You do not have to follow the speech with the text cursor or arrow key. The voice cursor does that for you. Confidential Information Nuance. All Rights Reserved.

49 Editing in EditScript MT 49 Using ALT+K When editing, the goal is to move the text cursor to the error as quickly as possible in order to make the correction. Having the voice cursor makes it easier to visually locate the error. ALT+K jumps your text cursor to the voice cursor for faster editing. ALT+K moves the text cursor to the word currently outlined by the red voice cursor and highlights that word. When you hear a mistake in the text, press ALT+K to jump the text cursor to the word that is marked by the voice cursor.. ALT+K If you react late and the voice cursor is past the incorrect word, you can CTRL+Left Arrow to get back to the incorrect word. ALT+K is one of many commands used to navigate quickly through a report. It is often used with CTRL+Arrow if you miss the targeted word using ALT+K.

50 50 Editing in EditScript MT Exercise 9 Jumping to a Word using ALT+K In this draft dictation the drugs, Ativan, Celexa and Zoloft, are incorrect. For this exercise, use ALT+K to jump the text cursor to the voice cursor when you locate one of the incorrect drug names. Do not correct the misspellings. The goal of this exercise is for you to practice jumping your text cursor to your voice cursor using ALT+K. 1. Listen to the dictation 2. Stop the dictation by removing your foot from the foot pedal when you hear the name of one of the drugs that is misspelled. 3. Press ALT+K to move the text cursor to the voice cursor since the voice cursor is 'marking' the location of the error. 4. Do not correct the error. 5. Restart the dictation and continue to stop at each misspelling and to press ALT+K. 6. Go through the entire dictation. 7. When finished, remove your headset and wait for further instructions. Confidential Information Nuance. All Rights Reserved.

51 Editing in EditScript MT 51 Exercise 10 Fixing a Word using ALT+K Use the new dictation you just downloaded. It is similar to the previous one where Ativan, Celexa and Zoloft are misspelled. In this exercise, fix the errors. 1. Listen to the dictation. 2. Stop the dictation by removing your foot from the foot pedal when you hear the name of one of the drugs that is incorrect. 3. Press ALT+K to move the text cursor to the voice cursor. 4. Fix the error. 5. Restart the dictation and continue to stop at each error, press ALT+K and fix the error. 6. When finished, remove your headset and wait for further instructions.

52 52 Editing in EditScript MT Using ALT+SHIFT+K ALT+SHIFT+K is the opposite of ALT+K. It moves the red voice cursor to the position of the text cursor. This is useful to rewind or fast forward to a specific word. Perhaps a clinician speaks a word that you cannot understand, but later says something that clarifies that word. Instead of rewinding the dictation with your foot pedal, you can move your text cursor to the word and press ALT+SHIFT+K. This moves the voice cursor to the location of the text cursor. Since the voice cursor is tied to the dictation audio, the audio begins at the location of the voice cursor. How to use ALT+SHIFT+K to repeat a word or phrase: Move your text cursor to the word or phrase Hold your foot down on the foot pedal Hold down the ALT+SHIFT keys Press K as often as necessary to hear the word repeatedly To return to the place in the dictation where you had been listening, move your text cursor there and press ALT+SHIFT+K. Confidential Information Nuance. All Rights Reserved.

53 Editing in EditScript MT 53 Exercise 11 Practice Edit this draft. Practice using MS Word shortcuts and EditScript MT commands. 1. Listen to the dictation. 2. Edit and fix the error. 3. Take your time and practice using what you have learned thusfar. 4. When finished, remove your headset and wait for further instructions..

54 54 Editing in EditScript MT Correction Macro ALT+. (PERIOD) ALT+. (period) When adding a period at the end of a sentence, you normally type the period, press the space bar twice and capitalize the first letter of the next word. The EditScript MT command, ALT+. (period), inserts a period, ensures two spaces and capitalizes the first letter of the first word in the next sentence. This saves you many key strokes. In order to use ALT+. (period) properly, the text cursor must be: in the space between the two sentences OR in the last word of the first sentence Using ALT+K with ALT+. (period) When you use ALT+K with ALT+. (period), try to stop the voice cursor at the beginning of the second sentence. Press ALT+K when the voice cursor is on the first word of the second sentence. This highlights that first word; the text cursor appears to land in the space between the two sentences. Press ALT+. (period) to place the period at the end of that last word of the first sentence. If you press ALT+K and land on the last word of the first sentence, use your Right Arrow key once to move the text cursor to the space between the two sentences. Then press ALT+. (period) to place the period at the end of that last word of the first sentence as intended. Confidential Information Nuance. All Rights Reserved.

55 Editing in EditScript MT 55 Exercise 12 Using ALT+. (Period) This draft dictation requires that periods be added. 1. Listen to the dictation. 2. When you find that a period is missing, move your text cursor to the error. (Press ALT+K, or CTRL+Arrow). 3. Press ALT+. (period) to insert the period. 4. When finished, remove your headset and wait for further instructions.

56 56 Editing in EditScript MT Correction Macro ALT+SHIFT+: (COLON) ALT+SHIFT+: (colon) ALT+SHIFT+: (colon) works in a similar manner as ALT+.(period). ALT+SHIFT+: (colon) inserts a colon, ensures two spaces and capitalizes the first letter of the first word following the colon. Several keystrokes are eliminated by typing the correction macro, ALT+SHIFT+: (colon) In order for ALT+SHIFT+: to work properly, the text cursor must be: in the space between the last word before the colon and first word after the colon OR in the last word prior to the colon Using ALT+K with ALT+SHIFT+: (colon) When you use ALT+K with ALT+SHIFT+: (colon), try to stop the voice cursor on the word after the colon. Press ALT+K when the voice cursor is on that first word. This highlights that first word; the text cursor appears to land in the space between the colon and the first word. Press ALT+SHIFT+: (colon) to place the colon at the end of that last word before the colon. If you press ALT+K and land on the word prior to the colon, use your Right Arrow key once to move the text cursor to the space between the colon and the first word. Then press ALT+SHIFT+: (colon) to place the colon at the end of that word as intended. Confidential Information Nuance. All Rights Reserved.

57 Editing in EditScript MT 57 Exercise 13 Using ALT+SHIFT+: (Colon) This draft dictation requires that colons be added. 1. Listen to the dictation. 2. When you find that a colon is missing, use the appropriate commands to navigate your text cursor to the error. 3. Press ALT+SHIFT+: (colon) to insert the colon. 4. When finished, remove your headset and wait for further instructions.

58 58 Editing in EditScript MT Exercise 14 - Practice Dictations Please transcribe or edit the next two practice dictations. This is a great opportunity to practice what you've learned thus far. Edit the header mouse free Incorporate some of your style guide requirements Use MS Word Shortcut and EditScript MT Commands 1. Edit the header, add the CC and transcribe the first dictation. 2. Upload the first dictation and get the next dictation. 3. Edit the second dictation as needed. 4. When finished, remove your headset and wait for further instruction. Confidential Information Nuance. All Rights Reserved.

59 EditScript Tools 59 5: EditScript Tools Objectives Upon completion of this module, you will be able to: Pend Dictations Insert and Use Templates Split Dictations

60 60 EditScript Tools Pending Dictations ALT+Y There are times when you have questions about a dictation that do not allow you to complete it prior to uploading it. In such cases you will pend that dictation with a note so that an administrator can review it and complete it. A pending note in EditScript MT tags the dictation as incomplete upon upload. There are many situations that will require you to add a note to pend a dictation. Reasons for pending will be communicated to you prior to Go-Live. In some situations EditScript MT automatically pends dictations. Automatic pends can occur because of a temporary MRN, no Date of Service or more than a specified number of blanks. The reasons for automatically pending dictations are defined by your institution. In most cases a blank in EditScript MT is defined as 5 underscores. 1. Press ALT+Y to open the Pending note dialog box. Confidential Information Nuance. All Rights Reserved.

61 EditScript Tools Enter a note. Your institution may have a specific naming convention and instructions about how notes should be written. 3. Press ALT+O for OK to save the note. You can open and modify the pending note as often as needed until you upload the dictation.

62 62 EditScript Tools 4. To clear or remove the pending note prior to uploading the dictation, press ALT+Y to open the note. 5. Press ALT+R for Clear Pending Note. 6. Press ALT+O for OK. 7. Press ALT+N for No. The dictation is no longer pended. Confidential Information Nuance. All Rights Reserved.

63 EditScript Tools 63 Exercise 15 Pend a Dictation In this dictation, the speaker is not speaking clearly. You will have to pend this dictation. 1. Listen to and edit the dictation as best as you can. 2. Pend the dictation to indicate the 'problem'. 3. When finished, remove your headset and wait for further instructions..

64 64 EditScript Tools Inserting and Using Templates ALT+M Some clinicians use standard text for a particular procedure. Rather than dictating the same information in every report, the clinician may call for a 'normal'. These normals or templates are available to you in EditScript MT. When the clinician calls for a 'normal', position your text cursor at the point in the report where you want to insert the template. That is where the template will paste. 1. Press ALT+M to open the Choose Template for Insertion dialog box. Confidential Information Nuance. All Rights Reserved.

65 EditScript Tools In the Find Tag in Current Table field, type the name of the required template. If your text cursor does not land in the Find Tag in Current Table field, press the Tab key, then type the template name. 3. Arrow down to highlight the correct Template. Depending on how your institution is configured, EditScript MT can preselect one or many templates based on Business Entity, Dictating Clinician and/or Work Type.

66 66 EditScript Tools To preview the highlighted template, press ALT+P To insert the highlighted template, press ALT+I To cancel and return to the dictation, press ALT+L To navigate mouse-free through the template chooser, use ALT+the underlined letter. The status line also shows these keyboard commands. 4. Press ALT+P to preview the template. 5. If this is the correct template, press ALT+I to insert this template into the dictation at the location of your cursor. If you want to choose another template, press ALT+T, to return to the list of templates. If you want to return to the dictation without inserting a template, press ALT+L to cancel. You can copy and paste part of the template into the report. From the preview screen, highlight the part of the template to be copied and pasted, press CTRL+C to copy, press ALT+L to close the preview screen, and press ALT+V to paste the template section into the dictation. Confidential Information Nuance. All Rights Reserved.

67 EditScript Tools 67 ALT+R Some templates have double question marks to represent blanks. After you have inserted the template into the report, type ALT+R to jump from?? to??. This jump and replace code helps you navigate faster and ensures that you do not miss a value that must be added. The two question marks?? can also be used to mark a section of the dictation that you need to return to prior to uploading the dictation. It can be used with blanks (?? ).

68 68 EditScript Tools Exercise 16 Insert a Template In this dictation, the clinician asks that his 'normal' be inserted. The procedure started with the right ear; the required template contains??. 1. Transcribe the dictation. 2. Insert the 'normal'. 3. Press ALT+R to replace the question marks (??). 4. When finished, remove your headset and wait for further instructions. Confidential Information Nuance. All Rights Reserved.

69 EditScript Tools 69 Splitting Dictations Some providers inadvertently record multiple dictations on one voice file. EditScript MT makes it easy to split that one file into multiple documents and to change the patient information accordingly. Each new document is assigned a unique dictation ID and the entire voice file is copied to each new dictation. As you listen to a dictation, split the dictation when you hear information for a new patient by clicking the Split Dictation button on the EditScript toolbar Your institution may have configured a keyboard command, ALT+SHIFT+6, for splitting dictations. For editable drafts, your cursor must be at end of the first report. EditScript MT highlights all of the text above the text cursor. This is the report that will be split and uploaded. For standard transcriptions, EditScript MT uploads the entire document that you have typed thusfar. 1. For a draft, place your text cursor at the end of the first report. 2. Click the Split Dictation button, 3. Press Enter (yes) to split the dictation and upload it. 4. All of the text below the split remains as part of the next dictation. The Header and CC information must be edited for each dictation. When you are on the last report in the file, you must listen to the entire voice file or the dictation will pend.

70 70 EditScript Tools Exercise 17 Split a Dictation This voice file contains three dictations. The three patients are: Bart Simpson Yogi Bear Betty Boop Edit and add pending notes as needed. 1. Edit the Headers and reports as needed. 2. Place your text cursor at the end of the first dictation. 3. Click the Split Dictation button 4. Edit the second dictation as needed. 5. Place your text cursor in the correct position and split the second dictation from the file. 6. Edit the third dictation, upload it and do not get a new dictation. 7. Remove your headset and wait for further instructions. Confidential Information Nuance. All Rights Reserved.

71 Managing Your Workflow 71 6: Managing Your Workflow Objectives Upon completion of this module, you will be able to: Explain and Use Workflow Best Practices Handle Priority Dictations View Metrics Search for Dictations Answer Review Questions

72 72 Managing Your Workflow Workflow Best Practices How EditScript MT Manages Dictations When you download your first dictation, one dictation is sent to your screen and several others are sent to your work queue. As you complete one dictation and upload it, a dictation from your work queue is sent to your screen. At the same time, another dictation from the general queue is automatically sent to your work queue. These dictations are Downloaded and Checked Out to you until either you finish them or you release them back to the general queue by exiting EditScript MT. If a dictation is opened on your screen, then the lines per hour clock is running. Best practice is to always finish the current dictation prior to taking a break. Then upload that dictation without downloading another. Viewing Dictations in Your Work Queue In order to determine when to take a break or how to plan your time, you need information about the next dictation in your queue. You can view the dictations in your work queue by typing ALT+Q. Best practice is to view your work queue when you do not have a dictation on your screen. Confidential Information Nuance. All Rights Reserved.

73 Managing Your Workflow Press ALT+Q to open the Dictations in the Queue dialog. Speaker Duration Standard or Edited Transcription Priority The work queue shows the dictations that are Downloaded and Checked Out to you. The order in which you will receive those dictations is based on the priority number. In the work queue, you see: Speaker and dictation duration Status: Standard Transcription or Edited Transcription Priority This information helps you make an informed decision about whether to download the next dictation or not. 2. Press ALT+E to close the Dictations in the Queue dialog. Pausing a Dictation If you are in the middle of the dictation and need to take a quick break, you can use the Pause feature. This stops the lines per hour meter on the dictation that you are working on and holds your position until you resume editing. During the pause, the dictation is locked onto your screen and the dictations in your work queue are still Downloaded and Checked Out to you. Pause EditScript and Transcription Timer is located in the Utilities drop-down menu.

74 74 Managing Your Workflow 1. Click the Utilities drop-down menu. 2. Click Pause EditScript and Transcription Timer. This opens a dialog box that tracks how long the dictation is paused. 3. When you are ready to return to the dictation, press ALT+R to Resume Editing. Taking Longer Breaks or Ending Your Work Day When taking a longer break or ending your day, finish the dictation, upload it without downloading another and exit EditScript MT. The dictations in your work queue will be sent back to the general queue and made available to other MTs. Always exit EditScript MT at the end of your work day. Emergencies In an emergency, you may not have time to finish a dictation and follow work flow best practices. In an emergency, do not leave the dictation on your screen. Do not leave dictations in your queue that are Downloaded and Checked Out to you. Confidential Information Nuance. All Rights Reserved.

75 Managing Your Workflow 75 The quickest way to exit the application is by clicking the X on the upper right corner of your screen. You will lose the work on the current dictation and the dictations in your queue are sent back to the general queue of dictations. When you exit EditScript MT without completing and uploading the current dictation, the following dialog box appears: If it is an emergency, click Yes. If you upload an incomplete dictation prior to exiting EditScript MT, the dictation will automatically pend. High Priority Dictations If you receive a 'stat' or high priority dictation, you will see the following message: Yes immediately accepts the high priority dictation. EditScript MT saves the current dictation that you are working on, and returns it after you have completed and uploaded the priority dictation. No holds the priority dictation. After you complete and upload the current dictation that you are working on, EditScript MT opens the priority dictation.

76 76 Managing Your Workflow Exercise 18 Workflow Best Practices In the table below, complete the information for WHAT TO DO and WHY: WHEN WHAT TO DO WHY Short break Long break Emergencies End of day View dictations in your work queue Priority dictation Your instructor will review this information with you. Confidential Information Nuance. All Rights Reserved.

77 Managing Your Workflow 77 Viewing and Printing Metrics ALT+X You can view your performance in EditScript MT in terms of lines per hour and feature usage. This information is presented by median and average lines per hour for both edited and standard (transcribed) reports. The Metrics dialog also shows which of the 6 features you have mastered and provides feedback about these features. 1. Press ALT+X to open the Enter Date Range dialog. The date range defaults to 'today's' date. 2. Accept the default dates or enter a new date range. 3. Click ALT+O for OK.

78 78 Managing Your Workflow The Transcription Metrics dialog shows: Link to Demos on the EditScript MT Features Completed transcriptions Metrics Recent Feature Usage Feedback This information is useful for tracking your progress using EditScript MT and for setting personal goals. 4. To close this dialog, press ALT+X. Confidential Information Nuance. All Rights Reserved.

79 Managing Your Workflow 79 EditScript MT Features The features that are tracked and displayed in the Recent Feature Usage section of the EditScript MT Metrics screen help increase your productivity. When used optimally, these features help you increase your lines per hour and cause less physical stress on your body. There are 6 recommended features that help with productivity gains. They are: CONTROL NAVIGATION using CTRL+Arrow keys LIMITED ARROW NAVIGATION - limiting use of single arrow keystrokes MOUSE FREE NAVIGATION using shortcut keys and commands instead of the mouse PLAY AUDIO FASTER using ALT+2 to increase audio speed CORRECTION MACROS using the punctuation commands ALT+. (period) and ALT+SHIFT+: (colon) MULTIPLE CURSORS using ALT+K Your mastery of these 6 features can be viewed in EditScript MT by pressing ALT+X. Your manager can also view your progress in the Feature Analysis Report. In order to increase your productivity using these features, it is best to learn them one at a time. After a feature has become 'second-nature', focus on another feature. The table below provides an indication of how your lines per hour can increase based on the number of features used. Total Features Used Average Lines Per Hour

80 80 Managing Your Workflow Searching for Previous Reports ALT+SHIFT+> You may search for and view previous dictations. This is useful for problem-solving a report that you are working on. 1. Press ALT+SHIFT+> 2. Enter the same login and password you use for EditScript MT. 3. You can also get to the Search for Transcriptions and Dictations page by going to entering the name of your institution and logging in to EditScript Online. The Search for Transcriptions and Dictations page opens. Search for dictations using one or more of the fields shown on this page. Best practice is to open the Search for Transcriptions and Dictations page at the beginning of your work day so it is readily available for reference throughout your day. Confidential Information Nuance. All Rights Reserved.

81 Managing Your Workflow Enter search criteria such as Patient Last Name. After you define your search criteria, you can also filter by using the Full Text Search at the bottom of the page. Here you can enter words and phrases found in the reports.

82 82 Managing Your Workflow 5. Press Search. Completed Dictation Audio File Only 6. Check the box next to the dictation you want to view. 7. Click View to open the actual dictation. 8. The dictation opens. View and listen to the dictation as needed. A speaker icon without a check box on the Search Results page means that the dictation has not been transcribed or edited. In this case you can only listen to the incomplete report by clicking the speaker icon. Confidential Information Nuance. All Rights Reserved.

83 Managing Your Workflow 83 EditScript MT Review Questions 1. In the header, you must select a different visit in the Visit Grid. How do you highlight the third visit/account# mouse-free? a) Press Tab twice b) Press the down arrow key twice c) Press Ctrl+down arrow twice 2. You type Alt+K to select a word. You then type Alt+Period. Where does the period go? a) At the end of the highlighted word b) At the end of the word before the highlighted word c) The highlighted word is deleted and replaced by a period 3. When do you use Alt+E? a) To exit EditScript. b) To add a CC c) To edit the Header 4. Which shortcut do you use to increase the audio speed? a) Alt+1 b) Alt+2 c) Alt+4 5. When you type Alt+K: a) The Text Cursor moves to the Voice Cursor position b) The Voice Cursor moves to the Text Cursor position c) The Voice Cursor pauses 6. Why use Ctrl+arrow? a) To move the voice cursor to the text cursor after using Alt+K b) To move mouse-free through the Header c) To navigate the text cursor quickly as needed

84 84 Managing Your Workflow 7. You notice that a section heading in the draft is all lower case. What is the best way to fix this error? a) Alt+K to the location and correct the error by deleting and retyping the heading. b) Use the Ctrl+arrow shortcut keys to navigate to the heading, Ctrl-Shift-Arrow to select the heading, Shift+F3 twice to upper case the heading c) Arrow key down to the heading, Shift+Arrow to select the words in the heading, Ctrl-Shift-A to uppercase the heading 8. In the header, you have to change the patient by doing a search or by selecting a different visit in the Visit Grid. Once you have highlighted the new patient name, how do you actually select that patient? a) Press Tab b) Type Alt+S c) Press the space bar 9. What is the shortcut to upload your last transcription of the day? a) Alt+U b) Alt-Shift+U c) Alt+N 10. You realize that the audio file for a draft contains multiple dictations. What do you do? a) Edit the draft up to the next/new dictation, make sure the text cursor is at the end of the previous dictation, and then click the Split Dictations button on the Workflow toolbar (or if available, use the appropriate keyboard command) b) Pend the dictation c) Highlight the text for the first part of the dictation then type Alt+S to split the dictation 11. When do you use ALT+X? a) To pend a dictation b) To view performance metrics and to access training demos c) To add a CC for extra copies Confidential Information Nuance. All Rights Reserved.

85 Appendix 85 Appendix The appendix contains information on: MT Instructions EditScript MT Certification Amending Dictations Creating a Document without Audio EditScript Commands

86 86 Appendix Appendix A: MT Instructions MT Instructions provide information that is pertinent to the dictation on which you are working. These instructions may automatically appear on the screen in the header or you may need to open the instructions dialog box to view the message. When there are MT Instructions, there is an icon in the status bar. The following shows how MT Instructions automatically appear in the header: ALT+SHIFT+W acts as a toggle to hide or unhide the automatic message. If there are instructions, but the instructions are not immediately visible, you will see icon in the right corner of the status bar. 1. Type ALT+SHIFT+F or click opens: 2. Type ALT+O or Enter to close the Instructions dialog box. to view the instructions. The Instructions dialog box MT Instructions can be defined by specific Speaker, Work Type and/or Business Entity. If you change any of these fields in the Header and save those changes, the MT Instructions may no longer be relevant. There may no longer be instructions or new instructions may appear. Confidential Information Nuance. All Rights Reserved.

87 Appendix 87 Appendix B - EditScript MT Certification EditScript MT Certification Certification requirements are performance based and have no prerequisites. All MTs who use EditScript MT are eligible for certification. Requirements for Advanced and Expert Certification are as follows: EditScript Advanced Certification: Master 3 of the 6 features; maintain this level for 3 months. Edit at least 10,000 lines at an average rate greater than 300 lines per hour (375 for Radiology). Produce high quality work that can be verified by your MT manager. EditScript Expert Certification: Master 5 of the 6 features; maintain this level for 3 months. Edit at least 10,000 lines at an average rate greater than 500 lines per hour (625 for Radiology). Produce high quality work that can be verified by your MT manager. The EditScript MT Certification program is a great way to set personal goals and to demonstrate your skills. How to Register for Certification 1. From the Utilities drop-down menu, click Online Tools.

88 88 Appendix 2. You can also access EditScript Online by going to entering the name of your institution and logging in. On the Online Tools page, click MT Feedback to register for EditScript MT Certification. Confidential Information Nuance. All Rights Reserved.

89 Appendix Press Click Here to open the Registration page. Registration 4. Enter the Registration Information. Name Address MT Manager 5. Press Submit.

90 90 Appendix Appendix C Amending Dictations ALT+SHIFT+A Occasionally, a dictation is an amendment to a previous dictation. EditScript MT makes it easy to add this new dictation to the original one. When a report is identified as an amendment, you must search for the original dictation and select it. EditScript MT adds the text of the original dictation to the beginning of the current dictation. 1. Press ALT+SHIFT+A to open the Search for Dictations to Link dialog. The application automatically searches on the MRN. You can narrow the search results by entering additional search information such as the speaker name and then typing ALT+S to search. Confidential Information Nuance. All Rights Reserved.

91 Appendix Based on the required information, use the Arrow Up or Down keys to highlight the correct dictation to amend. Dictation Status 3. The Work Status field shows the Status of the Dictation. You can select only Unsigned dictations to Amend. Press ALT+V to view the selected dictation. You can view Signed dictations for additional information, if needed.

92 92 Appendix 4. If this is the correct dictation, press ALT+A to insert this dictation at the beginning of the current dictation. 5. Press ALT+O to confirm changes prior to uploading this dictation. Confidential Information Nuance. All Rights Reserved.

93 Appendix 93 Appendix D Creating a Document without Audio EditScript MT allows you to create a document from a source other than an IntelliScript audio file, such a paper record or cassette tape. This is useful when a clinician requires a report, but is not able to dictate through the usual workflow. One of two icons on the EditScript MT Toolbar can be used to create a new document. - Used to used to upload the current completed dictation and to create a new document - Used to create a new document from a blank screen Your institution may have configured a keyboard command for each of these features. 1. Press or to create a new document. The new document has a unique dictation ID and 'unknown' in the Header. 2. Search for patient information based on the information that you have. 3. Transcribe the report and upload as usual. The application adds a short, generic voice message at the beginning of the dictation.

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