Customer Success Story: Dragon Medical 360 Network Edition with Microsoft Application Virtualization
Contents Contents 2 Introduction 3 Hardware and Software Configurations 3 Dragon Medical 360 Network Edition Servers 3 Sequencer 4 App-V Information 4 Applications 4 Configuring DM360 Network Edition for Use With App-V 4 Step One: Changing the Local Cache Location on the DM360 Network Edition Server 4 Step Two: Prepare the Sequencing Machine 5 Step Three: Run the Sequencer 6
Introduction Dictating and transcribing patient reports are important tasks in healthcare. Dragon Medical streamlines this process, converting a physician's speech into text automatically. The Dragon software is integrated with many common clinical applications, allowing dictation and transcription to occur seamlessly in the context of workflows that are already well-known to the physicians. The IT team at Medical Clinic of South Carolina (MUSC) wanted to make this ability accessible to its physicians any time, any place, on any platform desktop, smartphone, or tablet. To accomplish this, they used Microsoft's Application Virtualization platform (App-V) in conjunction with Dragon Medical 360 Network Edition (DM360 Network Edition) and their EHR, EpicCare from Epic Systems Corporation. This case study describes how they achieved this result. Note: While Nuance strives to provide guidance toward a smooth implementation of Dragon Medical, due to the variability in Virtual Desktop environments, the customer is ultimately responsible for the configuration, validation, and ongoing maintenance of their virtual desktop environments to provide a suitable platform for reliable operation of Dragon Medical. Hardware and Software Configurations The following tables document the hardware and software configurations Medical Clinic of South Carolina used in their implementation: Dragon Medical 360 Network Edition Servers Nuance Management Server URL Nuance Management Server Profile Server Speech Node Server Table 1: DM360 Network Edition Servers Value http://dragon-mgr/nmc/client.xbap Dragon-mgr Dragon-prof Dragon-node1-3 -
Sequencer Software Name (friendly) Dragon.101 Software Version (general) 4.6.1.30091 OS Sequenced On Windows 7 x86 with Service Pack 1 Primary Directory Q:\Dragon101 Adobe Reader Additional Software Installed on Sequencing VM Internet Explorer VMWare Table 2: Sequencer Configuration App-V Information Value App-V Name Dragon Medical 10.1 SPRJ File Name DragonMed.sprj SFT File Name DragonMed.sft Server URL: /content/dragon.101 Table 3: App-V Information Applications Application 1 Show Dragon Log Application 2 Dragon Medical 360 Network Edition Table 4: Applications Configuring DM360 Network Edition for Use With App- V The following sections describe in detail how the team at MUSC configured DM360 Network Edition to work with App-V: Step One: Changing the Local Cache Location on the DM360 Network Edition Server You need to change DM360 Network Edition's default local cache location order for the virtual package to work. The default location for the local cache is: \%appdata%\nuance\naturallyspeaking\cache\dragonusername For the MUSC environment, we changed this location to: - 4 -
C:\Program Files\Scripts\Dragon. You must pre-create this directory on the hard drive, or Dragon will not allow the user to log in. Complete the following steps to change the location of the cache: 1. On the DM360 Network Edition server, create a directory for the cache. 2. Log in to the Nuance Management Server (NMS) as an Administrator. 3. Go to Sites > Organization Overview > Site Details > Dragon Settings. 4. The Dragon Settings tab displays. Expand the Master User Profile section of the UI by clicking the + icon. 5. The Master User Profile section of the UI expands. Go to the Local cache directory field. 6. Click the Browse button, located at the end of the field, and navigate to the new cache location that you created in step 1. The path to the new cache appears in the Local cache directory field: 7. Click the Save button to save your changes. Step Two: Prepare the Sequencing Machine Complete the following steps to prepare the sequencing machine: 1. Start the sequencing machine. 2. Verify that sequencing machine has a physical Q:\ drive. 3. Join the sequencing machine to the domain. 4. Copy the DM360 Network Edition installation the files to the sequencing machine's desktop (the entire contents of the Client Software DVD directory). 5. Copy the NSDefaults.ini and NSApps.ini files to the sequencing machine's desktop. - 5 -
6. Create the following directory: C:\Program Files\Scripts\Dragon 7. Run the following command to create a DNS.bat, where <Path_to_Dragon_ MSI> is the path to the Dragon NaturallySpeaking.msi file, located in the directory on the desktop that you created in Step 4, and <Dragon_Serial_Number> is the serial number for your DM360 Network Edition software: "C:<Path_to_Dragon_MSI>\Dragon NaturallySpeaking 10.msi" SERIALNUMBER=<Dragon_Serial_Number> NAS_ADDRESS=dragonmgr-v DEFAULTSINI="c:\program files\scripts\dragonini\nsdefaults.ini" PRODUCTUPDATEFLAG=-1 8. Use VMWare to make a snapshot of the sequencer's current state. Step Three: Run the Sequencer Start the sequencer and select the options described in the following table: Packaging Create. Method Application Standard Application Type Select Perform a custom installation. Installer Dragon.101 Name Virtual Q:\ Dragon.101 Directory 1. Install VCRuntime from: \CLIENT DISK\ISSetupPrerequisites\VCRuntime.exe 2. Install the Nuance software certificates from \Nuance_Software_Certificates.msi 3. Copy nsdefaults.ini to: C:\Program Files\scripts\dragonini\nsdefaults.ini Installation 4. Install Dragon Naturally Speaking from the batch file that you created in Step 8 of Preparing the Sequencing Machine. NOTE: As Dragon NaturallySpeaking10.msi is completing, you will see Error 1722. DO NOT click OK. Clicking OK uninstalls DM360 Network Edition. At this point, bring the sequencer window into focus and check the box that says I am finished installing, then click Next. - 6 -
Configure Software Customize Create Editor Launch Dragon NaturallySpeaking. Select Customize, then choose the following options: Edit shortcuts... If you are using single sign-on (SSO) in Dragon, edit the Dragon Medical shortcuts to add /trusted to the end of the command line for SSO. Delete all Applications except for Dragon Log and Dragon Medical. Streaming... Launch Dragon Target OS... Select Allow this package to run on any operating system. Select Continue to modify package without saving using the package editor. Choose the following options: Properties Add Comments Tab OSD Tab Save Choose Dragon Medical and select SoftPkg\Implementation\VirtualEnv\Policies\Local_Interaction_Allowed. Enter TRUE in the lower right column, under the element text. Go to File > Save. Table 5: App-V 4.6 SP1 Sequencer - 7 -