DragonMedicalServer 3.6 AdministrationGuide en

Nuance ®
Dragon Medical
Server
Administration Guide
Dragon Medical Server 3.7
Table of contents
Introduction 4
Prerequisites 4
Security 4
Billing 4
References 4
Servers and ports 5
Network guidelines 7
Performance optimization 7
Network bandwidth 7
Network latency 8
Antivirus software 8
Proxy servers 9
Microphones 10
Microphone support for Dragon Medical SpeechKit .NET and COM editions 10
Microphone support for Dragon Medical SpeechKit Browser edition 11
Microphone support for Dragon Medical SpeechKit iOS edition 11
Microphone support for Dragon Medical SpeechKit Android edition 11
Mapping Topics and SpeechMagic ConTexts 12
Mapping topics to ConTexts for a Dragon Medical Server Cluster 12
Mapping topics to ConTexts for an organization 12
Remarks 13
Licensing 14
Users 15
SpeechMagic user profile 15
Nuance Management Center user account 15
Auto-provisioning 15
Creating user accounts 16
Working with user accounts 16
Auto-texts 18
Defining an auto-text in the Nuance Management Center 18
Defining a keyword in the Nuance Management Center 19
Searching for auto-texts in the Nuance Management Center 20
System monitoring 21
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© 2011-2020 Nuance Communications, Inc. All rights reserved.
Dragon Medical Analytics 24

Logging 25
Dragon Medical Server log files 25
Nuance Management Server (NMS) log files 25
System file share data 27
Core system data 27
Dynamic data 27
Log data 27
Backing up 28
Data priority 28
SpeechMagic SDK 28
Nuance Management Server 28
Dragon Medical Server 29
Restoring a Dragon Medical system from backup 29
Audit events 30
Modifying settings in a running system 31
Changes that do not require follow up action 31
Changes that require Dragon Medical services are restarted 31
Troubleshooting 32
Concepts 35
Acknowledgments 37
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Introduction
Welcome to the administration guide.
Dragon Medical Server is administered and configured via Nuance Management Server/Nuance Management
Center.
Prerequisites
n All required system components and services have been installed; for more information, see the Dragon
Medical Server Installation Guide.
n Speech data (such as Language Package and ConText with the corresponding license) has been installed in
SpeechMagic SDK; for more information, see the SpeechMagic Online Help.
Security
Dragon Medical works with audio and text data. To provide for the possibility that the data processed by Dragon
Medical contains patient health information (for example, Protected Health Information - protected under
applicable data protection regulations), the following features are available:
n Support for 256-bit AES encryption for communication between client applications and your data center.
n No persistent data storage on Dragon Medical SpeechKit deployments. Data is freed from memory when a
session is closed.
Be aware that some components of an on-premise data center can retain audio and text data persistently:
n Dragon Medical Server
n SpeechMagic File Server
n SpeechMagic System Tasks
It is your responsibility to manage your on-premise data center according to the applicable data protection
standards.
Dragon Medical complies with the Federal Information Processing Standard (FIPS).
Billing
The speech recognition system collects data in the backend that can be used for billing purposes. This data is
based on system usage.
References
n For more information on installing Dragon Medical Server, see the Dragon Medical Server Installation
Guide.
n For more information on Nuance Management Server/Nuance Management Center see the documentation
delivered with the product.
n For more information on SpeechMagic, see the SDK and the installation documentation delivered with the
product.
n For more information on Dragon Medical SpeechKit, see the corresponding client documentation.
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Servers and ports
The Dragon Medical Server, Nuance Management Server (NMS), Nuance Management Center (NMC),
SpeechMagic SDK and Text-To-Speech (TTS) servers communicate in the system. Dragon Medical SpeechKit
must be able to access the following ports on the corresponding server:
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Dragon Your web NMS TTS Server

Medical server
Server
Dragon Medical SpeechKit <your.Dragon N/A N/A N/A

.NET/COM edition Medical.Server>
port: <your port>
(default: 3712)
Dragon Medical SpeechKit <your.Dragon N/A N/A N/A

Android edition Medical.Server>
port: <your port>
(default: 3712)
Dragon Medical SpeechKit <your.Dragon <your.web.server> N/A N/A

Browser edition Medical.Server> port: 80, 443
port: <your port>
(default: 3712)
Dragon Medical SpeechKit <your.Dragon N/A N/A nsa.nuancehdp.com

iOS edition Medical.Server> port: 443
port: <your port>
(default: 3712)
Dragon Medical One <your.Dragon <your.web.server> <your.NMS.server> N/A

Desktop Application, Medical.Server> port: <your port> port: 80, 443
Dragon Medical Direct & port: <your port> (default: 80, 443)
Dragon Case and Care (default: 3712)
NMC N/A N/A <your.NMS.server> N/A

port: 443
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Network guidelines
Dragon Medical Server and Dragon Medical SpeechKit provide cloud-based, real-time speech recognition. They
can be used over any network connection: wired, WiFi or 3G/4G cellular networks.
The user’s speech is recognized once the audio data has been successfully transmitted to the on-premise data
center via secure Internet connection. This means that the user experience is affected by the quality of the
network connection.
Network bandwidth, network latency and background noise are likely to have an impact on a user's speech
recognition experience.
This chapter provides guidelines on the minimum network requirements for optimal user experience. Acceptable
performance is often dependent on the user's perception and expectations vary from user to user. Note that the
quality of a network connection cannot be consistently guaranteed over time - a connection that is good one
minute can degrade the next, especially if the user is mobile and roaming between WiFi and/or cellular towers.
Performance optimization
The following features are designed to optimize network-based speech performance:
n Audio compression: Dragon Medical uses a lossy codec to minimize bandwidth requirements while retaining
the high quality audio that is required for speech recognition. Audio transmission from a client to the on-
premise data center requires 10 kB/sec; results returned from the data center to the client require
approximately 2 kB/sec. If text-to-speech is used, audio streamed from the data center to the client will also
require approximately 8 kB/sec.
n Audio chunks and silence detection: Audio is streamed to the server in small blocks to increase
responsiveness. Data is transferred only when audio is being recorded; users who are not currently dictating
do not consume network bandwidth.
n SpeakAhead: Nuance has implemented SpeakAhead technology which enables the user to continue
dictating while the system compensates for network latency. The recognized text is, asynchronously, written
in the field that it was originally dictated for.
Network bandwidth
A user needs 10 kB/sec total bandwidth upstream and 2-8 kB/sec downstream. This means that the network
bandwidth requirements per user are minimal. Network connections are often shared and mobile users often
utilize multiple network connections as they roam from a hospital network to a 3G/4G cellular tower to a home or
public WiFi network.
To test individual connection speed we recommend using a standard tool such as http://speedtest.net. Mobile
users can utilize the native applications for iPhone and Android.
The quality of a network connection is not consistently guaranteed, especially for mobile users. In particular,
consider the following:
n iPhone devices use a weak/poor WiFi connection for data services even in the presence of a strong 3G/4G
signal.
n A strong 3G/4G signal does not guarantee a high bandwidth connection.
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Network latency
Network bandwidth is not the only factor in optimal speech recognition. Due to our bandwidth-consumption
optimization, network latency can often play a role in the user’s perception of performance.
In general, Dragon Medical Server converts audio to text in real time; this means one second of audio is
converted to text in one second or less. In order to provide near real-time results to the user, audio is streamed in
small chunks. Network latency is overhead that adds directly to the time it takes the user to see the results.
Network performance tools, such as Speedtest.net, report latency based on a ping of the geographically closest
server. However, since this does not report the latency between the user's device and Dragon Medical Server,
this data is of limited value. If a general speed test reveals high network latency, it is possible that the network
connection in general is poor and the user might experience delayed results. However, low reported network
latency, from a general speed test tool, does not guarantee the network path to the on-premise data center will
also exhibit low latency.
To accurately measure network latency from a desktop device to Dragon Medical Server, use the following
command line tool: tracert <YourServer>.<domain>
Note: Your servers might not reply to pings; it is therefore normal to receive 'request timed out' messages on
the last hop of the traceroute.
To accurately measure network latency from a mobile device to Dragon Medical Server, use an app that
performs a similar traceroute function, such as iNetTools for iOS and traceroute for Android.
The quality of network connections, especially for mobile users is not consistent. A one-time check of network
latency does not guarantee continued optimal performance.
Acceptable performance is often dependent on the user's perception and expectations vary from user to user. If
the user is experiencing high latency, our SpeakAhead feature enables the user to continue dictating while
results are processed asynchronously. However, users can grow impatient or frustrated waiting for results.
High level guidelines for network latency:
Antivirus software
Antivirus software can severely reduce the performance of the system. It is recommended not to run any
antivirus software on the speech recognition servers.
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The first step in investigating performance issues in a speech recognition system is to check if antivirus software
is running. If it is running, check if performance issues persist when it is deactivated.
If you use antivirus software, you should exclude the following from scanning:
n All traffic on ports used by Dragon Medical Server and NMS.
n The folders storing the system binaries and data: C:\Program Files\Nuance\DragonMedicalServer and
(by default) C:\ProgramData\Nuance\DragonMedicalServer .
n All system processes (processes executed from binaries in the C:\Program
Files\Nuance\DragonMedicalServer folder).
n The system file share.
n Any other data or network traffic where latency caused by scanning could affect performance.
Proxy servers
You should exclude all traffic on ports used by Dragon Medical Server and NMS from proxying, including
transparent proxy. Proxy servers add latency and can lack the throughput to properly process Dragon Medical
Server traffic. This can result in apparent loss of audio, lack of response by the Dragon Medical Recognition
Service and other problems. The Dragon Medical Recognition Service must not be connected via a proxy server
to other services such as NMS.
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Microphones
Microphone support for Dragon Medical SpeechKit .NET and COM
editions
Audio quality
Dragon Medical SpeechKit requires a microphone which records audio data with a bit depth of 16-bit and a
sampling rate of at least 16 kHz. We recommend testing the microphones that your users will work with before
you deploy Dragon Medical SpeechKit.
Audio data in virtualized environments

Dragon Medical SpeechKit .NET and COM editions can be deployed in a Citrix, Microsoft RDS or VMware
Horizon View environment.
To reduce the network bandwidth for audio data from the client PC to the virtualized application, install the
Nuance virtual extension for Citrix, RDS or VMware on the client PC. Download the extensions from the
Desktop SDK section of the Nuance Healthcare Development Platform,
https://www.nuancehealthcaredeveloper.com (log on and click Download Citrix and Windows Terminal
Server drivers).
You do not need to install the Nuance virtual extension on the server/virtual desktop where your application is
hosted. If the Nuance VMware Server & Virtual Desktop Audio Extension, Nuance RDS Server & Virtual
Desktop Audio Extension or Nuance Citrix Server & Virtual Desktop Audio Extension is already installed, we
recommend you uninstall it unless it is still used by another product.
For more information, see the documentation delivered with the Nuance virtual extensions.
Button controls
For information on supported control devices, see the release notes delivered with your Dragon Medical
SpeechKit edition.
For more information on configuring Nuance and Philips USB microphone buttons, see the SDK help delivered
with your Dragon Medical SpeechKit edition.
Button controls in virtualized environments

To enable Nuance PowerMic buttons in a Citrix XenApp/XenDesktop, Microsoft RDS or VMware Horizon View
environment, install the corresponding Nuance PowerMic extension on the client PC. Download the extensions
from the .NET SDK section of the Nuance Healthcare Development Platform,
https://www.nuancehealthcaredeveloper.com (log on and click Download Citrix and Windows Terminal
Server drivers).
You do not need to install the Nuance PowerMic extension on the server/virtual desktop where your application
is hosted. If the server/virtual desktop component of the Nuance PowerMic extension is already installed, we
recommend you uninstall it unless it is still used by another product.
To enable button controls for third-party devices, contact your device vendor for drivers that support your
virtualized environment; deploy them on the server/virtual desktop where your application is hosted and on the
client PC.
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Microphone support for Dragon Medical SpeechKit Browser edition

Audio quality
Dragon Medical SpeechKit requires a microphone which records audio data with a bit depth of 16-bit and a
sampling rate of at least 16 kHz. We recommend testing the microphones that your users will work with before
you deploy Dragon Medical SpeechKit.
Audio data in virtualized environments

Dragon Medical SpeechKit Browser edition can be deployed in a Citrix environment.
To reduce the network bandwidth for audio data from the client PC to the virtualized application, install the
Nuance Citrix Client Audio Extension on the client PC. Download the extension from the .NET SDK section of
the Nuance Healthcare Development Platform, https://www.nuancehealthcaredeveloper.com (log on and click
Download Citrix and Windows Terminal Server drivers).
You do not need to install the Nuance virtual extension on the server/virtual desktop where your application is
hosted. If the Nuance Citrix Server & Virtual Desktop Audio Extension is already installed, we recommend you
uninstall it unless it is still used by another product.
For more information, see the documentation delivered with the Nuance virtual extensions.
Button controls
Button controls are not supported.
Microphone support for Dragon Medical SpeechKit iOS edition

Tests have been performed with the built-in microphones and the packaged cable-based headsets of all
supported iOS devices (phones and tablets).
If a Bluetooth headset is connected to an iOS device, it is active for recording by default and a Bluetooth button
is displayed on the speech bar.
Microphone support for Dragon Medical SpeechKit Android edition

Tests have been performed with the built-in microphones and the packaged cable-based headsets of all major
Android device vendors (phones and tablets).
If a Bluetooth headset is connected to an Android device, it is active for recording by default and a Bluetooth
button is displayed on the speech bar.
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Mapping Topics and SpeechMagic ConTexts

Dragon Medical uses predefined topics to select the speech recognition vocabulary available, based on the
medical specialties your users work in.
The topics are:
n GeneralMedicine
n ClinicalAdministration
n Cardiology
n Emergency
n InternalMedicine
n MentalHealth
n Neurology
n ObstetricsAndGynecology
n Oncology
n Orthopaedics
n Pathology
n Pediatrics
n Surgery
You must map the predefined topics to the SpeechMagic ConTexts installed on your SpeechMagic Server.
Mapping topics to ConTexts for a Dragon Medical Server Cluster

To map topics to ConTexts at the level of the Dragon Medical Server Cluster, do the following:
1. Open the Nuance Management Center.
2. Open the Server Clusters ribbon and click Search .
3. Select your Dragon Medical Server Cluster and click the Details icon on the Server Cluster ribbon.
4. Open the Topics/ConTexts tab.
5. In the Language list, select the language the ConText is based on. If the language that you want is not in
the list, select a language from the list below and click Add Language .
6. Click Map , enter the exact name of the topic and corresponding ConText (the names are case sensitive) and
click Save .
7. Click OK to save your changes and close the tab.
Repeat this procedure for all the languages and topics your users require.
Mapping topics to ConTexts for an organization

Note: The organization mapping overrules the cluster wizard mapping. If a single mapping is defined on the
organization level, all mappings on the level of the Dragon Medical Server Cluster are ignored.
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To map topics to ConTexts for an organization, do the following:

1. Open the Nuance Management Center.
2. Open the Organizations ribbon and click Search .
3. Enter search criteria. If you do not enter any search criteria, all your organizations are displayed.
4. Select an organization from the list and click the Details icon.
5. Open the Products tab and expand Dragon Medical Server .
6. In the Topic/ConText Mapping section, select the language the ConText is based on. If the language that
you want is not in the list, select a language from the list below and click Add Language .
7. Click Map , enter the exact name of the topic and corresponding ConText (the names are case sensitive) and
click Save .
8. Click OK to save your changes and close the tab.
Repeat this procedure for all the languages and topics your users require.
Remarks
n The topic mapping algorithm scans every available mapping to find the best match based on the specified
language tag and topic. If no full match is found, the closest partial match is used; the topic might be
mapped to a ConText based on a different region (the region subtag of the language tag) than specified.
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Licensing
Initial configuration is done in Nuance Management Center (NMC) via the Dragon Medical Server Cluster
Wizard. To install additional licenses, do the following:
1. To access NMC, browse for https://<your.NMS.server>/nmchtml and log on with your admin account.
2. Open the Licensing ribbon.
3. In the Partners group, click Add Existing and do the following:
Name : Enter the name of the application/company.
ID: Delete the automatically generated partner GUID and replace it with the partner GUID you received from
the Nuance Order Desk.
Mode : Production is automatically selected; do not change this.
Note: If you use an application developed by Nuance this step is not necessary.
4. In the Administration group, click Import License Key and paste in your license key.
5. Click Show Information to see the number and expiration date of new licenses and/or the new expiration
date of existing licenses.
6. Click Import.
7. Log out of NMC and log in again.
If the organization associated with the new license does not have an organization token assigned, add one.
Proceed as follows:
1. Open the Organizations ribbon and click Search .
2. Enter search criteria. If you do not enter any search criteria, all your organizations are displayed.
3. Select an organization from the list and click the Details icon.
4. Open the Organization Tokens tab.
5. Click Add (the token is automatically generated) and then Save .
To view a report of the licenses used in your system, do the following:
1. Open the Reports ribbon and click License Use .
2. Enter search criteria and select a License Type from the list.
3. Click Search .
4. To export the results as a CSV file, click .
Remarks
n After applying a Dragon Medical license you must log out of NMC and log in again before the Dragon
Medical Server Cluster functionality is available.
n The organization token allows access to speech recognition functionality. It must be configured in third-party
applications that integrate Dragon Medical SpeechKit. For more information, see the documentation
delivered with the product or contact your vendor.
n The License Use report identifies licenses; you can reassign licenses that have not been used recently.
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Users
SpeechMagic user profile
Before users can access speech recognition functionality they need a SpeechMagic user profile that must have:
n Recognition rights assigned.
n A microphone (high resolution) or microphone (advanced resolution) input channel assigned.
n A ConText assigned.
For more information, see the SpeechMagic Online Help.
Remarks
n The SpeechMagic user name must be identical to the user name used in Dragon Medical; usually this is the
logon name used in the hospital application.
n For optimal speech recognition performance it is strongly recommended that users run SpeechMagic Initial
Training before first using the system.
n The user profile can be shared among several applications (which can be based on Dragon Medical,
SpeechMagic InterActive, or SpeechMagic SDK backend speech recognition). All applications that use the
same SpeechMagic user name will access the same user profile; this means that all applications will profit
from continued improvements due to adaptation of the user profile.
Nuance Management Center user account

If auto-provisioning is enabled, you do not need to create accounts for speech recognition users manually;
however, you can create an additional administration account.
Auto-provisioning
Auto-provisioning is enabled by default. This means that, the first time a user connects to the speech recognition
system, a user account is automatically created and a license is assigned.
Important: If there are no more licenses available, a user account is created but the new user will not be able
to use speech recognition.
It is recommended to keep auto-provisioning enabled, but in some circumstances you might want to disable it.
Creating accounts for speech recognition users manually enables you to enter more information on each user
(for example, location and department) and control license allocation.
To disable auto-provisioning, do the following:
1. Log on to NMC.
2. On the Sites ribbon, click Organization Overview and then Details.
3. Click the Auto-provisioning tab and make sure Dragon Medical Server is selected in the left pane.
4. Clear the Enable auto-provisioning for this product check box.
5. Click Save .
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To disable automatic license assignment, activate Restrict automatic license assignment to specific
license types in the Auto-provisioning tab. To keep automatic license assignment enabled for specific license
types, use the arrow buttons to move license types from Automatic license assignment disabled to
Automatic license assignment enabled . Optionally, activate Enable automatic license assignment for
newly imported license types.
Creating user accounts

To create a user account, do the following:
1. Open the User Accounts ribbon and click Add .
2. In the User Account Details dialog box, enter the First name , Last name and Login ; the other fields are
optional.
3. Open the Group Memberships tab and assign the user account to at least one group. If you are not
currently working with groups, assign the user account to the Dragon Medical group.
4. Click Save and select the license that you want to assign to the user in the Licenses dialog box, or Save &
New (to create another user account).
Working with user accounts

To view a list of users, do the following:
1. Open the User Accounts ribbon and click Search .
2. Select an Organization and enter search criteria. If you do not enter any search criteria, all users of your
Dragon Medical system are displayed.
To assign a license to a user account, do the following:
1. Open the Licensing ribbon and click View Licenses.
2. Click Search ; all licenses are displayed.
3. Select the license that you want to assign to the user.
4. In the License Allocation group, click Grant.
5. Select the user account from the list of Available Users and click OK.
To free licenses, select a row, click Revoke and select user accounts.
To manage a user account, right-click the user and select User Account Details.
To view a report of client versions used in your Dragon Medical system, do the following:
1. Open the Reports ribbon and click Client Version .
2. Enter search criteria and click Search .
Resetting user profiles

You can reset user profiles in the User Account Details dialog box, User Profile tab. This can fix the following
issues with an impact on users' speech recognition experience:
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n Multiple users in an organization use the same user name (therefore, the same user profile). After resetting
the user profile, make sure that each user in the organization logs on with a unique user name.
n A user's role or environment changes significantly; for example, a doctor moves to an administrative role or a
user moves from an environment with a lot of background noise to a quiet environment. The Dragon Medical
Adaptation Service can improve speech recognition quality faster after the user profile is reset.
Be careful when resetting a user profile; this action has the following consequences:
n The user profile must be readapted to the user's voice; this will have a short-term impact on speech
recognition quality.
n Words previously added to the vocabulary by the user are not available immediately after resetting the user
profile. It can take up to a few minutes of dictation for words previously added to the vocabulary to be
available again.
n The user cannot add or edit words until all words previously added to the vocabulary become available again.
Note: The user vocabulary is not reset when you reset a user profile. Any words added or disabled by the
user remain added or disabled.
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Auto-texts
The auto-text feature enables you to define standard blocks of text (often consisting of one or more paragraphs,
also called 'normals' or 'canned text') that your users can insert into their document with a short voice command.
Using auto-texts reduces the time the user needs to dictate and improves the consistency of documentation.
Auto-texts are displayed to end users in the personalization & help window, on the What You Can Say page,
Auto-texts section. To access it, the user can say what can I say while recording or tap/click the menu icon on
the speech bar.
Browser, .NET and COM editions: Users can also define auto-texts for their own user account from their
Dragon Medical SpeechKit client application, via the Manage Auto-texts page. They can select a block of text
they have dictated and say make that an auto-text or click + to add a new auto-text manually.
Android and iOS editions: Mobile users must have a Dragon Medical One or Dragon Medical Direct license to
define auto-texts for their own user account. For more information, see the end user documentation delivered
with the product.
Defining an auto-text in the Nuance Management Center

Scenario
n Your users are radiologists who frequently read chest x-rays. Most of these are normal and the doctors
frequently say PA and lateral views of the chest revealed a normal-sized heart. The lungs are clear
of any active infiltrations.
n You define an auto-text called 'normal chest' that contains this information.
n A doctor says the voice command <keyword> normal chest to insert the information. If you have defined
the keyword insert, a doctor would say the voice command insert normal chest.
Procedure
1. In NMC, open the Speech Recognition ribbon.
2. Click Manage .
3. Select your Organization .
4. In the tree view, select Auto-texts and the level you want to create the auto-text for (site, group or user).
5. In the Auto-text group, click Add .
6. Enter a Name (normal chest), a Description (optional) and select a Language .
7. Optional: Change the Spoken Phrase .
8. In the contents section, enter PA and lateral views of the chest revealed a normal-sized heart. The lungs
are clear of any active infiltrations.
9. Click Save .
Remarks
n To make auto-texts available for specific users, make sure to select the corresponding site or group in the
tree view.
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n Actions on the group level (for example deleting an auto-text) override those on the site level. Actions on the
user account level override group and site levels.
n A keyword is what the user says to tell the system that an auto-text is to be processed and displayed.
n The Name field contains the title of the auto-text (this is generally what users must say to insert the auto-
text); make sure it is unambiguous and easy to pronounce. It is strongly recommended that you give the
auto-text a distinctive name that cannot be misinterpreted as speech to be recognized. This helps to ensure
that it is correctly inserted.
n By default the Spoken Phrase is the same as the Name . If how the auto-text name is written and how it is
pronounced are very different, change the Spoken Phrase (how it is pronounced). You can only use
alphabetic characters in spoken phrases; special characters are not allowed. For acronyms that are spelled
out use capital letters, separated by spaces.
For spoken phrases do not use:
Very short phrases (such as one syllable only)
Capital letters (except for acronyms where the spoken phrase is the spelling; for example, C I A)
Abbreviations
Digits (use 'twelve' and not '12')
Punctuation marks (for example, ", !, ?, etc.)
Symbols (for example, +, -, &, $, etc.)
n Auto-texts can only occur once within a site, group or user account, but the same auto-text can occur in
different entities on the same level (for example, two groups) or on different levels (group and user of that
group).
n You cannot create two auto-texts with the same name, even if different spoken phrases are defined.
n You cannot create two auto-texts with the same spoken phrase, even if different names are defined.
n For more information on inserting auto-texts, see the Dragon Medical SpeechKit end user documentation
delivered with your product.
n Auto-texts can contain fields. Fields are gaps in the auto-text where users can enter specific text, for
example, patient data. To add a field to an auto-text, enter [ ] in the relevant place of the auto-text's
contents; you can enter any text between the field delimiters as default content, for example, CBC results
[within normal limits], vital signs [within normal limits]. When users insert the auto-text, they can decide
whether to replace the default values with specific text or use the default values.
n By default, auto-text fields are indicated by square brackets. Users can change the characters used as field
delimiters in Dragon Medical One Desktop Application on the General pane of the Options dialog box; any
previously defined fields using different delimiters will then no longer work. If delimiters are changed, the
new delimiters are used in all Dragon Medical applications for that user's account.
Defining a keyword in the Nuance Management Center

Scenario
n You define the keyword: insert.
n When the user says insert the system identifies that an auto-text is to be processed and displayed.
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Procedure
1. Open the Speech Recognition ribbon and click Keywords.
2. Select your Organization and enter insert as the Leading Keyword for English.
3. Click OK to save your settings.
Remarks
n You can define a leading keyword (said before the spoken phrase) and/or a trailing keyword (said after the
spoken phrase).
n insert is the default leading keyword for English.
n If a keyword is added or deleted, it is applied to all auto-texts that are defined in your organization.
n The maximum number of characters for a keyword is 25.
n You can only use alphabetic characters to define a keyword; as for spoken phrases, special characters are
not allowed.
Searching for auto-texts in the Nuance Management Center

Search for an auto-text in the Manage Auto-texts screen via its name.
To view the list of auto-texts associated with a user, group or site, do the following:
1. Open the Speech Recognition ribbon.
2. In the Auto-texts group, click Manage .
3. Expand the tree structure for the corresponding level.
4. Select a site, group or user.
Remarks
n You can refine your search via the Display all levels and Show disabled auto-texts options.
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System monitoring
It is recommended to schedule the following monitoring tasks:
n Check that at least one speech recognition server is running and available for speech recognition. For more
information, see: 'Dragon Medical Server health check' in the Dragon Medical Server Installation Guide.
n Check for Dragon Medical Recognition Service errors in the Windows Event Log. Recommended: Use errors
as notification triggers.
n Check that the Dragon Medical Adaptation Service and Dragon Medical Analytics Service are running.
Recommended: Every 5 minutes.
n Check that Nuance Management Server is available. Recommended: Every 5 minutes. For more
information, see: 'Nuance Management Server health check' in the Dragon Medical Server Installation
Guide.
n Monitor server CPU, RAM and disk space. A heavily used system generates many log files. For more
information, see: Logging.
n Monitor your Microsoft SQL Server.
Windows Event logs

Dragon Medical Server events are summarized on an hourly basis in the Windows Event logs, Dragon Medical
Server Summary folder. For each hour, the summary logs display the complete log text of the first occurrence
of each event type and the number of occurrences.
Detailed Windows Event logs, including references to the corresponding speech recognition session logs, are
saved in the Application folder.
Events are categorized according to the component affected and given the following Event IDs:
- 21 -
Event Description
ID
10000 General Dragon Medical error. Send the event ID, error message and associated log files to Nuance
for analysis.
11000 This error can be caused by running Dragon Medical Server Setup under a user account that does not
have the required permissions on the SQL server. For more information, see 'Permissions' in the
Dragon Medical Server Installation Guide.
12000 This error can occur if the server is out of disk space when a voice user interface (VUI) document is
created. Check if there is enough free space on both the local Dragon Medical Server and the system
file share, where local log files are moved at the end of each session.
13000 The Dragon Medical Server is overloaded; it cannot service new sessions before some of those in
progress are finished. Consider adding more servers to the Dragon Medical Server Cluster. For more
information, see 'Hardware requirements' in the Dragon Medical Server Installation Guide.
13100 For information only: Dragon Medical Recognition Service has started.
14000 General error at the speech recognition technology layer. Send the error message and any associated
files to Nuance for analysis. Additional technology-level logging might need to be enabled.
14100 Error when trying to start a session and load a user profile. The profile might have become corrupted.
If the problem persists, the user profile can be reset; the speech recognition quality might be affected
until the profile is readapted to the user’s voice.
20000 General SpeechMagic SDK error. Send the event ID, error message and associated log files to
Nuance for analysis. Additional technology-level logging might need to be enabled.
23000 For information only: SpeechMagic ConText Adaptation has started.
35000 Dragon Medical Adaptation Service general error. Send the event ID, error message and adaptation
log files to Nuance for analysis.
35100 For information only: Dragon Medical Adaptation Service has started.
40000 Error in Dragon Medical Server Setup. If Dragon Medical Server Setup fails repeatedly, send the
setup log files to Nuance for analysis.
50000 Error in the Dragon Medical Upgrade Service; this usually means that the service cannot be started.
Send the event ID, error message and associated log files to Nuance for analysis.
51000 For information only: Dragon Medical Upgrade Service has started.
55000 Dragon Medical Analytics Service general error. Send the analytics log files to Nuance for analysis.
55100 For information only: Dragon Medical Analytics Service has started.
60000 General Nuance Management Server (NMS) error. If the problem persists, send the associated
Dragon Medical Server and NMS log files to Nuance for analysis.
61000 This error can be caused by a timeout during the communication between the Dragon Medical
Recognition Service and NMS. If the problem persists, send the event ID, error message and
associated Dragon Medical Server and NMS log files to Nuance for analysis.
- 22 -
62000 The user’s speech recognition license has expired or is invalid, the maximum number of licenses has
already been assigned, or the user cannot be auto-provisioned. License management can be
configured in NMC, according to the specified licensing model.
63000 NMS authentication error. The user name and password are incorrect, or the user does not have the
permission required to make the request.
- 23 -
Dragon Medical Analytics

Dragon Medical Analytics is a web application that displays data collected about your speech recognition system
in a meaningful and easily accessible way.
To access Dragon Medical Analytics, go to: http(s)://<your.Dragon Medical.Server>:<port>/SpeechAnalytics
Use your Nuance Management Center (NMC) user credentials to log on; the pages visible to you depend on your
NMC permissions. For full access to all pages use an NMC administrator account.
Dragon Medical Analytics has the following pages:
n Dashboard
Displays overview information on your speech recognition system.
You can see the number of active users in the defined time period, the total length of sound data recorded in
that time period and peak usage (the number of users using the system at the busiest hour of the day). You
can filter by various values.
Click a box to see more information in graph form.
n Usage Details
You can analyze how well speech recognition is working and how much the system is used.
The data is displayed by user in grid form. You can sort and filter by various values.
You can export more detailed information to an Excel file (this is saved in the browser download folder).
n System Overview
Displays overview information on your speech recognition system, including the Dragon Medical Database,
system file share and Nuance Management Server (NMS); green indicates that the system is functioning
well.
You can see the number of active user sessions, recognitions (the number of users currently recording) and
speech recognition servers.
Activate Event Log to see a list of recent Dragon Medical Server events.
n Server Management
Displays how the system is working; green indicates that the system is functioning well.
You can see the date of the last server update, the current version installed, the CPU and RAM load.
The servers are listed; click a server to see an activity graph of that server.
n Event Log
Displays a list of recent Dragon Medical Server events (for example, error or warning events).
n Session Logs
You can collect log files to send to Nuance support if there is a problem with the system.
In the search results, click a link to download a zip file containing the corresponding files (this is saved in the
browser download folder).
When you download session logs, they are encrypted automatically and the password to decrypt them is
displayed.
- 24 -
Logging
Dragon Medical Server log files
Data related to the speech recognition performed for an end user and any client-related information (including
PHI, sound data and the recognized and corrected text) can be retrieved via Dragon Medical Analytics.
Log on as an NMC administrator and open the Session Logs tab. You can search by user name, organization,
partner or session GUID.
Information related to a speech recognition server, adaptation and interaction with other server components (for
example: database, NMS) is logged in the Dragon Medical Server logs and can be retrieved from the system file
share, at <UNC root path>\Logs\Server\<Dragon Medical Server version number>.
All log information is temporarily stored on the speech recognition servers and moved to the central file share
when available (at least once a day). If log information needs to be retrieved from the speech recognition servers
(for example, it is not written to the file share because of a configuration issue), it can be found locally, in the
data folder defined during Dragon Medical Server Setup, by default:
C:\ProgramData\Nuance\DragonMedicalServer .
For more information on storage requirements, see 'Hardware requirements' in the Dragon Medical Server
Installation Guide.
Purging Dragon Medical Server log files

The speech recognition servers automatically ensure that the storage space used does not exceed the
documented hardware requirements (no manual action is necessary to delete any files). For more information,
see 'Hardware requirements' in the Dragon Medical Server Installation Guide.
Dragon Medical Server logs are collected here until the maximum size of the folder is reached: <UNC root
path>\Logs\Server\<Dragon Medical Server version number>. If the maximum size of the folder is
exceeded at daily purge time, the oldest log files are deleted automatically.
Purging dictation data files

Dictation data files are collected to ensure optimal speech recognition quality. These files are deleted
automatically when the amount of dictation data exceeds the amount that is optimal for the system to improve
speech recognition quality. For more information, see: Dynamic data.
Note: Purging files has no impact on end users.
Sending log files

If issues occur, send all relevant log files to Nuance technical support. For more information on how to identify
relevant logs, see: Dragon Medical Server log files.
For more information on Dragon Medical Server event logs, see: Windows Event logs.
Nuance Management Server (NMS) log files

Log files for the Nuance Management Server (NMS) are temporarily stored here:
C:\ProgramData\NMS\Logs.
- 25 -
Log file size is directly proportional to system use. Approximately 500 kB of NMS log files can be generated, per
active user, per day. Therefore, a system with 3 speech recognition servers and 90 active users can generate
approximately 45 MB of NMS log files per day.
When a log file reaches the size limit of 10 MB, it is closed, moved to the central storage location and made
available for search and download via NMC. A new log file is created automatically. To search for log files in
NMC, log on as an administrator, and in the Utilities ribbon, open the Server Logs tab.
NMS log files and system data (including speech recognition usage/billing data) are purged, by default, after 90
days. To change this setting, log on to NMC, click , select System Settings, expand Nuance Management
Server , change the default values and click Save .
You cannot disable purging, except for usage transactions and converted usage transactions, which can be
disabled via System Settings, by setting the purge value to 0.
NMS log file purging is independent of Dragon Medical Server purging.
- 26 -
System file share data

The system file share root folder is specified via the Nuance Management Center (NMC) when the Dragon
Medical Server Cluster is configured (Dragon Medical Server Settings dialog box, UNC root path setting).
Core system data

Core system data is necessary for Dragon Medical Server to perform speech recognition. This type of data is
only modified during upgrades or configuration changes.
Dynamic data
Dynamic data consists of dictation data files. Dictation data files are stored for each user to ensure optimal
speech recognition quality by using historical data to train speech recognition profiles (adaptation). These files
are deleted automatically when the amount of dictation data exceeds the amount that is optimal for the system
to use for adaptation. Currently, 50 hours of sound data and recognized/corrected text are stored per user. Data
is also deleted when it is older than 5 years.
Log data
Log data is stored exclusively for analyzing any problems with the system. The amount of log data stored is
currently limited to 10 GB. The oldest log data is deleted automatically from the system file share when the
maximum size of the central log folder is exceeded. Log data is stored in subfolders of <UNC root
path>\Logs\Server .
Note: The <UNC root path\Logs> folder contains important data that should not be deleted. The system
automatically ensures that the total size of the system file share folders does not exceed the documented
hardware requirements.
For more information on system file share storage requirements, see 'Hardware requirements' in the Dragon
Medical Server Installation Guide.
- 27 -
Backing up
Data priority
High priority: Nuance Management Server Database; if this data cannot be restored, there will be a long-term
impact on end users. Billing data, system configuration data and data added manually by end users and system
administrators will be lost.
Important: Without a backup of the NMS Database, the whole system must be set up again; no other
backups will be useful.
High priority: SpeechMagic system data; if this data cannot be restored, there will be a long-term impact on
end users. Speech recognition quality will be severely reduced for an extended time period. Speech recognition
data, system configuration data and other data added manually by administrators and end users will be lost.
Medium priority: Dragon Medical Server dictation data files; if this data cannot be restored, there will be a
medium-term impact on end users. Speech recognition quality will be reduced while the system collects new
data that can be used for training speech recognition profiles.
Note: Be aware that the dictation data files are never modified; plan your backup strategy with this in mind.
Low priority: Dragon Medical system database; if this data cannot be restored, there will be a medium-term
impact on system administrators. Dragon Medical Analytics data will not be available until it is created again
from dictation data files.
SpeechMagic SDK
Use the standard SpeechMagic backup procedure. For more information, see the SpeechMagic Installation
Help.
Nuance Management Server

NMS automatically backs up the NMS Database, named NuanceMC , to the default database location on the
SQL Server. For more information, see: https://blogs.technet.microsoft.com/sqlman/2009/07/19/tsql-script-
determining-default-database-file-log-path/
The NMS backup location for automated backups can be redirected by moving the logical backup device
NuanceMCDump , on the SQL Server. For more information, see: https://msdn.microsoft.com/en-
us/library/ms179313.aspx#Anchor_8
Backup schedule:
n Transaction logs backup: hourly
n Differential database backup: daily at 1:30 AM
n Full database backup: weekly at 2:00 AM. The day of the full database backup is the same as the week day
of the installation.
If you use the automatic backup function it is recommended to move the NuanceMCDump.BAK file to a
suitable storage location regularly. For more information, see: https://msdn.microsoft.com/en-
us/library/ms179313.aspx. Make sure not to move the file while the automatic backup is running. Moving the
file will have no impact on the automatic backup schedule.
- 28 -
Backed up data that is more than a month old is deleted; copy the data to another location to keep it longer.
Remarks
n You can disable the automatic backup function in NMC; in the System Settings dialog box, activate the
Disable scheduled NMS database backups check box.
n If you disable the automatic backup function, make sure to use your own backup strategy.
n If you disable the automatic backup function, set a limit for the transaction log size based on your disk space
resources and usage requirements.
Dragon Medical Server

Dictation data files
It is strongly recommended to back up the Dragon Medical Server dictation data files, stored in the Dragon
Medical system file share in the Logs\Jobs folder. This data is required for the system to optimize speech
recognition quality for users.
Database
Back up the Dragon Medical system database at least weekly. The name of the Dragon Medical system
database is NuanceSAS.
Recovery model Simple is recommended for the Dragon Medical system database; this excludes transaction
logs.
Do not back up the NuanceSASClientCache database. If data is missing from this database, users will
experience a slight delay the next time they connect to the speech recognition system as their user profiles are
synchronized.
Restoring a Dragon Medical system from backup

Before restoring the Dragon Medical system, make sure to stop all Dragon Medical services and then restart
them after the restore procedure.
Remarks
n It is possible to restore the Logs folder separately.
n If there is a hardware failure or system corruption, a Dragon Medical Server or Nuance Management Server
can be reinstalled with no impact on system quality; restoring it from backup is not necessary. No essential
data is stored locally on a Dragon Medical Server or Nuance Management Server.
- 29 -
Audit events
Dragon Medical Server events (such as uploading an installation package or downloading session log files) are
stored in the Nuance Management Center for auditing purposes.
To view a report of audit events, do the following:
1. In NMC, open the Utilities ribbon.
2. Click Audit Events, enter search criteria and click Search .
Remarks
n Event IDs 3000 to 3999 are relevant for Dragon Medical Server. For example, event ID 3000 indicates that
an installation package has been uploaded and event ID 3001 indicates that an installation package has
been deleted.
n Event IDs 4000 to 4999 are relevant for Dragon Medical Server Cluster settings. For example, event ID 4005
indicates that the Dragon Medical Server Cluster settings have been changed in the NMS Database.
n To see a list of event IDs and descriptions, click Select Events in the Audit Events dialog box.
- 30 -
Modifying settings in a running system

You can modify your speech recognition system after it is up and running. Depending on the modification,
different follow up actions are required before the changes are applied.
Changes that do not require follow up action

n New ConText/topic mapping.
Changes that require Dragon Medical services are restarted

After all other modifications the Dragon Medical Recognition Service, Dragon Medical Analytics Service and the
Dragon Medical Adaptation Service must be restarted.
- 31 -
Troubleshooting
n Users get a 'no license available' message.
All licenses available in the Nuance Management Center (NMC) have been assigned to users. Any attempts
to connect by an additional user will be rejected because there are no licenses available. For more
information, see: Users.
Check if the user name is correct and if user has the corresponding language and topic/ConText assigned.
n You do not know which user IDs were assigned speech recognition licenses.
Proceed as follows:
1. In NMC, open the User Accounts ribbon.
2. Click Search and enter search criteria. If you do not enter search criteria, all of your users are displayed.
3. The Licenses column displays the license assigned to each user.
n You want to reassign users' speech recognition licenses.
Proceed as follows:
1. In NMC, open the Licensing ribbon.
2. Click View Licenses and then Search .
3. In the Licenses Summary screen, right-click your organization and select Revoke Licenses.
4. Use the arrow buttons to move users from Available Users to Selected Users.
5. Click OK to revoke the selected users' licenses.
If a license is available, it will be automatically assigned to the next user who connects to the speech
recognition system.
n You get a 'license expired' message.
Your 90-day evaluation license has expired. Please contact your account manager.
n You get a 'server did not recognize the license as valid' message.
There is a problem with your partner GUID and/or your organization token. Make sure you are passing these
values correctly to the SDK. Make sure the organization token does not contain non-printing ASCII
characters at the end of the string.
n For information on SpeechMagic SDK setup and maintenance, see the SpeechMagic SDK Installation
Help.
n If SpeechMagic SDK is upgraded make sure to restart the Dragon Medical Recognition Service, the Dragon
Medical Adaptation Service and the Dragon Medical Analytics Service.
n Your system suffers from performance issues.
The use of antivirus software on Dragon Medical Server and Nuance Management Server (NMS) can inhibit
performance. Deactivate antivirus software as a first step in investigating performance issues. For more
information, see: Network guidelines.
Do not use any kind of proxy for network traffic on the ports used by Dragon Medical Server and NMS.
n It is not possible to connect to Dragon Medical Server.
Check that the Dragon Medical Recognition Service and the GSPAdapters processes are running.
- 32 -
Check that the Dragon Medical Recognition Service is not blocked by your firewall.
Make sure that the port number is correctly set.
n Users get poor recognition results.
Reset user profiles. For more information, see: Resetting user profiles.
n User accounts are not created automatically when new users connect to the speech recognition system.
Check if auto-provisioning is enabled. For more information, see: Auto-provisioning.
n The Dragon Medical Recognition Service does not start.
Make sure that the clocks on all speech recognition servers and the database are synchronized and that their
time zones are correctly configured.
Make sure that the Dragon Medical Recognition Service user has the correct permissions. For more
information, see the Dragon Medical Server Installation Guide.
Check the Windows Event Log. For more information, see: Logging.
n Issues when stopping/restarting the Dragon Medical Recognition Service.
If you get an error stopping the service, try again.
After the Dragon Medical Recognition Service has been stopped, verify that no GSPAdapterHost processes
are left over (manually end any processes that are still running).
n In the Dragon Medical SpeechKit .NET/COM editions, the automatic audio adjustment feature does not
work.
Disable the interfering automatic gain control (AGC) of the recording device or the device drivers/sound card
drivers.
n In Google Chrome and Mozilla Firefox, the Dragon Medical Recognition Service does not start after the
microphone is unplugged and plugged back in.
Refresh the page and try again.
n In Internet Explorer 11, the cursor position is incorrect after copied text has been pasted in.
Move the cursor to the position you want.
n On macOS, the Dragon Medical Recognition Service does not start after switching between browsers.
Refresh the page and try again.
n On MacBook, via Safari browser, the Record button does not work.
For the Silverlight plugin, deactivate Run in Safe Mode in the Plug-in Settings (via the Preferences
menu, Security tab of the Safari browser).
n On iOS 9 (or higher) devices, the application's online help is not displayed.
Host the application's online help (set via [[NUSASession sharedSession]
setOnlineHelpUrl:@"..."]) with HTTPS and make sure it is not blocked via X-Frame-Options.
n On Android devices, the speech bar covers part of the soft keyboard.
Set windowSoftInputMode to stateHidden in the activity tag of the AndroidManifest.xml file; for
example:
<activity
android:windowSoftInputMode="stateHidden"
- 33 -
android:theme="@android:style/Theme.Dialog"
...
</activity>
Once this setting is made, the speech-enabled activity will start with the keyboard hidden.
n SpeechMagic data synchronization fails with the error: Speech recognition is temporarily not available
in this application because of an error on the speech recognition server. Please try again later.
The error (0x800703FA: Illegal operation attempted on a registry key that has been marked for
deletion.) can be found in the SmIaDataSyncClient log file. The related Windows Event ID is 1530.
On the machine where SpeechMagic is installed, in the Local Group Policy Editor, enable the Do not
forcefully unload the user registry at user logoff policy. For more information,
see: https://blogs.msdn.microsoft.com/distributedservices/2009/11/06/a-com-application-may-stop-
working-on-windows-server-2008-when-the-identity-user-logs-off/
n Poor recognition rate.
Run the SpeechMagic Initial Training module. For more information see the SpeechMagic SDK User Help.
- 34 -
Concepts
Nuance Healthcare Development Platform
Register to become a Nuance partner at https://www.nuancehealthcaredeveloper.com/. Once your registration
is approved you will receive a welcome kit and access to Dragon Medical SpeechKit for a 90-day evaluation
period.
group
One of the hierarchical levels in a Dragon Medical system. The Nuance Management Center (NMC) enables you
to manage your system at the level of organizations, sites, groups and user accounts.
It is useful to assign users to groups in order to assign them certain administrative rights or to make certain auto-
texts and words available to different people.
NMC is delivered with the following groups:
n NMC Administration : For users performing administration tasks in NMC.
n Dragon Medical: For users accessing speech recognition.
organization
The top hierarchical level in a Dragon Medical system. NMC enables you to manage your system at the level of
organizations, sites, groups and user accounts. Your development organization is set up at the start of your 90-
day evaluation period and allows access to speech recognition for four user accounts. When you move from an
evaluation to a production system, you can set up production organizations, which have no user account limits.
organization token
Each organization receives a unique organization token. A valid organization token must be passed from your
client applications together with your partner GUID; for more information, see the Dragon Medical SpeechKit
help.
partner GUID
Your partner GUID is provided in your welcome kit. Your partner GUID must be passed from your client
applications together with a valid organization token; for more information, see the Dragon Medical SpeechKit
help. Your partner GUID does not change and is not listed in NMC.
role
When you create a group in NMC, you must assign it one of the following roles, depending on the maximum set
of security rights it can receive:
n NMC Administrator : For administration users performing tasks in NMC.
n Speech recognition user : For users accessing speech recognition.
n User : A generic role that can be used to group users for any purpose.
site
One of the hierarchical levels in a Dragon Medical system. NMC enables you to manage your system at the level
of organizations, sites, groups and user accounts.
- 35 -
user account
Every user who accesses Dragon Medical from a client application has an NMC user account. A user account
includes logon and user profile information. These user accounts are automatically assigned to the Speech
recognition user group.
User accounts can also be created manually in NMC.
- 36 -
Acknowledgments
This product includes software developed by the Speex project:
n libspeex: http://www.speex.org/
This product includes software developed by the NSpeex project:
n NSpeex: http://nspeex.codeplex.com/
This product includes software developed by the Apache Software Foundation:
n log4net: http://logging.apache.org/log4net/
- 37 -

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Nuance ®

Dragon Medical Analytics 24

Servers and ports

Dragon Your web NMS TTS Server

Dragon Medical SpeechKit <your.Dragon N/A N/A N/A

Dragon Medical SpeechKit <your.Dragon N/A N/A N/A

Dragon Medical SpeechKit <your.Dragon <your.web.server> N/A N/A

Dragon Medical SpeechKit <your.Dragon N/A N/A nsa.nuancehdp.com

Dragon Medical One <your.Dragon <your.web.server> <your.NMS.server> N/A

NMC N/A N/A <your.NMS.server> N/A

Audio data in virtualized environments

Button controls in virtualized environments

Microphone support for Dragon Medical SpeechKit Browser edition

Audio data in virtualized environments

Microphone support for Dragon Medical SpeechKit iOS edition

Microphone support for Dragon Medical SpeechKit Android edition

Mapping Topics and SpeechMagic ConTexts

Mapping topics to ConTexts for a Dragon Medical Server Cluster

Mapping topics to ConTexts for an organization

To map topics to ConTexts for an organization, do the following:

Nuance Management Center user account

Creating user accounts

Working with user accounts

Resetting user profiles

Defining an auto-text in the Nuance Management Center

Defining a keyword in the Nuance Management Center

Searching for auto-texts in the Nuance Management Center

Windows Event logs

23000 For information only: SpeechMagic ConText Adaptation has started.

Dragon Medical Analytics

Purging Dragon Medical Server log files

Purging dictation data files

Note: Purging files has no impact on end users.

Sending log files

Nuance Management Server (NMS) log files

System file share data

Core system data

Nuance Management Server

Dragon Medical Server

Restoring a Dragon Medical system from backup

Modifying settings in a running system

Changes that do not require follow up action

Changes that require Dragon Medical services are restarted

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