• Introduction
• Features
• Dictation Bar
  • Components
  • Start dictation
• Dictionary
  • Add a word or acronym
  • Modify and remove existing words
  • Global words
• Templates
  • Add a template
  • Modify and remove existing templates
  • Use a template
  • Global templates
  • Templates with custom fields
• Transformations
  • Add a transformation
  • Modify and remove existing transformations
• Voice commands
• Units of measure
• Microphones and footswitches
  • Plantronics Voyager Legend UC
  • Plantronics Savi Go
  • Philips SpeechMike
  • Olympus Directrec DR
  • Nuance PowerMic II/III
  • Olympus footswitch to control the dictation system

Introduction

INVOX Medical is a powerful application that allows you to dictate clinical reports in a fast, efficient and easy way.

The INVOX Medical platform includes specific dictionaries for a multitude of medical specialties. These dictionaries have been developed from thousands of selected medical reports from each specialty and with the help of professionals from each area to ensure that the system is capable of recognizing the terms used in each medical specialty.

In this manual, you will learn about the different options that INVOX Medical offers to help you during report writing. In addition, you will find a quick guide on how to dictate certain characters or perform operations on the document you are working on using only your voice.

Features

The main functionalities of INVOX Medical are:

• Reduction of time and cost of reports.

• Vocabulary and resources adapted to each medical specialty and the specific service or center in which it is used.

• Continuous adaptation to the voice characteristics of each user.

• Creation and management of own dictionaries of medical words and acronyms.

• Creation and management of templates for the most frequent types of reports.

• Creation and management of text transformations.

• Ability to interact with reports using voice commands.

Dictation bar

The dictation bar will allow you to interact with INVOX Medical functionalities and receive feedback from speech recognition during dictation. You’ll be able to start and stop recognition, verify that the microphone is receiving audio correctly, view the recognition engine’s assumptions as you dictate, and create new words, templates, or transformations, among other things.

Components

1. Upload Progress Percentage. Displays the upload percentage during login.

2. Progress Status. Displays messages about the status of session initialization.

3. Dictation Button (Recognizer). Allows you to start or stop speech recognition.

4. Audio Level Indicator. Shows audio level activity during the session.

5. Status bar and hypothesis viewer. Shows messages about the status of the session and, during dictation, allows you to view the recognized hypotheses.

6. Button Dictionary. Opens the Dictionary management view.

7. Templates button. Opens the Templates management view.

8. Transformations button. Opens the Transformations management view.

9. Menu button. Displays the options menu.

10. Profile button. Displays user information.

11. Help button. Redirect to user help guide.

12. Support button. Redirect to INVOX Medical support center.

13. About button. Displays information about INVOX Medical.

14. Adaptation indicator. Displays the status of the recognition model adaptation process.

    1. Loading status. The adaptation process is in progress.
    2. Finished status. The adaptation process has finished successfully.

Start dictation

1. Click the microphone button to start dictation.
2. Dictate your medical report.
3. Click the Dictation button again to stop the recognizer.

Either use the available voice commands or press the dedicated button on your handheld microphone.

Dictionary

INVOX Medical includes linguistic resources for your medical specialty and also allows you to extend them by managing your own dictionary of words and acronyms. The possibilities offered by the “Dictionary” option are detailed below.

Add a word or acronym

With this option you can add specific terminology that the system does not recognize and that you use in your reports.

1. Press the “New” button in the main view to navigate to the word creation view.
2. Type the word or acronym you want to add.
3. Press the “Save” button to finish.

In some versions of INVOX Medical, when adding a new word or acronym, the possibility of adding it to a global dictionary shared with the rest of the users of their specialty and organizational unit (service, clinic, etc.) is offered.

This functionality allows users to complement INVOX Medical resources by improving the system as it is used, by avoiding multiple users having to add the same word, and by having the system recognize terminology that was not initially included in the system.

Modify and remove existing words

This option allows you to modify or delete previously added words.

1. Hover your mouse over the word you want to edit or delete.
2. If you want to edit the word:
   1. Modify the corresponding fields.
   2. Press the “Save” button to apply the changes.
3. If you want to remove the word:
   1. Click on the “Delete” button.
   2. Confirm the action to delete the word permanently.

After deleting or modifying a word you will not be able to revert the changes.

Global words

System administrators can add new words to the dictionary. In addition, as already indicated, words can be shared with the rest of the team. All this set of words is added to the vocabulary of the standard dictionary. You will be able to use these words but not modify or delete them since you are not the owner of them.

In this tab you can see all the global words that you have available in the current session.

Templates

Templates will allow you to create voice commands that will have predefined text associated with them. Every time you say that command, the associated text will be automatically written in the document where you are making the report.

These templates will help you, for example, to avoid having to repeat text that appears frequently, such as an address, a heading, or a part of a clinical diagnosis that is always described in the same way.

As a concrete example, you can define a template so that every time you say “ATBG Compatible” the text “Colon, biopsy: focal adenomatous transformation compatible with tubular adenoma with low-grade dysplasia” is written.

By default, to write the text defined in a template you must pause briefly in the dictation before saying the name of the template. That is, if we dictate the text “ATBG compatible sample obtained”, the system will write this sentence literally without making any substitutions. If we want it to perform the substitution, we will have to pause briefly before saying its name, that is, we would say “sample obtained”, pause briefly, and then say “ATBG compatible”. In this case INVOX Medical will write the corresponding replacement text.

Add a template

With this option you can add your own text templates.

1. Press the “New” button in the main view to navigate to the template creation view.
2. Type the template you want to add.
3. Press the “Save” button to finish.

You can mark the template as “Does not require pausing during dictation” if you want to be able to speak the template without having to pause.

Also, if you check the sharing option, your template will be available to other users of the same specialty and, in the same way, you will be able to access the templates shared by your colleagues through the “Specialty Templates” view.

Modify and remove existing templates

This option allows you to modify or remove previously added templates.

1. Hover your mouse over the template you want to edit or delete.
2. If you want to edit the template:
   1. Modify the corresponding fields.
   2. Press the “Save” button to apply the changes.
3. If you want to delete the template:
   1. Click on the “Delete” button.
   2. Confirm the action to delete permanently.

After deleting or modifying a template you will not be able to revert the changes.

Use a template

If you are in the template management view you can select the one you want to apply to the document without having to dictate it.

1. Hover your mouse over the template you want to apply.
2. Press the “Use” button to apply the template.

The template text will be applied to the report you are working on, at the current cursor position.

Global templates

Global templates are those that users of the same specialty have shared or that are added to the system by default. You will be able to use these templates but not modify or delete them since you are not the owner of them.

There may be naming conflicts between your templates, the templates shared by users in your specialty, and the system default templates. To resolve conflicts, the application will proceed as follows:

• If there is a conflict between your templates and any of the shared or system templates, your templates will always take precedence.

• If there is a conflict between a template that someone in your specialty has shared with you and a system template, the system template will always take precedence.

Templates with custom fields

Sometimes it can be useful to have predefined texts in which only some sections vary. In these cases, INVOX Medical offers you the ability to define custom fields that you can navigate to automatically using voice commands or via your microphone buttons.

By default, text fragments enclosed in square brackets [] will be interpreted by INVOX Medical as fields (for example, [LAST NAME], [SIZE] or [WEIGHT]).

Once the field is selected, you can dictate to replace it with the text you want to write. It is also possible to navigate between the fields included in the text with the buttons of some handheld microphones, as described in the corresponding model section.

Text Transformations

INVOX Medical offers the possibility to define text transformations. Using this concept, you can automatically replace a text with a specific one. Text transformations are therefore used to adapt the result of speech recognition to the needs and preferences of each user.

For example, if we have a text transformation like “medical history” => “HM”, if the user dictates “no history of cardiovascular disease in the patient’s medical history”, the resulting text will be “no there is a history of cardiovascular disease in the patient’s MH”.

Each time you dictate, parts of the recognized text that match defined transformations are automatically replaced with their respective replacements. Unlike text templates, you don’t have to pause to take advantage of this functionality since it’s not about commands.

An important consideration is that the pattern of the transformations is case-insensitive.

The possibilities offered by the “Transformations” option are detailed below.

Add a transformation

With this option you can add transformations to adapt the recognition result to your preferences. When adding a transformation, the application will ask you to write the pattern to transform and the corresponding replacement.

1. Press the “New” button in the main view to navigate to the transformation creation view.
2. Type the transformation you want to add.
3. Press the “Save” button to finish.

Modify and remove existing transformations

This option allows you to modify or remove previously added transformations.

1. Mouse over the transformation you want to edit or delete.
2. If you want to edit the transformation:
   1. Modify the corresponding fields.
   2. Press the “Save” button to apply the changes.
3. If you want to remove the transformation:
   1. Click on the “Delete” button.
   2. Confirm the action to delete permanently.

After removing or modifying a transformation you will not be able to revert the changes.

Voice Commands

Voice commands are only available in the following languages:

• Spanish.
• Brazilian Portuguese
• European Portuguese.

See the documentation for each language for the available commands.

Units of measure

INVOX Medical allows the dictation of measurement units automatically. To dictate a unit of measurement, you simply have to say its name (for example, centimeters) and INVOX will transform it into the symbol corresponding to that measurement.

For example, if you say “12 centimeters” you will automatically get “12 cm”. If you dictate several units consecutively, for example, “area of one by two point five by two centimeters”, INVOX will write it in an abbreviated form by replacing each “by” with the symbol “x” so that you will get “surface of 1 x 2.5 x 2 cm”. In this case, it is important to highlight that you must say all the measures continuously, that is, without pausing. Otherwise, the system will not be able to perform the automatic transformation of the words “by” since it will understand that after the pause you are referring to a different measure.

Below are the units of measurement included:

Microphones and footswitches

Note: you may be using different microphones than those described below.

Plantronics Voyager Legend UC

First use

1. Insert the USB adapter into the computer’s USB port.
2. Turn on the microphone on the headset on/off button.
3. After a few seconds the USB adapter will turn a solid blue light indicating that it is now paired with the headset.
4. Now the microphone is connected but closed (on mute). If you press the “Answer and end call” button on the headset, the microphone will be activated and the blue light on the receiver will begin to flash.

Condition

• Solid blue light: the microphone is synchronized with your receiver but deactivated. To activate it, press the “Answer and end call” button.

• Blinking blue light: the microphone is synchronized and activated. To deactivate it, press the “Answer and end call” button.

Volume

• The headset volume can be turned up and down using the “Volume +/-” button on the headset.

Usage

• To use the microphone, adjust it to your ear and position it so that it is close to your mouth but does not come into contact with your face.

• If the sound is played through the computer speaker instead of the earphone, please disconnect and reconnect the USB receiver.

• Turn off the microphone (steady blue light) if you are not going to use it for several minutes.

• When you finish using the microphone, always place it in the charging base.

Plantronics Savi Go

Components

First use

1. Plug the receiver into the computer’s USB port.
2. The receiver will illuminate with a steady red light.
3. Press and hold the square button on the headset for 5 seconds until it turns blue.
4. The receiver will illuminate with a solid blue light, indicating that it is connected to the headset.
5. Now the microphone is connected but closed (on mute). Pressing the button on the headset will activate the microphone and the blue light on the receiver will begin to flash.

Condition

• Red light: the headset needs to be paired with its receiver or it is turned off. Disconnect the receiver, make sure the headset is turned on (pressing the square button makes a click sound), and reconnect the receiver. If the headset is off, press and hold the square button for 5 seconds.

• Solid blue light: the microphone is synchronized with your receiver but deactivated. To activate it, press the button on the headset.

• Blinking blue light: the microphone is synchronized and activated. To turn it off, press the button on the headset.

Volume

• The volume of the microphone is automatically adjusted and cannot be changed.

• The headset volume can be turned up and down by side scrolling the square button.

Usage

• To use the microphone, adjust it to your ear and position it so that it is close to your mouth but does not come into contact with your face.
• If the sound is played through the computer speaker instead of the earphone, please disconnect and reconnect the USB receiver.
• Turn off the microphone (steady blue light) if you are not going to use it for several minutes.
• When you finish using the microphone, always place it in the charging base.

Philips SpeechMike

The Philips SpeechMike range offers a set of USB microphones that stand out for their extensive functionality and ease of use. The installation of these microphones is very simple since you must connect them to your computer and install the drivers (drivers) of the device that you can download from the Philips website or find on the CD that comes with the microphones (it is also possible that Windows will detect the device and install them automatically). On the CD there are also applications that allow you to assign functionalities to the microphone buttons.

In Windows “Control Panel” you can check if your microphone is correctly installed. If you are using Windows 7 or higher you can go to “Control Panel -> Hardware and Sound -> Manage Audio Devices” and, in the “Record” tab, a microphone of type ” should appear. SpeechMike”. If you are using Windows XP you can go to “Control Panel -> Sounds, Audio and Speech Devices -> Sounds and Audio Devices” and in the “Sound Recording” tab check that it is selected the microphone SpeechMike. If your microphone doesn’t show up make sure the device drivers were installed correctly.

INVOX Medical integrates with SpeechMike microphones and allows you to control the activation and deactivation of speech recognition through the record button (red button located in the central area of the device). Pressing this button will cause the system to transcribe the dictated audio and pressing it again will stop the transcription. In addition, INVOX Medical maintains its other dictation on and off mechanisms which are explained in the following sections.

The EOL button on the microphone can also be used to lock or unlock the application on which the dictation is transcribed (see section “Selecting the application on which the dictation is written” for a detailed description of this functionality).

You can also use the INS/OVR button to accept dictated text if you are dictating into an application that INVOX Medical cannot type directly into and the F1 button to toggle uppercase typing on and off.

The following table shows a summary of the functionality associated with each button:

Olympus Directrec DR

Olympus also has a wide range of USB microphones that are easy to use and configurable through its various buttons. To install these microphones you only have to connect them to your computer and, if necessary, install their drivers (drivers) available on the Olympus website or on the CD that accompanies the microphones. Windows will probably detect the microphone and install it automatically.

In Windows “Control Panel” you can check if your microphone is correctly installed. If you are using Windows 7 or higher you can go to “Control Panel -> Hardware and Sound -> Manage Audio Devices” and, in the “Record” tab, a microphone of type ” should appear. DR”. If you use Windows XP you can go to “Control Panel -> Sounds, Audio and Speech Devices –> Sounds and Audio Devices” and in the “Sound Recording” tab check that it has been selected the microphone “DR”. If your microphone doesn’t show up make sure the device drivers were installed correctly.

INVOX Medical integrates with Olympus DR microphones and allows you to control voice recognition on and off via the record button (red button located in the center of the device that can be clicked or button that scrolls up or down depending on your device model). The system will transcribe audio until you press the button again or move it to the Stop position. INVOX Medical maintains its other dictation on and off mechanisms which are explained in the following sections.

The NEW button on the microphone can also be used to lock or unlock the application on which the dictation is transcribed (see section “Selecting the application on which the dictation is written” for a detailed description of this functionality).

You can also use the INSERT/OVER button to accept dictated text if you are dictating into an application that INVOX Medical cannot type directly into. The NEW button on the microphone can also be used to lock or unlock the application on which the dictation is transcribed (see section “Selecting the application on which the dictation is written” for a detailed description of this functionality). You can also use the INSERT/OVER button to accept dictated text if you are dictating into an application that INVOX Medical cannot type directly into. Also, the F1 button will allow you to toggle uppercase typing on and off.

The following table shows a summary of the functionality associated with each button:

Nuance PowerMic

Nuance offers specialized USB microphones for speech recognition. To install these microphones you don’t need any drivers as Windows will automatically detect and install them.

In Windows “Control Panel” you can check if your microphone is correctly installed. If you are using Windows 7 or higher you can go to “Control Panel -> Hardware and Sound -> Manage Audio Devices” and, in the “Record” tab, a microphone of type ” should appear. PowerMic”. If you use Windows XP you can go to “Control Panel -> Sounds, Audio and Speech Devices –> Sounds and Audio Devices” and in the “Sound Recording” tab check that it has been selected the microphone “PowerMic”. If your microphone does not appear make sure the device is connected correctly.

INVOX Medical integrates with PowerMic microphones and allows you to control the activation and deactivation of voice recognition through the record button (red button located in the central area of the device). The system will transcribe audio until you press the button again. In addition, INVOX Medical maintains its other dictation on and off mechanisms which are explained in the following sections.

The FF and REW buttons (smaller buttons located to the right and left of the record button) allow you to switch the input mode between “Auxiliary Window” and “Keyboard Simulator”.

The Next and Previous buttons (larger buttons located to the right and left of the record button) allow you to select the next or previous field in the text, respectively.

The circular button to the left of the button on the microphone can also be used to lock or unlock the application into which the dictation is transcribed (see section “Selection of the application on which the dictated text is written” for a detailed description of this functionality).

You can also use the button to accept dictated text if you are dictating into an application that INVOX Medical cannot type directly into and the circular button to the to the right of the button to toggle uppercase typing on and off.

Olympus footswitch to control the dictation system

In addition to the microphone, its implantation could incorporate a pedal system that facilitates the control of INVOX Medical. Using the footswitch buttons you can turn dictation on or off or perform some commonly used commands like undo or redo the last change. The functionality of each button is configurable but by default is the next:

• “Listen” button (bottom central part): starts the dictation system when it is stepped on and stops the dictation system when it is released.

• “Top” button (top center): moves the cursor to the end of the document.

• “Rew” button (far right): deletes the last word typed. If you keep the button pressed, words will be deleted backwards until you stop pressing it or you reach the beginning of the document.

• “FF” button (far left): rewrites the last deleted word. If you keep the button pressed, words will be rewritten until you stop pressing it or the end of the document is reached.