This document provides instructions for using a note activator and managing active notes within a medical record system. It covers the process of creating, editing, and signing off notes, as well as improving voice recognition accuracy and creating macros in Dragon NaturallySpeaking. The use of macros allows for efficient insertion of standard text blocks into notes, thereby reducing the time required for physicians to complete documentation.

1. Notes
It’s Just You And The Dragon
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2. Activating Note
 To open the Note Activator, Click either the
Notes icon or selects New Note from the Notes
menu.
 Highlight the Note desired and click Activate.
 Clicking the Edit icon opens the Active Note
Editor.
 The Note Elements are now available for Editing
by clicking on the corresponding icon at the left
of the window.
 When finished Editing, Save and either Sign Off,
Route to another User, or File as Complete.

3. Activating Note
 After the first Note has been created in the
patient's record, the Note from Note feature may
be used.
 With this function, the contents of the previous
Note will be copied over to the new Note in most
elements.
 Notes may also be started and saved in
Workflow - for later Completion by the doctor or
staff. All Active Notes that have not been
Completed will also be found in the physician's
Workflow.

4. Active Notes
 Notes that have been Activated, but not
yet Completed, are found in two locations:
Active Notes Tab in the patient's chart;
Active Notes Tab in Workflow.
 After the Notes are Completed, they will
be filed under the Tab that was selected
when the Note was originally defined.

5. Active Note Sign Off
 Active Notes are Signed Off while in Edit
mode. The options for the digital signature
display are selected in Tools – Doctors.
 An image file containing the doctor’s
signature can be imported to eMedRec.
 When Sign Off is selected, the dialog box
opens. Select the routing desired: Fax;
File; Edit; Ad Hoc Route; No Routing.

6. Training Dragon
 The accuracy of voice recognition in Dragon
NaturallySpeaking can be improved by additional
Training. Select Dragon NatSpeak from the Menu bar
then select Accuracy Center to begin
 Click Add a single word to your vocabulary.
 Type in the word you want to Add.
 Check the box to affirm you want to train the
pronunciation of this word.
 Click Add.
 Click Go and say the word into your microphone.
 Click Done.
 The word is now saved to your personal vocabulary.

7. Creating Dragon Macros
 Blocks of text can be inserted into Notes by speaking a
single command after creating Macros in Dragon.
 Open the Command Browser in the Dragon menu and
Click Script – New.
 Give the command a name, usually an acronym and not
a normal word – like ROS1.
 Train the command and enter the desired block of text in
Content. Save.
 When dictating a Note it is now possible to just say
“ROS1” and a standard paragraph or more appears.
 The combination of Macros and Default text in Note
elements greatly reduces physician time when creating
Notes.