powerscribe 360 | reporting troubleshooting guide

PN 889672 September 24, 2015

PowerScribe® 360 | ReportingTroubleshooting Guide

The latest version of this manual is available from the Oracle iSupport Library.

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Printed in U. S. A. September 24, 2015

Trademarks

Nuance®, the Nuance logo, Dictaphone®, Dragon® NaturallySpeaking®, PowerScribe®, RadPort™, andRadWhere™ are trademarks or registered trademarks of Nuance Communications, Inc. or its affiliates in the UnitedStates and/or other countries. All other trademarks referenced herein are trademarks or registered trademarks of theirrespective owners.

Copyright Notice

This manual is copyrighted and all rights are reserved by Nuance Communications, Inc. No part of this publicationmay be reproduced, transmitted, transcribed, stored in a retrieval system, or translated into any language or computerlanguage, in any form or by any means, electronic, mechanical, magnetic, optical, chemical, manual, or otherwise,without the prior written permission of Dictaphone Healthcare Solutions, Nuance Communications, Inc., 1Wayside Rd., Burlington, MA 01803.

Copyright © 2011 Nuance Communications, Inc. All rights reserved.

Disclaimer

This document is provided "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, BUTNOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, ORNON-INFRINGEMENT. Nuance shall not under any circumstances be liable to any person for any special, incidental, indirect orconsequential damages, including, without limitation, damages resulting from use of OR RELIANCE ON the INFORMATION presented,loss of profits or revenues or costs of replacement goods, even if informed in advance of the possibility of such damages.

Every effort has been made to ensure the accuracy of the information presented. However, Nuance assumes no responsibility for the accuracyof the information. Product information is subject to change without notice. Changes, if any, will be incorporated in new editions of thispublication. Nuance may make improvements and/or changes in the products and/or the programs described in this publication at any timewithout notice. Mention of non-Nuance products or services is for information purposes only and constitutes neither an endorsement nor arecommendation.

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Table of Contents

Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

Troubleshooting Client Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Client Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1Install Wizard Interrupted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Application Launch Failures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2Client Closing Unexpectedly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2All Workstations Fail to Launch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2Individual Workstations Fail to Launch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

Client Latency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5Latency at Log-In. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5Latency When Signing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6Latency When Opening a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-16Latency is Random. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-17

Common Client Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-18Client Hangs/Crashes When Playing Audio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-18Client Starts but Not Seen on Desktop. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-20Error with Agfa PACS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21How to Enable Client Logging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-22

PX2008 HL7 Interface Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-26Orders or Reports Not Transferring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-26

Microphone Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-29Microphone Will Not Activate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-29Microphone Disconnects Randomly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-30Microphone Just Stops Working . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-33Microphone Latency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-35

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Troubleshooting Client Issues

Client Installation

Install Wizard Interrupted

"The wizard was interrupted before Nuance PowerScribe 360 | Reporting - Client couldbe completely installed. The system has not been modified. To install this program at alater time, run the installation again."

1. Verify the Philips Speech Mike software is not running on the workstation.

Exit the Speech Mike application from taskbar, and run the Client installationagain.

2. Verify that the Microsoft Office Applications on the workstation are not open.

Close any Microsoft Word, Outlook, Excel, etc., opened documents, and runthe Client installation again.

"Your system must be restarted due to another program install/uninstall."

This message indicates that the system restarted and you need to delete thePendingFileRenameOperations key in the system registry.

1. Launch the Registry editor.

2. Navigate to the following destination. Computer\HKEY_LOCAL_MACHINE\SYSTEM\CurrentControlSet\ Control\Session Manager

3. Locate and delete the key named: PendingFileRenameOperations.

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Application Launch Failures

Client Closing Unexpectedly

Many Client failures and exceptions are caused from missing Microsoft updates.

An example is the message "Client is Closing Nuance.PowerScribe360.exe…". This issue occurs because of a known issue in Ole32.dll that http://support.microsoft.com/kb/2541119 fixed.

To address this issue, run and apply all current Microsoft updates.

NOTE: If the system is V1.x, do not apply the .NET update for 4.5 andhigher.

All Workstations Fail to Launch

If no, the issue is most like related to the IIS configuration and primarily the MIMEtype is missing.

You should review the Dragon log and look for the following:

09:05:26.536 Roaming: RoamingInternetCopySOptionsIni cannot copy soptions ini file from http://AASJCSTLV398SQL/DragonUsers/luckt/current/soptions.ini to C:\Users\luckt\AppData\Local\Temp\dra1838\current\soptions.ini error = 151 Server return =404 Not Found

09:05:26.781 Roaming Error: Cannot copy options.ini file down from network luckt\current\soptions.ini to C:\ProgramData\Nuance\Dragon SDK Client Edition12\RoamingUsers\Default Server\Location_1\luckt\current\soptions.ini in RoamingInternetAcousticNew error = 151 Server return =404 Not Found

The messages indicate that the Mime Type is missing from the IIS configuration.

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To resolve, add the Mime Type to the server as shown below.

Individual Workstations Fail to Launch

If not, the issue is most likely local.

1. Ask the user to launch PowerScribe 360 in standalone mode.

2. Input the user log on credentials, by clicking the shift Key and then select login.This process forces the application to remove the local cache and to apply a freshcopy of the user’s roaming profile from the server.

If the user recently logged in and now cannot, this could be due to a failure during thelast log out because a file did not properly upload or was corrupted on upload.

First Step

1. Rename the user’s local workstation cache to save it for later analysis, if needed.

Client cache location: C:\program data\nuance\dragon 10 or 12\roaming\location1 (if 2.5 default server\location1)\

The user’s cache will be in a folder with their login name.

2. Ask the user to log in again.

If the user cannot log in, proceed to the next step.

If the user can log in and this is a repeated event (occurred before within 1month), escalate to a Problem manager.

If the user can log in and this is not a repeated event, document the ticket andseek Client agreement to solve it out.

You should assist the user / admin to restore the user’s profile from the checkpoint.When you use this restore, the system will put a copy of the bad profile in the debugfolder on the server. The purpose of this is so it can be collected and sent todevelopment to review. This may provide Nuance with a way to improve theapplication / system.

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To restore from checkpoint, you must go to the user’s profile in the Admin Portal.There are two possible selections to reset a user's profile: Restore CheckpointAcoustics or Entire Profile.

It is best to choose Restore Checkpoint (Entire Profile).

If the user does not have a checkpoint, you should run the Profile Remediation Toolagainst the profile and try logging in again. WHO?

If that does not resolve the issue, you will then have to choose the Delete Profile option.When the user logs back in, the user will have to re-train. Before choosing to delete theprofile, collect the profile from the server and local workstation and escalate todevelopment for analysis.

Note: The user’s AutoTexts, auto corrects, and custom words added bythe Admin are NOT lost, as they are stored in the DB, not in Dragon.

If the user cannot log in, escalate to a Problem manager.

If the user can log in and this is a repeated event (occurred before within 1month), escalate to a Problem manager.

If the user can log in and this is not a repeated event document the ticket and seekclient agreement to solve it out.

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Client Latency

Latency at Log-In

Error / delays when logging into Client may be due to Internet access not available forthe user logged in. When the Client launches it goes to the Internet to check thecertificate revocation list. This is a security feature in IE when the local machine has anoutdated list. Disabling the revocation check in production environments are notrecommended. Certificate revocation checking protects your clients against the use ofinvalid server authentication certificates either because they have expired or becausethey were revoked (e.g., when a server certificate was compromised).

To get the updated list, you can download it from Microsoft at: http://support.microsoft.com/kb/2677070

As an alternative, your site IT can disable certificate revocation check-in for IE.Starting with IE 7.0, server certificate revocation check-in is enabled by default. Thisfeature can be disable by clicking Internet Options on the Tools menu, selecting theAdvanced Tab, and clearing the Check for server certificate revocation check box, asshown below. You need to restart Internet Explorer for this setting change to occur.

If the issue is not resolved, escalate to a Problem manager.

If the issue is resolved and this is a repeated event (occurred before within 1month, escalate to a Problem manager.

If the issue is resolved and this is not a repeated event, document the ticket andseek Client agreement to solve it out.

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Latency When Signing

1. First, you can check if the user / site has “Save Audio” with report enabled. Youcan turn this setting off, if it is not required by the Client’s workflow.

This setting is available from Tools > Preferences > Dictation tab, Save audio withreport option.

This setting only needs to be On if:

Dictators save reports as a drafts and want to open them later on to complete thereport, and they want to hear the report audio. If the Save Audio setting is off(False), the wave files are not kept.

Residents and the attending wants to listen to the audio that the residents recordand to approve the report.

Editors want to send notes back to the physician for clarification about a report,and the physician wants to be able to listen to the audio. If the Save Audio settingis off (False), the audio would be deleted when the editor clicks Finish.

Admins want to be able to listen to the audio through the portal, i.e., QualityChecking edits.

Note: The Save Audio setting does not have to be On just for the editor’sworkflow. The system will automatically save the audio to send to theeditor, but the system will delete the audio when the editor clicks Finish.

2. Ask the user to test performance. Provide steps to do this.

If the issue is not resolved, go to the next step.

If the issue is resolved and this is a repeated event (occurred before within 1month), escalate to a Problem manager.

If the issue is resolved and this is not a repeated event, document the ticketand seek Client agreement to solve it out.

Next Step

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3. Check to see if the user has been running ACO/LMO.

If you see the user has not processed ACO / LMO in the past two (2) weeks, but haslogged in and used the system in that time period, you should see if the ACO or LMOfailed.

You can confirm the functionality from the RadPortal > Logs > ACO/LMO page. TheACO/LMO page displays individual SUS jobs with a recent date.

Jobs with Profile folder is not available in the Additional info field only indicates usersare scheduled in ACO/LMO but have not yet trained their voice profile.

This message was removed starting in V3.

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Reviewing Exception / Failure Messages

1. If you find a profile that is still failing ACO or LMO, after running the SpeechProfile Remediation Utility, review the stack trace to determine the cause.

All exceptions are logged to RadPortal. Jobs may be completing successfully, butfinishing with a state of 5 (Not Enough Data), which do NOT show in RadPortal.Exceptions are also logged to the Windows Event Viewer.

If the user has not run ACO / LMO in a long time, verify the user‘s profile settings arecorrect to allow data collection and upload.

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2. From the Dictation tab, check these settings:

Prompt to save speech files is set to Always Save.

Enable Dragon data collection is checked.

3. If the user is running ACO / LMO you should, as a troubleshooting step, renamethe user’s local workstation cache, for later analysis, if needed.

Client cache location: C:\program data\nuance\dragon 10 or 12\roaming\location1 (if 2.5 default server\location1)\

The user’s cache will be in a folder with their login name.

4. Have the user test performance.

If the issue is resolved, this indicates that the user’s server profile should be evaluated. I

Next Step

5. Check to see if the profile on the server is > 500 MB.

If it is, then the cause may be due to the user not running ACO often enough.

a. Set the user to run ACO every 2 or 3 days and LMO daily.

This will allow the user to improve performance and with the new ACOsetting, should run more often, preventing the buildup of local cache.

A word of warning: Never disable ACO or LMO and do not disable the standard profilesettings. These settings and ACO / LMO allow the system to properly clean up afteritself, while improving speech recognition.

6. Next, run the Profile Remediation tool.

a. Unzip the DNS Profile Checker.zip file.

b. Open the Release folder.

c. Locate and run Nuance.Radiology.DNSProfileChecker.exe.

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The following dialog displays.

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7. Use the folder selection tool to navigate to the DragonUsers folder.

8. Click Next.

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This page allows you to select the profiles that you would like to process. You canselect 1 profile, multi-select several profiles, or select all profiles (the ‘Select all’and ‘Deselect all’ are provided for your convenience).

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9. Select the profiles that you would like the tool to process, and click theicon to move them to the Profiles to be checked list.

10. Click Next.


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Click Start.

11. While the process is running, the messages write to the message area and indicatethe progress as to whether or not steps were successful.

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When processing completes, a similar dialog displays as shown below:

In this example, the messages indicate that 7 of 7 profiles were processed and noerrors were encountered. The LogData.log of all processing is saved in the Releasefolder.

12. Finally, have the user perform a speech file save (speech > save profile) on theClient.

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Latency When Opening a Report

Depending on the system and user volume, a single system can have thousands ofAutoText templates. The AutoText filter, when set for all users, can have an effect onhow quickly a report opens. Resetting the Client UI state can reset this for the user tothe default filter of relevant AutoTexts.

Resetting the Client state can be done with no impact on the user and does not requiredowntime. You will have to have the user log out for this to be done.

To reset the Client UI, with the user logged out of the Client:

1. From RadPortal > Setup > Accounts > User > Preferences, select Reset UI State.

If this does not work, you should look at how the AutoTexts are configured.

In v2 through 2.0.2, the method of loading AutoTexts changed. Each time youcompleted a report and started a new one, the system had to unload all of theAutoTexts and then reload all of the AutoTexts when opening the next report. Thiscreated latency if the user had many AutoTexts.

With v2.0.1 Patch 1 and v2.5 and later, the method was changed so that AutoTextswere loaded into memory when you loaded the first report, then only reloadedwhen changing sites. Latency can also occur if the user did not categorize his orher AutoTexts properly.

2. See if the user has many AutoTexts.

If so, see if they categorized, associated to modalities / procedure codes. Themore AutoTexts the user has that are not associated to a procedure / modality,the higher the probability latency will occur.

a. To test if the user has not categorized AutoTexts, have the user log out andexport all of the user’s AutoTexts.

b. Delete the AutoTexts.

c. Have the user log back in, start a report, and dictate and sign a report.

If it is operating normally, this indicates the AutoTexts need to be recategorized.

3. Go back and import the exported AutoTexts, and provide assistance and guidanceon categorizing the AutoTexts.

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Latency is Random

Check if the user / site has Save Audio with report enabled.

To set this option, from Tools > Preferences > Dictation , enable Save Audio withreport.

This setting only needs to be on if:

Dictators want save reports as drafts and want to open the reports later to finish,and if dictators want to be able to hear the report audio. If the Save Audio settingis Off (False), the wave file would not be saved.

Residents and the attending want to listen to the audio the resident recorded, andapprove the report.

Editors want to send a note back to the physician for clarification on a report, andthe physician wants to listen to the audio. If the audio setting is Off, the audio isdeleted when the editor clicks Finish.

Admins want to listen to the audio through the portal, i.e., Quality Checkingedits.

Note: Save Audio does not have to be on just for the editor’s workflow.The system will audio save the audio to send to the editor, but the systemwill delete the audio when the editor clicks Finish.

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Common Client Issues

Client Hangs/Crashes When Playing Audio

Editors who experience issues when playing back very long reports, or when a greatdeal of changes occur to a report (more like transcribing rather than editing) mayexperience crashes when playing the audio.

To address this, make the following change to the local machine:

1. First ensure that the audio sound mixer is enabled.

a. From the Control Panel, select Sounds.

b. Ensure the Audio Mixer Device shows under Recording Devices:

c. If you do not see the device, right-click and select Show Hidden Devices.

d. Right-click Rec Playback, and select Enable.

e. If the device does not show, even if hidden devices are shown, it means theaudio driver needs to be installed or upgraded.

Next Step

2. Edit the local workstations nssystems.ini to improve the applications ability tohandle multiple changes to a file.

To Edit the nssystem.ini:

a. Locate the file in: C:\ProgramData\Nuance\Dragon SDK Client Edition12.

b. Within the [Settings] section of the nssystem.ini file, add the following line ifit does not exist.

Maximal Amount of Difference Between Two texts=600

OR

If it does exist, edit the value to 600.

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This is a workstation specific modification and will not follow the usersprofile. Be sure that the PowerScribe 360 Client is closed before you modifythe Maximal amount of differences between two texts value.

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Client Starts but Not Seen on Desktop

When attempting to launch the PowerScribe 360 | Reporting Client, the Client does notdisplay, but appears on the task bar. Even when clicking the task bar, the Client will notdisplay.

1. From Start, select Run, and type regedit, and click OK.

2. Rename the HKCU\Software\Nuance\PowerScribe360 folder.

This will regenerate automatically.

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Error with Agfa PACS

When launching the Client in standalone or integrated, PowerScribe 360 displays anerror message:

"An error occurred initializing PACS. Please notify support. Invalid parameterspecified for the log file path or logging level."

This is caused by Windows 7 PCs having the wrong TEMP and TMP userenvironmental variables (check: Start > Run >%temp%).

To fix the error, update the environmental variables:

1. Right-click the Computer, select Properties.

2. Click Advanced system settings.

3. Click Environment Variables.

4. Select Temp, and click Edit.

5. Change the Variable value from %USERPROFILE%\Local Settings\Temp to%USERPROFILE%\AppData\Local\Temp.

6. Click OK.

7. Select TMP, and click Edit.

8. Change the Variable value from %USERPROFILE%\Local Settings\Temp to%USERPROFILE%\AppData\Local\Temp.

9. Click OK.

10. On the Advanced, click OK.

11. Close the Control Panel system window.

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How to Enable Client Logging

If the above actions do not address the issue, generate and collect logs for analysis toassist in identifying and correcting the issue.

Performance Logging for V3.0.x and Higher

Application logging can be enabled on a user or system level in RadPortal.

To enable application logging:

1. Log in to the Radport.

2. From Preferences, select Security.

3. Uncheck Disabled and check Report Workflow, Performance, and RASlogging.

WARNING: This logging can impact performance. Enable the Report Workflow,Performance, and RAS options only. Only enable more at development request.

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Enabling Performance Logging for V2.5.x and Lower

You must log in with administrative privileges to alter the registry of the Client Workstation.

Paths and values are case-sensitive!

1. Create the following folder: C:\Nuance\PowerScribe360\PerfLogs.

2. Create a Windows Registry Script File for Performance Logging:

a. Open a new Notepad file on the desktop.

b. Copy the following script, including the header into the Notepad file.

Windows Registry Editor Version 5.00

[HKEY_LOCAL_MACHINE\SOFTWARE\Nuance\PowerScribe360Perf]

"EnablePerformance"="True"

"DaysToKeepPerformanceLogs"="10"

"PerformanceLog"="C:\\Nuance\\PowerScribe360\\PerfLogs"

If enabling on a 64-bit workstation, replace the first line of registry keyabove with:

[HKEY_LOCAL_MACHINE\SOFTWARE\WOW6432Node\Nuance\PowerScribe360Perf ]

c. From File, select Save As and enter PS360PerformanceLog.reg as the filename, and select All Files as the Save as type.

d. Click Save and save the file on the desktop. A PS360PerformanceLog icondisplays on the desktop.

3. Double-click the PS360PerformanceLog icon on the Desktop.

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4. Click Yes when the Registry Editor prompts to add the information to the Registry.

Enabling Additional Client Logging

Additional application logging can be enabled for a user or at the system level.

To enable additional Client logging for V2.x and lower:

1. From RadPortal, select Preferences and Security.

2. Uncheck Disabled, and then select the required logging.

WARNING: This logging can impact performance. Enable the Report Workflow optiononly. Only enable more at development’s request.

How to Obtain Client Logs

With Performance logging enabled, have the user replicate the issue to generate logs.

For the Client version, retrieve the:

V2.5 and Higher:

1. Have the user upload logs to the Application Server.

a. Click Help, and select Upload Logs.

Lower than V2.5

1. Collect the logs manually.

a. From C:\Nuance\PowerScribe360\PerfLogs, copy the log.

Filename: PS360PERF + MMddyyHHmmss + MachineName + .log

V1.x through V2.0.x

a. Collect the logs manually.

a. From %temp% folder, copy the logs:

PACS integration logs (Vary depending on integration)

RadWhereCOM Logs

b. From Dragon logs in %appdata%\Nuance\Dragon SDK Client Edition12,copy the logs:

Dragon.log

Dragon.bak.log

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c. From Location: C:\Nuance\PowerScribe360\PerfLogs, copy the PowerScribe360 Performance Logs

Filename: PS360PERF + MMddyyHHmmss + MachineName + .log.

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PX2008 HL7 Interface Issues

Orders or Reports Not Transferring

The first priority is to get the HL7 stream operating. However, you should not stopthere. The cause of the outage should be investigated and a permanent resolutionapplied.

1. First, restart the RadBridge.

2. Verify if the HL7 traffic is uploading and downloading.

To verify that the interface is up and connected:

a. From the desktop interface server, view the Px2008 Monitor.

b. Verify that green lights (connected) or yellow lights (listening) on the left sideof the window display.

c. If the Px2008 Monitor is not launched, double-click the PX2008 Monitoricon.

d. If you do not have green or yellow lights, you need to restart the RadBridge.

e. If the HL7 stream is active and you see orders being received and reportsuploading, you should speak to the client to determine what is making thembelieve there is an issue with the HL7 stream.

3. Restart RadBridge.

a. Login to the Web server, and open Services.

b. Right-click the Nuance Web Bridge service, and select Stop.

c. Once the service has stopped, right-click Nuance Web Bridge service, andselect Start.

4. Verify that the HL7 stream is active.

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a. From the interface server desktop, view the Px2008 Monitor.



Note: Some of the PX2008 engines flash all red lights when they areupdating.






d. If the stream is not active, go to Step 6.

e. If the stream is active and this is a repeated event (occurred before within 1month), escalate to an Interface Problem manager.

f. If the stream is active and this is not a repeated event, document the ticket andseek client agreement to solve it out.

6. Restart the PX2008 application.

a. Login to the Interface server and open Services.

b. Right-click the PX2008 service, and select Stop.

c. Once the service has stopped, right-click PX2008 service, and select Start.






d. If the stream is not active, go to Step 8.

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e. If the stream is active and this is a repeated event (occurred before within 1month), escalate to an Interface Problem manager.

f. If the stream is active and this is not a repeated event, document the ticket andseek client agreement to solve it out.

8. Ask Client to Restart the RIS Connection.

Sometimes after restarting it may take a few minutes for orders to start flowing.

9. If, after a few minutes, no orders are being received or the RIS port receivingreports is not accepting the connection, you will need to ask the client to have theRIS team cycle the sending port / device.

10. Check the PX2008 Monitor to verify the orders and reports are flowing.

a. If the stream is not active, escalate to an Interface Problem manager.

b. If the stream is active and this is a repeated event (occurred before within 1month), escalate to an Interface Problem manager.

c. If the stream is active and this is not a repeated event, document the ticket andseek client agreement to solve it out.

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Microphone IssuesMicrophone issues can present themselves in different ways, but the root causes areusually the same.

The most important thing to do is ask questions and listen to the answers, before youtake any action. This ensures you take action that is most appropriate for the specificissue.

Below you will find some guidelines and questions to use, but you should use yourintuition to guide you to choosing the appropriate questions for your client.

Microphone Will Not Activate

Reregister the DLLs

DLLs failed to register properly: HIDDEV.dll and/or USBMGR.dll.

1. Re-register the DLLs using the provided script.

a. Download and extract regfix.zip from http://supportcontent.nuance.com/healthcare/documents/manauals/889672/reg fix.zip.

b. Run regfix.bat.

2. Apply the USB hot fix that is available through Microsoft. This hotfix addresses the issue which occurs because the initialization that is performed for the buffer of the audio data is insufficient when the audio is played. http://support.microsoft.com/kb/2721341.

http://supportcontent.nuance.com/healthcare/documents/manauals/889672/reg fix.zip

http://supportcontent.nuance.com/healthcare/documents/manauals/889672/reg fix.zip

http://support.microsoft.com/kb/2721341

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Microphone Disconnects Randomly

1. Verify that the Audio Mixer device is available and enabled.

a. From the Control Panel, select Sounds.

b. From the Recording tab, ensure the Audio Mixer Device (which looks like aPCI Card and is usually labeled Rec Playback) displays.

If the device does not display, even if hidden devices are shown, it means theaudio driver needs to be upgraded.

c. If you do not see the device, right-click and select Show Hidden Devices.

d. Right-click Rec Playback, and select Enable.

2. Remove remnant USB devices that can accumulate and interfere with theinstallation of the PowerMic devices.

a. Open the Device Manager.

b. From View, select Show hidden devices.

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Notice how many remnant USB device drivers (grayed-out) clutter DeviceManager, shown below.

c. Right-click each non-present driver for the USB Human Interface Device,USB Audio Device and USB Composite Device, and then click the Uninstallmenu option.

No Hidden Devices Appears

If you select Show Hidden Devices, and no additional devices appear, you will need tochange the system variables to allow them to show. Below is a procedure to add onesystem environmental variable, which allows drivers for non-present devices to bedisplayed in Device Manager. Removal of these non-present devices has proven to bebeneficial in resolving issues relating to the installation of the PowerMic USB device.

a. On the workstation, click Start and select the Control Panel.

b. From the Control Panel, select System.

c. Click the Advanced tab, and then click Environmental Variables.

d. In the System variables boxes, enter the values shown below:

Variable name: DEVMGR_SHOW_NONPRESENT_DEVICES

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Variable value: 1

e. Click OK. The new variable should be displayed as shown below.

f. Click OK and OK to close.

g. Unplug the PowerMic and reboot the workstation.

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Microphone Just Stops Working

3. Disable Power Save Options

Power Save options can cause the USB / Microphone to go to sleep if the system thinksit is not being used. Some areas to adjust are:

Disabling Power save features in BIOS like Intel Speed Step Technology (akaRuntime Power Management).

Switch Windows power plan to high performance.

4. Change the Minimum Processor State of the Current Power Plan to 50%

a. From the Control Panel, select Power Options.

b. From the Power Options dialog, select Change plan settings.

c. Click Change advanced power settings.

d. From the Advanced settings dialog, select Processor power management.

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e. Click Minimum processor state, and change the Plugged in percentage to50%.

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Microphone Latency

Latency When Pressing the Dictate Button on the PowerMic

When pressing the record button on the microphone, if the recording does not start fora few seconds, you should disable Audio Playback Enhancements in the audio devices.One symptom is when you see the audiodg.exe process spikes CPU usage to 80% ormore for short periods. (View in the Task Manager.).

1. On the taskbar, right-click the Speakers icon, and then select Playback devices.

2. From the Playback tab, right-click Speakers, and select Properties.

3. From the Enhancements tab, and check Disable all enhancements.

4. Switch Windows power plan to high performance, see the steps provided above in Change the Minimum Processor State of the Current Power Plan to 50% instructions.

Last Resort

5. Add an Internal USB PCI Card

In rare cases, there may be an issue with certain USB chipsets, which have displayedissues with USB devices like the PowerMic. This is mostly seen with a chipset that runsa combo USB port which can run at both USB2.0 and USB3.0 at the same time (eachport on the bus running at different speeds).

Symptoms

When an author pushes stop (on SpeechMike or GUI) to finish recording inSMSB-Recorder or SMSB-Editor, the front-end either freezes or the error message "anunknown internal error has occurred" is shown. When opening the recording devicesin Windows, also the Windows interface freezes. Both user interfaces respond againwhen the audio device is unplugged from USB port.

In SMSBRecorder.log the error messages "ERROR: OnError(-2147216946)", "ERROR: smxaudInternal", and "ERROR: 44003: SmXAudio Error code: 44003" are logged. Issue occurs with several audio devices from different vendors (Nuance PowerMic, Philips SpeechMike, Grundig SonicMic, etc.), but so far only on Operating System Windows 7.

Cause

The connection to the audio device is lost due to a Windows driver crash. Ourassumption is, that Intel chip set drivers, respectively USB controller drivers cause thiscrash due to the following workarounds being possible.

This can be resolved by adding a high speed internal PCI USB card. The cards that havebeen used successfully are:

Insignia USB 3.0 PCIe Host Card NS-PCCUP53/NS-PCCUP53-C. Transcend Model PDU3 USB 3.0 PCI Express.

powerscribe 360 | reporting troubleshooting guide

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