Dictaphone Enterprise Speech System (DESS)

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	Dictaphone Enterprise Speech System (DESS) is an on-premises dictation/transcription system that is designed to reduce transcription costs and speed report turnaround time through the creation and distribution of medical reports. Dictaphone Enterprise Speech System is comprised of four key components: dictation, transcription, document distribution and online reporting. The DESS is comprised of one (1) to four (4) dedicated servers depending on configuration. In certain configurations, the vendor will accept patient/encounter information via a Health Level Seven (HL7) feed and can then return completed reports to the Electronic Medical Record (EMR) via HL7 feed. Data is stored in a Microsoft Structured Query Language (SQL) Server database that is password protected, but not encrypted. Note: The vendor has discontinued this technology.
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:	This technology has not been assessed by the Section 508 Office. The Implementer of this technology has the responsibility to ensure the version deployed is 508-compliant. Section 508 compliance may be reviewed by the Section 508 Office and appropriate remedial action required if necessary. For additional information or assistance regarding Section 508, please contact the Section 508 Office at Section508@va.gov.
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v19.6
Decision Date:	06/28/2019 at 13:56:10 UTC
Introduced By:	SCCM
Vendor Name:	Nuance

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Technology, obtained from the vendor (or from the release source).

Version	Release Date	Vendor End of Life Date	Vendor Desupport Date
8	10/06/2009
8.4	10/01/2013

Current Decision Matrix (06/06/2019)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VA IT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported. Any major.minor version that is not listed in the VA Decision Matrix is considered unapproved for use.

Legend:

White	Approved: The technology/standard has been approved for use.
Yellow	Approved w/Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Unapproved: This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Divest: VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unapproved may be found on the Decision tab for the specific entry.
Black	Prohibited: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Planning/Evaluation Constraint:The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology approved with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology approved with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

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Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

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Q3

Q4

8

Unapproved

8.4

Unapproved

Decision Constraints


[1]	This Technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population.

[2]	Veteran Affairs facilities using this technology must ensure that the product integrates with the VistA Computerized Record System and Text Integration Utilities. Facilities using this technology must ensure security requirements specified in Veterans Health Affairs Handbook 1605.1 are met for remote dictation and on-site and contract transcription services.

[3]	Veteran Affairs facilities using this technology must ensure that the product integrates with the VistA Computerized Record System and Text Integration Utilities. Additionally, use of this technology must meet Veterans Affairs (VA) Directive 6500 and implement Federal Information Processing Standards (FIPS 199) for all laptop devices and National Institute of Standards and Technology Special Publication 800-53 for all desktop devices when VA sensitive information is involved, or additional mitigating controls must be documented in an approved System Security Plan (SSP) to prevent potential disclosure of PII/PHI data. Additionally, projects which interface with external VA partners must have a Memorandum of Understanding and Interconnection Security Agreements (MOU/ISA), which detail the security requirements for users and systems that share information and resources outside of the VA production network.

[4]	As of April 23, 2015, per the Deputy CIO of Architecture, Strategy and Design (ASD), all technologies in use by the VA require an assessment by the VA Section 508 office. Section 508 of the Rehabilitation Act Amendments of 1998 is a federal law that sets the guidelines for technology accessibility. A VA Section 508 assessment of this technology has not been completed at the time of publication. Therefore, as of April 23, 2015 only users of this technology who have deployed the technology to the production environment, or have project design and implementation plans approved, may continue to operate this technology. In the case of a project that has implemented, or been approved for a specific site or number of users, and that project needs to expand operations to other sites or to an increased user base, it may do so as long as the project stays on the existing version of the technology that was approved or implemented as of April 22, 2015. Use of this technology in all other cases is prohibited.

[5]	Veteran Affairs facilities using this technology must ensure that the product integrates with the VistA Computerized Record System and Text Integration Utilities. Additionally, use of this technology must meet Veterans Affairs (VA) Directive 6500 and implement Federal Information Processing Standards (FIPS 199) for all laptop devices and National Institute of Standards and Technology Special Publication 800-53 for all desktop devices when VA sensitive information is involved, or additional mitigating controls must be documented in an approved System Security Plan (SSP) to prevent potential disclosure of PII/PHI data. Additionally, projects which interface with external VA partner must have a Memorandum of Understanding and Interconnection Security Agreements (MOU/ISA) which detail the security requirements for users and systems that share information and resources outside of the VA production network.

[6]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[7]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[8]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[9]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
There are no references identified for this entry.

Technology Components

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Name	Description
Enterprise TextSystem (EXText)	This is a set of modules that provide report distribution capabilities and integration with patient information systems. The component includes report routing, electronic signatures, templates and document review capabilities.
Enterprise TurboSpeech (EXSpeech)	This component is based on the Dragon speech recognition engine and provides background speech recognition.
Enterprise VoiceSystem (EXVoice)	This is a set of applications that support efficient dictation workflow and improved report turnaround time.
Enterprise Workstation (EWS)	This is a multi-purpose browser-based application that supports Personal Computer-based dictation, electronic signature and provider self-editing, as well as support for background-speech-assisted report editing by a medical transcriptionist.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Collaboration and Electronic Workplace Productivity Software	Miscellaneous Productivity Tools and Utilities

Operating Systems Supported by the Technology

Windows Client - Approved w/Constraints
Windows Server - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

This is a mature technology.
This technology has the potential to reduce a patient`s length of stay in acute care settings by automatically producing medical reports from real-time speech.
This technology has the potential to improve Medical Transcriptionist (MT) productivity and performance as dictations do not need to be typed from scratch.
At the time of writing, no National Institute of Standards and Technology (NIST) vulnerabilities had been reported and no VA Network Security Operations Center (NSOC) bulletins had been issued for the latest versions of this technology.

Adoption Risks

This technology is no longer supported or provided by the vendor.
This technology may collect, store or transmit Personally Identifiable Information (PII) or Protected Health information (PHI) and proper security standards must be followed in these cases.
There are other approved solutions that provide similar functionality available on the TRM. The use of several similar solutions may increase organization requirements for support and maintenance.

Architectural Risks

This technology is not portable as it runs only on Windows platforms.
This technology can store data using a Structured Query Language (SQL) database.

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General Information

Vendor Release Information

Current Decision Matrix (06/06/2019)

Decision Constraints

References

Technology Components

VA Categories View the VA Categorization Framework

Operating Systems Supported by the Technology

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

Adoption Risks

Architectural Risks

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VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (06/06/2019)

Decision Constraints

References

Technology Components

VA Categories View the VA Categorization Framework

Operating Systems Supported by the Technology

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

Adoption Risks

Architectural Risks

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