Virtual Scribe

Moraph resells, implements and runs Nuance Dragon clinical documentation for hospitals, health systems and medical groups. We set up Dragon Medical One speech recognition, and ambient documentation where you license it, so clinicians can dictate or have their notes drafted inside the EHR, then operate the service day to day: user setup, shared templates and vocabulary, support, monitoring and change. Clinicians review and sign every note, and your organization keeps the decisions on privacy, consent and documentation policy.

The problem it solves

Clinicians spend a large share of their day typing notes into the EHR, often after clinic hours. Many organizations already own speech recognition licences but use them unevenly: profiles are set up once and never tuned, shared templates drift from documentation policy, new clinicians wait for accounts, and nobody owns the problems that make dictation feel unreliable. When ambient documentation is introduced, questions about patient consent, recording and who checks the draft note are left to each clinic to answer.

Who it’s for

• Chief medical information officers and physician documentation leads
• Physicians, advanced practice providers and other clinicians who document in the EHR
• Health information management and clinical documentation integrity teams
• EHR and clinical applications teams who support clinicians at the workstation
• Privacy and compliance officers responsible for patient information and consent

1. OnboardClinicians are given a Dragon licence and profile, a microphone or mobile microphone app, and the shared vocabulary and templates for their specialty, ready to use in the EHR.
2. DocumentClinicians dictate directly into the EHR, use voice commands and auto-texts to insert standard text, or, where ambient documentation is licensed, have a draft note produced from the visit conversation for them to edit.
3. Support and tuneMoraph handles recognition, microphone and integration issues as second-line support, and maintains shared vocabulary and templates through approved changes.
4. ReviewEach month Moraph reports usage, support and change activity, and reviews it with your documentation lead to target training and licences where they are needed.

Speech recognition in the EHR

Dragon Medical One turns clinicians' dictation into text directly in the EHR and other clinical applications, configured for the applications you use.

Profiles that follow the clinician

Each clinician's speech profile and personal settings are held in the cloud, so they work on any configured workstation.

Specialty vocabularies

Dragon's medical vocabularies are set by specialty, and Moraph adds approved local terms such as clinic names and local drug formulary entries.

Shared auto-texts

Standard text such as exam templates and patient instructions is inserted by voice, maintained by Moraph and approved by your documentation lead.

Ambient documentation, where licensed

Where you license Nuance's ambient capability, a draft note is produced from the visit conversation for the clinician to review, edit and sign.

Mobile microphone

Clinicians can use a smartphone as a secure microphone through Nuance's mobile app where you allow it, configured with your device policy.

Consent and use rules

Clinic-level rules for when ambient capture may be used, how patients are told and how agreement is recorded, written with your privacy officer.

Licence management

Licences assigned, reclaimed and reported by department, so they go to clinicians who use them.

Second-line support

Moraph takes recognition, microphone, profile and EHR integration issues from your service desk and escalates platform defects to Nuance.

Controlled changes

Every change to shared templates, vocabulary or settings has a request, an approver and a record.

Usage and adoption reporting

Use by department and clinician, licences not used, and recurring support issues, reviewed monthly.

Onboarding and offboarding

New clinicians are set up from your requests, and departing clinicians' access is removed when your leaver process tells Moraph.

Documentation lead

CMIO or physician lead who approves the baseline, shared templates and ambient documentation rules

Clinician

Dictates or uses ambient documentation, reviews and signs every note, and keeps their own auto-texts

Health information management lead

Checks templates against documentation and coding policy and reviews documentation quality

Privacy officer

Sets consent and use rules for ambient capture and decides on privacy events

Moraph speech platform engineer

Sets up users, profiles, templates and integrations and resolves second-line issues under approved changes

Moraph service manager

Runs the monthly service review, tracks requests and escalations, and reports on usage and support

Electronic health record

Dragon is configured to insert text into your EHR's note fields, and ambient draft notes are placed where your EHR integration supports it.

Single sign-on

Staff administrator access, and clinician sign-in where the platform supports it, go through your identity provider.

Virtual desktop and workstations

Dragon is set up for the virtual desktop or workstation build your clinicians use, tested with your desktop team.

Microphones and mobile devices

Supported handheld microphones and Nuance's mobile microphone app, deployed under your device management policies.

Your service desk

Tickets pass between your IT service management tool and Moraph's, so clinicians report problems in the usual place.

HR and medical staff records

Joiner and leaver requests from your HR or medical staff office drive account creation and removal.

Usage reporting

Usage and licence data from the platform is combined with Moraph's ticket and change records for monthly reporting.

Business associate agreement

Moraph signs a business associate agreement with your organization because the service involves PHI, and Nuance's own agreement covers the platform.

Named Moraph administrators

Moraph staff work with individual accounts, the least administrator rights the service needs and multi-factor authentication; there are no shared accounts.

Role-based access

What each person at your organization and at Moraph can see and do follows their role; requesting a change is separate from approving it.

Complete audit trail

Moraph's change and ticket records show who did what and when, alongside the platform's own administration logs.

Encryption and keys

Service records Moraph holds are encrypted, with keys Moraph staff cannot use without explicit, time-bound authorization.

Audited company-wide

Moraph is audited to SOC 2 Type II and ISO/IEC 27001 across the company, including the teams that run this service. Nuance's own attestations cover the platform.

Licences through Moraph

Moraph resells the Dragon subscription and runs it as one service, subject to Nuance's terms.

Your existing Dragon licences

If you already license Dragon, Moraph reviews the current setup against a new baseline and takes over its operation.

Co-managed

Your team keeps some tasks, such as first-line support or user setup, and Moraph runs the rest; the split is written into the responsibilities for the service.

Discovery

We review your EHR, workstation and virtual desktop builds, existing licences, departments in scope and current documentation policies with your IT and clinical leads.

Baseline design

We propose settings, specialty vocabularies, shared templates and support arrangements, and agree the baseline with your documentation lead.

Consent and use rules

Where ambient documentation is in scope, we draft clinic-level rules for patient notice, agreement and clinician review with your privacy officer.

Build and integration

The service is configured to the baseline and tested in your EHR and on your workstation builds and mobile devices.

Rollout by department

Clinicians are set up in waves with orientation, quick reference guides and extra support in the first weeks of each wave.

Handover to operations

Change process, approvers, support routes, escalation contacts and reporting are agreed, and the service moves into day-to-day operation.

• Moraph is not Nuance. Nuance operates the Dragon platform, and Nuance's own service commitments, roadmap, maintenance and outages apply.
• Dragon licences are subject to Nuance's terms. Ambient documentation and some other capabilities need their own licences.
• Speech recognition and ambient documentation produce text that can contain errors. The clinician must review, correct and sign every note.
• Moraph does not provide clinical documentation, coding or medical advice, and does not edit or sign notes on anyone's behalf.
• Consent rules for recording patient conversations vary by state. Your organization decides its consent and notice policy; Moraph helps document and apply it.
• EHR integration depends on what your EHR and Nuance support together. Some note fields or workflows may need manual steps.
• Recognition quality depends on microphones, network and workstation builds that your organization manages.
• Moraph does not make privacy or breach notification decisions; your privacy officer does.

• List your current licences and compare them with who actually uses the service
• Ask a few clinicians where dictation fails them today and check whether the proposed baseline addresses it
• Review the shared template process and confirm who approves shared text
• Walk through a support ticket from your service desk to Moraph and back
• If ambient documentation is in scope, review the draft consent and notice rules with your privacy officer
• Confirm the split of responsibilities between your IT team, Moraph and Nuance