Dictation and Speech Recognition Blog

Dragon Medical Practice Edition Update 4.3.1 – the last update ever!

Dragon Medical Practice Edition Update 4.31.  - the last update ever!  
Doctors, Nurses, PA’s and other medical providers have loved using Dragon Medical Practice Edition for the past 20 years. 
This new update is the last update for this medical version of Dragon and will carry you until such time the product becomes unusable because of future updates to Windows.  
We hope your software will continue to serve you for the next several years.  Want to move to the cloud and start with Dragon Medical One? Leave Dragon Medical Practice Edition 4 behind and go to the cloud – Better speed, accuracy and EHR compatibility!  
Sign up for a free Trial of Dragon Medical One Cloud based subscription service today!

What’s new

DMPE 4.3.1 is a full release for customers that use Dragon Medical Practice Edition 2.x, 3.x and 4.x. This release is provided for US English, UK English, French, and German.

  • Security enhancements to improve Dragon’s security and resiliency.

  • Removed unused binaries related to the old Sax-based engine for Advanced Scripting.
    An earlier version of DMPE added WinWrap Basic as the scripting engine for the Advanced Scripting feature; replacing the SAX engine in older releases.

  • Product updates are now handled by FlexNetConnect to better support the downloading of large installers.
    Note: When you check for updates and there are no updates available, DMPE 4.3.1 will not display any messages.

System requirements



Minimum: 4 GB for all operating systems.



Minimum: 2.2 GHz Intel® dual core or equivalent AMD processor. Faster processors yield faster performance.

Free hard disk space:


  • 4GB if DVD installation, or
  • 12GB if downloading installation files

Supported operating systems:


  • Windows 7, 8.1, and 10, 32-bit and 64-bit
  • Windows Server 2008 R2
  • Windows Server 2012
  • Windows Server 2012 R2
  • Windows Server 2016
  • Windows Server 2019



  • Internet Explorer 11 or the current version of Chrome or Edge for online Help and for installation if installing from the Web
  • Microsoft .NET Framework version 4.5.2 or later

    Generally, the .NET Framework is pre-installed on Windows 7, 8.1, and 10 computers. If you do not have it installed, you are prompted to install it during Dragon’s installation.

    Nuance does not provide the .NET Framework with your installation; you must download the installation file from microsoft.com.

  • Microsoft Visual C++ 2012 Runtime (full build only)

    If you do not have it installed, you are prompted to install it during Dragon’s installation.

  • An audio input device capable of 16-bit recording for dictation

Upgrade instructions

Before you begin

Dragon Medical Practice Edition only supports upgrades only from the following previous version of Dragon Medical Practice Edition: V2.x, V3.x, or V4.x.

Dragon Medical Practice Edition does not support upgrades from any other versions or editions. If you have any other version or edition installed, you must first uninstall your existing version prior to installing Dragon Medical Practice Edition version 4.3.1.

Dragon 4.3.1 is a major upgrade. When you upgrade to version 4.3.1, the upgrade process now uninstalls your previous Dragon version automatically. You no longer need to uninstall your existing Dragon version before you upgrade.

Export your current User Profile

Before you upgrade, you will need to export your user profile and copy it to a safe location.

To export User Profiles from Dragon Medical Practice Edition:

  1. On the DragonBar, select Profile > Manage User Profiles.
  2. The Manage User Profiles dialog box opens.
  3. Select the User Profile in the list that you want to export.
  4. When the Browse For Folder dialog box opens, navigate to the folder where you want to store the exported User Profile (or create a new folder by clicking the Make New Folder button) and click OK.
  5. When a dialog box opens displaying a message indicating the export was successful, click OK.
  6. Repeat steps 3 through 6 for each set of User Profiles you want to export.
  7. Click Close .
  8. In the operating system, navigate to the directory where you exported the User Profiles. In that directory you find a separate folder for each exported User Profile, labeled with the user name.

Exporting custom words

If you added custom words or phrases to your vocabulary using the Vocabulary Editor, Add new word or phrase feature, or email and document analysis features, Dragon retains them during the upgrade. Optionally consider exporting any custom words to create a backup copy in case you need to re-install the previous version.

To export your custom words:

  1. From the DragonBar, select Tools>Vocabulary Center>Export custom word and phrase list.

    The Export Custom Words dialog box opens.

  2. Navigate to the folder where you want to save the file.
  3. Say or type a name.
  4. Select the export file format. The options are .XML or .TXT. To export words with word properties, select the XML format.
  5. Say or click Save.

Exporting custom commands

If you added custom commands, Dragon retains them during the upgrade. Optionally consider exporting any custom commands to create a backup copy in case you need to re-install the previous version.

To export custom commands:

  1. From the DragonBar, select Tools>Command Center>Command Browser.
  2. Select Mode>Manage.
  3. To export only custom commands, choose User-defined in the Group drop-down list.

    If you do not see User-defined commands in the drop-down list, you do not have any custom commands.

  4. Click the plus sign (+) to expand the list of commands.
  5. Select the check box next to the commands to export.
  6. Click Export.

Roaming user profiles

If you are using the Roaming feature, you must first upgrade your Roaming user profiles before upgrading client computers. For instructions, call Voice Automated, 800-597-6600

Upgrading Dragon

For automatic upgrades, Dragon updates your software automatically. You do not need to uninstall your existing version first. Dragon also retains your user profiles, custom words, and commands.

  1. Close any open programs.
  2. You may have to turn off your anti-virus program if it blocks the installation of Dragon.
  3. Do one of the following:
    Insert the DVD. The installation begins immediately. If the installation does not start automatically, run setup.exe from the DVD.
    Browse to the area where you downloaded Dragon and double-click setup.exe to run it.
    1. Install the Microsoft .NET Framework if prompted.

You may need to restart the computer after installing the .NET Framework.

    1. In the Dragon InstallShield wizard, click Next to begin the Dragon installation.
    2. Read the license terms and click the radio button to indicate you agree to the terms.
    3. Click Next to proceed to the next screen.
    4. Enter or confirm your customer information.
    5. Enter your serial number, and click Next.
    6. Select a set up type and installation directory.
    7. Click Next.
    8. If you selected Custom, choose the program features to install. Click Next.
    9. Click Install.

The installation begins.

  1. After the installation process is complete, click Finish.
  2. Follow the steps to activate Dragon.

Upgrading Dragon via a command line

You can perform a full Dragon upgrade through a command line using msiexec.exe or setup.exe .

Requirements to upgrade Dragon using msiexec.exe

You must include the REINSTALL=ALL and REINSTALLMODE=vomus parameters in the MSI command line

Example Dragon upgrade using msiexec.exe

msiexec /i <path to MSI> SKIP_PENDINGREBOOT_CHECK=1 
		REINSTALL=ALL REINSTALLMODE=vomus /Liwmo!e <path to log>

For more information, see ‘MSI properties for Dragon installations’ in the DMPE Client Installation Guide.

Fixed issues



DMPE would sometimes continue to record and recognize dictation although the microphone was stopped.

Issue fixed.

When running the Upgrade User Profiles wizard, the information in the Profile Upgrade details would not be correct.

Issue fixed. The correct details now appear.

Custom desktop shortcuts do not launch file.

Issue fixed.

Misleading add-on notification for non supported browser (Microsoft Edge)

Issue fixed – message no longer appears when Microsoft Edge is started when Dragon is running.


Known issues



No messages are displayed when clicking the “Check for updates” link from the Help menu

When you check for updates and there are no updates available, DMPE 4.3.1 will not display any messages.

The Dragon web extension dialog pops up even after extension is installed in the browser.

The Dragon web extension dialog can re-display every time you start your browser.

This problem is seen when you have not set a default URL in your browser. Setting a default URL to load when you start the browser stops this problem. For example, to set a default URL in Chrome:

  1. Click the Chrome menu (the three dots next to left of the address bar) and select Settings.

  2. Go to On Startup and select Open a specific page or set of pages to add the default URL to load each time you start Chrome.

You cannot import a user profile with the same name as your open user profile.


If your currently open profile is the same name as the profile you are trying to import, a “please wait” message will quickly flash and nothing else will happen. Dragon cannot finish the import and no profile appears in the display.

Splash screen changes after running a repair install.

After running a repair install, the splash screen identifies the product as English and not UK English.

The “send an email/send document as email” commands do not work in Word 2019.

The “send an email/send document as email” commands do not work in Word 2019.

The commands work as expected in Word 2016.

The Learn from Specific Documents tool does not work with GoogleDocs


if you try to run the Learn from Specific Documents Tool (Tools>Vocabulary Center>Learn From Specific Documents) with Google Doc, Dragon will ask for Google Docs credentials but will not be able to login to Google Docs to run the tool.

The “Read Line” and “Play Back Line” commands don’t function correctly in Microsoft Word 2016/2019

The “Read Line” and “Play Back Line” commands cause Dragon to read or playback the line from where you have placed the cursor.

In Word 2016/2019, the “Read Line” and “Play Back Line” commands cause Dragon to read or playback the entire paragraph from where you have placed the cursor.

Poor recognition and audio issues in Citrix environment on Windows Server 2016

Recognition may be poor and the audio may be distorted when using Citrix on Windows Server 2016. This is not an issue on Windows Server 2012 or Server 2008 R2. The issue occurs on XenApp and XenDesktop in Optimized mode; it does not occur in XenDesktop Generic mode.

Adding exported vocabulary using NSAdmin strips advanced settings

When you export a vocabulary and then add it to Dragon using the NSAdmin tool, the advanced settings (Context and Printed Form) are stripped from some words.

Workaround: Import the vocabulary using the Manage Vocabularies option from the DragonBar.

Or, do the following:

  1. Copy the itn_d.enh file in this directory:


    NSAdmin creates the CustomeXXXX folder in this directory when you use NSAdmin to add a vocabulary. In this example, XXXX refers to the vocabulary ID specified while adding the vocabulary through NSAdmin.

  2. Replace the existing itn_d.enh in the following directory with the one you copied:


    When you create a new user profile and you add a new vocabulary using NSAdmin, the user profile is created in this folder.

  3. Reload the user profile and check whether the settings for the custom word appear.

Slight delays after copying and pasting large documents

Pasting documents of 40+ pages into Gmail may take up to 15 seconds before the microphone can be turned on and you can dictate. Dragon is not hanging; there is simply a delay.

Some navigation commands not working correctly in Microsoft Outlook 2019 in embedded email view

The following commands do not work correctly in Outlook 2019 in embedded email view:

  • “Go to the To Field”
  • “Go to the Cc Field”
  • “Go to the Bcc Field”

However, the commands do work in pop-out view.

New scripting engine (WinWrap) returns long as typename for integer

When you create a command with the Advanced Scripting feature, the new WinWrap Basic engine returns typename long instead of integer.

Windows “X” (or “Close”) button flickers in applications during dictation

When you dictate in DragonPad, Notepad, or Microsoft Word, the “X” (or “Close”) button may flicker.

When exporting a DEU or FRA vocabulary, importing it may change the associated region

When you export a vocabulary (for example , fra-CHE language/region or deu-AUT language/region) and then import it, the region becomes deu-DEU or fra-FRA.

This is for FRA or DEU vocabularies only.

VocTool stuck at Authorization token window for Google Drive documents

When you attempt to use the VocTool with GoogleDocs, the VocTool gets stuck at the Google Drive Authorization screen.

With Published Dragon, dictation is allowed without having focus on an edit control

When you are using Citrix and you start to dictate when no application or edit control has focus, text may be entered into a non-visible/background dictation box that you cannot close and this prevents Dragon from closing properly.

Workaround: Ensure that focus is on the published application prior to dictating.

DragonBar not restored from Tray mode

The DragonBar does not get restored from Tray mode for some users when Dragon is installed with the Start Dragon minimized in the tray option as the default.

Workaround: Close and relaunch Dragon and Dragon will be correctly in Tray mode and the DragonBar can be restored.

Error message indicating user profile cannot be closed because applications are using it occurs

Having multiple unsaved documents open while trying to shut down Dragon may trigger this message. Ensure that all documents are properly saved and closed prior to shutting down Dragon.

If you have DMPE installed on a terminal server and you have roaming user profiles on the same server from a previous version of DMPE, you cannot import those user profiles if that roaming profile is still active

If you run into this issue, try moving the location of the profile in question using Windows Explorer and then try importing again.


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