Nabla Dictation

Nabla Dictation is a lightweight, real-time speech-to-text tool enabling clinicians to dictate directly at the cursor—anywhere on their computer. It works seamlessly within any EHR and other apps like email, Teams, document editing etc. Nabla Dictation is available on PC and Mac. This feature is available in private beta only for now.

Once installed on the desktop, Nabla Dictation appears as a floating bar that you can move around your screen with drag and drop:

We recommend setting up a hotkey to activate and stop dictation under Menu “…” -> Settings.

You can use your smartphone as a microphone with Nabla Dictation. It is typically useful with desktop computers that do not have a good hardware microphone or external mic. Download the app here:

• Android App

• iOS App

Nabla Dictation works with most hardware microphones. Nuance PowerMics II, III and IV. If your Mic buttons do not work as expected, please reach out to Nabla (see contact below).

You have the option to open a “scratchpad” window if you start dictating while the cursor is not active in a text field. This feature is in beta and turned off by default, but can be turned on under “…” -> Settings -> General

When this optional setting is on, if you start dictating while your cursor is not in a text field, you will see a window appear on top of the floating bar. When you do not put your cursor in a text field, your voice will be transcribed directly in the scratchpad window.

If you click in a text field while the scratchpad is open, Nabla will continue transcribing where ever the cursor is placed. Before closing the scratchpad, make sure you copy its content to paste it over into its desired destination. Once the scratchpad window is closed, its content is lost.

In Nabla Dictation, all punctuation must be explicitly dictated.

• Dictated punctuation marks: . , ! ? - : ; " [ ] ( ) — [see full list here]

• New line – Moves to a new line

• New paragraph – Starts a new paragraph

• New dash – Creates a bullet point (\n-)

• Note: “?” must be explicitly dictated (they are rare in clinical notes)

• Say: "New line, number one" → Produces:
  1.

• Common editing commands:
  "delete word", "scratch that", "erase that", "remove that"

• Next field – Moves to the next input field

• Say: "new section [name]"
  Example: "new section plan" → Outputs:
  Assessment and Plan:

Works with section names:
Allergies, Appointments, Assessment, Assessment and plan, Cardiovascular risks, Chief complaint, Current medications, Diet appointments, Diet chief complaint, Diet habits, Diet lifestyle, Diet medical history, Diet objectives, Diet vitals, Family history, History of present illness, Imaging results, Immunizations, Lab results, Mental health exam, Mental health history, Past medical history, Past obstetric history, Past surgical history, Physical exam, Plan, Prescription, Psychology history of complaint, Soap assessment, Soap assessment and plan, Soap diagnostic tests ordered, Soap objective, Soap physical exam, Soap plan, Soap subjective, Social history, Symptoms, Vitals, Well child care, Clinical history, Past medications, Gaps in care, Member focused care plan, Referrals, Results, Call summary, Patient goals, Goals, Medical procedures performed, HPI, Review of systems, Subjective, Objective.

Words that are not spelled properly by Nabla Dictation can be added into your 'Custom Dictionary'. This feature is shared with your Nabla Ambient account, so that you do not need to configure this twice.

Under “…” > Settings > Custom Dictionary.

See Personal Dictionary for directions on set-up.

You can trigger auto text with Nabla Dictation using the 'Dot phrases' feature. These are shared with our Ambient product and can currently be configured under Menu “…” -> Settings -> Dot Phrases.

Note: Unlike Ambient, Dictation dot phrases are static—they do not adapt to context. They are more like vocal text templates.

You have the option to configure custom commands (sometimes named “step-by-step macros”) to automate workflows with a sequence of actions, triggered with your voice.

• Text entry

• Keystrokes / shortcuts

• Wait time (sometimes necessary when interacting with your EHR)

To configure a custom command: Menu “…” -> Settings -> Custom Commands.

When configuring a custom command, first give it a name and an associate voice trigger.

Make sure you configure each step of your automated action exactly how you would do it manually with your keyboard, including wait times.

You can share your custom commands and dot phrases with colleagues via a shareable link.

This feature is available starting at version 0.7.1 of Nabla Dictation.

Sharing commands (sender)

1. Open Settings and navigate to your list of custom commands (or dot phrases).

2. Click "Share" at the bottom of your command list.

   

3. Select one or multiple commands you want to share.

   

4. A sharing URL is generated — copy it and send it to the receiving user (e.g., via email, or Teams).

Importing shared commands (receiver)

1. Copy the sharing URL you received.

2. In Nabla Dictation, go to Custom Commands (or Dot Phrases).

3. Next to "New command", click the down caret (▾) menu and select "Import".

   

4. Paste the sharing URL.

   

5. The shared command(s) will be imported into your list.

   

Important things to know

• Importing creates a copy of the command, it does not link to the original author's version. If the author updates their command later, your imported copy will not change.

• Conflict handling: If an imported command conflicts with an existing one (e.g., same voice trigger), it will appear with an orange warning icon. The warning indicates what needs to be resolved (e.g., rename the voice trigger) before the imported command can be used.

  

Navigation in Epic

• Next field – Moves to the next input field (Epic [***] wildcards)

Using Epic SmartPhrases with Nabla

You can easily use your Epic SmartPhrases with Nabla as a custom command action. Here’s how:

1. Create a new Custom Command and set a voice trigger for it (e.g. “Insert lab results”).

2. In “Steps to Execute”, select “Insert EHR Dot Phrase”

   

3. Enter the corresponding EHR dot phrase in the action configuration section

   

When you use Nabla Dictation and say the configured voice trigger, Nabla will automatically insert your Epic SmartPhrase and simulate the Enter key (no need to have that step configured).

Anchor Speech Focus

You sometimes need to be looking at other things (patient chart, files, etc.) while dictating inside an Epic note. But since dictation follows the cursor by default, text might end up in unexpected places.

To activate Anchor Speech, say:

anchor speech focus

The command "anchors" dictation to wherever the cursor is at the moment of uttering the command, so that you can then freely roam around while dictating.

The floating bar aspect then changes, adding a little lock:

To release Anchor, say “Release Speech Focus”

➡️ This feature is available to everyone using Nabla Dictation version 0.6.0 or above with our Epic integration.

You can share feedback about Nabla Dictation or transcription errors under “…” -> Settings -> Share feedback. This will allow us to retrieve valuable insight from you on how to improve this tool or which words are typically mis-transcribed.

When you share feedback, Nabla Dictation can attach the last 2 minutes (never more) of audio used to dictate. This is optional and can be turned off for any feedback you share. Any audio that is being share is automatically de-identified before being stored on the Nabla side.