In practice, dictation is part of everyday life: doctor’s letters, test results, progress notes, and correspondence. Speech recognition saves a noticeable amount of time. But as soon as patient data comes into play, choosing the right software is no longer just a matter of convenience. Many well-known dictation solutions send the spoken audio to a cloud for processing, often to servers outside the EU. For doctors and medical assistants, this raises two serious issues at once: the medical duty of confidentiality under Section 203 of the German Criminal Code (StGB) and the GDPR.
This guide explains why local speech recognition is the smoother option for medical practices, where Dragon Medical fits in as a specialized solution, and when a streamlined, local alternative like Flinktext makes sense.
Why Cloud Dictation Is a Sensitive Issue in Medical Practices
An audio recording from the examination room almost always contains personal health data. Name, diagnosis, medication, medical history: These are categories of data requiring special protection under Article 9 of the GDPR. Whoever dictates the recording is the one who processes it.
§ 203 StGB: Physician-Patient Confidentiality
Physicians are subject to professional confidentiality under Section 203 of the German Criminal Code (StGB). Anyone who discloses another person’s confidential information that was entrusted to them in their professional capacity may be liable to criminal prosecution. The use of external service providers is permitted only under the conditions set forth in Section 203(3) of the German Criminal Code (StGB), that is, if the parties involved are properly integrated into the process and are themselves bound by a duty of confidentiality. The uncontrolled uploading of a dictation containing patient information to a cloud service provider does not automatically fall within this framework. Depending on the circumstances, this could pose a compliance risk. This is not merely a matter of a potential fine; it may also involve criminal liability under § 203.
GDPR and Transfers to Third Countries
If audio data is transferred to a service provider in a third country such as the United States, the GDPR’s requirements for transfers to third countries (Chapter V, Article 44 et seq.) apply. As a rule, this requires a sound legal basis, a data processing agreement (DPA), and documentation of the transfer in the record of processing activities. The bar is set high for health data. This is precisely where the adoption of cloud tools stalls in many medical practices.
The Clean Solution: Local Processing
If speech recognition runs entirely on the device, the audio never leaves the Mac. There is no transfer to a third country because there is no transfer at all. There is no external processor that would need to be involved under Section 203 of the German Criminal Code (StGB). Local processing thus helps ensure confidentiality and reduces the risk of unintended disclosure to third parties. Specifically, local speech recognition means:
- The language model is stored directly on the Mac and performs computations on-device.
- No account, no login, no server round trip.
- The dictation feature works even without an internet connection.
- You retain control over where data is created and stored.
Dragon Medical is fairly rated
Dragon Medical (from Nuance, now part of Microsoft) is the established specialized medical speech recognition solution. It offers extensive medical vocabularies, achieves high recognition accuracy for specialized terminology, and is often deeply integrated into practice management and hospital systems. For structured documentation of medical findings using specialized vocabulary, this is a robust solution tailored specifically to the field. That should not be downplayed here.
It is important to distinguish between the different product lines: Dragon Medical One is cloud-based and operates on a subscription model. In addition, there are local desktop versions that run on the user’s own computer. Those who prioritize local processing should carefully consider which version they use and where the data is processed. Depending on the version, licensing costs for specialized medical solutions often range from several hundred to over a thousand euros per workstation per year.
Flinktext is intentionally different: a streamlined, local, all-purpose dictation app without specialized medical terminology. It is not a medical device and is not intended to replace a certified clinical documentation solution. For general correspondence, notes, emails, cover letters, and texts in everyday practice, it is a lightweight, data-efficient tool that operates without the cloud.
Comparison: Flinktext and Dragon Medical
| Quick Text | Dragon Medical One | Dragon Medical (Desktop) | |
|---|---|---|---|
| Processing | locally on-device (default) | cloud-based | locally on the computer |
| Medical Vocabulary | No (general dictation) | Yes, extensive | Yes, extensive |
| PVS/KIS Integration | No, text at the cursor in every app | Yes, deeply integrated | yes |
| platform | macOS | Windows-focused | Windows-focused |
| Account required | no | yes | depending on the variant |
| Telemetry as Standard | none | depends on the provider | depends on the provider |
| open source | Yes, MIT, verifiable code | no | no |
| Price | free | Subscription, starting at several hundred EUR per year | License, often four digits long |
| AVV | upon request | About Providers | depending on the application |
The table shows two different categories of tools—not “good” versus “bad.” If you need highly specialized medical dictation with medical vocabulary and system integration, a specialized solution is the right choice for you. If you’re looking for a local, free, and auditable solution for general dictation in everyday practice—where no audio leaves the premises—Flinktext offers a streamlined alternative to Dragon Medical designed specifically for this purpose.
Flinktext: Local dictation software for the Mac
Flinktext is a native macOS menu bar app from Lighthouse Consulting. Its operation is intentionally simple: hold down the hotkey, speak, and release. The recognized text appears immediately at the cursor, in any app—whether in your email client, browser, or word processor window. Four modes cover everyday needs: “Raw” provides a 1:1 transcript, “Polished” refines the text into proper written German, “Compose” turns a spoken command into a written text, and “Emoji” adds emojis as needed.
The Verifiable Data Protection Features
These points can be verified in the open-source code:
- 100% local by default. Speech recognition uses a bundled Whisper model that runs on the device. Your audio never leaves the device.
- No telemetry, no tracking, no account. There are no analytics or crash reporters sending data in the background.
- Keys are stored only in the Keychain. Login credentials are stored exclusively on the device in the macOS Keychain, without iCloud sync.
- Open source under the MIT license. The code is publicly available on GitHub and can be reviewed by your IT department or your data protection officer.
Optional cloud backends are available for particularly complex formulations, but they are disabled by default. They become active only when a user explicitly enables them and provides their own API key. By default, everything remains local.
Can be used in compliance with the GDPR; not certified
It’s important to be honest about this: No software is GDPR-certified on its own, and Flinktext is not a medical device. GDPR compliance arises from actual use—that is, from the combination of tools, processes, and documentation. Flinktext is one such tool. It provides the technical foundation that enables local, data-minimal processing and thus allows for GDPR-compliant use. Ensuring legally compliant integration into the practice’s operations remains the responsibility of the practice. We provide a data processing agreement (DPA) and data protection documentation upon request.
Frequently Asked Questions
Is Flinktext a medical speech recognition program like Dragon Medical? No, not in the strict sense. Flinktext is a general-purpose, local dictation app without specialized medical vocabulary, and it is not a medical device. It is a streamlined, local tool for general correspondence, notes, and texts in everyday practice. For highly specialized medical reports involving technical terminology and system integration, specialized solutions remain the appropriate choice.
Are my dictations uploaded to the cloud? No, not in standard mode. Speech recognition runs on-device using a bundled Whisper model; your audio never leaves the device. Optional cloud backends are disabled by default and only become active if you enable them yourself and provide your own key.
Is Flinktext suitable for physicians under Section 203 of the German Criminal Code (StGB)? Local processing specifically addresses the issue that professionals bound by professional confidentiality should not disclose confidential information to external service providers without first reviewing it. Since, by default, no audio leaves the device, this transmission does not occur. This helps ensure compliance with professional confidentiality. For mandatory use in your practice, please review the setup with your data protection officer.
Does the dictation feature work without an internet connection? Yes. Since processing takes place locally, dictation works entirely offline.
How much does Flinktext cost? The app is free and open source under the MIT license. You can download a ready-to-use DMG file without having to compile it yourself.
Does Flinktext run on Windows? Flinktext is a native macOS app. Dragon Medical, on the other hand, is designed for Windows. In mixed environments, it’s worth considering which devices will be used for dictation.
Next step
If you want to use dictation in your practice without sending patient data to the U.S. cloud, the local version is the safer option. Download Flinktext for free from the Flinktext product page and contact us to discuss a data-protection-compliant rollout in your practice or medical center. 🧭
Flinktext: The Dictation App for Mac
Free, open source, 100% local by default. Download, open, dictate.
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