We use the Kurzweil system, now called Lernout and Hausbie, for grossing.
We are a large
teaching hospital and have residents.  It took about a year to fully
integrate.  (Actually in July
when we got new 1st year residents, our usage jumped to 100%, proving my
suspicion that the
previous users were our problem.)   We are interfaced with Cerner.

I can go on and on- Call me or e.mail me direct-
Beth Morehead
MUSC
Chas, SC
drewsb@musc.edu
(843) 792-4223