Twelve Thumb Buttons: A Razer Naga V2 HyperSpeed in the Reading Room

A mouse built for online role-playing games turns out to be a very good reading-room mouse. The Razer Naga V2 HyperSpeed has a grid of twelve buttons under the thumb, another seven around the top, and a wireless connection that runs for months on one AA battery. One reader mapped the thumb grid to RadPro Hub, the report editor, and the PACS, and has not touched the keyboard for a sign-and-next since. Here is the setup.

Why a gaming mouse

The thumb grid is the whole argument. Twelve buttons in a three-by-four block, each one reachable without moving your hand off the mouse, is exactly the interface a radiologist needs while scrolling a stack. Every action that would otherwise mean reaching for the keyboard, or for the dictation microphone's two or three programmable buttons, fits under the thumb. The HyperSpeed model runs on a 2.4 GHz dongle or Bluetooth, weighs about the same as an ordinary office mouse, and has no lighting to explain to a colleague.

The mapping

Buttons are assigned in Razer Synapse, the vendor's configuration software, and the mouse stores the profile onboard so it keeps working on a workstation where Synapse is not installed. That onboard memory matters: set the mouse up at home, plug it in at work, and the buttons do what you configured without installing anything on the hospital machine.

1. Top row of the thumb grid: RadPro Hub. Button 1 sends the open report (Backtick). Button 2 sends it with a template (Shift+Backtick). Button 3 pastes the polished report back (Ctrl+Backtick).
2. Second row: the report editor. Previous field, next field, and sign, which the Hub maps to F13, F14 and F15.
3. Third row: the PACS. Measure, arrow, and one window preset, on F18, F19 and F21.
4. Bottom row: the sequences. Sign off and advance (Ctrl+F12), the "Integrate these findings" marker (Alt+Backtick), and a spare. The reader's spare is a second window preset.

Synapse also offers a shift layer, called HyperShift, that gives every button a second function while a chosen button is held. The reader uses it for the remaining PACS presets and for the training-capture key (Ctrl+Shift+Backtick), which is pressed once per case at most and does not deserve a button of its own.

What changed in a shift

• The keyboard stopped being on the path. Scroll the stack, press a thumb button to measure, press another to sign, press another to advance. The right hand never leaves the mouse and the left hand holds the microphone.
• Complex cases got the one-key treatment too. On a pan-scan, the top row sends the dictation to RadPro AI and brings the structured draft back. The paste that used to be the objection to a separate reporting assistant is now a thumb press.
• It went with them to the next site. The profile lives on the mouse. The Hub sends keys to whatever editor is in front. A locum's whole setup fits in a coat pocket.

The cautions

Twelve buttons under the thumb means twelve ways to press the wrong one, and a wrong press can be a paste into a clinical record or an advance past a case you had not finished. Put the destructive actions, sign and advance, on the buttons the thumb reaches least naturally, and leave a blank button between them and the frequent ones for the first month. Keep the editor in front when you press a RadPro key, and use Ctrl+Z if a paste lands where you did not expect. As with any new hardware, check your institution's rules on peripherals; a mouse with onboard memory is usually the easiest kind of device to get approved, because nothing has to be installed.