Brian is having issues typing because of nerve damage. Can he use the Amazon Echo to dictate what he types? The Echo has over 15,000 skills, so there's bound to be something that it can do for him, and he can always write his own skills as well.
But for general purpose dictation, the Echo may not be good for Brian's IT needs because he'll need to use specialized vocabulary. Dragon Dictate may have a specialized vocabulary add-on that would work.