The Radiology Dictation System That Became Microsoft's Property

Nuance PowerScribe is the dominant radiology dictation and reporting system in hospitals and imaging centers. If you're a radiologist, you've probably used it. If you're searching for it in 2026, you should know that Nuance doesn't own PowerScribe anymore.

Microsoft bought Nuance in 2022 for 20 billion dollars. PowerScribe is now a Microsoft product. Development continues because hospitals pay substantial licensing fees, but the ownership change matters for anyone evaluating radiology dictation options.

What PowerScribe Actually Is

PowerScribe is enterprise radiology dictation software designed for hospital workflows. It integrates with PACS systems, electronic health records, and imaging equipment.

Radiologists dictate findings using specialized vocabulary. PowerScribe handles complex medical terminology, anatomical terms, and measurement notations. Reports generate automatically with proper formatting.

The system works well for radiology because it was built specifically for radiology workflows over 20+ years of development. Templates for every imaging modality, integration with every major EHR system, compliance with healthcare regulations.

PowerScribe isn't software you buy. It's enterprise licensing that costs hospitals tens to hundreds of thousands annually depending on volume and features. Individual radiologists don't purchase PowerScribe - hospitals do.

The Microsoft Acquisition Implications

Microsoft bought Nuance in 2022 primarily for healthcare AI and conversational AI technology. PowerScribe came with the acquisition.

What changed: Microsoft owns PowerScribe now. Hospitals licensing PowerScribe are licensing from Microsoft. The product continues because healthcare contracts are lucrative.

What stayed the same: PowerScribe functionality hasn't dramatically changed. It's the same system radiologists were using before the acquisition, with incremental updates.

The uncertainty: Microsoft's long-term plans for PowerScribe aren't entirely clear. Will they integrate it with Azure AI? Will they maintain it as a standalone legacy product? Hospital IT departments evaluating long-term radiology dictation strategies face these questions.

When PowerScribe Makes Sense

PowerScribe makes sense for specific radiology environments:

Large hospital radiology departments. The enterprise integration, established workflows, and comprehensive templates justify the substantial cost.

Academic medical centers. Teaching hospitals need the workflow features, quality assurance tools, and integration capabilities PowerScribe provides.

Multi-site imaging networks. Organizations with multiple locations need centralized reporting and standardized workflows that PowerScribe enables.

Established radiology practices already using PowerScribe. Switching costs are enormous when radiologists are trained on existing systems and templates are customized.

These are environments where PowerScribe's enterprise features and radiology-specific design justify the cost.

When PowerScribe Doesn't Make Sense

PowerScribe is overkill or impractical for:

Individual radiologists or small practices. The enterprise pricing and complexity don't match small-scale needs.

Teleradiology or independent reading. Radiologists reading from home or providing remote coverage don't need full PowerScribe infrastructure.

Non-radiology physicians needing occasional imaging reports. Emergency medicine, orthopedics, primary care - PowerScribe is radiology-specific.

Budget-constrained facilities. Small hospitals and imaging centers where PowerScribe licensing represents significant capital allocation.

For these users, modern AI dictation provides accurate medical transcription without enterprise complexity and cost.

What I Use for Medical Dictation

I use Dictation Daddy for everything - radiology reports, clinical notes, patient communications, documentation, all medical writing. I have obvious bias (I built it), but the differences matter for individual physicians and smaller practices:

96-98 percent accuracy with medical terminology without any training required. Handles anatomical terms, pathology vocabulary, pharmaceutical names immediately.

Automatic formatting. Reports generate with proper structure, punctuation, paragraphs without voice commands. No saying "period comma new paragraph" constantly.

Available on Mac, Windows, iPhone, Android, and Chrome extension. The apps don't sync between devices, but dictation works consistently everywhere. Under 100 dollars per year base pricing. For healthcare organizations needing enhanced security, there's an enterprise plan with SOC2 and HIPAA compliance options.

Not a PowerScribe replacement for large radiology departments needing enterprise integration. But for individual physicians, small practices, teleradiology, and non-radiology specialties, AI dictation provides accurate medical transcription without enterprise complexity.

The PowerScribe Alternatives Landscape

Large radiology departments: PowerScribe remains dominant. Integration, templates, and established workflows make switching difficult despite high cost.

Individual radiologists and small practices: AI dictation like Dictation Daddy provides medical accuracy at fraction of PowerScribe cost without enterprise complexity.

Non-radiology physicians: General medical dictation doesn't require radiology-specific features. AI dictation handles medical terminology across specialties.

The decision depends on scale. Enterprise radiology with hundreds of reads daily needs PowerScribe capabilities. Individual physicians and smaller practices get better value from modern AI dictation.

The Uncomfortable Reality

PowerScribe is excellent radiology dictation software for large hospital departments willing to pay enterprise pricing. It's also owned by Microsoft now instead of Nuance, which creates long-term uncertainty about product direction.

For radiologists searching "Nuance PowerScribe" in 2026: If you're in a large hospital, PowerScribe is probably what you're already using and will continue using. The Microsoft ownership doesn't change day-to-day functionality.

If you're an individual radiologist, small practice, or non-radiology physician looking at PowerScribe pricing, modern AI dictation provides accurate medical transcription at fraction of the cost without enterprise complexity.

PowerScribe makes sense at enterprise scale. Below that scale, better options exist that provide medical accuracy without enterprise pricing and infrastructure requirements.

Last updated: January 16, 2026, verified with current PowerScribe ownership and radiology dictation options