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PowerScribe vs Fluency for Imaging: radiology reporting software compared for 2026

The short answer

PowerScribe and Fluency for Imaging are the two speech-driven radiology reporting platforms most US groups shortlist against each other. PowerScribe is Microsoft's, acquired with Nuance, and its current product is PowerScribe One; PowerScribe 360 annual renewals and maintenance end on August 31, 2026, with full support ending August 31, 2027. Fluency for Imaging is no longer a Solventum product: Smart Reporting agreed on October 16, 2025 to acquire it, forming a new parent company called Jacobian, headquartered in Munich and Pittsburgh. The short version of the comparison is that Fluency has won the customer-satisfaction ranking in this category repeatedly, while PowerScribe has by far the larger US install base, including 165 federal contract awards naming it against 7 naming the Fluency lineage. Neither vendor publishes list pricing.

These two products have been the real shortlist in US radiology reporting for years, and both changed hands recently enough that the org chart is now part of the evaluation.

PowerScribe came to Microsoft with Nuance. The live product is PowerScribe One, cloud-hosted and subscription priced, and the reason so many groups are comparing anything at all right now is a date: PowerScribe 360 annual renewals and maintenance end on August 31, 2026, and full support ends August 31, 2027. That deadline forces a decision rather than inviting one, which is a bad way to buy a system your reports are written in.

Fluency for Imaging has moved further. It started as M*Modal, was acquired by 3M, went to Solventum when 3M completed that spin-off on April 1, 2024, and then left Solventum entirely: Smart Reporting, a German structured-reporting specialist, announced a definitive agreement to acquire it on October 16, 2025, with the combined company named Jacobian. If you last evaluated this product as 3M M*Modal Fluency for Imaging, you were evaluating a different corporate parent two owners ago.

That matters less for the software than for the contract. Both products are mature, both do speech-driven reporting well, and the feature lists have converged more than either vendor's marketing suggests. What separates them for a buyer in 2026 is install-base scale, the satisfaction record, deployment flexibility, and how comfortable you are signing a multi-year agreement with a company that is itself mid-transition.

Radiological.ai is not a column in the table below, and deliberately so. We do not sell a dictation platform. The assistant flags suspected findings for your review, prioritizes the worklist so suspected urgent studies surface first, and drafts the structured report into your own template. The radiologist reviews, edits and signs every report.

Last updated August 2026

The Reading Station

Assistant ready

Worklist

SERIES 1 · AX

SLICE 24/64

SAMPLE STUDY

NOT FOR DIAGNOSTIC USE

W 80 · L 40

Structured report

Draft

Run the assistant to draft this report for review.

You review & sign

Illustrative sample · not a real patient study, not a diagnosis

Drafted in · you review & sign Worklist re-prioritized

Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional judgment.

See the comparison

Flag · prioritize · draft · you review and sign

PowerScribe One and Fluency for Imaging are the two mature speech-driven radiology reporting platforms in the US market; this page compares them neutrally on ownership, capability, deployment and public contract data, and Radiological.ai is not one of the two.

Side by side

PowerScribe One vs Fluency for Imaging, side by side

Neither column is the sales column. Both are compiled from the vendors' own published material and from public records, with the sources named in the note below the table.

What you are comparing	PowerScribe One	Fluency for Imaging
Who owns it today	Microsoft, following its acquisition of Nuance	Jacobian, formed when Smart Reporting agreed on October 16, 2025 to acquire the product from Solventum. Headquartered in Munich, Germany and Pittsburgh, USA
Ownership history	Nuance, then Microsoft	M*Modal, then 3M, then Solventum after the April 1, 2024 spin-off, then Jacobian at the end of 2025
Current product name	PowerScribe One, the stated upgrade path from PowerScribe 360	Fluency for Imaging, previously sold as Solventum and 3M M*Modal Fluency for Imaging
Forcing deadline	PowerScribe 360 annual renewals and maintenance end August 31, 2026; full support ends August 31, 2027	No published end-of-life deadline driving a migration
Customer satisfaction record	Not the category winner in the Best in KLAS front-end imaging speech recognition rankings	Vendor states #1 Best in KLAS for Speech Recognition: Front-End Imaging five years running. Solventum's February 5, 2025 release independently confirms the 2025 award
Speech recognition	Cloud Speech, which vendor materials describe as removing per-radiologist voice profile training	Speech recognition with natural language understanding applied to the dictated narrative
Ambient or free-speech mode	Ambient Mode	Ambient mode, described as turning free speech into complete structured reports
AI-drafted impression	Smart Impression, drafting the impression and recommendations from dictated findings in the radiologist's own style	GenAI reporting assistance, with structured reporting inherited from the Smart Reporting side of the merger
Documentation quality checking	Quality Check and Smart Assist	Computer-assisted physician documentation delivering real-time nudges before signing, covering actionable results reporting, gender, laterality and MSK extremity inconsistencies
Peer review	Not named as a distinct module in the nine published PowerScribe One capabilities	Peer review module using the ACR standardized three-point rating scale
Critical results handling	EMR Follow-up for recommendation tracking	Actionable findings result management and critical results notification as named modules
AI findings on the images	AI Findings, an integration layer surfacing third-party AI through the Precision Imaging Network rather than a native model	Positioned as connecting to AI systems through FHIR-based integration rather than shipping native image AI
Deployment options	Cloud-hosted subscription	Vendor lists full cloud, customer cloud, hybrid and on-premises installations
Teaching and residency workflow	Not named as a distinct published capability	Resident and teaching workflows named as a distinct capability
Vendor-stated scale	Large existing US install base, no current published user count	Vendor states 10,000+ radiologist users and 80M+ exams per year across the combined company
US federal contract footprint	165 prime awards naming PowerScribe, totaling $38,202,976, median $89,221	7 prime awards naming M*Modal, totaling $451,740, median $62,786
Published list pricing	None published; quoted per site through Microsoft or a reseller	None published; quoted per site

Compiled August 2026 from the Microsoft PowerScribe One product and support documentation, Jacobian's Fluency for Imaging product pages, the Solventum Fluency for Imaging fact sheet, the Smart Reporting announcement of October 16, 2025, and prime award records from USAspending.gov. Vendor-stated figures are labeled as such. Both products ship on a fast release cycle, so confirm the current capability list and contract terms with each vendor before building a shortlist around this table.

Side by side

Radiological.ai vs Fluency for Imaging, honestly

A fair look at what each does well. Both are capable tools. Here is where they differ.

What matters	Radiological.ai	Fluency for Imaging
What the product is	An assistant that flags suspected findings, prioritizes the worklist and drafts the structured report	Both PowerScribe One and Fluency for Imaging are speech-driven reporting platforms: the system your report is written in
Whether it replaces your reporter	No. It works alongside the reporting platform you keep	Yes, by definition. Choosing between them is a platform replacement project
Worklist triage and prioritization	Suspected urgent studies surface to the top of the queue for your review	Worklist order is generally a RIS or PACS function rather than a reporting-platform one
Finding flags for review	Flags suspected findings as a second set of eyes on each study	Both connect to third-party image AI rather than shipping native detection
Migration burden	Connects to the PACS you already run; no template migration	Template library, macros, configuration and radiologist training all move with the platform
Regulatory status	Decision support; we make no regulatory-status claims on this site	Confirm the current regulatory position of any AI module directly with each vendor
Best suited for	Groups that want support inside the read without changing the reporting platform	Groups that have decided the reporting platform itself must change

Comparison reflects general, publicly understood positioning. Capabilities change, so check each product for the latest.

If the reason you are here is the PowerScribe 360 deadline rather than dissatisfaction, start with PowerScribe One vs PowerScribe 360, which covers what actually changes in the upgrade, and the PowerScribe 360 end of life dates for the timeline you are working against.

For the vendor-level view rather than the product-level one, our PowerScribe alternative comparison sets out the wider replacement options, and the DeepHealth Reporting Pro comparison covers the third reporting platform that now shows up on US shortlists.

Whichever platform wins, the drafting mechanics decide how much time you get back. Structured radiology reporting covers drafting into your own section templates, and radiology report template ownership is worth reading before signature, because the template library is the asset nobody else keeps a copy of.

Why groups pick Radiological.ai

One assistant across the whole read

Two good platforms, one real question

The capability lists have converged. Both do speech-driven reporting, ambient dictation, structured output and quality nudges. The honest differentiators for a 2026 buyer are the satisfaction record, deployment flexibility, and which vendor transition you are more comfortable underwriting for the life of the contract.

Do not let the deadline pick for you

The August 31, 2026 PowerScribe 360 renewal date is a real constraint, not a reason to skip the evaluation. PowerScribe 360 and PowerScribe One can run side by side during a migration, which means you can protect continuity while still running a genuine comparison rather than defaulting to the upgrade path.

The assistant question is separate

Whichever platform you pick, the report still has to be read, prioritized and drafted. Radiological.ai connects over standard DICOM to the PACS you already run, flags suspected findings, prioritizes the worklist and drafts into your own templates, and it does not ask you to change the system your reports live in.

Good questions

Fluency for Imaging vs Radiological.ai, answered

Both are speech-driven radiology reporting platforms, and their capability sets have largely converged. The practical differences are ownership and scale: PowerScribe belongs to Microsoft and has a much larger US install base, while Fluency for Imaging is now a Jacobian product and holds the stronger customer-satisfaction record in the Best in KLAS front-end imaging speech recognition category. Fluency also offers on-premises deployment, where PowerScribe One is cloud-hosted.

Jacobian. Smart Reporting, a German structured-reporting company, announced a definitive agreement on October 16, 2025 to acquire Fluency for Imaging from Solventum, and the combined company was named Jacobian, headquartered in Munich, Germany and Pittsburgh, USA. Before that the product passed from M*Modal to 3M, and then to Solventum when 3M completed that spin-off on April 1, 2024.

No. Solventum agreed to sell it in October 2025 and the product now sits with Jacobian. You will still find Solventum-branded fact sheets and support documents in circulation, and the Solventum product page now redirects to Jacobian. Separately, Solventum announced on August 5, 2026 that it intends to separate its remaining Health Information Systems business, which is a different transaction and does not involve Fluency for Imaging.

Neither is better in the abstract, and the answer turns on three things. If you need on-premises or hybrid deployment, Fluency lists it and PowerScribe One does not. If you value the largest US install base and the deepest reseller and integration ecosystem, PowerScribe has it. If customer-reported satisfaction is your tiebreaker, Fluency has repeatedly taken the top spot in its KLAS category. Run both against your own case mix before deciding.

The vendor states that Fluency for Imaging has been ranked #1 Best in KLAS for Speech Recognition: Front-End Imaging five years in a row. That is verifiable for the 2025 award, which Solventum announced on February 5, 2025 and described as the fifth time the product took the top spot. Best in KLAS rankings reflect customer-reported satisfaction from interviewed users, not independent testing of accuracy.

Neither vendor publishes list pricing, so any figure quoted publicly is somebody else's negotiated deal. Public federal contract records give the only reproducible anchor: 165 prime awards naming PowerScribe total $38,202,976 with a median of $89,221, while 7 awards naming M*Modal total $451,740. Ask each vendor for a fully loaded first-year total and the year-three renewal figure in writing.

In federal contracting, clearly yes, and the gap is not close. Treat that as one signal rather than the whole market: most US radiology volume sits in private practices and health systems that do not appear in federal award data at all. Keyword matching on public award records is also imperfect, so the counts are a floor rather than a census.

Yes, and groups do it in both directions. The work is not the software connection, it is the template library, the macros and AutoText, the PACS and RIS interfaces, and radiologist training. Export your templates and configuration while your current contract is live and your administrator still has access, because that is the asset you cannot recreate afterward.

Annual renewals and maintenance for PowerScribe 360 end on August 31, 2026, and full support ends August 31, 2027. Running an unsupported reporting platform is the one option that is not really available, because a reporting outage stops the entire read. The vendor path is PowerScribe One, and the two can run side by side during migration.

Not natively. PowerScribe One surfaces third-party AI through the Precision Imaging Network, and Fluency for Imaging is positioned as connecting to AI systems through FHIR-based integration. In both cases the image AI is somebody else's product, which means detection and worklist triage remain a separate purchase and a separate contract.

They are worth asking about rather than worrying about. Both products have survived ownership changes with continuity of service. The questions to put in writing are what the support model looks like after transition, whether your named support contacts change, what the roadmap commitment is for the modules you actually use, and what the renewal uplift cap is over the term.

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See how Radiological.ai reads alongside your group

One assistant that flags suspected findings, prioritizes the worklist, and drafts the structured report on X-ray, CT and MRI. You review and sign every study.

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Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional medical judgment.