Since announcing Dragon Copilot at RSNA 2025, healthcare organizations have advanced their AI strategies, not only by modernizing their reporting experience with PowerScribe One, but by extending it with Dragon Copilot to unlock a new, unified, AI-driven workflow that brings generative, multimodal, and agentic AI directly into the radiologist’s day-to-day experience. From accurate cloud speech-driven report creation to in-workflow insights and AI-generated draft content, PowerScribe One with Dragon Copilot helps radiologists work more efficiently, reduce cognitive load, and deliver high-quality reports with confidence.
Building on that foundation, a growing community of customers and partners are fueling rapid innovation by fine-tuning new models, deploying AI applications, and developing specialized agents that expand what’s possible across the diagnostic imaging ecosystem. This momentum is shaping the next era of radiology—one defined by continuous innovation, open collaboration, and powerful new ways to connect insights from image to action.
Listening first: How customer feedback shapes every innovation
For decades, PowerScribe has been built alongside radiologists, grounded in real-world workflows and shaped by continuous feedback and close clinical partnerships with healthcare organizations across the country. This approach, building with radiologists and grounding innovation in real-world use, is fundamental to how we design and evolve our solutions, especially when it comes to performant AI. Those insights directly shaped how we evolved to PowerScribe One, where preserving the workflows and integrations that teams rely on while introducing a more modern, cloud-enabled experience designed for what comes next.
We’ve invested in dedicated voice-of-customer programs and teams whose sole focus is to continuously gather feedback. From advisory boards, clinical partnerships, and real-world usage, we translate those insights directly into our roadmap. This isn’t a one-time input; it’s an ongoing loop that ensures the capabilities we deliver reflect the evolving needs of radiologists across a wide range of environments.
That’s why we partner closely with organizations like University of Rochester Medical Center (URMC), St. Luke’s University Health Network (St. Luke’s), along with many others, through early preview programs ahead of general availability, so they can guide how innovation needs to be integrated. By embedding structured preview and validation stages into our development cycle, we align our releases with customer readiness, continuously refining based on real-world feedback. The result: technology that not only pushes boundaries, but prioritizes the workflow and overall customer experience.
Ultimately, it’s this approach, continuous collaboration grounded in the day-to-day realities of radiology, that gives us confidence in how we are shaping the future of the reporting workflow. This foundation makes these customer stories not just possible, but repeatable at scale.
PowerScribe One serves as the foundation for what’s next
At URMC and St. Luke’s, trust in PowerScribe One began with confidence in a cloud-based foundation designed to scale and integrate seamlessly into the radiologist’s workflow. For URMC, moving to the cloud was essential to unlock advanced AI capabilities that improve efficiency and provider satisfaction amid rising volumes and increasing cognitive demands. At St. Luke’s, modernization with cloud capabilities was equally strategic, enabling innovation while maintaining continuity and trust across the enterprise.
Our partnership and deep engagement model with URMC and St. Luke’s are reinforced at scale: today, more than 10,000 radiologists across 250+ organizations have migrated to PowerScribe One, generating millions of reports every week, across environments ranging from large Integrated Delivery Networks (IDNs) and academic medical centers to independent reading groups. That experience shaped a clear understanding of how to bring AI into the reporting workflow—not as a separate tool, but as a capability embedded directly where radiologists work, without introducing additional steps or fragmentation.
Both organizations are realizing real outcomes through PowerScribe One and its AI features, including generated draft impressions personalized to each radiologist that support improved efficiency and report quality.
“We chose PowerScribe One so we could really take advantage of cloud-based reporting. It gives our radiologists built‑in AI, excellent speech recognition and personalized impressions, making it easier to keep up with increasing demands while continuing to deliver great patient care. Microsoft has been with us every step of the way, staying responsive and supportive through implementation, go‑live and ongoing adoption. We will continue this partnership to continue to improve our workflows and efficiency.”
Robert Fournier, MD, Chairman of Radiology, St. Luke’s University Health Network
At URMC and St. Luke’s, generated draft impressions were widely adopted because the feature works natively inside the reporting workflow—helping ensure key findings are pulled from the report and summarized in the impression section, reinforcing radiologists’ confidence in their report quality.
The ongoing adoption of PowerScribe One and its draft impression capabilities reflects a broader principle: when AI is fully integrated into the workflow, it enables radiologists to deliver more consistent, efficient, and high-quality reports without disrupting how they work.
Extending AI in the reporting workflow with Dragon Copilot
Now, URMC and St. Luke’s are extending these capabilities with Dragon Copilot, building on PowerScribe One to introduce intelligent summarization and automation directly within the reporting experience. Both organizations are actively leveraging prior report summarization, a feature within Dragon Copilot, to surface essential patient context from relevant prior reports, helping radiologists interpret studies with greater clarity and focus. At URMC, this capability is already delivering value by improving visibility into patient history.
“It works amazingly…it provides a great interface for seeing so much about the patient you otherwise might not see.”
Sean Cleary, MD, Vice Chair of Informatics for Imaging Sciences, University of Rochester Medical Center
Looking ahead, both organizations see significant potential as Dragon Copilot continues to evolve. As it gains access to richer patient context and connects to a broader ecosystem of first- and third-party AI applications and agents, Dragon Copilot can help to further reduce cognitive load and enable continuous innovation without disrupting the radiologist’s workflow.
Meeting customers where they are: From deploying off-the-shelf AI to fine-tuning models
Increasingly, innovation in radiology is shaped not just by what Microsoft delivers, but by how customers and partners extend AI within real-world workflows—helping radiologists work more efficiently, surface critical insights faster, and support better patient care.
As AI adoption expands across radiology, organizations aren’t moving along a single path; they’re navigating a wide range of needs simultaneously. Some are focused on deploying trusted, ready-to-use AI solutions directly into clinical workflows, while others are exploring how to build, customize, and push the boundaries of what’s possible with AI. At Microsoft, we’re designing with this range in mind to meet customers where they are and support multiple approaches to innovation.
For organizations looking to quickly operationalize AI, we provide a streamlined path forward with centralized access to a curated set of FDA-cleared third-party imaging AI applications from our ecosystem of partners—helping simplify how they are evaluated, deployed, and integrated. These applications integrate with our reporting workflows, enabling radiologists to access AI-powered insights within PowerScribe One and helping simplify the adoption of new capabilities.
For St. Luke’s, this approach enabled the rapid deployment of a fracture detection model from Gleamer, delivering immediate impact across its geographically distributed network and helping ensure more consistent diagnostic support regardless of where patients entered the system.
In addition to bringing FDA-cleared imaging AI into practice today, we provide the flexibility for customers and partners to build, customize, and extend AI capabilities as their needs evolve. Our premium medical imaging foundation models, MedImageInsight Premium and CXRReportGen Premium, can be requested for preview through Microsoft Foundry, and are designed for fine-tuning across modalities and workflows. These models are not medical devices, but they enable teams to build and fine-tune models that can complement clinically validated imaging AI solutions.
Delivered as fully managed endpoints, our premium models are continuously improved with curated data and enable AI builders, health systems, and partners to develop institution-specific solutions tailored to local data, specialty use cases, and evolving clinical needs. Models derived from CXRReportGen Premium can be integrated into experiences like Dragon Copilot, bringing high-performing AI directly into the radiologist’s workflow for summarization and report generation.
Together, this approach allows organizations to combine production-grade, regulated AI with ongoing innovation on a single platform, bridging standardized diagnostics and bespoke AI development. Companies like Milvue, a radiology-focused AI developer, are already using our models to accelerate development of solutions tailored to real-world clinical workflows.
“Milvue is building a radiology-native VLM. By working with Microsoft and leveraging CXRReportGen, we could start from a strong foundation allowing our team to focus on what matters most: turning foundation-model capability into clinically validated, workflow-ready radiology solutions.”
Alexandre Parpaleix Co-Founder/CEO, Milvue
No matter where customers and partners are in their journey with generative, multimodal, and agentic AI, we’re here to support them. From clinical applications like PowerScribe One and Dragon Copilot to customizable models from Microsoft Foundry, we provide a trusted, scalable foundation for innovation—enabling organizations to advance at their own pace while keeping workflows, performance, and outcomes at the center.
We’re excited to bring this next wave of radiology innovation to life at the SIIM26 Annual Meeting + InformaticsTECH Expo. Join us in Pittsburgh, PA to experience it firsthand. Visit us at the SIIM 2026 Booth #630–632 where customers and partners can explore our solutions, see live demos, and engage with our models in an interactive learning lab. See what’s possible when AI is truly embedded in the workflow.
