PowerScribe 360 support has ended: what radiologists face now

August 31, 2026 passed. PowerScribe 360 end of support is no longer a future concern or a planning deadline on a Gantt chart. It arrived. Nuance is no longer issuing security patches, bug fixes, or technical support for any version of PowerScribe 360. The software still runs, but it runs unsupported, and for radiology practices that have not yet migrated, the calculus is now different from what it was in June.

This is not a repeat of the pre-EOL migration guide. That guide covered the four paths and the decision framework before the deadline. This one is for the practices that are past it, and for the radiologists thinking about what to do with the 11 months remaining before full end-of-life in August 2027.

What changed on September 1, 2026?

The software did not stop working. A 360 installation running on August 31 still runs on September 1. That is the part people misunderstand about “end of support”: it is not a kill switch. It is a cutoff for vendor maintenance.

What changed is this: any security vulnerability found in PowerScribe 360 from September 1 onward will not receive a patch. Any software bug reported after August 31 will not be fixed. If Windows updates, PACS updates, or network infrastructure changes in your environment create a compatibility problem with 360, Nuance will not resolve it. The system is frozen at wherever it was when support ended.

For environments where the 360 workstation is tightly air-gapped and never touches external networks, the practical risk from that change is lower. For environments where 360 sits on a network segment that also handles other hospital systems, the compliance teams are going to start asking questions, if they have not already.

Does running unsupported software violate HIPAA?

The short answer is: it depends on your environment, and “it depends” is not a comfortable answer when it involves PHI.

HIPAA’s Security Rule requires covered entities to apply security patches in a reasonable timeframe and to keep software current where doing so is feasible. Running software with known, unpatched vulnerabilities that handles protected health information is a risk your compliance and risk teams need to formally assess and document. Saying “we knew it was unsupported but we had a plan” is a different posture from saying “we were unaware.” The risk is not theoretical: if an incident involves PowerScribe 360 after end-of-support, the audit record will show that your organization operated on software the vendor had already stopped maintaining.

Most compliance officers will want a documented risk assessment and a migration timeline before signing off on continued 360 use. Some will not sign off at all. The calculus is a function of your environment, your risk tolerance, and your counsel’s read on the relevant standards. What is not in dispute is that the risk profile changed on September 1.

How long can you realistically stay on PowerScribe 360?

There are two constraints: technical and regulatory.

The technical constraint is compatibility. Full end-of-life arrives August 31, 2027. After that date, Nuance offers no compatibility guarantees for 360 when PACS, RIS, or operating system versions update. That does not mean everything breaks on September 1, 2027. It means Nuance will make no effort to prevent breakage, and you will have no recourse when it happens. A PACS vendor upgrade that changes an API your 360 integration uses, a Windows security update that changes how legacy software connects to the network: these could surface at any point in the next 11 months, and after August 2027, there is no fix coming.

The regulatory constraint is more variable. If your compliance team has accepted the current risk posture, the technical limit is the binding one. For most environments, planning around August 2027 as a hard out is the right framing.

That said, a 1-3 month implementation window for an enterprise reporting platform means the planning starts now, not in June 2027. If you are evaluating PowerScribe One or an enterprise alternative, the procurement and rollout timeline is not a weekend project.

What is Nuance asking you to do instead?

Migrate to PowerScribe One. That is the intended path. PowerScribe One is the cloud-hosted version: everything 360 did for institutional deployments, now processed on Microsoft Azure. Smart Impression for AI-drafted impressions, peer review, quality checks, PACS and RIS integration, structured reporting templates, and the full enterprise radiology workflow layer.

For departments that genuinely use those features, PowerScribe One is the right migration target. The feature set is broader than 360 in several areas. The vendor relationship with Nuance remains intact. The institutional knowledge embedded in your 360 templates and workflows can be migrated rather than rebuilt.

What changes is the pricing model. PowerScribe 360 was a perpetual license plus annual maintenance. PowerScribe One is a cloud subscription, priced per organization through a sales process, not published publicly. The terms you were able to negotiate for 360 may not transfer to One, and the renewal structure is no longer a maintenance payment on software you own: it is a recurring bill for access to a cloud service. Practices migrating from 360 have reported that the new pricing conversation is different from the old one.

If that shift matters to your organization, it is worth understanding clearly before committing.

When does front-end dictation make more sense than PowerScribe One?

There is a real group of 360 users for whom this forced migration reveals a category mismatch that was always there. They were using 360 as a dictation tool. Not as a reporting platform. They were not using peer review, structured encoding, CAPD nudges, or Smart Impression. They had a license and a workflow and they dictated their reports. The platform features sat unused.

For that group, migrating to PowerScribe One is paying subscription pricing for features they will still not use. The question worth asking is not “which enterprise platform do we move to” but “do we need an enterprise platform at all, or do we need to dictate?”

A front-end dictation tool answers the second question differently. It turns speech into text at the cursor, in whatever application has focus: RIS fields, PACS report editors, browser-based reporting tools, Microsoft Word, Citrix and remote desktop sessions. No PACS API integration is required, because the tool types where the cursor is rather than connecting at the system level. If you can type there, you can dictate there.

RadMyk is built on that model. The speech model runs on your machine. Patient audio never leaves the reading room, and the software keeps working when the network fails. Vocabulary is tuned for radiology: anatomy, laterality, modalities, and the cadence of structured reports. Published accuracy is 96.1% word accuracy, measured on the public benchmark rather than under vendor-ideal conditions.

It is a one-time purchase. The current launch price is $199 for the first 100 users (after that, the list price is $299), and that is the full cost. No subscription, no per-provider monthly fee, no migration fee, no per-word meter. For a radiologist whose main use of PowerScribe 360 was dictation, the pricing page represents a different conversation from the one PowerScribe One will bring.

The limitations are equally worth stating. RadMyk has no peer review, no structured encoding, no CAPD, no Smart Impression, and no PACS API integration. If any of those capabilities are in active use at your department, RadMyk is the wrong category of product for that role. The full PowerScribe alternatives guide covers the complete landscape for practices evaluating their options. The head-to-head comparison with PowerScribe goes deeper on where the products overlap and where they do not.

For enterprise deployments, RadMyk’s local model means no shared cloud accounts or credentials to provision and rotate, license control from a central admin console, and a cost that books as one-time capital expenditure rather than recurring opex. That deployment profile is a different kind of conversation for a finance team than a per-seat subscription.

What does the PowerScribe 360 episode reveal about renting dictation tools?

The honest version of what has happened: a large vendor decided to retire a product, and thousands of radiology practices now face a forced migration with a new pricing model.

This is not a criticism of Nuance specifically. It is the structural reality of renting software rather than owning it. When you subscribe, the vendor’s business decisions become your operational decisions. PowerScribe 360 users who relied on the product for 15 years now face a migration with a timeline set by Nuance, a pricing conversation they had no part in shaping, and a deadline they cannot negotiate.

That pattern is not unique to this product. M*Modal Fluency for Imaging is mid-divestiture to Jacobian, a transition that has been running for over a year with the rebranding still in progress. Dragon Medical One is being folded into Dragon Copilot, which adds ambient AI features but also a roadmap controlled by Microsoft. The point is not that any of these vendors are acting in bad faith. The point is that every cloud subscription product on this list is subject to the same structural dynamic: the vendor’s decisions run the calendar.

An on-device, one-time-purchase tool is not subject to that dynamic. Why radiologists hate voice dictation covers the frustrations that built up over years of rented, login-gated, cloud-dependent software. The 360 sunset is a specific example of where that frustration comes from structurally.

What to do now

If your practice is still on PowerScribe 360, the migration path depends on which parts of the platform you use.

If the answer is peer review, structured templates, PACS integration, quality checks, and the full workflow layer: migrate to PowerScribe One or evaluate M*Modal Fluency for Imaging or Dolbey Fusion Narrate Dx. Those are the right tools for that job. The migration project is real and the timeline is under 11 months.

If the answer is: you mainly dictate. Consider what front-end dictation costs today compared to a new cloud subscription. The math runs in a different direction than it did when 360 was a sunk cost.

A 28-day free trial for RadMyk requires no credit card. Most radiologists know within a week of real reporting whether a front-end dictation tool does the job. The full end-of-life date is August 2027. That is enough time to evaluate, migrate, and know what you own before the final deadline.

Voice-to-text is a basic tool of the trade, not a premium you rent forever. The 360 sunset clarified which group you are in. The question now is what you choose next.