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Medical dictation software compared: an honest look at Dragon alternatives in 2026

Dragon Medical One, Dragon Copilot, Heidi, Augnito, Windows and Mac dictation, TechVoice: platforms, languages, vocabulary, pricing and data hosting compared.

The TechVoice team 9 min read

For years, choosing medical dictation software meant choosing a version of Dragon. In 2026 the field is wider: Microsoft is moving Dragon Medical One users towards Dragon Copilot, newer vendors offer free dictation or free trials, the dictation built into Windows and the Mac is a keystroke away, and so-called ambient assistants write the note from the consultation itself.

We make TechVoice, one of the tools in this comparison. To keep it useful, we set ourselves a rule: every fact about a competitor comes from a page we read in November 2026, listed at the end of the article, and nothing is estimated. Where a price is not published, we say “on request”. TechVoice’s limits sit in the table alongside everyone else’s.

Three kinds of tool

  • Specialist medical dictation: you speak and the text is written word for word, with a medical vocabulary. Dragon Medical One, Heidi Dictate, Augnito Spectra and TechVoice belong here.
  • Built-in general dictation: Windows, Word, the Mac and the iPhone. Free or included in a subscription, it handles everyday language well but has no medical vocabulary of its own.
  • Ambient assistants, or AI scribes: they listen to the conversation between clinician and patient, then write a structured note themselves. Nabla, Dragon Copilot in ambient mode and Augnito Omni are examples. It is a different job from dictation: you no longer dictate, you review what the tool has written.

Comparison table (November 2026)

Tool Type Platforms Languages Specialist vocabulary Public price Health data
Dragon Medical One (Microsoft) Medical dictation Workstation, into the application of your choice; smartphone as a microphone (PowerMic Mobile) English and French pages; used in the NHS and in French hospitals Medical vocabulary, no voice profile training; shareable custom shortcuts On request Hosted on Azure, certified for French health data (HDS), in the Lille University Hospital deployment (2021)
Dragon Copilot (Microsoft) Dictation and ambient assistant Web, mobile, desktop Multilingual conversations; available in the UK, Ireland, France and other countries Specialty-specific, customisable notes On request Not specified on the product page
Heidi Dictate Medical dictation Heidi desktop app, Windows and macOS: types wherever your cursor is 90+ languages announced Built-in clinical vocabulary; a term corrected once is remembered Free in Heidi Desktop; paid plans with no price shown Data kept in the EU/EEA (GDPR)
Augnito Spectra Medical dictation Windows, web, Chrome, iOS, Android Dictation languages not listed; 37+ languages for conversation capture (Omni) Custom vocabulary; 55+ specialties 7-day trial, then on request Cloud or on-premises; GDPR, HIPAA, ISO 27001; hosting region not specified
Windows and Word dictation General dictation Windows; Word on Windows, Mac, web and mobile English and many other languages No custom vocabulary mentioned Included in Windows; Word: Microsoft 365 subscription Online recognition by Microsoft; Word keeps neither the audio nor the text
Mac and iPhone dictation General dictation macOS, iOS, iPadOS Depends on language and region No custom vocabulary mentioned Included with the device Processed on the device or sent to Apple’s servers, depending on settings
Nabla Ambient assistant Web, iOS, Android, Chrome extension Site in English and French; languages not listed Not applicable: writes the note from the consultation Free trial, then on request HIPAA, SOC 2, ISO 27001, GDPR announced
TechVoice Medical dictation Browser (Chrome or Safari) on computer, tablet or phone, nothing to install English and French Vocabulary from your specialty, your sample documents and your corrections Free points with no card, then a monthly subscription Scaleway, in France; not a certified health data host: do not dictate patient identifiers

This table reflects what each vendor states publicly. It does not measure recognition quality: we have not tested the other tools on a common corpus.

Dragon Medical One and Dragon Copilot

Dragon Medical One remains the long-standing reference for hospital dictation; Microsoft’s UK page features Guy’s and St Thomas’ NHS Foundation Trust. Microsoft’s pages highlight dictation “into the application of your choice”, no voice profile training, custom shortcuts shared between users and departments, and PowerMic Mobile, which turns a smartphone into a dictation microphone. In 2021, Lille University Hospital in France deployed it hosted on Microsoft Azure, which holds the French certification for health data hosting (HDS). No price is published.

Microsoft is now promoting Dragon Copilot, which combines Dragon Medical One’s dictation with DAX Copilot’s ambient listening and generative AI. The product page invites users to “migrate from Dragon Medical One to Dragon Copilot” and lists, for physicians, the United States, Canada, the United Kingdom, Ireland, France, Germany, Austria, Belgium, the Netherlands and Switzerland. Pricing goes through a sales representative.

Best for: hospitals and practices that want a solution integrated with the electronic health record, a contract with a major vendor and certified hosting for health data.

Heidi Dictate

Heidi offers an ambient scribe and a dictation module, Heidi Dictate, built into its desktop app for Windows and macOS. Heidi announces more than 90 languages, a built-in clinical vocabulary, and a term learned after a single correction. In November 2026, dictation is free in Heidi Desktop; the paid plans (Clinician, Practice, Enterprise) show no price. Its GDPR page says data stays within the EU/EEA.

Best for: clinicians at a computer who want to dictate straight into their clinical system, free of charge, and may later move to ambient notes.

Augnito

Augnito separates dictation (Spectra) from its ambient assistant (Omni). Spectra claims 99% accuracy “out of the box”, custom vocabulary and macros; the vendor announces more than 55 specialties and apps for Windows, web, Chrome, iOS and Android. The Spectra page does not list dictation languages: the only figure given is Omni’s 37+ languages for conversation capture. The trial lasts 7 days with no credit card; pricing is then on request. Deployment can be cloud or on-premises; the page shows GDPR, HIPAA, ISO 27001 and SOC 2 logos without naming a hosting region.

Best for: organisations that want multi-device dictation integrated with their EHR and are ready to negotiate a contract.

Free dictation in Windows, Word and on the Mac

This is the simplest place to start, and it costs nothing beyond your computer.

  • Windows: Windows key + H starts voice typing. It relies on Microsoft’s online speech recognition, and its voice commands work in US English only.
  • Word: the Dictate button requires a Microsoft 365 subscription and an internet connection. Microsoft says your voice is sent to it to produce the text, and that neither the audio nor the transcription is stored.
  • Mac and iPhone: dictation starts from the microphone key or a keyboard shortcut. Depending on settings, it is processed on the device or sent to Apple’s servers.

None of these mention a custom vocabulary in their documentation. They are fine for letters and notes in everyday language, and struggle with rare terms. We have not measured them; in our own tests, a speech recognition model used on its own, without a vocabulary, missed up to one specialist term in three.

Ambient assistants: Nabla and others

Ambient assistants do not replace dictation; they answer a different need. Nabla, for example, captures the patient-clinician conversation and generates structured clinical notes automatically, integrated with EHRs such as Epic; it offers web, iOS and Android apps, and pricing on request after a free trial. Dragon Copilot, Heidi and Augnito Omni offer this mode too.

They suit consultations where most of the content is said with the patient. For an operative report, a referral letter or a summary dictated alone at your desk, dictation remains the natural tool.

TechVoice, limits included

TechVoice is online medical dictation built around the vocabulary of your specialty. Text appears as you speak; when you stop, a correction pass reworks it with your vocabulary, drawn from three sources: your specialty, a few sample documents you upload, and each of your corrections, remembered for future dictations. The correction only touches misheard words; if it strays too far from what you said, the recognised text is kept. You can also upload a recording made elsewhere, up to 60 minutes. The details are in our article on how AI voice dictation works, and medical use on our medical dictation page.

Our internal measurements were made on a test corpus in French: live, about 25% of specialist terms wrong in the raw text and about 5% after correction; on upload, 9.6% then 2.6%. These figures come from synthetic voices: they are optimistic and serve to compare settings with one another, not to predict your own error rate. They do not cover English.

What TechVoice does not do, as of November 2026:

  1. No certified health data hosting. TechVoice is not HDS-certified (the French standard for hosting health data). Do not dictate anything that identifies a patient: no name, date of birth or record number. Dictate the clinical content, then add the patient’s identity in your clinical system. Voice and text are processed by Mistral AI and hosted by Scaleway, in France; the audio is not kept after transcription.
  2. Two languages only: English and French.
  3. A browser app. It does not type directly into your clinical system: you copy and paste the corrected text.
  4. No ambient mode. TechVoice transcribes what you dictate; it does not write a note from a consultation.

On pricing, free points are given when you sign up, with no credit card, followed by two monthly subscriptions you can cancel at any time: current amounts are on our pricing section.

Which one, for whom

  • You are a hospital or practice dictating identifiable patient data: a tool with certified health data hosting and EHR integration, such as Dragon Medical One or Dragon Copilot. Whatever the vendor, ask for its current certificates and their scope.
  • You want free dictation on a computer, into every application: start with Windows + H or Mac dictation for everyday language, or try Heidi Dictate for a clinical vocabulary.
  • You want the consultation to write itself up: an ambient assistant such as Nabla, Heidi or Dragon Copilot.
  • You dictate reports or letters full of specialist terms on your own, in English or French, with nothing to install: TechVoice, as long as patient identifiers stay out of the dictation.

The only test that counts is your own: a week of real documents, in your specialty, with your voice and your microphone. To estimate what dictation could save you, see our time-savings calculation.

Sources

Pages read on 11 November 2026.

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