Welcome to the Capital Note, a newsletter about business, finance, and economics. On the menu today: the history of Nuance's Dragon brand, J&J vaccine halted, Jack Ma capitulates, and W. Brian Arthur on "Economics in Nouns and Verbs." To sign up for the Capital Note, follow this link. Dragon 2.0 Yesterday, Microsoft announced a $16 billion acquisition of language-processing firm Nuance Communications, the latest in a string of big-ticket deals closed by CEO Satya Nadella, who spearheaded the purchases of LinkedIn and Github, among others. With the addition of Nuance's cutting-edge language-processing technology (the lion's share of which is in the health-care sector), Microsoft hopes to beef up its enterprise cloud offering.

Coronavirus has killed hundreds of thousands of people and has strained health systems around the world, but for Tony Young there may be a patch of a silver lining. The pandemic is accelerating use of technology to radically advance medicine and save lives in the future. "There are so many fantastic examples of the way in which technology is empowering our patients and our professionals," says Prof Young, a surgeon and national clinical lead for NHS England. Having launched his own medical-technology start-ups, he is helping to introduce innovations across the UK health service. Digital tools, whether for data management and drug development or enhanced diagnosis and treatment, have sharply improved the response to the threat of infection and all sorts of disease.

At HIMSS20 next month, Nuance Communications, an AI-based clinician information systems vendor, will introduce new systems to the Nuance AI Marketplace for Diagnostic Imaging designed to provide a one-stop shop for radiologists to review and purchase AI models to improve their workflow. The AI Marketplace is similar to the idea of an app store – a digital marketplace that enables subscribers to purchase applications, or, in the case of Nuance, AI models. The goal is to connect developers to radiologists, creating a direct line of communication to help build and improve AI models to meet their evolving needs and improve functionality of algorithms from development to practice. The AI Marketplace provides radiologists with tools for reading and reporting efficiencies, giving radiologists a unique opportunity to integrate AI models from various developers, collaborate on AI development and improvement, and ease administrative burdens of physicians overall, said Karen Holzberger, senior vice president and general manager, diagnostics, at Nuance Communications. "The solutions available in our AI Marketplace automate routine reporting and image analysis, aid in diagnosis, and help uncover incidental findings," Holzberger explained.

Artificial intelligence is a highly complex technology that, once implemented, requires ongoing oversight to make sure it is doing what is expected of it and ensure it is operating at optimal levels. Healthcare provider organizations using AI technologies also need to make sure they're getting the biggest bang for their buck. In other words, they need to optimize the AI so that the technologies are meeting the specific needs of their organizations. We spoke with six artificial intelligence experts, each with extensive experience in healthcare deployments, who offered comprehensive advice on how CIOs and other health IT workers can optimize their AI systems and approaches to best work for their provider organizations. Optimizing AI depends on the understanding of what AI is capable of and applying it to the right problem, said Joe Petro, chief technology officer at Nuance Communications, a vendor of AI technology for medical image interpretations.

Tech giant Microsoft is teaming up with Nuance Communications to use technology to solve a big pain point for doctors--too much time spent on documenting and administrative tasks. The two companies are collaborating to use ambient technology combined with artificial intelligence, automation and cloud computing to create an exam room experience where the clinical documentation "writes itself," the companies said in a press release. Physician burnout continues to be a significant problem in healthcare. A recent study shows that primary care doctors now spend two hours on administrative tasks for every hour they're involved in direct patient care. Physicians reported one to two hours of after-hours work each night, mostly related to administrative tasks.

At Nuance Communications' Healthcare Partner Event in Berlin, web content editor Ian Bolland listened to Dr Nils Lenke's presentation'The I in AI', and spoke to the senior director, innovation management, Nuance, about how the'artificial intelligence' is built to allow its Dragon voice recognition system to work. For there to be artificial intelligence there must be human intelligence – which is probably one of the reasons why Dr Lenke feels that AI will be there to assist humans, and doesn't predict that robots will take over the world. In his presentation to delegates at Nuance Communications' Healthcare Partner Event in Berlin, Dr Lenke demonstrated the thinking behind building the intelligence that goes into building the artificial intelligence that powers the kind of speech recognition the company pioneers. A lot his talk focussed on'training data' to the point where human intelligence is rebuilt to make artificial intelligence as effective as possible, in the same way as with sound and photo recognition. Succinctly put, you can do mathematics with words.

Digital assistants have become a major trend in government at every level and across geographies, and could soon be a mainstay in many state and federal agencies in the U.S. Recent favorable signs include an executive order launching the American AI Initiative and the Health and Human Services Department awarding 57 spots on its Intelligent Automation/Artificial Intelligence (AI) contract, according to natural language processing (NLP) expert William Meisel, president of TMA Associates. Speaking at the AI World Government conference, held last month in Washington, D.C., Meisel says digital assistants (aka "intelligent" or "virtual" assistants) are among the most developed and least risky ways to implement AI--and "the closest to what we see in sci-fi." Digital assistants are broadly applicable across departments and agencies looking to cut costs and boost human productivity and have a minimum probability of failure and unintended consequences. For a citizenry looking for answers, they're also a "nice alternative to automated systems and long hold times," he adds. Juniper Research reports that, by 2023, one-quarter of the populace will be using digital voice assistants daily, says Meisel.

Right now, there is no common ground with most of the AI technology consumers engage with. Instead of knowing who you are by simply the sound of your voice, most people are identified as a fresh user every time. Logging you in, authenticating you and knowing your history will be critical--and it all must be done seamlessly. Pins, passwords, security questions won't cut it,

Advancements in AI, machine learning and conversational technologies coupled with consumers' desire to self-serve is fuelling widespread adoption of virtual assistants and chatbots for customer engagement. Yet despite their popularity many implementations fail to live up to customer and organizational expectations. Designing an AI-powered conversation to sufficiently meet consumer needs and return real business value requires not just technology--but a nuanced strategy and in-depth considerations. Join leading user experience and customer engagement experts as they share key principles and lessons learned from designing millions of conversational AI interactions for some of the world's largest organizations--across messaging, web and IVR. Wherever you are in your journey--whether you're just considering implementing a conversational virtual assistant or wondering why your current one isn't living up to expectations--this is a must-attend Webinar.

This column describes work being done at Nuance Communication in developing virtual personal assistants (VPAs) that can engage in extended task center dialogues and the involve the coordination of many complex modules, along with conversational and collaborative support to such VPAs.