Have a read (may need an account).

Some thoughts…

• The shift of the “archive” out of PACS has been well-discussed and is occurring today with the maturation of the VNA market; though these primarily serve PACS.
• I believe that the next evolution will be a significant advancement in the ease at which a medical imaging record may be discovered and accessed. And these records will be dynamically transformed and provided to the wishes of the consumer (user or application). This will come through new REST-based Web protocols, such as those being defined in DICOM WG-27 and the HL7 FHIR initiative; as well as modern full text search methods.
• With these new methods the lines between records in DICOM, document, or structured data formats will be blurred and the content much easier to cross-index and normalize.
• The same evolution (easy to find, access, use) will occur to resources, such modalities and clinical specialists. The freedom I have to find and reserve a flight among dozens of providers within seconds compared to the ability to book an appointment for a CT exam would be laughable, were it not depressing.