I talked with industry veteran Jim Maughan today. I met Jim (too many)
years ago when he was at DuPont and I was at Trinity Computing Systems.
He's one of the few real experts in diagnostic imaging departmental
operations, having worked in radiology information systems (RIS) and
picture archiving and communications systems (PACS) as both a vendor
and consultant.

The radiology PACS market is on the back side of the market adoption
bell curve. Currently about 25% of PACS purchases are replacement
systems, and Jim expects that to go up to 30% in the near future. One
of the biggest challenges implementing a new PACS is incorporating the
film archive into electronic reading workflows. When implementing a
replacement PACS the challenge becomes migrating the PACS image archive
from the old to new system.

Jim has joined with Fred Behlen from the University of Chicago to form the company Migratek and provide image archive migration services with a twist. There are two approaches
to PACS archive migration, the old way using DICOM commands (very time
consuming), and the new way developed by Migratek. Their web site has a
great explanation of how they work their magic. If you're planning a
migration, check them out.