A system for coordinating a process across at least two independent Picture Archiving and Communication System (PACS) to allow interoperability of the PACS with each PACS handling the acquisition, retrieval, transmission, storage, and display of patients medical images using the Digital Imaging and Communications in Medicine (DICOM) standard, wherein each PACS includes at least one modality that acquires DICOM images, at least one workstation that retrieves and displays DICOM images, and at least one server that transmits, manages, and stores images and controls the at least one modality and the at least one work station, wherein each image has an associated DICOM tag and an associated patient tag unique to each PACS, wherein the process from one PACS to another PACS includes at least one process step defined by at least one modality, workstation, server, DICOM tag, or patient tag, wherein the servers included in the at least two PACS connect to the system as slaves, wherein the system works with medical imaging workflows and can interface to other DICOM entities and can connect to and serve as the master controller for said servers and make their images available through its own interface such that it appears to the DICOM entities as though the images were resident on the system itself even though they are not, the system comprising: a. a rules engine defining a set of transformation rules for each image, modality, workstation, server, DICOM tag, patient tags, and process step from each PACS; b. a data unification and transformation engine identifying and resolving any conflict on the identities or values of the modalities, workstations, servers, DICOM tags, patient tags, and process step from all PACS using said rules engine by tracking and assigning a unique super-identity or super-value as applicable to each modality, workstation, server, DICOM tag, patient tag, and process step for all PACS; c. at least one database storing a list of the DICOM tags of each image from each PACS, and storing the tracking and assignment of the super-identities or super-values by said data and transformation engine; d. a security framework that controls access to each image from each PACS based on the assignment of the super-identities or super-values by said data unification and transformation engine and stored in said at least one database; and e. a control engine performing the process steps to acquire, retrieve, transmit, store and/or display the images from any of said at least two PACS based on the DICOM tag and the assignment of the super-identities or super-values stored in said at least one database; f. an interface, through which the control engine of the system interacts with connected DICOM entities connected to the system as clients, in particular modalities, users, workstations and other PACS servers that are not connected to the system as slaves. a. a rules engine defining a set of transformation rules for each image, modality, workstation, server, DICOM tag, patient tags, and process step from each PACS; b. a data unification and transformation engine identifying and resolving any conflict on the identities or values of the modalities, workstations, servers, DICOM tags, patient tags, and process step from all PACS using said rules engine by tracking and assigning a unique super-identity or super-value as applicable to each modality, workstation, server, DICOM tag, patient tag, and process step for all PACS; c. at least one database storing a list of the DICOM tags of each image from each PACS, and storing the tracking and assignment of the super-identities or super-values by said data and transformation engine; d. a security framework that controls access to each image from each PACS based on the assignment of the super-identities or super-values by said data unification and transformation engine and stored in said at least one database; and e. a control engine performing the process steps to acquire, retrieve, transmit, store and/or display the images from any of said at least two PACS based on the DICOM tag and the assignment of the super-identities or super-values stored in said at least one database; f. an interface, through which the control engine of the system interacts with connected DICOM entities connected to the system as clients, in particular modalities, users, workstations and other PACS servers that are not connected to the system as slaves.