PACS has become a commodity and is no longer regarded as specialized software. The functionalities of a PACS are constantly expanding, most have become commonplace. Prices for PACS have consistently dropped over the last 20 years because the required infrastructure requirements have been reduced, and because the software has become more and more mature and can be based on common techniques. Functional requirements, on the other hand, have increased along with end-user expectations. Service remains very important. Most time and money is now spent on implementation and configuration. This is where we think PACSs can still make a lot of gains. By being smarter about the setup (i.e. hanging protocols) or limiting the implementation by connecting (to the cloud) instead of installing, costs can be reduced.