Over the past 20 years, the field of radiology has built an impressive digital infrastructure, automating many portions of the imaging process from the time of order entry through image distribution.  With the advent of small, low-cost, high quality digital cameras, other medical specialties have turned to imaging to visualize and document disorders yet, they have not implemented the same type of digital infrastructure as radiology.    Today, thousands of medical images are obtained in hospitals each day.  With the increasing reliance on imaging, there is a greater need to build systems and processes to obtain, store, and distribute these images across the enterprise so that health care providers can better care for their patients.  Even though many of these problems have been solved in radiology, the solutions are not easily transferred to other specialties due to the differences in imaging hardware and the image acquisition workflow.    The purpose of this talk is to describe the problems facing hospitals as they begin to build enterprise imaging archives and to discuss potential solutions to these problems.