Lifespan is a five-hospital system in Providence, R.I., managing more than 500,000 radiology and cardiology exams per year. To balance the image management needs across departments, meet the daily demands of access to full clinical information across their health system with an eye on future participation in the Accountable Care initiative, Lifespan is embarking on a multi-year journey to leverage IT infrastructure as a strategic asset and utilize a combination of an enterprise vendor neutral archive coupled with archive neutral PACS for radiology, cardiology, endoscopy and other departments.