A system to transparently and efficiently coordinate a process across at least two independent Picture Archiving and Communication System (PACS) to allow interoperability of the PACS to acquire, retrieve, transmit, store and/or display medical images of patients. The system includes: (1) a rule engine defining a set of transformation rules for data related to the images; (2) a data unification and transformation engine identifying and resolving any conflict of the data, and tracking and assigning a unique super-identity or super-value to the data; (3) at least one database storing a list of the data and the tracking and assignment of the super-identities or super-values; (4) a security framework that controls access to the data; and (5) a control engine performing the process steps.
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