Typically DICOM brokers were used with older radiology modalities or PACS systems that didn’t have DICOM capability built into them. The Broker stepped in to fill the void. Some old names in the game I remember are Mirta and Merge. Now usually your PACS system will create the DICOM worklist (or process other DICOM message requests) necessary for modailities from the orders fed to the PACS. Then modalites will do a DICOM WorkList query to the PACS for that information. DICOM supports a lot of processes, but the main ones in use are WORKLIST, QUREY/RETRIEVE, STORE, SEND, and PRINT.
The DICOM standard is very complex and quite verbose as it was developed by (NEMA – National Electrical Manufacturers Association). You can do DICOM via Cloverleaf, but I’d suggest avoiding it when possible. As you can quess many vendor have variations and custom tag they support with their modalities making DICOM as bad it not worse in some cases a the HL7 “standard” from a vendor perspective.
Here in Germany we use a product called IDeal from a french company called ETIAM (the also sell in the states). IDeal is IHE compliant and stores HL7 orders into a database, so that DICOM modalities can query for their worklists. IDeal is also able to send back the study UID, so that a HIS can query for images with the DICOM WADO call to the pacs.
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