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Even worse, without a method to manage patient identity across records where more than one patient identity domain is involved, the records for two different people can be linked to one patient, resulting in a potentially serious risk for harm. This paper proposes a maturity model to assess and categorize the capabilities of different imaging information technology systems, such as Picture Archiving Communication and Archiving System, Vendor Neutral Archive, and other image management and viewing applications.In value-based decision mak