AI Coding, DICOM Sync & the Future of PACS | Chris Hafey

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What happens when a 25-year medical imaging veteran retires, then comes back with an AI coding assistant and rebuilds his entire mental model of how PACS gets built? Chris Hafey, founder of Merkalis and longtime fixture in the imaging informatics community, joins Imaging Informatics Unplugged to talk about coding with Claude and other LLMs, why he believes solo founders can now out-build 50-person dev teams, and what that means for PACS administration, Radiology IT, and Enterprise Imaging going forward. We dig into the real story behind his Monday-morning community meetups, the skill-degradation risk facing junior engineers as AI takes over more of the coding, and the Merkle-tree-based architecture Chris built to solve DICOM synchronization — a problem that's plagued Vendor Neutral Archives and Imaging Informatics teams trying to keep on-prem and cloud PACS in sync. Chris also explains why he thinks some legacy PACS vendors would be better off rebuilding from scratch than fighting decades of technical debt, and what AI in Radiology and HL7-connected systems need to actually trust the data they're syncing. If you work anywhere near PACS, DICOM, or healthcare IT and want an unfiltered, practical conversation instead of a vendor pitch, this one's for you.Jason also shares an update on the CIIP Foundations Program for imaging informatics professionals working toward their credential, plus a first look at the new DICOM training program featuring hands-on live imaging learning labs. Learn more at nagelsconsulting.com.Key Topics Covered• How Chris's Monday-morning imaging community meetup started during COVID, went on hiatus, and came back unfiltered• Going from hand-coding for a month to building a full DICOM web server with OHIF integration in about two hours of real thinking time using Claude• Why Chris believes a small domain-expert team using LLMs can now do what used to require a 50-person dev team and tens of millions in funding• The skill-degradation risk for junior and senior engineers as LLMs take over more of