Historical study migration is basically the movement of studies off of the source PACS in reverse chronological order. The last studies in are the first studies to be migrated out (LIFO). The migration starts at a defined point in time and works backward until the source PACS is empty.

While a practical approach, it does not reflect the practice of radiology where patients don't show up in reverse chronological order. They arrive in random order. The migration implication being that the most relevant study may not yet be available on the target PACS so some sort of intervention is required.

Acuo developed the "Smart Migration" approach to mitigate this situation. The approach involves prefetching studies based on schedule messages for scheduled studies (HL7) and DICOM modality Worklist (DMWL) messages for emergent studies. In many cases, Smart Migration can be enhanced through custom HIS/RIS interfaces based on customer requirements.

The Smart Migration application processes the Schedule or DMWL requests and prioritizes the study migration. The entire study folder is migrated (or the folder for a specific date range), not just the relevant prior study, thus completing that study migration. Smart Migration can easily be combined with standard migration. Smart Migration transactions take priority over historical migration tasks. Radiologist confidence improves when they have reliable access to relevant prior studies.