WASHINGTON, D.C.—Just as PACS liberated studies from their confinement to hard film, so CDs and cloud computing are enabling image sharing across institutions, communities and beyond. But as the cloud buzz grows louder, a group of presenters at the 2011 meeting of the Society for Imaging Informatics in Medicine (SIIM) argued on Thursday that the technology may be green—and ultimately inferior to Integrating the Healthcare Enterprise (IHE) initiative.