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At the core of the dcm4che project is a robust implementation of the DICOM standard. The dcm4che DICOM toolkit & library is used in many production applications across the world and the current (5.x) version has been re-architected for high performance and flexibility.
Also contained within the dcm4che project is dcm4chee (the extra 'e' stands for 'enterprise'). dcm4chee is an Image Manager/Image Archive (according to IHE). The application contains the DICOM, HL7 services and interfaces that are required to provide storage, retrieval, and workflow to a healthcare environment