The international DICOM 3 standard for a single patient record exchange media (CD-R)) provided the necessary definition for digital recording and distribution of cardiac angiographic patient data. The medical industry developed archive and review stations that allow the replacement of the 35 mm cine film. SIEMENS launched ACOM.T.O.P. in late 1995. The benefits and technical solution are presented in this paper. Today, the solution for networked real-time image data distribution within the hospital has become reality. Further integration of hemodynamic data, connectivity of hospital information systems, easy access and distribution of such high volume data from and to remote locations is well under way. ACOM.net is used as an example for the realization of commercial products to fulfill the demands of cardiologist and hospital administrators.