The ACR-NEMA Standard was published five years ago. Implementations are just now becoming available in a form other than a prototype. Though this seems like a long interval between the initial work and results, the organization responsible for the Standard, the ACR-NEMA Digital Imaging and Communications Standards Committee, has not been idle. Much of the progress which has been made is the result of cooperative work involving industry, the Committee and its Working Groups (WG), and the medical imaging user community. This paper will briefly review the history of the development of what is now a family of ACR-NEMA standards, describe the current activity of the Working Groups, and indicate in what directions the WGs are headed for both new and updated standards.