DICOM practices a continuous maintenance process that results in an updated edition of the Standard being published 4 or 5 times per year.

Members of the imaging community are encouraged to Submit a Change Proposal or Submit a New Work Item Proposal.

The following diagram shows more detailed steps for those directly involved in updates to the Standard.

For more information on the process for collaboration between DICOM and HL7, see the presentation here.

Additional details of the development process are discussed in the DICOM Governance, particularly in Section 8.