the module uses protocols such as HL7, DICOM so it is not necessarily tied to dcm4chee.
I havent tried any PACS together with https://github.com/openmrs/openmrs-module-radiology but thats because I dont know any other open source PACS that has a DICOM modality worklist (MWL) which is what the radiology module relies on.
The technical features we need the PACS to have in order for the radiology module to work are:
can receive HL7v2 ORM messages (specifically version 2.3.1 at the moment) to create orders in its DICOM MWL
sends DICOM MPPS messages on updates of the orders in the DICOM MWL
It would be great if you would try it out and give us feedback since the module aims to be independent of the PACS implementation. I am sure there would be some changes needed for it to work, but we are definitely willing to make them.
We were considering the possibilities of using the radiology module for integrating with any of the commercial PACS which hospitals would have procured. With the context you have provided, it will help in checking the feasibility.