Abstract: A system, for exchanging medical image data between different processing systems, includes a central repository and an interface. The central repository stores configuration information including entity related information and authorization information. The authorization information associates a user with an indicator of authorization to access particular patient medical records. Multiple different processing systems of corresponding different entities use the configuration information to access medical image data repositories of the corresponding different entities and to enable exchange of medical image data between the different entities. The interface receives, from a first processing system of a first entity, a user initiated request to access a medical image repository of a second processing system of a second entity. The interface accesses the central repository in retrieving configuration information. The interface communicates the retrieved configuration information to the first processing system.