Abstract: The present invention provides a medical image management system and method that uses a central data management system to centrally manage the storage and transmission of electronic records containing medical images between remotely located facilities. The present invention also provides a system and method for packaging an image for secure transmission. The present invention also provides a system for tracking delivery and review of images and various attachments or augmentations to the image files. The invention also provides a system and method for providing lifetime storage of images that may be accessed by different authorized imaging centers and providers throughout the life of the patient. An image or file is packaged to be transmitted through a firewall of an image viewing location and stored in a relational database at the remote viewer. The image is delivered to a physician for ready accessibility at a remote viewer. Various files may be added to the patient's file at remote viewers.