Abstract: A computer-based method and apparatus to facilitate the exchange of pathology studies for the purpose of providing a primary or secondary pathological diagnosis. A study consists of one or more lower-resolution images, the references to the corresponding higher-resolution images, associated image metadata, study metadata and patient metadata. The studies are exchanged from one organization (hospital, practice, or individual physician) to another organization through a set of interconnected dispatcher services. In a cloud model, a plurality of dispatchers may be connected through a Global Dispatcher, both facilitating the addition of new organizations to the cloud and allowing for the addressing of studies from any organization in the cloud to any organization, group or individual in the cloud. By this means, the originating organization may obtain the desired level of care through the selection of recipient organizations, groups and individuals according to the organization's existing criteria.