Abstract: Prior studies associated with a patient are pre-fetched from multiple institutions and made available to a radiologist while the radiologist is viewing a series. Intelligent report generation is template driven with templates based on modality, body part, and radiologist. The template provides access to macros specific to the study as well as previously dictated entries for particular fields, to enable re-use of standard text in a contextual manner. Likewise, entry of text in one field of the report may cause related text to be propagated to other fields, such as from the findings to the impression, automatically as specified by the radiologist. Billing codes are automatically applied based on the report content. Communication by the radiologist with other physicians and institutions is implemented via the reporting system. Since communication instances pass through the radiology system, it is possible to associate and log communication instances with the studies.