The most critical aspect of a radiologist’s work is the communication of his findings to the attending physician responsible for the patient’s care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means for improving communications between radiologists and attending physicians. In this paper, we first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then describe a multimedia communications system designed by our research team focusing on database and medical reports organization and architecture. Finally, we report some of key results of an in-hospital trial linking the Department of Radiological Sciences and the Emergency Department at the Ottawa Civic Hospital, a 950 bed tertiary care teaching hospital. © 1990 IEEE