The aim of this paper is to present an open and generic medical tele-expertise architecture which may be implemented intra and inter hospitals in any medical or call centre and at home. This architecture is based on TCP/IP Internet technology and on the XML metalanguage for data representation, storage and communication. It is composed of a main application installed on a web server for the intelligent management of the messages exchange and of distributed client applications for sending and

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... eiving the tele-expertise requests via HTTPS. A message contains the communicating parties, the Electronic Health Record (EHR) and any attached files like SCP-ECGs or DICOM images. In order to guarantee the reception of the message in due time, the expert should be able to receive anywhere different kinds of notifications by means of different types of devices that depend on the available technologies (Pager, SMS, PDA, etc.). This new infrastructure is being experimented within the Lyon area in a setting that includes an emergency department, regional and general hospitals, the Cardiology Hospital of Lyon and patients homes. .