In the last two decades, the trend in healthcare information technology has been towards digital and multimedia concepts. The next generation of healthcare information systems will consist of a vast network of heterogeneous, autonomous and distributed imaging scanners, Hospital Information Systems (HIS), medical information from clinical departments such as Radiology Information Systems (RIS), and large quantities of multimedia medical data held on a range of Picture Archiving and Communication Systems (PACS). Providing an organizational framework that can integrate this varied collection of resources is a key challenge system researchers and developers face. In order to increase the availability of global or previously non-accessible information and to address the demanding new information processing requirements for diverse image-assisted medical applications, there is a need to integrate HIS/RIS data and medical image data of Picture Archiving and Communication Systems (PACS). This paper gives a description of the general requirements for HIS/RIS/PACS integration with reference to prefetching, network and image archives. The main purpose of this paper is to present an architecture to allow not just structured text, such as patient records to be accessed in a distributed environment, but also multimedia data such as PACS images. The system architecture consists of modules that provide kernel functionality (kernel functionality provides distributed access) and modules that are needed to fulfill the requirements of data handling within HIS/PACS. The system architecture will, thus, provide a facility for requesting, decomposing and processing a global query, which allows a clinician to request patient records along with the image associated with patient examinations.