A medical laboratory report communications gateway computer system is presented. The gateway is configured to receive medical laboratory reports from a plurality of clients. The gateway uses report form data stored in a database to perform an inbound translation on the medical laboratory report to transform the medical laboratory report to a canonical form. The gateway identifies a destination client for the medical laboratory report, and determines an outbound message form based on the destination client. The gateway performs the selected outbound translation on the medical laboratory report in the canonical form to transform the medical laboratory report in the canonical form into a form useable by the destination client. The gateway then transmits the translated medical laboratory report to the destination client.