A messaging system (100) for routing clinical messages includes an event handler and a standardized protocol (105). The event handler (106) receives one or more inbound messages from one or more event sources (102). The event sources (102) include one or more worklist items. The event handler (106) further stores the worklist items in an event database (198) and generates and communicates outbound messages for one or more worklist items in the event database (198) that need to be acted upon, as determined by one or more rules. The standardized protocol (105) is used to represent the inbound messages and the outbound messages.