A method of distributing an image study to a chosen image reader comprising: receiving an image study from an image producer at a third party communication module; sending a receive notification message from a third party communication module to a messaging layer; sending a study available notification message from the messaging layer to a workload distribution engine wherein the available notification message includes extracted image study information pulled from study headers of the image study; identifying image study rules from the extracted image study information; applying an image study complexity to the image study based on the image study rules; calculating image reader complexities for a plurality of image readers subscribed to receive image studies from the image producer, each of the image reader complexities calculated using the image study complexity and an image reader profile assigned to each of the plurality of accredited image readers; identifying the first image study reader to subscribe to coverage as a hot seat image reader and applying a study complexity adjustment for being a hot seat image reader; selecting the chosen image reader from the plurality of image readers based on the image reader complexities; assigning the image study to the chosen image reader; displaying the image study on a user interface to the chosen image reader; wherein the selecting steps further comprises: sorting the plurality of image readers according to the image reader complexities from a lowest complexity to a highest complexity; and selecting from the sorted plurality of image readers an image reader with the lowest complexity to be the chosen image reader. receiving an image study from an image producer at a third party communication module; sending a receive notification message from a third party communication module to a messaging layer; sending a study available notification message from the messaging layer to a workload distribution engine wherein the available notification message includes extracted image study information pulled from study headers of the image study; identifying image study rules from the extracted image study information; applying an image study complexity to the image study based on the image study rules; calculating image reader complexities for a plurality of image readers subscribed to receive image studies from the image producer, each of the image reader complexities calculated using the image study complexity and an image reader profile assigned to each of the plurality of accredited image readers; identifying the first image study reader to subscribe to coverage as a hot seat image reader and applying a study complexity adjustment for being a hot seat image reader; selecting the chosen image reader from the plurality of image readers based on the image reader complexities; assigning the image study to the chosen image reader; displaying the image study on a user interface to the chosen image reader; wherein the selecting steps further comprises: sorting the plurality of image readers according to the image reader complexities from a lowest complexity to a highest complexity; and selecting from the sorted plurality of image readers an image reader with the lowest complexity to be the chosen image reader.