An imaging system, comprising: an image acquisition device; a device controller comprising an electronic processor programmed to operate the image acquisition device to acquire medical images of a patient and to maintain a machine log storing an operating history of the image acquisition device; a server computer programmed to retrieve patient information from at least one health information system, HIS; and at least one feedback device ( 50, 52); wherein the device controller, the server computer, or a combination of the device controller and server computer is programmed to implement at least one state machine ( 30, 44) having a plurality of states defined by values of state variables wherein the states represent respective attainable states of an image acquisition procedure and the image acquisition device, the at least one state machine configured to transition between states during the image acquisition procedure whereby the at least one state machine represents a current state of the image acquisition procedure and the image acquisition device, wherein the values of the state variables of the at least one state machine are determined based at least on content of the machine log for the image acquisition device and patient information retrieved by the server computer from the at least one HIS; and wherein the at least one feedback device is configured to provide guidance to an operator for performing the image acquisition procedure based on a current state of the at least one state machine, wherein the at least one state machine ( 30, 44) comprises: a first state machine being a system state machine representing the imaging acquisition device and having a plurality of states, wherein the values of the state variables of the first state machine are determined based on content of the machine log for the image acquisition device; and a second state machine being an examination state machine representing the image acquisition procedure and having a plurality of states, wherein the values of the state variables of the second state machine are determined based at least on the first state machine and patient information retrieved by the server from the at least one HIS. an image acquisition device; a device controller comprising an electronic processor programmed to operate the image acquisition device to acquire medical images of a patient and to maintain a machine log storing an operating history of the image acquisition device; a server computer programmed to retrieve patient information from at least one health information system, HIS; and at least one feedback device ( 50, 52); wherein the device controller, the server computer, or a combination of the device controller and server computer is programmed to implement at least one state machine ( 30, 44) having a plurality of states defined by values of state variables wherein the states represent respective attainable states of an image acquisition procedure and the image acquisition device, the at least one state machine configured to transition between states during the image acquisition procedure whereby the at least one state machine represents a current state of the image acquisition procedure and the image acquisition device, wherein the values of the state variables of the at least one state machine are determined based at least on content of the machine log for the image acquisition device and patient information retrieved by the server computer from the at least one HIS; and wherein the at least one feedback device is configured to provide guidance to an operator for performing the image acquisition procedure based on a current state of the at least one state machine, wherein the at least one state machine ( 30, 44) comprises: a first state machine being a system state machine representing the imaging acquisition device and having a plurality of states, wherein the values of the state variables of the first state machine are determined based on content of the machine log for the image acquisition device; and a second state machine being an examination state machine representing the image acquisition procedure and having a plurality of states, wherein the values of the state variables of the second state machine are determined based at least on the first state machine and patient information retrieved by the server from the at least one HIS. a first state machine being a system state machine representing the imaging acquisition device and having a plurality of states, wherein the values of the state variables of the first state machine are determined based on content of the machine log for the image acquisition device; and a second state machine being an examination state machine representing the image acquisition procedure and having a plurality of states, wherein the values of the state variables of the second state machine are determined based at least on the first state machine and patient information retrieved by the server from the at least one HIS.