A messaging system for routing clinical messages, said messaging system comprising: an event handler that: receives one or more inbound messages, including one or more worklist items, from one or more event sources, wherein a worklist item is an action to be performed in response to an event; stores the worklist items in an event database; and, generates and communicates outbound messages for one or more worklist items in the event database that need to be acted upon, as determined by one or more rules; and a standardized protocol to represent the inbound messages and the outbound messages, wherein the event handler verifies and/or modifies the worklist items of the inbound messages using one or more rules, wherein the rules are based on one or more of hospital policies, target settings, properties of the inbound messages, on-call status, worklists, and workflows, wherein the event handler is further configured to: receive a worklist item for a location, device, or patient from the inbound messages, wherein the location, device, or patient includes an escalation sequence of escalation levels, each escalation level including a target; determine whether the worklist item is to be escalated using the rules; in response to determining the worklist item is to be escalated using the rules, identify a next escalation level of the location, device, or patient, the next escalation level including only target or targets not already servicing higher and/or equal priority worklist items; and, generate and communicate an outbound message for the worklist item to the identified target. an event handler that: receives one or more inbound messages, including one or more worklist items, from one or more event sources, wherein a worklist item is an action to be performed in response to an event; stores the worklist items in an event database; and, generates and communicates outbound messages for one or more worklist items in the event database that need to be acted upon, as determined by one or more rules; and receives one or more inbound messages, including one or more worklist items, from one or more event sources, wherein a worklist item is an action to be performed in response to an event; stores the worklist items in an event database; and, generates and communicates outbound messages for one or more worklist items in the event database that need to be acted upon, as determined by one or more rules; and a standardized protocol to represent the inbound messages and the outbound messages, wherein the event handler verifies and/or modifies the worklist items of the inbound messages using one or more rules, wherein the rules are based on one or more of hospital policies, target settings, properties of the inbound messages, on-call status, worklists, and workflows, wherein the event handler is further configured to: receive a worklist item for a location, device, or patient from the inbound messages, wherein the location, device, or patient includes an escalation sequence of escalation levels, each escalation level including a target; determine whether the worklist item is to be escalated using the rules; in response to determining the worklist item is to be escalated using the rules, identify a next escalation level of the location, device, or patient, the next escalation level including only target or targets not already servicing higher and/or equal priority worklist items; and, generate and communicate an outbound message for the worklist item to the identified target. receive a worklist item for a location, device, or patient from the inbound messages, wherein the location, device, or patient includes an escalation sequence of escalation levels, each escalation level including a target; determine whether the worklist item is to be escalated using the rules; in response to determining the worklist item is to be escalated using the rules, identify a next escalation level of the location, device, or patient, the next escalation level including only target or targets not already servicing higher and/or equal priority worklist items; and, generate and communicate an outbound message for the worklist item to the identified target.