1. A method of administering medical digital images in a distributed medical digital image computing environment, the method comprising: receiving a request for an image processing transaction to process the medical digital image, the request containing a medical image to be processed, metadata describing the medical image, and a type of service request for the image; storing the medical image in one or more of the medical image caches; creating, in dependence upon transaction parsing rules and the contents of the request, a medical image business object representing the business transaction; wherein the medical image business object also includes a ticket to access the medical image in the cache and wherein the ticket includes a symbolic representation of the location of the medical image in the cache; selecting, in dependence upon workflow selection rules and the attributes of the medical image business object, one or more clinical workflows to process the medical image; and processing the medical image of the request with the clinical workflows, thereby creating a resultant business object and resultant medical image including accessing the medical image in the cache using the ticket.