Integrating patient synchronized applications (PSA) into hos- pital information systems (HIS) is becoming an essential ob- jective for improving high quality care by reducing the work created by the recurring task of patient selection within vari- ous clinical and administrative applications. The introduced architecture is based on IHE´s PSA profile which it extends with a conferencing feature. As part of such a conference, clients in the same context can message each other, share information, send workflow information, and perform dis- tributed diagnosis on patient records. The architecture was then implemented in a prototype HIS for evaluating the tech- nical feasibility and potential workflow enhancements.