In medical healthcare, two contrasting tendencies can be observed. On the one hand, recent technological advancements allow maintaining a quality in medical treatment that was hardly to imagine some years ago. On the other hand, the investment in newer medical devices and the necessary training of the physicians is highly cost intensive and can be hardly regained without proper management of the clinical processes. This is the aim of the PROGEMM (Process-Oriented Generic Management of Medical Knowledge) approach that is presented in this paper. PROGEMM combines the specification and execution of structured workflows combined with highly flexible and knowledge-intensive tasks. It assists physicians as well as other medical professionals in their daily work and, because it is based on the widespread DICOM (Digital Imaging and Communications in Medicine) standard, provides a platform for collaboration among physically dispersed physicians.