Current efforts relating to the uptake, evaluation and research into digital medical imaging require the large-scale collection of images (both unprocessed and processed) and data. This demand has led us to design and implement a flexible mammographic image repository, which prospectively collects images and data from multiple screening sites throughout the UK. The MIDB has been designed and created to provide a centralised, fully annotated dataset for research purposes. One of the most important features is the inclusion of unprocessed images. In addition to the images and data, systems have been created to allow expert radiologists to annotate the images with interesting clinical features and provide descriptors of these features. MedXViewer (Medical eXtensible Viewer) is an application we have designed to allow workstation-independent, PACS-less viewing and interaction with anonymised medical images (e.g. for observer studies). With these integrated tools, the MIDB has become a valuable resource for running remote observer studies and providing data and statistics for imaging based-research projects. Previously, studies were run by laborious transfers of images to PACS at remote sites and paper-based data manually curated into databases. Apart from the inconvenience, these approaches also suffer from a lack of accurate location information from the paper-based forms.