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This paper discusses a context model developed for medical laboratory information system of Tartu University Hospital laboratories (in Tartu, Estonia). Due to the size, structure and complex history of the laboratory infrastructure, managing user communications and even achieving a common vocabulary has become a serious task. Most of the concepts used by the laboratory personnel depend on the particular cultural, organizational or other types of context, thus reducing the problem of user communications to context management. In this paper we present a cross-linked hierarchical approach to building a context management engine that uses open context space and a flexible attribute value delegation mechanism. We discuss development objectives of the laboratory information system together with the design decisions made and summarize the first user experience. Even though the context engine is currently implemented for use in laboratory environment, its architecture is general enough to support a considerably larger variety of application domains.