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As a growing number of studies suggest that clinical decision support systems (CDSSs) have a positive impact on reducing medical errors, the significance of integrated CDSSs becomes evident. Our Medical Intelligent Decision Aid Systems (IDEAs) Research Group is exploring this potential by deploying a prototype implementation of integrated clinical decision support in a Neonatal Intensive Care Unit (NICU), the goal being to evaluate the effectiveness of real-time decision support. Our paper presents the eXtended Markup Language (XML)-based technological foundation for this integrated 'intelligent' NICU. This includes a description of the logical data manipulations required to process medical data, produce an XML-enabled CDSS result, and transmit this information to the NICU client in real-time.