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This work extends the functionality of our earlier XML-based health care framework for integrating clinical decision support systems (CDSSs) with capabilities for defining, detecting, and generating clinical alerts in the neonatal intensive care unit (NICU). A first step in this work involved creating a complete NICU XML schema for defining and constraining medical device data, CDSS inputs and outputs, and clinical alerts. The alerts are customizable through a flexible user interface that automatically creates XML documents based on the physician's input specifications. XML documents are transmitted to a central Java application for alert display and transmission. Transmitting XML-based alerts allows the alert information to be shareable in many contexts- within and between hospital information systems, and from remote locations. This is particularly useful when one considers the possibility of offering CDSS-generated alerting systems as ubiquitous web services to pre-authorized users.