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In this paper we explore the design options for the development of a combined physician-parent decision support tool for a neonatal intensive care unit (NICU), known as PPADS or Physician and Parent Decision Support. The work incorporates previous research on the development of a clinical data repository and the development of an NICU clinical decision support system (CDSS) for physicians that predicts mortality and a number of potential complications. In this work, we are combining the physician and parent tools to develop a system designed to facilitate parents' involvement in the shared decision-making process for difficult treatment decisions for their critically ill babies in the NICU. We have described the framework and architectural design for developing the combined physician-parent tool. We identified the design criteria and mode of operation, as well as the standards that apply to this type of decision system. We also explored the existing open-source technologies that would best fit this type of design. Finally, we have developed a prototype of the system that was evaluated by our physician partner and a nurse decision support specialist. Future work will involve a pilot usability study in a tertiary level NICU.