Service Consumers (CDSC, clinical decision support consortium; PECARN, pediatric emergency care applied research network; SMART, substitutable medical application reference technology), input formats (CCD, continuity of care document; RDF, resource description framework; VMR, virtual medical record), and block architecture of the enterprise clinical rules service (ECRS), a modular decision support service. ECRS modules include a controller, a patient factory, which transforms input data into an inference model, a set of shared terminology services for translation and classification, and a backend rules execution service (RES). The RES wrapper abstracts the connection to the RES, allowing different rules engines to serve as the decision processor.