An opportunity exists for automated clinical decision support, in which raw source data from a conventional physiological monitoring system are continuously streamed to an independent analysis platform. Such a system would enable a wider range of functionality than offered by the source monitoring system. Although vendor solutions for this purpose are emerging, we developed our own system in order to control the expense and to permit forensic analysis of the internal core functionality of the system. In this report, we describe a platform that can provide decision support for trauma patients in an Emergency Department (ED). System evaluation spanned 39 days, and included a total of 2200 patient session hrs of real-time monitoring. We highlight the technical issues that we confronted, including protection of the core monitoring network, the real-time communication of electronic medical data, and the reliability of the real-time analysis. Detailing these nuanced technical issues may be valuable to other software developers or for those interested in investing in a vendor solution for similar functionality.