The authors describe their experience designing a controlled medical vocabulary server created to support the exchange of patient data and medical decision logic. The first section introduces practical and theoretical premises that guided the design of the vocabulary server. The second section describes a series of structures needed to implement the proposed server, emphasizing their conformance to the design premises. The third section introduces potential applications that provide services to end users and also a group of tools necessary for maintaining the server corpus. In the fourth section, the authors propose an implementation strategy based on a common framework and on the participation of groups from different health-related domains.