A clinical decision support system (16) monitors one or more patients. The system (16) includes one or more processors (84) programmed to receive patient data for the patients. For each patient, one or more monitoring rules are selected from a plurality of monitoring rules based on patient data availability and/or patient context. A determination is made as to whether a patient is deteriorating using the selected monitoring rules for the patient. In response to determining the patient is deteriorating, an alert is generated.
