This paper describes the Collaborative Social and Medical Services Sys
tem, a robust information infrastructure for integrated social and med
ical care. The Collaborative Social and Medical Services System design
and architecture address the primary goals of creating a readily exte
nsible social and ambulatory care system. Our initial step toward reac
hing this goal is the delivery of an application supporting the operat
ions of the Baylor Teen Health Clinics. This paper discusses our proto
type experiences, system architecture, components, and the standards w
e are addressing.