A computer-implemented patient monitoring system includes a patient data monitoring system on a first computing system, including a patient medical data query engine configured to generate one or more rule execution requests. The monitoring system further includes a network circuit communicating with the medical database system and one or more remote patient care computing devices. The remote care computing devices in turn include a patient medical data repository and a query response engine configured to respond to received rule execution requests. Responding to rule execution requests includes verifying the validity of a rule execution request, identifying data in the patient medical data repository responsive to the rule execution request, and transmitting response patient medical data responsive to the rule execution request.