Abstract: Methods, computer-readable media, and systems provide design decision management (DDM) to manage the various design decisions made by a client healthcare provider during the design of a healthcare management system by a solution-provider company. A DDM system provides a user interface and allows a user to access data from design decision databases, analyze accessed data, and conduct design review of client design decisions. Design review is initiated when a client design decision conflicts with a company-recommended design decision. The design review process determines if the conflicting client design decision should be approved and implemented or if the company-recommended design decision should be implemented.