The core concept of the decision support system is to establish machine learning-based predictive modelsenable their interpretability to support physicians making clinical decisions in practice. The developed technique is part of the capstone project named "Smart Emergency Department," sponsored by the Ministry of ScienceTechnology. The system comprises NTUH (National Taiwan University Hospital) EMR (Electronic Medical Record) importance analysis, accurate clinical quality indicator prediction,similar medical record retrieval. It is expected to improve the patients＇ flowalleviate emergency department crowding. It has been verified in retrospective studieswill officially enter the clinical trial phase this year.