Electronic procedures are currently being used to document the steps in performing medical operations for the Space Shuttle and/or the International Space Station (ISS). Capturing the data electronically makes is easier to manage, modify and query the contents of the procedures. For the ISS, NASA is currently transitioning to electronic procedures based on the eXtensible Markup Language (XML) standard. Modeling procedures electronically using XML has a number of benefits. Procedures can be quickly and effectively searched to determine which procedures are affected by software and hardware changes. Procedures are more easily shared by other computer-based systems. And procedure execution aids become possible, such as real time data capture and automatic book marking of the current procedure step. Such procedure models will be an important component of an integrated Medical Decision Support needed for future exploration missions. The primary purpose of this project is to continue to research and develop a Procedure Representation Language (PRL) and support tools that will benefit the creation, maintenance, and use of the medical procedures, and to develop them in such a way that new advances can be easily inserted, eventually leading to the Medical Decision Support system.