A method for adapting the architecture of the hospital district development project portfolio to a changing project environment is deleloped in the paper. It is based on the concepts of strategic management and intelligent decision support. The method implements a phased approach that includes analysis of priority projects, formulation of strategic goals, monitoring of the external environment, justification of changes to the current portfolio, and modelling of alternative development scenarios. It is based on a set of criteria such as value, risk, resource availability, completeness, urgency, and project budget. This ensures dynamic flexibility and soundness of management decisions in a changing project environment. A decision support system has been developed based on the proposed method. It is implemented in the Python environment using the Tkinter, Matplotlib, Pandas, and Ttk libraries. The developed DSS provides interactive parameter input, automatic generation of the initial data table, calculation of the integral assessment of projects, and visualization of integral assessments. The functionality allows you to save results and switch between interface tabs for convenient analysis. Testing of the system on a conditional set of seven projects demonstrated its resistance to changes in input parameters, correct ranking, and ability to automatically generate a priority list. The integral assessments of the projects ranged from 0.04 to 0.59, and the visualisation results clearly defined the limits of the feasibility of including projects in the portfolio. The test showed 100% accuracy in forming the top 3 projects, which indicates the high reliability of the decisions made.
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