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We propose a novel On-line Continuous Ontology Evolution and Clinical Intelligence Discovery (OCOE&CID) approach to pry open an intrinsically closed skeletal ontology core (onto-core) for real-time evolution. This approach was verified successfully with the TCM (Traditional Chinese Medicine) telemedicine system operated by the Nong's Company Limited of the Hong Kong SAR. An open evolvable onto-core is conceptually the combination of "a closed skeletal TCM onto-core plus the master aliases table (MAT) contents". The OCOE&CID mechanism automatically lets its text miner WEKA plough through the open web looking for new scientific findings. It then prunes the findings and adds the result to enrich the MAT contents. This achieves on-line knowledge acquisition, which is essential to the real-time incessant TCM onto-core evolutionary process. The MAT contents are stored in four related special data structures, which can be appended/disconnected to/from the skeletal TCM onto-core. As a result, the knowledge updates in the open evolvable onto- core affect only the MAT contents and do not alter any of the original skeletal onto-core information that was installed by consensus certification. The MAT contents are necessary for supporting the unique OCOE&CID semantic aliasing operation, which standardizes TCM knowledge with respect to the established enterprise vocabulary and discovers clinical intelligence. [ABSTRACT FROM AUTHOR]