Clinical Decision Support: It’s More than Just Alerts

Although the use of clinical decision support (CDS) dates back to the 1970s, the effectiveness of CDS remains in question. Changes in clinician behavior are demonstrated in some but not all CDS studies. Design, workflow integration, and usability are all important factors to CDS adoption and use. The ultimate goal of a CDS system (CDSS) is to demonstrate change in clinical outcomes, yet the evidence is lacking. Challenges include conducting CDSS studies in operational settings and powering these studies to show statistical differences. In this chapter, we will review the definitions of CDS and CDSS, the different types of active CDS, (e.g., alerts, reminders, corollary orders), briefly review the impact of care settings and vendor on CDS design, methods of implementation for success, and future challenges and opportunities.