Clinical decision support: progress and opportunities

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In 2005, the American Medical Informatics Association (AMIA) along with the support of the office of the national coordinator (ONC) and the Agency for Healthcare Research and Quality (AHRQ), started a roadmap and set of activities relating to clinical decision support (CDS). The goal was to identify what worked and what needed more attention.


The road map included a critical path with recommended three pillar activities:

  • Best knowledge available when needed
  • High adoption and effective use
  • Continued improvement of knowledge and CDS methods

National progress was monitored by conducting an environmental scan, reviewing published literature, white papers, reports by stakeholders and recent legislation.


The roadmap of activities is assessed over three years and while noteworthy progress is made, substantial work remains. Recommended consideration included trends in clinical imputing and increase availability of funds to support HIT.


Authors concluded that continued progress would significantly help in the following activities: the designation of a single entity to coordinate CDS development and deployment, the development and use of techniques to measure the use of CDS tools, continued research funding for CDS and the development of an updated critical path. The CDS efforts are supported by a significant amount of federal resources and the authors believe the initiatives and activities are attainable.


Clinical decision support development is evolving rapidly and is a hot topic in healthcare. Maintenance and monitoring can be extremely difficult. The roadmap provided in this article has shed light on what works and what doesn’t. Continued efforts in CDS and HIT is going to be essential and I like how the authors noted identified critical paths for success.The implications for this article will help aide in the transitions of the installment a CDS system within different healthcare facilities across the nation. It also gives users and health informatics professionals an idea of how CDS may be improved and areas in which to improve CDS workflow. These areas of CDS will aide in the progression of increased CDS usage with EHRs as well.


Lyman, Jason A., Cohn, Wendy F., Bloomrosen, Meryl, Detmer, Don E. (2010). Clinical decision support: progress and opportunities. JAMIA, 14, 487-492. Retrieved February 22, 2015, from