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CDS - Clinical Decision Support

Clinical Decision Support (CDS) provides timely information to help inform decisions about a patient's care and has the ability to significantly impact improvements in quality, safety, efficiency, and effectiveness of health care. The Centers for Medicare & Medicaid Services (CMS) defines CDS as "health IT functionality that builds upon the foundation of an EHR to provide persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care.” CDS encompasses a variety of tools and processes to enhance decision-making in the clinical workflow. CDS is not simply an alert, notification, or explicit care suggestion. CDS encompasses, but is not limited to

  • Computerized alerts and reminders for providers and patients
  • Clinical guidelines
  • Condition-specific order sets
  • Focused patient data reports and summaries
  • Documentation templates
  • Diagnostic support
  • Contextually relevant reference information

CDS is not intended to replace clinician judgment, but rather to provide a tool to assist care team members in making timely, informed, and higher quality decisions. The CDS Five Rights model states improvements are achieved in desired healthcare outcomes if communicating 

  • The right information
  • To the right person
  • In the right CDS intervention format
  • Through the right channel
  • At the right time in workflow

CDS and eCQMs are closely related, share many common requirements, data elements, and support health care quality improvement. The impact of a CDS intervention may be assessed with an eCQM

Use CDS Connect, a collaborative model for CDS development.

Visit the Patient-Centered Clinical Decision Support Resource Center, a community developing, disseminating, sharing, and applying evidence-enabled, patient-centered clinical decision support.

Read more about CDS in the Agency for Healthcare Research and Quality Clinical Decision Support Overview

Understand CDS's role in Health IT-enabled quality improvement in the Office of the National Coordinator for Health IT's  Planning and Implementing Improved Care Processes

Learn about Key Federal CDS Efforts

Appropriate Use Criteria Program is a CMS program to promote the adoption of appropriate use criteria for advanced diagnostic imaging services through CDS. Appropriate use criteria are evidence-based and assist professionals who order and furnish applicable imaging services to make the most appropriate treatment decisions for a specific clinical condition.

Patient-Centered Outcomes Research (PCOR) CDS Initiative from the Agency for Healthcare Research and Quality, aims to accelerate evidence into practice through CDS and to move CDS closer to becoming more shareable, health IT standards-based, and publicly-available. The initiative has three main components

  • Patient-Centered CDS Learning Network - an initiative bringing together diverse stakeholders to promote a sustainable community around developing, disseminating, and applying PCOR-enabled CDS
  • CDS Connect demonstrates a web-based repository service to enable the CDS community to identify evidence-based standards of care, translate and codify information into an interoperable standard, and leverage tooling to promote a collaborative model of CDS development
  • Funding opportunities for grants to develop and scale CDS based on PCOR findings

Adapting Clinical Guidelines for the Digital Age - Centers for Disease Control and Prevention, through the Director of Public Health Science and Surveillance, is leading an initiative to connect experts and solutions that can help ensure our most up-to-date scientific evidence is followed and results in desired outcomes. Connecting research and evidence swiftly and accurately to those who need it most, including clinicians and patients, can help save lives. This initiative includes three high-level steps

  • Multi-stakeholder Kaizen event, hosted by CDC in early February 2018, identifying how clinical guidelines can be better adapted for implementation in a digital age
  • Post-Kaizen implementation period, where the future state process developed during the Kaizen event is tested and refined as it is applied to select “pilot” guidelines
  • Publication and socialization of the resulting standardized process to share knowledge gained from the piloting and work towards scaling across the industry to help the scientific evidence in clinical guidelines reach patient care more easily, quickly, accurately, and consistently - beginning with an Implementation Guide (planned to be balloted at HL7 in September 2019)

Optimizing Strategies for Clinical Decision Support - The National Academy of Medicine and the Office of the National Coordinator for Health Information Technology special publication summarizes a meeting series with multi-stakeholder experts who discussed the potential of CDS to transform care.

The standards used for the electronic representation of CDS and eCQMs were developed separately and used different data models and computable expression languages. CMS and the Office of the National Coordinator for Health Information Technology (ONC) supported efforts to identify, develop, harmonize standards. Clinical Quality Language (CQL) is a logic expression language that can be used with both CDS and eCQMs. CQL will be used in eCQMs for CMS calendar year 2019 reporting/performance periods. Learn more about efforts to harmonize standards for CDS and eCQM.

Current standards

Visit the HL7 CQL CDS Workgroup Project Homepage

Last Updated: Jul 29, 2019