A roadmap for national action on clinical decision support
Open accessAbstract
This document comprises an AMIA Board of Directors approved White Paper that presents a roadmap for national action on clinical decision support. It is published in JAMIA for archival and dissemination purposes. The full text of this material has been previously published on the AMIA Web site (www.amia.org/inside/initiatives/cds). AMIA is the copyright holder.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The initial codes for qualitative domains and themes were created by both authors using conceptual frameworks from Osheroff's Five Rights of Clinical Decision Support and broader principles of human-centered design.
“The initial codes for qualitative domains and themes were created by both authors using conceptual frameworks from Osheroff’s Five Rights of Clinical Decision Support as well as broader principles of human-centered design.”
From Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support (2026) · cites this paper as [27]
The Executive Summary (page not specified) describes CDS as delivering person-specific information to clinicians, staff, or patients at appropriate times, which overlaps with elements of the cited framework. Our copy does not name or set out Osheroff’s Five Rights. It also cannot establish how the citing authors created their qualitative codes; the broader human-centered design principles are not clearly attributed to this source. (LLM, conf=0.79)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The quality of health care delivered to adults in the United States
McGlynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., & Kerr, E. A. (2003) · New England Journal of Medicine · doi:10.1056/nejmsa022615 · Cited by 5,079 · see citing works
Flagged first, then by citations
Research works printed but not linked: 41
- [1]1. Abookire SA, Teich JM, Sandige H, Paterno MD, Martin MT, Kuperman GJ, Bates DW. Improving allergy alerting in a computerized physician order entry system. AMIA Annu Symp Proc. 2000;2-6.
- [4]4. Bates DW. Using information technology to improve surgical safety. Br J Surg. 2004;91:939-40.
- [5]5. Bates DW. Computerized physician order entry and medication errors: finding a balance. J Biomed Inform. 2005a;38:259-261.
- [6]6. Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348:2526-34.
- [7]7. Bates DW, Kuperman G, Teich JM. Computerized physician order entry and quality of care. Qual Manag Health Care. 1994;2:18-27.
- [8]8. Bates DW, Kuperman GJ, Rittenberg E, Teich JM, Fiskio J, Ma'luf N, Onderdonk A, Wybenga D, Winkelman J, Brennan TA, Komaroff AL, Tanasijevic M. A randomized trial of a computer-based intervention to reduce utilization of redundant laboratory tests. Am J Med. 1999;106:144-50.
- [10]10. making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10:523-530.
- [10]10. Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, et al., Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311-6.
- [11]11. Bates DW, Yu DT. Clinical impact of drug-drug interactions with systemic azole antifungals. Drugs Today (Barc). 2003;39:801-13.
- [12]12. Birkmeyer CM, Lee J, Bates DW, Birkmeyer JD. Will electronic order entry reduce health care costs? Eff Clin Pract. 2002;5:67-74.
- [13]13. Chertow GM, Lee J, Kuperman GJ, Burdick E, Horsky J, Seger DL, et al., Guided medication dosing for inpatients with renal insufficiency. JAMA. 2001;286:2839-44.
- [15]15. Chaudry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, et al., Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Int Med. 2006;144:742.
- [17]17. Fischer MA, Solomon DH, Teich JM, Avorn J. Conversion from intravenous to oral medications: assessment of a computerized intervention for hospitalized patients. Arch Intern Med. 2003;163:2585-9.
- [18]18. Forrey AW, McDonald CJ, DeMoor G, Huff SM, Leavelle D, Leland D, Fiers T, Charles L, Griffin B, Stalling F, Tullis A, Hutchins K, Baenziger J. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic reporting of clinical laboratory test results. Clin Chem. 1996;42:81-90.
- [19]19. Gurwitz JH, Field TS, Judge J, Rochon P, Harrold LR, Cadoret C, et al. The incidence of adverse drug events in two large academic long-term care facilities. Am J Med. 2005;118:251-8.
- [21]21. Harpole LH, Khorasani R, Fiskio J, Kuperman GJ, Bates DW. Automated evidence-based critiquing of orders for abdominal radiographs: impact on utilization and appropriateness. J Am Med Inform Assoc. 1997;4:511-21.
- [22]22. Institute of Medicine. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000.
- [23]23. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21 st Century. Washington, DC: National Academy Press; 2001.
- [24]24. Institute of Medicine. Patient Safety: Achieving a New Standard for Care. Washington, DC: National Academy Press; 2004.
- [26]26. Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med. 2003;163:1409-16.
- [27]27. Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005;330:765.
- [28]28. Khorasani R, Bates DW, Teeger S, Rothschild JM, Adams DF, Seltzer SE. Is terminology used effectively to convey diagnostic certainty in radiology reports? Acad Radiol. 2003;10:685-8.
- [30]30. Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, Strom BL. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293:1197-203.
- [32]32. Kuperman GJ, Gandhi TK, Bates DW. Effective drug-allergy checking: methodological and operational issues. J Biomed Inform. 2003;36:70-9.
- [33]33. Kuperman GJ, Marston E, Paterno M, et al. Creating an enterprise-wide allergy repository at Partners HealthCare System. AMIA Annu Symp Proc. 2003:376-80.
- [35]35. Linder JA, Bates DW, Lee GM, Finkelstein JA. Antibiotic treatment of children with sore throat. JAMA. 2005;294:2315-22.
- [36]36. Makoul G, Curry RH, Tang PC. The use of electronic medical records: communication patterns in outpatient encounters. J Am Med Inform Assoc. 2001;8:610-5.
- [37]37. McDonald CJ, Overhage JM, Mamlin BW, Dexter PD, Tierney WM.Physicians, information technology, and health care systems: a journey, not a destination. J Am Med Inform Assoc. 2004;11: 121-4.
- [39]39. Murray MD, Harris LE, Overhage JM, Zhou XH, Eckert GJ, Smith FE, et al. Failure of computerized treatment suggestions to improve health outcomes of outpatients with uncomplicated hypertension: results of a randomized controlled trial. Pharmacotherapy. 2004;24:324-37.
- [40]40. Miller RA, Gardner RM. Summary Recommendations for responsible monitoring and regulation of clinical software systems. Ann Intern Med. 1997;127:842-5.
- [41]41. Miller RA, Gardner RM. Recommendations for Responsible Monitoring and Regulation of Clinical Software Systems. J Am Med Inform Assoc. 1997;4:442-57.
- [42]42. Morimoto T, Gandhi TK, Seger AC, Hsieh TC, Bates DW. Adverse drug events and medication errors: detection and classification methods. Qual Saf Health Care. 2004;13:306-14.
- [43]43. Osheroff JA, Pifer EA, Teich JM, Sittig DF, Jenders RA. Improving outcomes with clinical decision support: an implementer's guide. Chicago: Healthcare Information and Management Systems Society Press; 2005.
- [44]44. Overhage JM, Tierney WM, Zhou XH, McDonald CJ. A randomized trial of 'corollary orders' to prevent errors of omission. J Am Med Inform Assoc. 1997;4:364-75.
- [45]45. Pryor TA, Hripcsak G. The Arden syntax for medical logic modules. Int J Clin Monit Comput. 1993;10:215-24.
- [46]46. Sittig DF, Krall MA, Dykstra RH, Russell A, Chin HL. A survey of factors affecting clinician acceptance of clinical decision support. BMC Med Inform Decis Mak. 20061;6:6.
- [47]47. Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr CD, Bates DW. Effects of physician order entry on prescribing practices. Arch Int Med. 2000;160:2741-7.
- [48]48. Teich JM, Osheroff JA, Pifer EA, Sittig DF, Jenders RA, and the CDS Expert Review Panel. Clinical decision support in electronic prescribing: recommendations and an action plan. J Am Med Inform Assoc. 2005;12:365-76.
- [51]51. Tierney WM, Overhage JM, Murray MD, et al. Effects of computerized guidelines for managing heart disease in primary care. J Gen Intern Med. 2003;18:967-76.
- [52]52. Van der Sijs H, Aarts J, Vulto A, Berg M. Overriding of drug safety alerts in computerized physician order entry. J Am Med Inform Assoc. 2006;13:138-47.
- [53]53. Wang SJ, Middleton B, Prosser LA, et al. A cost-benefit analysis of electronic medical records in primary care. Am J Med. 2003;114:397-403.
Cited by
Sorted by citations
An overview of clinical decision support systems: Benefits, risks, and strategies for success
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0221-y · Cited by 3,019 · see citing works
Genomic and personalized medicine: foundations and applications
Ginsburg, G. S., & Willard, H. F. (2009) · Translational Research · doi:10.1016/j.trsl.2009.09.005 · Cited by 637 · see citing works
Antoniadi, A. M., Du, Y., Guendouz, Y., Wei, L., Mazo, C., Becker, B. A., & Mooney, C. (2021) · Applied Sciences · doi:10.3390/app11115088 · Cited by 629 · see citing works
Levin, S., Toerper, M., Hamrock, E., Hinson, J. S., Barnes, S., Gardner, H., Dugas, A., Linton, B., Kirsch, T., & Kelen, G. (2018) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.08.005 · Cited by 424 · see citing works
Human-Centered Tools for Coping with Imperfect Algorithms During Medical Decision-Making
Cai, C. J., Reif, E., Hegde, N., Hipp, J., Kim, B., Smilkov, D., Wattenberg, M., Viegas, F., Corrado, G. S., Stumpe, M. C., et al. (2019) · Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3290605.3300234 · Cited by 405 · see citing works
Bennett, C. C., & Hauser, K. (2013) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2012.12.003 · Cited by 378 · see citing works
Wang, D., Wang, L., Zhang, Z., Wang, D., Zhu, H., Gao, Y., Fan, X., & Tian, F. (2021) · Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3411764.3445432 · Cited by 209 · see citing works
Jacobs, M., He, J., F. Pradier, M., Lam, B., Ahn, A. C., McCoy, T. H., Perlis, R. H., Doshi-Velez, F., & Gajos, K. Z. (2021) · Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3411764.3445385 · Cited by 177 · see citing works
Meunier, P.-Y., Raynaud, C., Guimaraes, E., Gueyffier, F., & Letrilliart, L. (2023) · The Annals of Family Medicine · doi:10.1370/afm.2908 · Cited by 149 · see citing works
Implementation and utilization of genetic testing in personalized medicine
Scott, S., Abul-Husn, N., Owusu Obeng, A., Sanderson, S., & Gottesman, O. (2014) · Pharmacogenomics and Personalized Medicine · doi:10.2147/pgpm.s48887 · Cited by 106 · see citing works
Explainability in medicine in an era of AI-based clinical decision support systems
Pierce, R. L., Van Biesen, W., Van Cauwenberge, D., Decruyenaere, J., & Sterckx, S. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.903600 · Cited by 95 · see citing works
Clinical decision support systems in the pediatric intensive care unit*
Mack, E. H., Wheeler, D. S., & Embi, P. J. (2009) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e3181936b23 · Cited by 76 · see citing works
Automated alerts and reminders targeting patients: A review of the literature
Perri-Moore, S., Kapsandoy, S., Doyon, K., Hill, B., Archer, M., Shane-McWhorter, L., Bray, B. E., & Zeng-Treitler, Q. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.12.010 · Cited by 74 · see citing works
Wright, A., Sittig, D. F., Ash, J. S., Erickson, J. L., Hickman, T. T., Paterno, M., Gebhardt, E., McMullen, C., Tsurikova, R., Dixon, B. E., et al. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2015.08.008 · Cited by 55 · see citing works
Self-citationSanchez-Pinto, L. N., & Khemani, R. G. (2016) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000000750 · Cited by 52 · see citing works
Zhao, C., Jiang, J., Guan, Y., Guo, X., & He, B. (2018) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2018.03.005 · Cited by 41 · see citing works
Clinical decision support for therapeutic decision-making in cancer: a systematic review
Beauchemin, M., Murray, M. T., Sung, L., Hershman, D. L., Weng, C., & Schnall, R. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.07.019 · Cited by 38 · see citing works
McCulloh, R. J., Fouquet, S. D., Herigon, J., Biondi, E. A., Kennedy, B., Kerns, E., DePorre, A., Markham, J. L., Chan, Y. R., Nelson, K., et al. (2018) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocy069 · Cited by 36 · see citing works
Laxar, D., Eitenberger, M., Maleczek, M., Kaider, A., Hammerle, F. P., & Kimberger, O. (2023) · BMC Medicine · doi:10.1186/s12916-023-03068-2 · Cited by 19 · see citing works
“In healthcare, the term clinical decision support systems (CDSS) is used to refer to a system that “provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care” [1].”
BackgroundSOUSA, V. E. C., LOPEZ, K. D., FEBRETTI, A., STIFTER, J., YAO, Y., JOHNSON, A., WILKIE, D. J., & KEENAN, G. M. (2015) · CIN: Computers, Informatics, Nursing · doi:10.1097/cin.0000000000000185 · Cited by 18 · see citing works
Get To The Point! Problem-Based Curated Data Views To Augment Care For Critically Ill Patients
Zhang, M., Ehrmann, D., Mazwi, M., Eytan, D., Ghassemi, M., & Chevalier, F. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3501887 · Cited by 16 · see citing works
Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support
Khan, A., & Schnipper, J. (2026) · Applied Clinical Informatics · doi:10.1055/a-2955-9555
- Authors
- Osheroff, J. A., Teich, J. M., Middleton, B., Steen, E. B., Wright, A., & Detmer, D. E.
- Affiliations
- University of Pennsylvania Health System (US)
- Harvard University (US)
- American Medical Informatics Association (US)
- Oregon Health & Science University (US)
- Corresponding author
- Detmer, D. E.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-03-01
- Volume
- 14
- Issue
- 2
- Pages
- 141-145
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC2213467
- OpenAlex
- W2166617999
- Cited by
- 707
- References
- 1
- Citations by year
- 2026: 31 · 2025: 43 · 2024: 36 · 2023: 26 · 2022: 33 · 2021: 40 · 2020: 43 · 2019: 40 · 2018: 40 · 2017: 29 · 2016: 43 · 2015: 43 · 2014: 38 · 2013: 42 · 2012: 38
- FWCI
- 80.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Keywords
- clinical decision support, national action plans, health IT policy, Amia
- MeSH terms
- Decision Making, Computer-Assisted, Health Planning, United States, Decision Support Systems, Clinical
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review