Computerized Clinical Decision Support in a Hospital Information System

Since the big potential of medical decision making was first realized, hundreds of articles introducing Clinical Decision Support Systems (CDSSs) have been published in the last three decades. But even today, only few systems are in clinical use. Even fewer are in use outside their site of origin, and their full potential for optimizing the healthcare system is far from realized. Clinician’s acceptance and utilization of CDSSs depends on its workflow-oriented, context-sensitive accessibility, and availability at the point of care, integrated into a Hospital Information System (HIS). Commercially available HIS often focus on administrative tasks and mostly do not provide additional knowledge based functionality. This paper works out advantages and disadvantages of several approaches and compares them against possible alternatives. Finally, experiences, gained by clinical use of two introduced systems, integrated in the HIS of the Vienna General Hospital, to analyze the little use of CDSSs in today’s clinical routine