Clinical decision support is the brains behind an advanced implementation of electronic health records. EHRs, e-prescribing systems, computerized physician order entry, and medication reconciliation systems all are strengthened by some form of clinical decision support. CDS can help physician reach proper diagnoses, ask the right questions, and perform appropriate tests on the front end of the decision-making process--preventing errors of omission--as well as stop errors of commission on the back end, during treatment and procedures.

The Stage 1 criteria for Meaningful Use of EHRs to qualify providers for Medicare and Medicaid bonuses require but a single rule for clinical decision support, down from the five previously proposed. Expect the minimum to rise to at least five rules during Stage 2, which will likely start in 2014. Clearly, federal officials expect CDS to be part of a complete EHR.

KLAS Enterprises has identified five elements of clinical decision support: order sets, multi-parameter alerting, nursing care plans, reference content, and drug information databases. Different vendors take different approaches to their CDS products, but they have one thing in common: a deep clinical knowledge base that helps promote patient safety. Here is our look at 10 CDS developers and vendors. If you have a CDS system in place but are not seeing a significant return on investment, it may be time to shop around.