Clinical Decision Support In the Flow of Care: Insights That Respect Clinical Judgment

Clinicians, including myself, have long turned to evidence-based resources to validate their thinking, support continuous learning, and stay aligned with the latest standards of care. As decision support tools have gone digital, high-quality, evidence-based content has moved even closer to the point of care. As a result, Clinical Decision Support (CDS) has become an essential partner in how clinicians access and apply evidence every day.

But one of the biggest barriers is that CDS rarely fits neatly into the flow of care. Too often, it lives in a separate tab or standalone tool, adding clicks and context switching to already overflowing workflows. The result isn’t a lack of trust or interest; it’s simply too much friction. And, most importantly, even when the content served is accurate, it’s often not tailored to the patient sitting in front of us. Clinicians are required to quickly recall and enter relevant details, like the patient’s age, allergies, and recent treatment history, to obtain more precise answers.

The opportunity ahead isn’t to convince clinicians to use decision support—we already do! It’s to reimagine CDS so that it feels native to the way clinicians think and document. Over the past year, my clinical and technical colleagues and I have been investigating how to integrate trusted clinical content into care delivery. Through that work, we’ve identified several guiding principles for CDS design that apply whether a clinician is preparing for an encounter, talking to a patient, or reviewing orders.

1) Trust starts with transparency

For decision support to be usable, clinicians need more than an answer—they need to know why it’s right and trust its provenance. That means responses tied to high-quality, continuously updated sources with clear citations, rather than an opaque model output. It also means designing the user experience so the evidence is a click away and easy to audit. When the rationale is transparent, clinicians can apply their judgment with confidence, turning CDS into a collaborator rather than a black box.

2) Context is everything

The same content lands differently depending on the patient, the visit, and the task at hand. A future-proof CDS system can “see” and incorporate that context—pulling cues from the conversation, chart, and even health system guidelines—and surface what’s most relevant. For example, highlighting dosing subtleties for a patient with chronic kidney disease or tailoring a pediatric care pathway. Embedding CDS directly within documentation processes and review workflows provides the opportunity to unlock that context, cutting the need to jump between tools.

3) Precision beats volume

We rarely need a textbook chapter in the middle of our workflow; we need the right insight, distilled to what matters for this patient and this decision. The most effective CDS surfaces concise, targeted information—sometimes just a nudge—rather than long blocks of reference material. Whether it’s surfacing the right imaging study to order, flagging a contraindication, or offering updated treatment guides—precision builds trust. The goal isn’t to give clinicians more information; it’s to deliver the most relevant information at precisely the right level of depth.

4) Respect clinical agency

The goal of CDS is not to replace human judgment, but to strengthen it. The most effective systems make it clear that clinicians are in control, choosing when to engage with insights and how to apply them. When CDS presents evidence-based options alongside citations, rather than dictating a single course of action, it reinforces expertise instead of overriding it. By keeping the experience opt-in and transparent, decision support becomes something clinicians want to use, not something imposed on them.

5) Measure what matters

While time and efficiency gains are often the first goals, there’s a deeper opportunity to measure quality and impact. Metrics like engagement at key moments—when clinicians turn to the CDS tool—and first-touch resolution—whether surfaced information answers a question on the first pass—offer tangible signals of value today. As CDS becomes more seamlessly integrated into care, we’ll better understand how real-time access to trusted, contextualized evidence influences outcomes in ways we haven’t been able to measure before.

6) Partnerships make it possible

Embedded CDS relies on close collaboration between trusted content, intelligent workflow platforms, and underlying data systems, like the EHR. Trusted, evidence-based content is the foundation. Workflow and documentation platforms provide the clinical and conversational context that makes that content relevant. The patient chart contributes structured data that further refines and contextualizes content. When these pieces work in harmony, without adding to user-facing complexity, the magic of fully integrated CDS comes to life.

It’s encouraging to see technology companies advancing this vision with increasingly sophisticated AI models and feature sets. And yet, the real breakthroughs will come from pairing technical excellence with the lived experience of clinicians. As we know, the tools that have the most significant impact are those built with clinicians, not just for them. When integrated CDS is shaped by real workflows and grounded by clinical judgment, it will reflect the best of modern medicine: learning, adapting, and delivering care with context and clarity.