Computer clinical decision support that automates personalized clinical care: A challenging but needed healthcare delivery strategy

Alan H. Morris, Christopher Horvat, Brian Stagg, David W. Grainger, Michael Lanspa, James Orme, Terry P. Clemmer, Lindell K. Weaver, Frank O. Thomas, Colin K. Grissom, Ellie Hirshberg, Thomas D. East, Carrie Jane Wallace, Michael P. Young, Dean F. Sittig, Mary Suchyta, James E. Pearl, Antinio Pesenti, Michela Bombino, Eduardo BeckKatherine A. Sward, Charlene Weir, Shobha Phansalkar, Gordon R. Bernard, B. Taylor Thompson, Roy Brower, Jonathon Truwit, Jay Steingrub, R. Duncan Hiten, Douglas F. Willson, Jerry J. Zimmerman, Vinay Nadkarni, Adrienne G. Randolph, Martha A.Q. Curley, Christopher J.L. Newth, Jacques Lacroix, Michael S.D. Agus, Kang Hoe Lee, Bennett P. Deboisblanc, Frederick Alan Moore, R. Scott Evans, Dean K. Sorenson, Anthony Wong, Michael V. Boland, Willard H. Dere, Alan Crandall, Julio Facelli, Stanley M. Huff, Peter J. Haug, Ulrike Pielmeier, Stephen E. Rees, Dan S. Karbing, Steen Andreassen, Eddy Fan, Roberta M. Goldring, Kenneth I. Berger, Beno W. Oppenheimer, E. Wesley Ely, Brian W. Pickering, David A. Schoenfeld, Irena Tocino, Russell S. Gonnering, Peter J. Pronovost, Lucy A. Savitz, Didier Dreyfuss, Arthur S. Slutsky, James D. Crapo, Michael R. Pinsky, Brent James, Donald M. Berwick

Research output: Contribution to journalReview articlepeer-review


How to deliver best care in various clinical settings remains a vexing problem. All pertinent healthcare-related questions have not, cannot, and will not be addressable with costly time-and resource-consuming controlled clinical trials. At present, evidence-based guidelines can address only a small fraction of the types of care that clinicians deliver. Furthermore, underserved areas rarely can access state-of-The-Art evidence-based guidelines in real-Time, and often lack the wherewithal to implement advanced guidelines. Care providers in such settings frequently do not have sufficient training to undertake advanced guideline implementation. Nevertheless, in advanced modern healthcare delivery environments, use of eActions (validated clinical decision support systems) could help overcome the cognitive limitations of overburdened clinicians. Widespread use of eActions will require surmounting current healthcare technical and cultural barriers and installing clinical evidence/data curation systems. The authors expect that increased numbers of evidence-based guidelines will result from future comparative effectiveness clinical research carried out during routine healthcare delivery within learning healthcare systems.

Original languageEnglish (US)
Pages (from-to)178-194
Number of pages17
JournalJournal of the American Medical Informatics Association
Issue number1
StatePublished - Jan 1 2023


  • automated clinical care
  • clinical
  • clinicians
  • closed-loop
  • computers
  • decision-support

ASJC Scopus subject areas

  • Health Informatics


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