ABSTRACT
Clinical Decision Support System (CDSS) has potential opportunities to improve overall safety, quality
and cost-effectiveness of healthcare. The CDSS has existed for more than four decades, but its adoption
rate by medical communities is not encouraging even in the countries that have been a pioneer in
developing them. At many sites, it was problematic, stalled in the planning stages or never even attempted.
To date, CDSS is considered as a partially successful system. Several current challenges have
not been adequately addressed during the development of CDSS. As per latest research, the lists of
challenges are: improve the human-computer interface, disseminate best practices in CDSS design,
development, and implementation, summarize patient-level information, prioritize and filter recommendations
to the user, create an architecture for sharing executable CDSS modules and services,
combine recommendations for patients with co-morbidities, prioritize CDSS content development and
implementation, create Internet-accessible clinical decision support repositories, use free text information
to drive clinical decision support, and mine huge clinical databases to create new CDSS. The
preceding list has been considered as challenges due to unmet expectations of CDSS’s stakeholders,
such as CDSS product development and maintenance team (product owner, project managers, system
architect, system designers, system developers, system administrators, and system maintenance
team), sales and marketing personnel, end-users. We found that most of the CDSS literature talked
about the challenges and their details, but they do not throw enough light from CDSS stakeholders’
perspective while building and upon using CDSS. This paper describes CDSS from various stakeholders’
perspective, highlighting the challenges faced by them in owning, building, and using them.