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Step 5: Achieve Meaningful Use Stage 1

Clinical Decision Support Rule


Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.


Implement one clinical decision support rule.

Clinical Importance

Clinical Decision Support (CDS) is a process designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient specific interventions, assessments, recommendations, or other forms of guidance that are then presented to a decision making recipient or recipients that can include clinicians, patients, and others involved in care delivery. (Osheroff, 2012; Bright, Wong, Dhurjati et al, 2012;  Kawamoto, Houlihan, Balas et al, 2005).It represents one of the most promising tools to mitigate the ever-increasing complexity of the day-to-day care practice of medicine. When implemented successfully, CDS can assure that all patients in a practice receive appropriate and timely preventive services. The effective use of a clinical decision support system means patients get the right tests, the right medications, and the right treatment, particularly for chronic conditions.

CMS Resources

The following resources are available to help you meet the Clinical Decision Support Rule meaningful use core measure.

Related CMS EHR Incentive Program Frequently Asked Questions

Lessons from the Field

"To approach any major practice transformation, starting small and building off lessons learned is vital. Input from staff at all levels — from billing representatives to physicians — must be incorporated to ensure the system works for every internal stakeholder to ultimately improve the quality of care for patients."

David Peterman, MD, President, Primary Health Medical Group

Coordination between physicians, nurses, administration, and IT is crucial for the successful implementation of a clinical decision support system. The entire team needs to look at the processes in place and create new processes to work within the clinical decision support system. With multiple clinics, we tested and revised clinic processes multiple times before incorporating the new system at all of our clinics. This testing phase allowed us to refine how we worked with the clinical decision support system to ensure that patients received the best care based on evidence-based medicine. The successful implementation of a clinical decision support system means patients get the right tests, the right medications, and the right treatment for their chronic condition.

National Learning Consortium Resources

The NLC resources are examples of tools that are used in the field today, and that are recommended by “boots-on-the-ground” professionals. The NLC, in partnership with HealthIT.gov, shares this collective EHR implementation knowledge and resources throughout this site.

National Learning Consortium Resources
Resource NameDescriptionSource

Clinical Decision Support Initiative


Collection of research regarding the use of CDS to promote safe and effective health care.

Agency for Healthcare Research and Quality (AHRQ)

Clinical Decision Support Systems Studies



Summary of PubMed articles specific to clinical decision support system implementation, case studies, and best practices.


Electronic Preventative Services Selector (ePSS)


Tool designed to help primary care clinicians identify the screening, counseling, and preventive medication services that are appropriate for their patients.

Agency for Healthcare Research and Quality (AHRQ)

Pediatric Rules and Reminders


Downloadable pediatric rules and reminders for the ambulatory environment to serve as examples of reminders that can be integrated into EHR systems and modified to fit the needs of the practice.

Agency for Healthcare Research and Quality (AHRQ)

The material in these guides and tools represents the collective EHR implementation experiences and knowledge gained directly from the field of ONC’s outreach programs (REC, Beacon, State HIE) and through the Health Information Technology Research Center (HITRC) Communities of Practice (CoPs) in their performance of technical support and EHR implementation assistance to primary care providers. The information contained in these resources is not intended to serve as legal advice nor should it substitute for legal counsel. The resource list is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.


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