A Brief History of Clinical Decision Support. Technical, Social, Cultural, Economic, and Governmental Perspectives.

This chapter provides a historical context for the current high degree of interest in clinical decision support systems. It focuses on two aspects of history: (1) The development and evolution of the scientific and technical basis for the field, in terms of the primary research methodologies that have been proposed, tested, refined, extended, and in some cases deployed and evaluated in operational settings; (2) Major social, cultural, economic, management, and governmental influences on health care providers, health care delivery organizations, and the health care public that have contributed to the current climate of enthusiasm and eagerness for wide deployment and usage of CDS, but also to some of the barriers to success. Some of these themes represent key dimensions of activity in CDS currently, whereas others are related more to the underlying research to create the databases or knowledge used in CDS, and still others are of interest mainly in terms of their historical influence on current approaches.