Computerized clinical decision support systems have the potential to improve care, but implementing CDS systems in real-world settings has many challenges that must be addressed to meaningfully affect patient care, according to a study published this week in the Journal of the American Medical Association. The study used data from the Medicare Imaging Demonstration to evaluate the relationship of CDS system use with the proportion of imaging orders matched to appropriate criteria, the appropriateness of ordered images and the proportion of orders changed following feedback. “Most orders were unable to be matched by the CDS systems to appropriateness criteria,” the study notes. The Protecting Access to Medicare Act mandates use of CDS systems for the ordering of advanced diagnostic imaging in Medicare starting in 2017.