A new report from Orem, Utah-based KLAS, Clinical Decision Support 2011: Understanding the Impact, asked 344 providers to rate their Clinical Decision Support (CDS) tools’ performance to better understand the influence of these new CDS tools on patient care. KLAS measured levels of impact by asking providers to rate their influence on clinical decisions and standardizing care. Provider response was passionate and, in some cases, polarized. The study found most tools did well in one of these main arenas, but rarely in both. Measured CDS areas included care plans, diagnostic tools, disease reference tools, drug databases, drug reference tools, order sets, and surveillance tools. The study examined vendors such as Cerner, EBSCO, Elsevier, First DataBank, Isabel, Logical Images, Thomson Reuters, Wolters Kluwer, and Zynx. Respondents say poor integration with clinical workflow is the Achilles heel hindering CDS success. Additionally, many reported issues with alert fatigue—politely describing it as an “overly sensitive mess.” Though every CDS segment had key struggles, KLAS noted that providers are optimistic about the future as CDS tools increase in workflow integration, usability, and adoption.