Table 1: Potential Benefits of Using a System-Agnostic CDS Service

Potential Benefit Examples
Relative ease and flexibility with which a CDS service can be leveraged across applications and care settings to implement CDS capabilities Using SEBASTIAN, four CDS applications were developed across two care settings by one health informaticist (KK) in about six months [5]
Commercial medication knowledge resources can be adapted for use within various CDS applications
Facilitation of centralized knowledge management and sharing Commercial medication knowledge vendors manage knowledge centrally for large numbers of client institutions
SEBASTIAN supports multiple CDS applications deployed across divergent care settings [5,16,17]
Potential to support multiple underlying knowledge representations and knowledge resources through a common service interface SEBASTIAN can leverage any knowledge resource accessible through the Java programming language [5]
HL7 and OMG Decision Support Service standards do not restrict the underlying knowledge representation formalism [19,20]
Improved simplicity and componentization (separation of concerns) A system-agnostic CDS service does not need to be concerned with when it is leveraged; how required data are retrieved; or how patient-specific inferences are communicated to end-users [24]
A system-agnostic CDS service can be loosely coupled with other functionally independent system components and services to fulfill various CDS needs [16,17]
Easier testing and validation SEBASTIAN test cases can focus solely on the underlying clinical decision logic [5]
SEBASTIAN clinical decision rules can undergo batch regression testing [5]
Enabling of distributed CDS development Medication CDS capabilities are developed across numerous vendors and institutions using commercial medication knowledge bases
Duke enterprise care quality reporting system developed using SEBASTIAN, but with minimal need for involvement by SEBASTIAN development team