A total of 99 studies [24,25,26, 40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135] were included in the review (Fig. 1; list of references in supplementary materials) describing barriers to the implementation of 85 different CDSS. CDSS that were evaluated in more than one study were at different stages of development and therefore described differently across studies.

Flowchart. CDSS = Clinical Decision Support System; PCP: Primary Care Provider

Nearly all (n = 94) studies [24, 26, 40,41,42,43,44,45, 47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70, 72,73,74,75,76,77,78,79,80,81,82,83, 85,86,87,88,89,90,91,92,93,94,95,