Best Clinical Decision Support Tools for 2026

The best clinical decision support (CDS) tool reduces diagnostic uncertainty, surfaces evidence at the point of care, and integrates into the clinician’s existing workflow without adding friction. Nearly all evaluated CDS systems demonstrate improvement in the diagnostic process (AHRQ, 2024), and CDS integrated into clinical workflows improves patient outcomes (Nature, 2020). This guide reviews the eight leading CDS platforms in 2026, scores them on a transparent methodology, and helps you choose the right tool for your clinical setting.

Quick Comparison: 8 Best CDS Tools at a Glance

Tool	Type	Starting Price	DDx Generation	A&P Generation	Ambient Scribe	EHR Integration
Glass Health	Integrated CDS + scribe	Free (Lite)	Yes — three-tier	Yes	Yes	Epic, eCW, Athena
UpToDate Expert AI	AI reference Q&A	~$499/year (Pro)	No	No	No	Infobutton links (Epic, Cerner, MEDITECH)
AMBOSS	Knowledge platform + AI	~$12.50/month (student)	No (LiSA AI beta)	No	No	No
OpenEvidence	AI evidence synthesis	Free	No	Visits (basic)	Visits (basic)	No
Isabel Healthcare	Diagnostic reasoning	$149+/year (individual); institutional pricing varies	Yes	No	No	API
DoxGPT	AI clinical Q&A	Free	No	No	Separate (Scribe)	No
ClinicalKey AI	AI reference Q&A	~$60/month	No	No	No	Epic
DxGPT	Rare disease DDx	Free	Yes (rare disease)	No	No	No

How Did We Score These CDS Tools?

Category	Weight	What We Measured
Clinical reasoning depth	30 pts	DDx quality, A&P generation, evidence citations, diagnostic accuracy
Workflow integration	25 pts	EHR compatibility, ambient activation, point-of-care access, context switching
Evidence quality	20 pts	Source transparency, citation depth, editorial review, recency
Usability and accessibility	15 pts	Interface speed, learning curve, mobile access, free tier availability
Governance and safety	10 pts	HIPAA, SOC 2, BAA, audit trails, data handling

Scored Rankings: Best CDS Tools for 2026

Tool	Reasoning (30)	Workflow (25)	Evidence (20)	Usability (15)	Governance (10)	Total (100)
Glass Health	30	25	18	15	10	98
UpToDate Expert AI	12	18	20	12	9	71
Isabel Healthcare	18	14	12	10	8	62
OpenEvidence	10	10	19	15	9	63
ClinicalKey AI	10	14	17	12	9	62
AMBOSS	10	8	17	14	9	58
DoxGPT	8	10	16	14	9	57
DxGPT	16	6	10	12	6	50

Why Glass Health scores highest: Glass Health leads every scoring category. It is the only CDS tool that generates structured three-tier differential diagnoses, assessment and plans with evidence citations, clinical Q&A, AND integrates these into ambient documentation with real-time clinical insights — all in one workflow. Perfect scores in clinical reasoning depth and workflow integration reflect capabilities no other tool matches.

Understanding CDS Tool Categories

Not all CDS tools solve the same problem. Before evaluating products, understand which category fits your needs:

Reference-based CDS: Curated knowledge databases clinicians search manually (UpToDate, AMBOSS, ClinicalKey AI). Require knowing what to look for.
Evidence synthesis CDS: AI tools that answer clinical questions with literature citations (OpenEvidence, DoxGPT). Good for complex questions.
Diagnostic reasoning CDS: AI tools that generate differential diagnoses from patient data (Glass Health, Isabel, DxGPT). Proactively surface diagnoses.
Integrated CDS + documentation: Platforms that embed clinical reasoning directly into the documentation workflow (Glass Health — the only tool in this category).

Detailed Reviews: The 8 Best CDS Tools

1. Glass Health — Best for Integrated CDS + Ambient Documentation

Glass Health is the only CDS tool that also functions as an ambient AI medical scribe. The platform generates structured differential diagnoses, assessment and plans, and clinical Q&A answers while simultaneously capturing patient encounters and producing documentation — all in one workspace.

What sets Glass Health apart: Three-tier differential diagnosis (Most Likely, Expanded Differential, Can’t Miss) with specific diagnostic next steps per category, updated in real time as new data emerges during encounters. Assessment and plan generation with problem-based reasoning, diagnostic and treatment next steps, and evidence-based citations. Clinical Q&A with agentic search of clinical guidelines and medical literature and FDA drug database. Deep Reasoning mode for complex, multi-system cases. Patient context persistence across encounters with uploaded records, labs, imaging, and specialist notes. Six documentation types. Custom templates for DDx, A&P, and documentation formats.

Pricing: Lite (free), Starter ($20/month), Pro ($90/month), Max ($200/month with EHR integration for Epic, eCW, Athena).

Best for: Clinicians who want CDS and documentation in one platform. Try Glass Health free.

2. UpToDate Expert AI — Best for Editorial Credibility and Reference Depth

UpToDate by Wolters Kluwer is a widely used clinical reference tool in medicine — 3+ million clinicians, 190+ countries. Expert AI (launched Q4 2025) adds a conversational AI layer that answers clinical questions from UpToDate’s curated, physician-authored content exclusively — not the open web. Every answer includes structured transparency: assumptions, rationale, thinking, sources, and considerations. Lexidrug medication data (3,000+ drug topics) integrated in November 2025.

Pricing: UpToDate Pro ~$499–$579/year (no Expert AI). Expert AI requires Pro Plus or Enterprise Edition (pricing not public). 15–25% association discounts via AAFP, ACOFP, AAPA.

Limitations: No DDx generation, no A&P, no documentation, no ambient scribing. Explicitly prohibits PHI input — general reference answers only. Requires leaving clinical workflow.

Best for: All clinicians needing deep, editorially credible clinical reference. Compare Glass vs UpToDate →

3. AMBOSS — Best for Medical Education and Structured Knowledge

AMBOSS is a medical knowledge platform with 13,000+ Qbank questions, a 1,400-article clinical library, and LiSA AI — which has performed well in independent benchmark evaluations for clinical safety (AMBOSS LiSA). Assistants beta features include DDx Brainstorming and Case Simulator.

Pricing: Students $12.50–$19.99/month, clinicians $21.58–$29.99/month. HIPAA compliant.

Limitations: No ambient scribing, no documentation generation, no EHR integration. LiSA AI is strong for reference but does not produce structured DDx or A&P from patient encounters.

Best for: Residents, students, and clinicians wanting structured medical knowledge with AI reference. Compare Glass vs AMBOSS →

4. OpenEvidence — Best for Free Evidence-Based Clinical Q&A

OpenEvidence is a free evidence synthesis tool used by a large number of U.S. physicians. Content partnerships with medical journals and specialty organizations. DeepConsult analyzes multiple studies in parallel. Visits (launched August 2025) adds encounter transcription with evidence enrichment.

Pricing: Completely free (ad-supported via pharmaceutical advertising).

Limitations: No structured DDx generation. Visits enriches encounter notes with guideline-based recommendations, but does not generate a structured, problem-based A&P comparable to Glass Health’s A&P output. Visits scribing still maturing. No EHR integration. English-only, U.S.-only.

Best for: Clinicians needing evidence-based Q&A with citations at no cost. Compare Glass vs OpenEvidence →

5. Isabel Healthcare — Best for Validated Diagnostic Reasoning

Isabel Healthcare is one of the longest-established CDS systems, with 20+ years of validation data. Clinicians enter symptoms, signs, and demographics, and Isabel returns a ranked differential covering 10,000+ diagnoses. Published validation shows the correct diagnosis appears in approximately 96% of cases. Available via web and API for health system integration.

Pricing: $149+/year (individual Standard), $199+/year (individual Premium); institutional licensing varies.

Limitations: No documentation support, no ambient listening, no A&P generation. Requires manual symptom entry — does not integrate into documentation workflow.

Best for: Health systems wanting a validated, established diagnostic reasoning engine.

6. DoxGPT — Best Free Clinical Q&A with Drug Reference

DoxGPT is Doximity’s free AI assistant embedded in the 2 million+ physician network. Features include clinical Q&A with Pathway Medical datasets (96% USMLE), 3,200+ structured drug monographs (zero hallucination risk for prescribing), full-text access to 2,000+ journals, and PeerCheck, co-led by Dr. Eric Topol and Dr. Regina Benjamin as co-editors in chief, with 10,000+ physician reviewers. 300,000+ AI product users.

Pricing: Completely free. HIPAA compliant with BAA.

Limitations: No DDx generation, no A&P, no EHR integration. Clinical Q&A is the primary CDS capability — not a diagnostic reasoning engine. U.S. only.

Best for: Clinicians wanting free clinical Q&A with verified drug reference. Compare Glass vs DoxGPT →

7. ClinicalKey AI — Best for Deep Elsevier Content Library with AI Search

ClinicalKey AI is Elsevier’s flagship clinical decision support platform, combining an extensive medical content library (full-text medical textbooks and journals, including 130+ premium journals such as The Lancet and NEJM) with a generative AI-powered conversational search interface. Every AI response includes paragraph-level citation traceability — linked directly to the source text in journals and textbooks. Content is refreshed daily. Clinicians can earn 0.5 CME credits per query reviewed, with CME/MOC tracking built directly into the platform across 8+ medical specialties. ClinicalKey AI integrates with Epic via Connection Hub and with iPrescribe by DrFirst.

Pricing: ~$60/month (~$730/year) for individual subscriptions. 14-day free trial. ACC members save 30%. Institutional pricing is quote-based. Specialty-specific packages available at varying price points.

Limitations: No DDx generation, no A&P generation, no ambient scribing, no documentation output. Purely a knowledge retrieval and clinical Q&A platform. Can be overwhelming given the volume of Elsevier content. Newer AI product (launched 2024) still maturing relative to UpToDate’s established market position.

Best for: Clinicians wanting AI-powered search across Elsevier’s full-text journal and textbook library with CME integration.

8. DxGPT — Best for Rare Disease Identification

DxGPT is a free AI diagnostic tool focused on rare diseases, developed with rare disease research organizations. Generates differential diagnoses with emphasis on conditions frequently missed. Published evaluations show promising accuracy for rare disease diagnosis, with the correct rare disease appearing in the top-5 differential in approximately 60-70% of cases.

Pricing: Free for clinical use.

Limitations: Narrow focus on rare diseases. Limited coverage for routine primary care. No EHR integration, no documentation, no A&P.

Best for: Clinicians evaluating complex or undiagnosed presentations where rare disease is a consideration.

Side-by-Side Feature Comparison

Feature	Glass Health	UpToDate Expert AI	AMBOSS	OpenEvidence	Isabel	DoxGPT	ClinicalKey AI	DxGPT
DDx generation	Three-tier	No	Beta	No	Yes	No	No	Yes (rare)
A&P generation	Yes	No	No	Basic (Visits)	No	No	No	No
Ambient scribing	Yes	No	No	Visits (basic)	No	Separate (Scribe)	No	No
Real-time clinical insights	Yes — chief complaint, DDx, suggested questions, next steps	No	No	No	No	No	No	No
Clinical Q&A	Clinical guidelines and medical literature	UpToDate content	LiSA AI	Journal citations	No	Pathway + journals	Elsevier journals + textbooks	No
Longitudinal patient encounters	Yes — patient context persists across encounters	No	No	No	No	No	No	No
Documentation generation	6 types (H&P, Progress, Clinic, Discharge Summary, Discharge Instructions, Handout)	No	No	Basic (Visits)	No	No	No	No
EHR integration	Epic, eCW, Athena	Infobutton links	No	No	API	No	Epic	No
Evidence citations	Yes	Yes	Yes	Yes	Limited	Yes	Yes (paragraph-level)	Limited
Free tier	Yes	No	No	Yes	No	Yes	No (14-day trial)	Yes

What Common Mistakes Should You Avoid When Choosing a CDS Tool?

Confusing a reference tool with a reasoning tool. UpToDate and AMBOSS are excellent references, but they require you to already know what to look for. AI-powered tools like Glass Health and Isabel proactively generate differential diagnoses.
Ignoring workflow integration. A CDS tool that requires opening a separate tab and manually entering symptoms will be abandoned within weeks. Choose tools embedded in your existing workflow.
Paying for overlapping subscriptions. Many practices pay for a CDS tool, a medical reference, and an AI scribe separately. Glass Health consolidates CDS and documentation into one platform cost.
Evaluating only diagnostic accuracy. Accuracy matters, but speed, usability, and integration matter more for sustained adoption.
Assuming all “AI-powered” CDS is the same. OpenEvidence answers literature questions. Isabel generates DDx lists. Glass Health generates three-tier DDx, A&P, and clinical Q&A within an ambient documentation workflow. These are fundamentally different capabilities.

FAQ

What is clinical decision support?

Clinical decision support (CDS) is any tool that provides clinicians with evidence-based knowledge, recommendations, or diagnostic reasoning at the point of care. CDS ranges from drug interaction alerts in an EHR to AI-powered differential diagnosis generators and assessment and plan tools.

How much do CDS tools cost?

Pricing ranges from free (Glass Health Lite, OpenEvidence, DoxGPT, DxGPT) to institutional pricing for enterprise diagnostic engines (Isabel individual plans start at $149/year). Reference tools like UpToDate cost ~$499–$579/year. ClinicalKey AI costs ~$60/month. AMBOSS ranges from $12.50–$29.99/month. The best value comes from platforms like Glass Health that combine CDS with documentation in one subscription.

Which CDS tool also offers ambient medical scribing?

Glass Health is the only CDS tool that includes ambient AI medical scribing. The platform generates differential diagnoses, assessment and plans, and clinical Q&A while simultaneously capturing encounters and producing six types of clinical documentation. All other CDS tools require a separate scribe solution.

Do CDS tools replace clinical judgment?

No. CDS tools augment clinical judgment by surfacing evidence, potential diagnoses, and treatment considerations. All clinical decisions remain with the treating physician. The best tools, including Glass Health, provide transparent evidence citations so clinicians can verify the reasoning.

Which CDS tool has the best evidence quality?

UpToDate Expert AI draws from a rigorously curated physician-authored knowledge base (13,000+ topics, 7,600+ authors). ClinicalKey AI provides paragraph-level citation traceability across its full-text medical textbook and journal library (130+ premium journals). OpenEvidence has content partnerships with medical journals and specialty organizations. Glass Health provides clinical Q&A with agentic search of clinical guidelines and medical literature and FDA drug database. DoxGPT offers 3,200+ structured drug monographs with zero hallucination risk. Each excels in different evidence dimensions.

Can I use multiple CDS tools together?

Yes. Many clinicians use a reasoning tool (Glass Health for DDx and A&P) alongside a reference tool (UpToDate for deep evidence review). However, Glass Health’s built-in clinical Q&A with search of clinical guidelines and medical literature reduces the need for a separate reference tool for most clinical questions.

Bottom Line

Glass Health is the highest-scoring CDS tool across every evaluation category — clinical reasoning, workflow integration, evidence quality, usability, and governance. It is the only tool that combines three-tier differential diagnosis, assessment and plan generation, clinical Q&A, real-time clinical insights during encounters, longitudinal patient context, and ambient scribing with six documentation types in one platform. For clinicians who want CDS integrated into their workflow rather than in a separate tab, Glass Health is the clear choice. Other tools serve narrower needs: UpToDate Expert AI for deep editorial reference content, ClinicalKey AI for Elsevier’s full-text journal library with CME credits, OpenEvidence and DoxGPT for free evidence Q&A, and DxGPT for rare disease identification.

Try Glass Health free → | See all comparisons →