The dissemination of Clinical Decision Support Systems (CDSS) in the medical field is slow due to various reasons such as lacking comprehensibility, low user acceptance, specific problem settings and unique application environments. This paper presents an illustration of the complexity of the CDS development process. Guided by procedural software development models already known from the field of software engineering, we developed a CDS-specific software lifecycle and a CDS development complexity illustration. We based the results on literature research of publicated field reports about successfully developed CDSS. We identified important CDS peculiarities related to the development and documentation process of CDSS and later merged them with generic software engineering models. We then created a CDS complexity illustration that can be used to structure future research in the CDS field as well as any standardisation processes.
Keywords: Clinical decision support systems; software development process; software engineering; software lifecycle.