A new and emerging second-generation clinical decision support (CDS) system goes far beyond alerts. It infers possible questions and needs before they are explicitly asked, and it combines reference information seamlessly with tools for taking action. It embraces order sets, guideline helpers, problem-based documentation templates, just-in-time flowsheets and data displays, and intelligent integrated reference information. Such interventions can help to contain costs, control medical errors, boost clinical productivity and improve quality. Some of the most significant innovations in CDS belong to the category of referential or informational CDS. These features play a critical role in quality improvement and compliance programs. Following are just some of the innovations IT professionals are likely to experience through second-generation CDS systems:1. varying depth for varying needs, 2. support of the workflow, 3. infobuttons or knowledge-links, 4. information now and later, 5. triggered reference, 6. multimodal reference, 7. two-factor questions, and 8. patient access.