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Computerized clinical decision support (CDS) faces challenges to interoperability and scalability. Centralized, web-based solutions offer a mechanism to share the cost of CDS development, maintenance, and implementation across practices. Data standards have emerged to facilitate interoperability and rapid integration of such third-party CDS. This case report describes the challenges to implementation and scalability of an integrated, web-based CDS intervention for EMergency department-initiateddoi:10.1093/jamiaopen/ooz053 pmid:32025639 pmcid:PMC6994013 fatcat:thv5rlo6k5a7fnz5vwanpncom4