# HELP Clinical Decision Support System **Type:** work **Status:** Draft **Confidence:** Medium **Focus:** clinical decision support, medical informatics, electronic health records, hospital systems **Era:** 1967-present in successor forms; major HELP development in the 1970s-1990s **Location:** LDS Hospital and University of Utah, Salt Lake City, UT **Updated:** 2026-05-16 **Pull:** *Long before EHRs became ordinary, a Salt Lake City hospital system showed computers could participate in care while care was happening.* ## Summary HELP, short for Health Evaluation through Logical Processing, was a hospital information system built at LDS Hospital in Salt Lake City with deep ties to the University of Utah medical-informatics community. Led by people such as Homer R. Warner, T. Allan Pryor, and Reed M. Gardner, it grew from specialized cardiac and intensive-care settings into an integrated hospital system for patient data, orders, laboratory results, pharmacy, radiology, nursing documentation, research, and teaching. The distinctive thing was not just digitizing hospital records. HELP connected structured clinical data to medical logic and knowledge modules so the system could generate alerts, reminders, protocols, antibiotic guidance, ventilator support, blood-product guidance, and other decision support inside routine care. ## Why It Matters Modern medicine depends on electronic health records and clinical decision support, but in the 1970s and 1980s that future was not obvious. Many hospital systems were mainly administrative or billing tools. HELP made the stronger claim that a hospital computer could help clinicians make better decisions while patients were being treated. It became one of the reference systems in medical informatics, alongside Regenstrief and VA systems, for showing how computerized patient data and executable medical knowledge could fit into clinical workflow. It also helped give Intermountain's later quality-improvement work a data-rich base. ## What Was Built The hard problem was not storing facts. HELP had to ingest messy hospital data quickly enough to matter, represent medical rules in executable form, send advice to clinicians without breaking workflow, and remain trusted in a high-stakes environment where bad alerts could be ignored or dangerous. The system also had to behave like infrastructure. A clinical platform touching orders, pharmacy, lab data, monitors, and bedside protocols cannot stay a research demo. Its longevity is part of the achievement. ## Utah Context HELP grew out of the unusually strong medical-informatics cluster around LDS Hospital, Intermountain, and the University of Utah. That places Utah in the early history of not just biotechnology and devices, but healthcare software: systems that changed how clinical knowledge was represented, measured, and acted on. The page also belongs beside [Utah Population Database](utah-population-database.md). Both are data infrastructure stories, but they point in different directions: UPDB links population-scale records for research, while HELP operationalized patient data and knowledge at the bedside. ## Caveats HELP was a pioneering system, but it was part of a broader national movement. Regenstrief, the VA, Brigham, and other sites were also crucial. Many HELP results came from one unusually informatics-friendly health system, so not every intervention generalized easily. The system's architecture eventually aged and successor platforms had to replace parts of it. ## Evidence - [Source record: HELP Hospital Information System Papers](help-clinical-decision-support-source.md) - [Pryor, Warner, and Gardner: HELP--A Total Hospital Information System](https://pmc.ncbi.nlm.nih.gov/articles/PMC2203749/) - [PubMed: The HELP hospital information system: update 1998](https://pubmed.ncbi.nlm.nih.gov/10405877/) - [PMC: Clinical Decision Support: a 25 Year Retrospective and a 25 Year Vision](https://pmc.ncbi.nlm.nih.gov/articles/PMC5171504/) - [Springer: HELP: A Dynamic Hospital Information System](https://link.springer.com/book/10.1007/978-1-4612-3070-0) ## Open Questions - Consider a future `people/homer-warner.md` page if the wiki starts adding real Utah informatics biographies.