MDSSs (medical decision support systems) are computer applications providing clinicians with suitable information about a patient's clinical situation, as well as knowledge relevant to the situation, appropriately filtered and presented, to improve the quality of care and the patients' health. As is the case with any intervention aiming at influencing medical practices and their impact on the patients' health, it seems appropriate to question their real value through a methodology for reliable evaluation. Evaluation methods are necessarily dependent on the questions raised and it is common for different questions to lead to different methodologies and different processes of data collection and analysis. In the light of this, better consideration and better implementation of the evaluation processes of these systems are major criteria on which their future depends.

Information systems in the health field should be communicating to foster cooperation of professionals in the health process centered on the patient, and to assist in medical decision. Therefore, communication through computer tools and the creation of computerized patient records require the use of semantic repositories whose control is required. Indeed, the sharing of patient data principle is needed particularly because of the development of medical knowledge, which helps to segment the expertise, skills and roles of players. The application of this principle allows greater coordination between professionals and requires appropriate and scalable information systems. The necessary data sharing and the development of information systems strongly emphasizes the issue of semantic interoperability of health systems and management repositories. However, if, in the context of the interoperability of information systems, choice, maintenance and the use of semantic standards are necessary conditions, the behavior of players and practices of evaluation procedures are nevertheless essential component for proper functioning.