Poor decisions are rarely intentional, but are driven by high task loads, cognitive biases, knowledge or training deficits, lack of access to critical information, and unintended incentives. In the movement from volume- to value-based healthcare, good clinical decisions will be critical for financial viability, brand recognition, and success in alternative payment models. Addressing these issues will lead to far better clinical decisions and will markedly reduce the costs of care and drive value into the system.