A clinical decision support system is disclosed, comprising pathway models (1) for at least a class of medical conditions defined in respect of a first dictionary and first semantics (13) matching a need of groups of users having different roles in respect of a clinical workflow. A pathway generator (5) generates a first representation (6) of a patient specific clinical pathway in accordance with the source model. A pathway translator (7) translates the first representation (6) of the patient specific clinical pathway into a corresponding second representation (8) of the patient specific clinical pathway in accordance with the target model, using the mapping model (3) to map elements of the first representation (6) into corresponding elements of the second representation (8).