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This paper presents a pioneering and practical experience in the development and implementation of a clinical decision support system (CDSS) based on natural language processing (NLP) and artificial intelligence (AI) techniques. Our CDSS notifies primary care physicians in real time about recommendations regarding the healthcare process. This is, to the best of our knowledge, the first real-time CDSS implemented in the Spanish National Health System. We achieved adherence rate improvements in eight out of 18 practices. Moreover, the provider’s feedback was very positive, describing the solution as fast, useful, and unintrusive. Our CDSS reduced clinical variability and revealed the usefulness of NLP and AI techniques for the evaluation and improvement of health care.