Clinical and economic results from a randomized trial of clinical decision support in a rural health network.

Abstract

Replication studies evaluate technologies in usual use settings. We conducted a clinical trial to determine whether reductions in clinical and economic results observed in a previous study could be replicated in a larger setting. Subjects were randomized to receive intervention (email notifications for sentinel health events sent to their care managers) or control. The primary outcome was the rate of emergency department visits for low severity conditions. Secondary outcomes included: medical costs and other clinical event rates. We randomized 13,454 individuals (intervention, 6740; control, 6714). Subjects in both groups had similar rates of clinical events and medical costs. The use of email notifications to care managers was associated with no reductions in clinical events or medical costs.