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Clinical and Economic Results from a Randomized Trial of Clinical Decision Support in a Rural Health Network

BACKGROUND
Replication studies evaluate technologies in usual use settings.


METHODS
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.


MAIN OUTCOME MEASURES
The primary outcome was the rate of emergency department visits for low severity conditions. Secondary outcomes included: medical costs and other clinical event rates.


RESULTS
We randomized 13,454 individuals (intervention, 6740; control, 6714). Subjects in both groups had similar rates of clinical events and medical costs.


CONCLUSION
The use of email notifications to care managers was associated with no reductions in clinical events or medical costs.