Charles D. MacLean|Michaël Gagnon|Peter W. Callas|Benjamin Littenberg
The Vermont Diabetes Information System: A Cluster Randomized Trial of a Population Based Decision Support System
University of Vermont|Allen Hospital|University of Vermont Medical Center|University of Vermont|University of Vermont
optimal care patients diabetes difficult achieve clinical practiceto evaluate impact registry decision support system processes care physiologic controlrandomized trial clustering practice level involving 7412 adults diabetes 64 primary care practices northeastprovider decision support reminders overdue diabetes tests alerts regarding abnormal results quarterly population reports peer comparisons patient decision support reminders alertsprocess physiologic outcomes evaluated subjects functional status evaluated random patient sample via questionnaire used multiple logistic regression quantify effect adjusting clustering potential confounders intervention subjects significantly likely receive guidelineappropriate testing cholesterol 139 95ci 107 180 p 0012 creatinine 140 95ci 106 184 p 0018 proteinuria 174 95ci 113 169 p 0012 a1c 117 95 ci 080 172 p 043 rates control a1c ldl cholesterol similar two groups differences blood pressure body mass index functional statusa chronic disease registry decision support system based easily obtainable laboratory data feasible acceptable patients providers system improved process laboratory monitoring primary care physiologic control