Use of Diabetes Wizard EMR-based clinical decision support system Conference Paper uri icon


  • Objective: Medical groups have invested billions of dollars in Electronic Medical Records (EMRs), but few studies have examined the cost-effectiveness of EMR-based clinical decision support (CDS). This study examined the cost-effectiveness of EMR-based CDS for adults with diabetes.
    Data Sources/Setting: Clinical outcome and cost data from a randomized clinical trial of EMR-based CDS were used as inputs into a diabetes simulation model. The simulation cohort included 1,092 patients with diabetes with A1c above goal at baseline.
    Study Design: The UKPDS Outcomes Model, a validated simulation model of diabetes, was used to evaluate remaining life years, quality adjusted life years (QALYs), and health care costs over patient lifetimes (40-year time horizon) from the health system perspective. Costs of diabetes related complications were estimated from the cost accounting system of a large health plan.
    Principal Findings: Patients in the intervention group had significantly lowered A1c (.26%, p=.014) relative to patients in the control arm. Intervention costs were $94 per patient in the first year and $18 per patient in the following years. In the base case analysis, EMR-based CDS increased lifetime QALYs by 0.04 and reduced lifetime costs by $13,484. The cost-effectiveness of EMR-based CDS persisted in one-way, two way, and probabilistic sensitivity analyses.
    Conclusions: Simulations showed that EMR-based CDS was related to increased quality of life and reduced costs for patients with diabetes. Widespread adoption of sophisticated point-of-care CDS has the potential to improve the quality of care for patients with chronic conditions while reducing costs to the health care system.

publication date

  • 2011