Automated Telephone Outreach With Speech Recognition to Improve Diabetes Care: A Randomized Controlled Study

Inclusion Criteria: * Age 18 years or older * Diabetes, defined as either 1) filled a prescription for insulin or an oral hypoglycemic agent; or, 2) had two outpatient or one inpatient or two outpatients encounter claims with an ICD9-CM or CPT code indicating diabetes. * Gap in a key diabetes management metric as evidenced by no claim for a dilated eye examination in the prior 15 months and no claim for one or more of the following tests: glycated hemoglobin, LDL-cholesterol, or microalbumin. (Individuals with evidence of having received ACE-inhibitors or angiotensin receptor blockers were considered to have had a microalbumin test.) Exclusion Criteria: * No primary care clinician in the data base * Those who had previously asked the health plan to exclude them from research or quality improvement * Women whose claim records contained diagnoses suggesting gestational diabetes