While the Institute of Medicine (2001) has promoted health information technology to improve the process of care such as compliance with clinical practice guidelines and quicker access to clinical information, diagnostic tests, and treatment results, very little was known about how a clinical decision support system can contribute to diabetes management in a rural setting. The primary aim of this study was to determine if the use of a clinical decision support system would positively impact the quality outcomes for diabetes management. The more narrowly focused researchable problem was that it is unknown if the use of a clinical decision support system in a rural primary care setting would be effective in improving process and outcomes measures for type 2 diabetic patients. The study focused on the relationship of the use of clinical decision support systems on process and outcomes measures for adult type 2 diabetes patients. The study was a quantitative correlation study. The independent variable measured was the use of a clinical decision support system. The dependent variables were process and outcomes measures for type 2 diabetes: hemoglobin A1c (HbA1c) test within six months; low-density lipoprotein (LDL) cholesterol evaluation within 12months; urine microalbumin test within12 months. Targeted ranges for these levels included an HbA1c level of less than 7%; LDL levels less than 100mg/dL; and urine microalbumin levels less than 30 mg per 24 hours (Chaudrey, et al., 2009). The theoretical framework was Utility Theory, with the underlying concept that a clinical decision support system was a tool that provides information that leads to higher quality care and therefore the highest utility. The study tested the applicability of Utility Theory by determining if a clinical decision support system provided health benefits for adult patients with type 2 diabetes. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]