Embedded point of care stratified block randomization: demonstration of the point of care randomization (POCR) engine with an electronic health record pragmatic clinical trial
We describe a new custom feature within our Epic Systems electronic health record (EHR) that automates stratified randomization at the point-of-care or order. As a demonstration use-case, we conducted a randomized trial of a provider-facing alert for short-interval HbA1c orders. Over 3 months the alert dramatically reduced repeat orders. This transportable clinical informatics application transforms health systems' ability to conduct pragmatic clinical trials and deliver clinical care within the EHR.
Authors
- WILLIAM TURNER
- Mark J. Pletcher (ORCID: https://orcid.org/0000-0002-6966-1312)
- Catherine A. Sarkisian (ORCID: https://orcid.org/0000-0003-2768-2323)
- Sitaram Vangala
- Richard Kemper Leuchter
- Eric M. Cheng (ORCID: https://orcid.org/0000-0002-2568-5603)
- Khalda A. Ibrahim
- Jory Purvis
- Amy Machado
- Julia Tabar
- Jade A. Verdeflor
- Alina Goncharova
- Chad Wes Villaflores
Institutions
- Los Angeles County Department of Health Services (US)
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- UCLA Health (US)
- Geriatric Research Education and Clinical Center (US)
- Olive View-UCLA Medical Center (US)
- VA Greater Los Angeles Healthcare System (US)
- University of San Francisco (US)
Publication Details
- Journal
- medRxiv
- Published
- 2026-01-28
- DOI
- https://doi.org/10.64898/2026.01.26.26344847
- Primary Topic
- Electronic Health Records Systems
- Type
- article
- Field-Weighted Citation Impact
- 0.00