Evaluating medication record creation before and after an electronic health record transition

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Substantial decrease in turnaround time (quantitative data not provided)

• Primary Outcome: Turnaround time for medication build requests

• Nnt Or Sensitivity: Not applicable - process improvement study

• Confidence Interval: Not reported

Clinical Application

Requires significant multidisciplinary coordination and iterative process refinement Relevant for Australian hospitals undergoing EHR transitions, though specific Epic/Cerner experience may vary. Could inform TGA medication safety initiatives and hospital accreditation standards Hospital pharmacy departments and informatics teams planning EHR transitions

Abstract

PURPOSE: In 2022, St. Jude Children's Research Hospital underwent an electronic health record (EHR) transition, migrating from Cerner Millennium to Epic. This transition required a comprehensive revision of the medication build and configuration process and, subsequently, prompted an analysis of lessons learned during the transition. Through enhancement of the medication build and configuration process, the standardized procedure increases collaboration with subject matter experts and other departments within the institution as medication records are created. SUMMARY: The transition involved stakeholder meetings with members from operational leadership, informatics, medication safety, and pharmacy inventory management to update the existing process to support the new system. Through the creation of an initial version and subsequent iterations, the process was refined to efficiently support and control the quality of medication build requests. The updated process also maintained existing oversight over the entire process. The transition highlighted differences between the original EHR and the updated EHR in the management of medication builds. The differences between the EHRs and medication build processes presented a learning curve for individuals involved in medication builds and resulted in an initial lengthening of the turnaround time. Following iterative improvements to the usability of the medication build process and enhancements in automatic communication, the turnaround time substantially decreased. CONCLUSION: The insights gleaned from the transition process underscore the importance of aligning operational processes with user needs, fostering iterative improvements, prioritizing effective communication, and maintaining a delicate balance between urgency and accuracy in managing medication record creation and configuration within EHRs. This knowledge can be used to guide the creation of a medication build process or transition from an existing process.

References

1. 1.Compagner, C., Aguero, D., & Campbell, P. K. (2026). Evaluating medication record creation before and after an electronic health record transition. American Journal of Health-System Pharmacy, 83(8). https://doi.org/10.1093/ajhp/zxaf328