Embedded point of care stratified block randomization: demonstration of the point of care randomization (POCR) engine with an electronic health record pragmatic clinical trial

medRxiv 2026 Preprint Open access

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Authors: Catherine A. Sarkisian, Khalda A. Ibrahim, Sitaram Vangala, Chad Wes A. Villaflores, Eric M. Cheng, WILLIAM TURNER, Richard Kemper Leuchter, Amy Machado, Julia Tabar, Jade A. Verdeflor, Jory Purvis, Alina Goncharova
+1 more Mark J. Pletcher
DOI: 10.64898/2026.01.26.26344847
Cited by: 0
References: 8

Abstract

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.

Fields of Study & Subjects

Electronic Health Records Systems Statistical Methods in Clinical Trials Advanced Causal Inference Techniques

Publication details

Journal / source
medRxiv
Publication date
28 January 2026
Language
EN
Document type
Preprint