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

Sarkisian, C.; Ibrahim, K.; Vangala, S.; Villaflores, C. W.; Cheng, E. M.; Turner, W.; Leuchter, R. K.; Machado, A.; Tabar, J.; Verdeflor, J. A.; Purvis, J.; Goncharova, A.; Pletcher, M. J.

2026-01-28 health informatics
10.64898/2026.01.26.26344847 medRxiv
Show 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.

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