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Electronic Health Record (EHR) systems are often configured to address challenges and improve patient safety for persons with Parkinson's disease (PWP). For example, EHR systems can help identify Parkinson's disease (PD) patients across the hospital by flagging a patient's diagnosis in their chart, preventing errors in medication and dosing through the use of clinical decision support, and supplementing staff education through care plans that provide step-by-step road maps for disease-based care of a specific patient population. However, most EHR-based solutions are locally developed and, thus, difficult to scale widely or apply uniformly across hospital systems. In 2020, the Parkinson's Foundation, a national and international leader in PD research, education, and advocacy, and Epic, a leading EHR vendor with more than 35% market share in the United States, launched a partnership to reduce risks to hospitalized PWP using standardized EHR-based solutions. This article discusses that project which included leadership from physician informaticists, movement disorders specialists, hospital quality officers, the Parkinson's Foundation and members of the Parkinson's community. We describe the best practice solutions developed through this project. We highlight those that are currently available as standard defaults or options within the Epic EHR, discuss the successes and limitations of these solutions, and consider opportunities for scalability in environments beyond a single EHR vendor. The Parkinson's Foundation and Epic launched a partnership to develop best practice solutions in the Epic EHR system to improve safety for PWP in the hospital. The goal of the partnership was to create the EHR tools that will have the greatest impact on outcomes for hospitalized PWP., Competing Interests: AW is a volunteer member of the Epic Neuroscience Specialty Steering Board. BW serves as Section Head of Movement Disorders at the Cleveland Clinic. Over the years, he has received research grants from the NIH and Parkinson’s Foundation. He has served as site investigator and/or co-investigator for clinical research studies sponsored by grants from Industry to Cleveland Clinic. Currently, he is the site PI for Neuroderm (Mitsubishi Tanabe Pharma), Discern (Great Lakes Neurotech/NIH R44), Tempo 2, and Tempo 3 studies (Cerevel Therapeutics) and a grant from the Parkinson’s Foundation to improve the inpatient care of People with PD. He has served as a consultant or speaker for Medtronic, Boston Scientific, and Abbott. AB Director of Strategic Initiatives, Parkinson’s Foundation EB Associate Director of Strategic Initiatives, Parkinson’s Foundation. KA was supported by the Michael J Fox Edmund J. Safra Fellowship in Movement Disorders from July 2017–July 2019. She previously served as Investigator and/or medical monitor for clinical trials supported by Aptinyx Inc. Genentech Roche Ltd., EIP Pharma Inc., Michael J Fox foundation for PD research, NINDS, and Acadia Pharmaceuticals Inc., and Biogene. She previously served as Co-I of a Lewy Body Dementia Association Research Center of Excellence site. The work presented here was supported by a Parkinson Foundation Community Grant (awarded to IR). IR serves as Director of the University of Rochester Parkinson’s Foundation Center of Excellence and her contributions to this article were supported by a Parkinson’s Foundation Community Grant, Parkinson’s Disease Hospital Optimization Project (PD-HOP) for which she served as PI. IR has received research and/or training grants from NIH, Parkinson’s Foundation and the Michael J. Fox Foundation. IR has served as a site investigator and/or co-investigator for clinical research studies sponsored by grants from Industry to the University of Rochester, currently including F. Hoffmann-La Roche Ltd., Acadia Pharm, and Jazz Pharmaceuticals. KM is an employee of Epic, a health IT software company which licenses electronic health record software and provides related services to health care organizations that pay Epic for such software and services. She and Epic have no financial disclosures or conflicts of interest related to this article. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Wu, Walter, Brooks, Buetow, Amodeo, Richard, Mundth and Azmi.)

Background: Patients with Parkinson's disease (PD) are at increased risk for hospital acquired complications. Deviations from home medication schedules and delays in administration are major contributing factors. We had previously developed a protocol to ensure adherence to home medication schedules using "custom" ordering. In this study we are assessing the impact this order type may have on reducing delays in PD medication administration in the hospital., Material and Methods: We reviewed 31,404 orders placed for PD medications from January 2, 2016 to April 30 2021. We evaluated the orders to determine if they were placed in a Custom format or using a default non-custom order entry. We further evaluated all orders to determine if there was a relationship with the order type and timely administration of medications. We compared medications that were administered within 1 min, 15 min, 30 min and 60 min of due times across custom orders vs. non-custom default orders. We also evaluated the relationship between ordering providers and type of orders placed as well as hospital unit and type of orders placed., Results: 14,204 (45.23%) orders were placed using a custom schedule and 17,200 (54.77%) orders were placed using non-custom defaults. The custom group showed a significantly lower median delay of 3.06 minutes compared to the non-custom group ( p <.001). Custom orders had a significantly more recent median date than non-custom default orders (2019-10-07 vs. 2018-01-06, p <0.001). In additional analyses, medication administration delays were significantly improved for custom orders compared to non-custom orders, with likelihoods 1.64 times higher within 1 minute, 1.40 times higher within 15 minutes, and 1.33 times higher within 30 minutes of the due time ( p <0.001 for all comparisons)., Conclusion: This is the largest study to date examining the effects of order entry type on timely administration of PD medications in the hospital. Orders placed using a custom schedule may help reduce delays in administration of PD medications., Competing Interests: JMP is employed and hold equity in Superior Medical Experts, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Azmi, Cocoziello, Ruzicka, Clar, Pederson, Jacob, Thomas, Rocco, Bobek, Pereira-Argenziano, Roth and Thomas.)