Integration of electronic health records with automated compounding for parenteral nutrition: A narrative review

The integration of electronic health record systems has transformed healthcare by enhancing workflow efficiency, improving data accessibility, and enhancing patient safety. King Fahad Medical City transitioned from a fragmented, paper-based parenteral nutrition management system to a fully integrated Epic electronic health record system, replacing the standalone Baxter ABACUS software. This review outlines a structured approach to integrating automated compounding devices with Epic, incorporating standardized data exchange protocols, interoperability frameworks, development of parenteral nutrition order sets, barcode-enabled verification, and staff training. The clinical decision support system within Epic optimized parenteral nutrition prescription accuracy through real-time alerts, dose limits, and automated calculations. A dedicated parenteral nutrition navigator tool further simplified access to patient data, supporting informed clinical decision-making. This manuscript focuses on the implementation process rather than outcome evaluation. A qualitative approach, using process mapping, training assessments, and end-user feedback, was employed to guide and monitor the integration progress. System refinement and multidisciplinary collaboration resolved challenges, including barcode recognition failures and coding mismatches. This experience underscores the importance of interoperability, decision support tools, and continuous quality improvement in optimizing parenteral nutrition therapy within electronic health record systems, offering a scalable model for healthcare institutions seeking digital transformation.