Download our case study: Avera Health Drives Precision Medicine at the Point of Care


About: Avera Health (Sioux Falls, SD) is one of the largest health systems in the Midwest. With more than 300 care locations in five states, the organization serves a population of nearly 1 million people. This integrated healthcare system includes 37 hospitals and a state-of-the-art human molecular genetics laboratory, the Avera Institute for Human Genetics. In 2021, Avera Health was recognized by CHIME as a HealthCare’s Most Wired organization, earning the highest status of Level 10.

Challenge: Medical staff across Avera’s hundreds of hospitals and clinics shared MEDITECH’s integrated EHR. But because AIHG’s processes were not automated, clinicians had to revert to paper orders for pharmacogenomic testing, which disrupted workflow. Avera’s IT committee realized they needed to design the future‐state workflow to leverage their EHR. The improved workflow would use discrete pharmacogenomics data to drive clinical decision support and guide clinicians to the most appropriate drug options for the patient.

Execution: The improvement project, which took place at Avera McKennan Hospital & University Health Center, was broken down into three phases: 

  • Documenting: For patients who require comprehensive pain management, the AIHG pharmacists document their interpretation of the patient’s genetic profile and drug recommendations in a standardized note template. 
  • Ordering: Providers order pain genotyping tests using MEDITECH’s CPOE solution. Because pharmacogenomic results are now formatted as structured data, genetic lab results flow to the ordering providers’ desktops. 
  • Alerting: Clinical decision support rules created in MEDITECH’s CPOE solution flag clinicians based on the results of the patient’s pain genotyping panel. These alerts guide more appropriate medication prescribing.

Results: By incorporating pharmacogenomics into clinical workflows for safer, more efficient pain control at Avera McKennan, Avera Health has realized numerous benefits to patients, clinicians, and the health system. Here are a few benefits the organization has experienced by improving clinical processes: 

  • By minimizing medication trial and error, patients have experienced improved pain management as they transition to recovery. 
  • Physician satisfaction and productivity have increased. Tests are easier to order, results are easier to locate, and active clinical support guides better decision-making. Plus, a comprehensive “picture” of the patient is accessible system-wide in the EHR. 
  • New processes ensure optimal pain management and alleviate safety concerns related to adverse drug events. 

As Avera Health implements MEDITECH’s Expanse EHR, it continues to build on its success with actionable pharmacogenomic data and clinical decision support, which are crucial to improving the quality of care