Epic Cutover Success: How Licensed Pharmacists Delivered a Seamless Medication Migration

A case study in clinician-led medication order migration for Epic go-live success

For hospitals preparing for an Epic go-live, few milestones carry more operational risk than cutover. This 24-hour period requires all active patient data to be manually transcribed from a legacy system into the new EHR environment. Orders, medications, and care plans must be moved accurately and efficiently while patients remain in beds and providers prepare for a system shift.

At a public district medical center in California, leadership recognized the inherent risk of relying on internal staff to manage this high-pressure task. Facing a critical pharmacy staffing gap, they partnered with ReMedi Health Solutions to deploy a dedicated team of licensed pharmacists for clinical backloading. The result was a comprehensive, on-time transition that set the foundation for a successful Epic go-live.

The Challenge: A 24-Hour Deadline with No Room for Error

Historically, hospitals have relied on internal clinicians for overnight EHR cutover, often nurses and pharmacists volunteering for extra shifts to manage the transition. This model carries significant operational risks.

Staff Fatigue and Burnout

Expecting internal staff to work overnight and return the next morning for go-live undermines readiness and morale at a time when clinical clarity is critical.

Patient Safety Concerns

Manual medication order migration introduces the risk of transcription errors, especially when completed by exhausted staff under time constraints. In an inpatient setting, these errors can directly impact patient safety.

Tight Operational Window

The hospital had one night to complete all inpatient chart conversions. Delays in data entry would impact patient handoffs, order continuity, and physician readiness at go-live.

Leadership knew a different approach was required: one that treated Epic cutover as a clinical operation, not an administrative task.

The ReMedi Approach: A Purpose-Built Pharmacy Team for Clinical Backloading

ReMedi deployed a specialized team of licensed pharmacists trained in both Epic workflows and clinical documentation. This model provided clinical credibility and operational precision for the most critical component of cutover: medication orders.

Clinical Migration, Not Data Entry

Medication order migration requires clinical pharmacy expertise. Pharmacists must evaluate drug interactions, verify dosage and frequency alignment between systems, navigate best practice alerts (BPAs), and ensure that each order is clinically appropriate for the Epic environment. This is not a task that can be delegated to non-clinical staff or even physicians unfamiliar with pharmacy workflows.

ReMedi’s pharmacists ensured that medication orders were transcribed, reviewed, and verified to maintain exact dosage and frequency alignment between the legacy Meditech system and Epic. This approach preserved the clinical integrity of each patient’s care plan, ensuring that Epic reflected the full, accurate current state of each chart.

Triple-Check Quality Assurance

ReMedi implemented a three-tiered validation process to ensure accuracy and patient safety:

Transcription: A licensed pharmacist entered the order into Epic.

Checker: A second pharmacist cross-referenced the Epic entry against the legacy Meditech record.

Verifier: A senior pharmacist performed final sign-off before the order was made live.

This redundant workflow eliminated the risk of incomplete or inaccurate medication data at go-live, directly supporting patient safety in the inpatient setting.

Hybrid Delivery Model

The engagement utilized a hybrid staffing approach with one pharmacist and one project manager on-site, while the remainder of the team worked virtually. This model allowed ReMedi to rapidly scale resources while maintaining close coordination with hospital leadership throughout the cutover window.

The Outcome: A Seamless Go-Live Morning

By 12:00 AM, ReMedi’s team had completed the full inpatient medication order cutover, finishing four hours ahead of schedule. In the following hours prior to go-live, ReMedi pharmacists continued to review and reconcile any medication changes that occurred overnight, ensuring the most current and accurate data was available when clinicians logged in.

On-Time Completion: Every patient’s medication orders were fully transcribed and validated before go-live, with four hours to spare.

Continuous Reconciliation: Post-cutover reconciliation ensured any overnight medication changes were captured and reflected in Epic.

Fully Rested Internal Teams: Clinical staff arrived on Day 1 ready to engage with Epic rather than recovering from an overnight shift.

“There was a major gap. We didn’t have the pharmacists we needed. ReMedi was able to supplement that, and it would have been impossible to do this without their service.”

– Hospital Leadership

Strategic Insight for Health System Leaders

This engagement reinforces a critical operational principle: Epic cutover is not an afterthought. It is a clinical operation that directly impacts patient safety, provider confidence, and go-live momentum.

ReMedi’s approach to clinical backloading eliminates the risks of fatigue-driven errors, protects internal staffing resources, and ensures a clean transition into the new EHR environment without compromising quality. By deploying licensed pharmacists rather than general consultants or exhausted internal staff, health systems can protect the most vulnerable component of cutover: continuity of care for inpatients.

For health systems planning an Epic deployment, this case demonstrates a scalable, clinician-first strategy to de-risk one of the most fragile stages of implementation. The investment in specialized clinical resources for cutover pays dividends in patient safety, staff morale, and operational readiness from Day 1.

To learn more about ReMedi’s EHR Cutover and Clinical Backloading services, contact us at info@remedihs.com.