Automated Dose Rounding Gets a Round of Applause

Epic medication adjustments lead to fewer wasted vials and more transparent dosing


Chemotherapy infusion medications are expensive, so reducing medication waste can lead to a lot of savings. Dose rounding, endorsed by the American Society of Clinical Oncology as a safe and effective cost-reduction method, prevents waste by reducing the number of partial vials the pharmacy uses. The University of California San Francisco Medical Center reports that automated dose rounding in Epic not only makes medication dose calculations clearer, it improves communication within the care team.

UCSF implemented automated rounding for select medications in Epic in their oncology pharmacies after a pilot in 2016. They saved an estimated $2 million in 2017 by using 572 fewer vials of 12 common, high-value drugs after implementing automated dose rounding. Since 2017, UCSF has implemented automated rounding for an additional 22 drugs.

“Cost savings are ongoing after initial setup… for each dose, for each cycle, for each patient, you could be saving,” says Ed Yoo, a UCSF oncology pharmacist.

And because clinicians can see when rounding has occurred for a patient’s dose in the system, dosing is more transparent. “It’s nice that, when the system auto-rounds, it captures that information and displays it consistently,” Yoo says.

Epic community members can view UCSF’s presentation and listen to the audio.