Digitizing the Healthcare Provider Experience

When brands can find innovative ways to help relieve providers of administrative burdens that take away from the direct care of patients, everyone wins. This is particularly true in specialty medication, where processes can vary and most prescriptions need some level of authorization or verification.

Traditionally, specialty providers and their staff spent much of their time manually managing the prescribing process by fax or mail. This paper-based approach often delayed a patient’s start on therapy, which can put them at greater risk of non-adherence. Provider portals helped, but time that should have been spent working with patients was being spent navigating these systems.

So, what can brands do to help alleviate some of this burden on the provider? The answer is a common but seemingly unlikely solution: non-commercial pharmacies (NCPs).

Easing the Prescriber Workflow

The concept of a NCP is simple enough: a virtual holding spot for a prescription that is sent to a dispensing pharmacy once benefit verifications, prior authorizations (PAs), copay programs, and other fulfillment needs are completed. This model is often not used to its full potential. Rethinking the ways NCPs could streamline the enrollment process may help decrease provider burdens and ultimately help patients get on therapy faster.

If providers regularly used a specific NCP’s portal at the point of prescribing, they wouldn’t have to leave their workflow to bounce around between several portals every day and learn all their nuances. The prescribing process would take a matter of seconds, rather than several minutes because less steps are needed to enroll the patient. This extra time can then be used with the patient and help strengthen the patient/provider relationship.

Furthermore, rather than exiting the EHR and manually filling out a patient enrollment form, the provider selects the NCP to receive the prescription for the drug, just like they would any retail pharmacy at the point of prescribing. Providers don’t need to duplicate data because it is already in the EHR, and this information is automatically included in the prescription.

Helping Patients Start Therapy Faster

The provider takes the prescription and initiates electronic benefit verification and PA services, with direct payer connectivity, to determine coverage criteria. After the benefit verification is complete, the provider returns the PA requirements back to the HCP’s EHR, requiring  only the clinical or medical necessity information for the authorization, all of which is done electronically within minutes.

In-workflow EHR prescribing means no more sending a fax and waiting for a live person to see it and respond, and certainly no need to manually mail information to the payer. This can give patients access to their medication days, even weeks, faster. Plus, the time providers would have spent dealing with these authorizations can now be used where it belongs: with the patient.

When a brand invests in innovative tools that create a seamless prescribing and approval process that eases administrative burdens, providers can spend more time with patients, get them on therapy faster, and increase the likelihood they will adhere to their medications.

  • Julia Laurin

    Julia Laurin is Chief Product Officer at ConnectiveRx. Julia leads enterprise-wide product strategy, product lifecycle management, and R&D innovation. She also oversees provider network development, data governance, and market research.

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