SmartPA: An electronic solution for secure prior authorization processing

Abstract

Electronic Prior Authorization (Electronic PA) is a fast and efficient way of ensuring that prior authorization, needed for medical drug and treatment dispensing, is accurately and promptly completed, supporting quick delivery of medications to patients. Electronic PA (ePA) solutions are the next big revolution in healthcare industry after the introduction of electronic health records. ePA is a time saver for prescribers as well as a cost-saving solution to insurance companies and Medicare services. ePA is new to the industry and due to a knowledge gap among medical professionals and their IT solution providers, ePA applications lack sophisticated components to ease the workflow. Instead of being time-saving, broken ePA processes become time consuming. A research study identified common gaps around the PA process by interviewing and gathering feedback from key stakeholders in the process. The results of the study have demonstrated how a new electronic solution that was developed working with the stakeholders has helped close some of the identified gaps. The resulting solution, SmartPA, provides a secure, reliable interface in support of medical standards, as well as enhancing the PA workflow process.