Friday, April 24, 2020

Medication Access During Uncertain Times—Improving Provider Workflows to Help Patients in Need

Today’s guest post comes from Miranda Gill, Senior Director of Provider Network at CoverMyMeds.

Miranda reviews how the pandemic affects the ability of healthcare workers to complete administrative responsibilities like prior authorization. She then outlines how electronic automation is helping patients get needed medications while face-to-face interactions are restricted.

Learn more about healthcare IT solutions for providers and patients in CoverMyMeds’ 2020 Medication Access Report, or schedule a virtual meeting.

Medication Access During Uncertain Times – Improving Provider Workflows to Help Patients in Need
By Miranda Gill, MSN, RN, NEA-BC, Senior Director of Provider Network, CoverMyMeds

As a former emergency department nurse, I am deeply moved by the firsthand accounts of frontline healthcare workers during this COVID-19 crisis. When all others retreat to safety, these men and women solemnly turn toward the danger to help save lives—fully understanding the personal risks and often lacking essential resources. To me, this exemplifies what it means to be a hero.

Even as overworked providers and their teams make sacrifices to care for those infected with coronavirus, they are also responsible for on-going or unrelated healthcare needs of patients as well. During these times, patients still need help to get the medications they need to live healthy lives.

Obligatory and often burdensome administrative responsibilities for medication access have not gone away. How in the world do providers have any extra time to deal with a backlog of prescription prior authorization (PA) requests, or to resolve a full queue of requirements for starting patients on specialty therapies?

Now more than ever, providers can lean on technology to improve or replace these persistent and manual healthcare processes.


Even in less tumultuous times, administrative responsibilities like PA can fall near the bottom of providers’ priority lists. Such tasks are reported to distract from clinical care and lead to poor patient outcomes.

Making phone calls and faxing forms to complete PA requests is likely further from the minds of clinicians now working long shifts to prepare for the pandemic and care for the influx of infected patients.

While some states have waived PA requirements for essential services through the Centers for Medicare and Medicaid Services (CMS) during the COVID-19 crisis, many providers across the nation are still responsible for completing PA requests.

Offices and hospitals integrated with healthcare IT solutions like electronic prior authorization (ePA), real-time benefit check (RTBC), or electronic workflows for specialty therapies are better positioned to handle the everyday housekeeping duties that must still be completed to help patients access their medications.

By introducing automation into traditionally manual workflows – providers and pharmacists are free to focus more of their time on pertinent functions of their jobs and less time on the phone or fax machine. Just as critical, electronic solutions help to accelerate time to therapy – allowing patients to more quickly start their journey to wellness and hopefully remain on therapy.

Auto-starting PA requests when needed, auto-populating PA or enrollment forms with stored information, enabling auto-determination of PA requests via pre-defined approval criteria and communicating in real-time via electronic connections all help to save clinicians time.

With many call centers shutdown and face-to-face interactions restricted, electronic automation is critical for helping patients get the medications they need. As indicated in Dr. Fein’s recent survey on the industry impact of COVID-19, the value of electronic solutions is clearer than ever and may spark a wave of digital friendly engagement.

Beyond time and cost savings for providers, new technology is also helping to streamline enrollment into clinical trials for emerging therapeutics. Stay-at-home orders and quarantine protocols are severely affecting on-going and in-design clinical trials as participants are unable to make check-ups for results to be collected.

The expected delays to product launch dates are disheartening for hopeful patients waiting for new treatments. By reducing search and enrollment time for patients into clinical trials, electronic solutions may help to mitigate the collateral damage to research and development programs.


At CoverMyMeds, we are committed to helping our network partners through this crisis. For over a decade, we have devoted significant time and resources to build an electronic infrastructure – allowing us to seamlessly continue our operations despite a mandatory work-from-home order.

As our solutions are rooted in technology, we’ve been able to lean on the electronic automation of our systems to ensure providers, pharmacists and payers are able to complete their work. This strong foundation enables us to be a consistent partner.

When live support is needed, our dedicated teams have stepped up in a big way. Relative to last year, we’ve seen an increase in the number of inbound calls and chats as our network partners rely on us as a trusted resource during this time (CoverMyMeds data on file).

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Our flexible and selfless employees were also able to transition their workspaces to home without sacrificing quality of support. In fact, through their dedicated service, we’ve actually seen a reduction in response time relative to last year for inbound chats and calls from our network partners – 95 percent of responses occurred within 20 seconds (CoverMyMeds data on file).

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With many people now working from home, data security is top priority. Data transmitted to and from CoverMyMeds’ network is transmitted in accordance with federal regulations and industry standards – helping to ensure data security even when working remotely.

For as long as it takes to defeat this virus, we are committed to serving the healthcare system through our technology and providing the highest level of support for the heroes on the frontlines. Learn more about healthcare IT solutions for providers and patients in CoverMyMeds’ 2020 Medication Access Report, or schedule a virtual meeting.

Sponsored guest posts are bylined articles that are screened by Drug Channels to ensure a topical relevance to our exclusive audience. These posts do not necessarily reflect our opinions and should not be considered endorsements.

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