Increased Health IT Clinician Burden Calls for Greater Interoperability

While almost half of pharmacists and two-thirds of prescribers reported an increase in health IT use over the past 18 months, further interoperability efforts are needed to address clinician burden, according to new Surescripts survey results.

Surescripts partnered with PSB Insights to administer the survey to 520 pharmacists, 200 prescribers, and 300 patients in June and July of 2021.

The survey results revealed that the majority of pharmacists and many prescribers believe the responsibilities of providers—including nurses, physician assistants, physicians, specialists, and non-clinical professionals—have grown since the onset of COVID-19.

Additionally, more than half of pharmacists reported increased patient questions in the past 18 months, and only 1 in 5 pharmacists felt very prepared to handle the new demands of their role.

“These changes put continued pressure on the healthcare system and reinforce the need to address ongoing challenges related to interoperability, prescription costs, and provider burnout,” Tom Skelton, chief executive officer of Surescripts, said in a public statement.

“The critical next step in the industry is overcoming the barriers to team-based care, including the need for increased information sharing, replacing outdated technology, and the human factor in how care teams communicate,” Skelton continued.

The survey found that nearly all pharmacists (99 percent) and prescribers (91 percent) expect the future of care delivery to follow a team-based care model, which hinges on care coordination and communication between care team members.

Most prescriber-pharmacist communication still happens by phone or fax; prescribers communicate by phone or fax 50 percent of the time and pharmacists communicate through these technologies 58 percent of the time.

The research also revealed that during an average work week, a pharmacist spends as much time communicating with prescribers and insurers (five hours) as consulting with patients.

The typical pharmacist has questions for a prescribing doctor for 22 percent of prescriptions. Prescribers reported that 35 percent of the questions they receive from pharmacists are about prior authorization and lower-cost alternatives. 

The survey found that most pharmacists (57 percent) reported an increase in prior authorization requirements in the past 18 months, and 1 in 4pharmacists still use fax to process them.

Prior authorization requirements add to pharmacist and clinician burden. More than half of prescribers and pharmacists described following up on prior authorizations as “very frustrating.” Prior authorization follow-up takes a prescriber an average of three hours per week.

“It’s essential that we empower prescribers and pharmacists so they can endure in this moment and prepare for the next major health crisis,” said Andrew Mellin, MD, vice president and chief medical information officer of Surescripts.

“While challenges still exist, we have the technology they need to access actionable patient intelligence when and where it’s needed most, so they spend less time on administrative tasks and focus on what matters—their patients,” Mellin continued.

Electronic prior authorization (ePA) aims to speed up the prior authorization process by documenting digitally instead of via phone or fax. ePA solutions can be integrated into EHR systems to help providers easily request prior authorization within their clinical workflows.

To better understand how electronic prior authorization might impact patients and providers, America’s Health Insurance Plans (AHIP) launched the Fast Prior Authorization Technology Highway (Fast PATH) initiative in early 2020.

Six payers participated in the project, which ran for approximately 12 months. Availity and Surescripts served as the program’s health IT partners.

After implementing the ePA interoperability solution, the total number of prior authorizations jumped by 34 percent. A third of these transactions took two hours or less, compared to before, when 24 percent of prior authorizations took two days or longer to fulfill.

Sixty-two percent of prior authorizations were electronic after the health IT solution was implemented, and traditional prior authorizations were cut nearly in half.

Most providers who used ePA had positive feedback. Six in ten providers who used prior authorization regularly said that ePA made it easier to know whether they needed to request prior authorization.

Among less experienced providers, the results were milder. Less than half (47 percent) said that it was easier to understand if prior authorization was required with ePA, while 43 percent said they did not observe a difference.