Implementation and impact assessment of integrated electronic prior authorization in an academic health system
Implementation and impact assessment of integrated electronic prior authorization in an academic health system
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DOI：
10.1016/j.japh.2020.01.012
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发表时间：
2020-07-01
影响因子：
2.1
通讯作者：
Rim, Matthew H.
中科院分区：
文献类型：
--
作者：
Birdsall, Ashley D.;Kappenman, Ashley M.;Rim, Matthew H.
目的：描述了在整个系统范围内实施的综合电子事先授权（ePA）及其影响在一个集中的事先授权（PA）部门在学术health system.Setting：处方药一直是增长最快的领域之一的医疗保健，并继续推进，因此，与药物相关的成本不断上升。药房福利管理人员实施PA等工具以管理成本。PA通常被患者和临床工作人员视为不方便和令人恼火。实践描述：药房门诊临床护理中心（PAC 3），一个集中的PA部门，为系统内的一些诊所提供PA服务。自2014年以来，该系统一直致力于优化人工（通过电话和传真）PA流程。然而，这仍然是一个耗时的多步骤过程。实践创新：卫生系统面临的PA问题的解决方案是ePA，它涉及通过在线门户以电子方式处理PA或集成在电子健康记录中。该系统首先选择了一个电子健康档案供应商，然后在电子健康档案中实施。软件准备就绪后，系统采取分阶段部署的方法，并在少数专科和初级保健诊所实施ePA。评估：平均24%的PAC 3处理的PA是由ePA完成的。该系统发现，1名相当于全职的公共事务协调员每月处理的公共事务数量增加了25%。此外，62%的PA周转时间减少，使患者能够更快地接受药物治疗。结果：不适用。结论：ePA提供了几个好处的系统，包括减少周转时间。这使患者能够更早地接受药物治疗并开始治疗。ePA流程还提高了效率，允许PAC 3集中管理其他诊所的PA，从而减少了诊所的工作量。(C)2020年美国药学协会（R）。爱思唯尔公司出版All rights reserved.
Objective: To describe the system-wide implementation of integrated electronic prior authorization (ePA) and its impact within a centralized prior authorization (PA) department in an academic health system.Setting: Prescription drugs have been among the fastest growing areas of health care and continue to advance; therefore, costs associated with medications are continually rising. Pharmacy benefit managers implement tools such as PAs in an effort to manage costs. PAs are often viewed as inconvenient and irritating by both patients and clinical staff.Practice description: The pharmacy ambulatory clinical care center (PAC3), a centralized PA department, provides PA services to some clinics within the system. Since 2014, the system has worked to optimize the manual (by telephone and fax) PA process. However, it is still a timeconsuming, multistep process.Practice innovation: A resolution to the PA problems that health systems face is ePA, which involves processing PAs electronically through an online portal or integrated within an electronic health record. The system began the implementation process with the selection of an ePA vendor, followed by implementation within the electronic health record. Once the software was ready, the system took a phased rollout approach and implemented ePA in a few specialty and primary care clinics at a time.Evaluation: An average of 24% of PAs processed by PAC3 were completed by ePA. The system saw a 25% increase in the number of PAs processed per month by 1 PA coordinator full-time equivalent. In addition, a 62% decrease in the PA turnaround time allowed patients to receive medications faster.Results: Not applicable.Conclusion: ePA offers several benefits to the system including decreased turnaround time. This allows patients to receive medications and start therapy earlier. The ePA process also increased efficiency, allowing PAC3 to centrally manage PAs for additional clinics, thereby decreasing the workload in the clinic. (C) 2020 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.