Section 06: Health System
As health systems employ a large and increasing number of providers across the U.S., ensuring that their administrators and providers are engaging with ePA solutions could be crucial for saving time, controlling costs and advancing patient care.
Learn about ePA benefits for health systems
Status of Health Systems
While the definition of health systems can vary, they are minimally comprised of one hospital and one group of physicians that offer comprehensive care (i.e. primary and specialty care).31
The number of health systems in 2016 reached 626 and these account for approximately 70 percent of all hospitals in the U.S. As a result, nearly 45 percent of physicians are employed by health systems.31
Along with general growth and expansion, independent specialty practices are vertically integrating into health systems. Over the last decade, more than half of oncology practices were absorbed into health systems — increasing from 20 percent in 2007 to 54 percent in 2017 — and other specialty practices are following a similar trend.15
* Adapted from The 2018-19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors
Ensuring all providers are adopting ePA solutions is critical to the success of ePA for all stakeholders. Additionally, as specialty practices are progressively integrating within health systems, ePA can be used to simplify the complicated specialty process for providers, helping patients get their medications more quickly.
Drivers for ePA Adoption in Health Systems
Health systems stand to significantly benefit from modernizing the PA process via electronic solutions. A health system can seamlessly integrate with an ePA solution through connection with their EHR system as nearly all EHR systems are committed to ePA.
Streamlined Workflow
Streamlined PA workflows within EHR systems — prospective ePA workflow saves an additional 13.2 days in turnaround time32
ADVANCED SECURITY
Controlled access to patient information through EHR systems and web portals — ideal ePA solutions are fully HIPPA compliant33
SHORTER TURNAROUND TIMES
Short turnaround times for PA determinations — 86 percent occur within one day or less34
INCREASED SPEED TO THERAPY
Faster turnaround times on PA requests leads to greater dispense rates for medications — 80 percent higher in some cases35
REDUCED COSTS
Less administrative costs — approximately $8 saved per PA request36
REDUCED BURDEN
Less burden for providers — approximately 15 minutes saved per PA request37
Centralized PA Teams
Centralized teams of administrators dedicated to completing PA requests are becoming increasingly more common for their abilities to effectively handle the large volume of PA requests generated at health systems and communicate ePA procedures during employee turnover.
In a single year, a centralized PA team of 15 members at a health system of ~1500 physicians was able to improve the number of same day (≤ 24 hours) ePA submissions from 31 percent to 92 percent.36
One team improved same day (≤ 24 hours) ePA submissions from 31 percent to 92 percent.
Case Study: Success of ePA in a Health System
A large health system of ~1500 physicians integrated an ePA solution into their Epic EHR system. In less than a year, they saw the following results:39
Provider adoption increased by nearly 20 percent, from 850 to 1000 NPIs.
Fifty-eight percent increase in PA requests initiated through the EHR system in workflow relative to a web portal solution.
The average turnaround time for PA determinations decreased by 25 percent in seven months when PA requests were completed through the EHR system rather than a web portal solution.
With so much care taking place at health systems, ensuring that ePA technology is readily available for providers to use in workflow can increase operational efficiency while decreasing time-to-therapy for patients, among other benefits. Successful integrations of ePA at health systems have seen strong provider adoption and return on investment in less than a year through dedicated side-by-side support of the ePA vendor. Effective centralized PA teams at health systems can also see a boost in productivity through streamlined and automated ePA functionalities. Health systems can take a big step forward in advancing patient care and provider wellness through adoption of ePA.
Key Takeaway
Health systems represent a major opportunity for driving provider adoption of ePA. With ePA availability in EHR systems nearing 100 percent, health systems can easily deliver in-workflow ePA solutions to their providers. As health systems gain more specialty practices, ePA may be leveraged as an intelligent solution for the complicated specialty process and motivate health system wide adoption.
