Background Medication access teams play a critical role in reducing time to therapy, ensuring reimbursement, and supporting patients through complex benefit and prior authorization (PA) processes. At our academic health system, these services have historically been decentralized across infusion and specialty pharmacy, resulting in fragmented workflows, inconsistent performance metrics, and challenges demonstrating operational value. Under new pharmacy leadership, a systemwide transition is planned to unify these services under a single structure, migrate from manual shared-drive processes to a centralized digital platform, and implement technology solutions to support sustainable growth.
Purpose This project seeks to streamline medication access services across an academic health system by centralizing fragmented workflows, standardizing prior authorization processes, and leveraging digital infrastructure. Currently, medication access functions are decentralized across infusion and specialty pharmacy teams, leading to inefficiencies, inconsistent performance metrics, and difficulty demonstrating value. The planned initiative will establish a unified medication access service under pharmacy leadership, supported by centralized Epic workqueues, a standardized Request for Proposal (RFP) process for technology vendors, and cloud-based operational tools. Anticipated outcomes include improved efficiency, sustainability, and scalability of patient access services.
Methods A phased, systemwide redesign of medication access operations is planned. The project will begin with mapping of current workflows, staffing models, and technology infrastructure to identify inefficiencies and redundancies. Next, centralized Epic referral workqueues will be implemented to standardize case intake and routing across sites of care. A structured RFP process will be conducted to evaluate prior authorization management software platforms, including drafting requirements, vendor scoring, and preparation for contracting. Concurrently, a cloud-based infrastructure will be designed to include centralized case tracking logs, a standardized SOP library, and an operational KPI dashboard. Stakeholder engagement will be prioritized, with iterative feedback planned from pharmacy leadership, frontline access staff, and IT partners. A future-state roadmap will then be developed to ensure scalability, sustainability, and alignment with organizational priorities.
Results Since the project is in progress, results are not yet available. Planned evaluation metrics include:
- Case routing efficiency and reduction in manual processing following Epic workqueue implementation.
- Standardization of intake and triage across infusion and specialty pharmacy.
- Vendor selection outcomes from the RFP process, including anticipated automation of prior authorization workflows.
- Impact of cloud-based infrastructure on real-time workload monitoring, case tracking, and KPI reporting.
- Staff-reported changes in workload distribution, role clarity, and overall satisfaction.
It is anticipated that these measures will demonstrate improved consistency in operations, greater transparency of performance data, and enhanced scalability of services.
Conclusion This project is expected to demonstrate the value of centralizing medication access services under unified pharmacy leadership and investing in scalable infrastructure. Anticipated benefits include greater efficiency, standardization, and transparency across the health system. Once implemented, these strategies may reduce workflow redundancies, improve data accessibility, and support informed decision-making. The planned model aims to serve as a replicable framework for health systems seeking to optimize medication access teams and improve patient access to therapy.
