Harnessing Informatics to Reduce Physician Burden: Improving Prior Authorization Processes
Harnessing informatics' power to cut physician burdens | American Medical Association
Summary
Dr. Viet Nguyen of HL7 International highlights the severe challenges posed by 'prior authorization' in healthcare. According to an AMA survey, many physicians report risks such as treatment abandonment and care delays due to these processes. To solve this, efforts are focused on improving workflows using standard technologies like FHIR.
Details
Dr. Viet Nguyen of HL7 International points out that 'prior authorization' imposes a significant burden on healthcare providers. An AMA survey from 2024 found that 82% of physicians felt the possibility of treatment abandonment due to prior authorization, 93% reported care delays, and 89% linked it to increased physician burnout. Dr. Nguyen emphasizes that HL7 is focusing not only on data standardization but also on 'workflow' standardization. By using common languages like FHIR, it becomes possible to smooth data transmission between physicians and payers, preventing dangerous obstacles caused by communication gaps in the prior authorization process. Electronic prior authorization systems eliminate the need for checking multiple portals; required information and status checks can be managed in one location. This reduces the burden on both clinicians at the point of care and back-office staff. HL7 stresses that continuous feedback from physicians is critical for improving this process, as clinical input helps make the standards better.
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