Next Steps Towards ePA

By EHRA Chair David Bucciferro (Foothold Technology)

Health information technology (IT) holds great promise for contributing to efforts to streamline and improve the efficiency of the highly complex prior authorization process, and the EHR Association is confident that electronic health record (EHR) systems have a vital role to play in doing so. However, the adoption of electronic prior authorization (ePA) is not without its challenges – challenges that will require time, significant cross-stakeholder coordination, and standardization of access to and exchange of related data to overcome.

As we laid out in the previous three blogs in this series, the EHR Association supports streamlining the ePA process, provided the effort is appropriately supported by accepted standards and care is taken to avoid past mistakes of rolling out policy requirements faster than standards have been developed to support the work. 

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Standards will Make or Break Efforts Toward ePA

By Janet Campbell (Epic), EHRA Public Policy Leadership Workgroup Vice Chair

This is part two in a four-part series examining the need for ePA, the barriers presented by the current environment, necessary capabilities, and functionality, and the EHR Association’s policy recommendations. Part one can be read here.

Streamlining the electronic prior authorization (ePA) process will require significant coordination and standardization across multiple domains within individual healthcare organizations, across dozens of health plans covering their patients, and across the health IT tools in use by every participant in the process.

Progress is being made by various stakeholders in terms of standards development. Notably, the Coverage Requirements Determination (CRD), Documentation Templates and Rules (DTR), and the Prior Authorization Support (PAS) implementation guides – all a part of the Da Vinci Project’s efforts to understand functional requirements, build consensus on a technical approach, pilot, and iterate – have resulted in significant progress toward the enablement of highly automated prior authorization workflows.

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