Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process

Abstract Background Processes such as prior authorization (PA) for medications, implemented by health insurance companies to ensure that safe, appropriate, cost-effective, and evidence-based care is provided to all members, have created inefficiencies within healthcare systems. Thus, healthcare syst...

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Autores principales:	Laney K. Jones, Ilene G. Ladd, Christina Gregor, Michael A. Evans, Jove Graham, Michael R. Gionfriddo
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Implementation science Prior authorization Qualitative Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/348ad5c51dcc4bafa10a3d2fa1a3e401
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spelling	oai:doaj.org-article:348ad5c51dcc4bafa10a3d2fa1a3e4012021-11-21T12:06:25ZEvaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process10.1186/s12913-021-07287-21472-6963https://doaj.org/article/348ad5c51dcc4bafa10a3d2fa1a3e4012021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07287-2https://doaj.org/toc/1472-6963Abstract Background Processes such as prior authorization (PA) for medications, implemented by health insurance companies to ensure that safe, appropriate, cost-effective, and evidence-based care is provided to all members, have created inefficiencies within healthcare systems. Thus, healthcare systems have implemented supplemental processes to reduce burden and ensure efficiency, timeliness, and appropriate care. Objective Evaluate implementation outcomes of two initiatives related to PA for medications: a common record that records all PA-related information that was integrated into the health record and an auto-routing of specialty prescriptions to a hospital-owned specialty pharmacy. Methods We conducted semi-structured interviews with medical staff to understand their experience, acceptability, adoption, and feasibility of these initiatives guided by Proctor’s Framework for Implementation Outcomes. Transcripts were analyzed using consensus coding. Results Eleven medical staff participated in semi-structured interviews. The two initiatives were analyzed together because the findings were similar across both for our outcomes of acceptability, adoption, and feasibility. Participants found the implemented initiatives to be acceptable and beneficial but felt there were still challenges with the new workflow. The initiatives were fully adopted by only one clinic site within the healthcare system, but limitations arose when adopting to another site. Individuals felt the initiatives were feasible and improved workflow, communication, and transparency. However, participants described future adaptations that would help improve this process including improved standardization, automation, and transparency. Conclusion The acceptability, adoption, and feasibility of two initiatives to improve the PA process within the one clinical site were well received but issues of generalizability limited the initiatives adoption system wide.Laney K. JonesIlene G. LaddChristina GregorMichael A. EvansJove GrahamMichael R. GionfriddoBMCarticleImplementation sciencePrior authorizationQualitativePublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Implementation science Prior authorization Qualitative Public aspects of medicine RA1-1270
spellingShingle	Implementation science Prior authorization Qualitative Public aspects of medicine RA1-1270 Laney K. Jones Ilene G. Ladd Christina Gregor Michael A. Evans Jove Graham Michael R. Gionfriddo Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
description	Abstract Background Processes such as prior authorization (PA) for medications, implemented by health insurance companies to ensure that safe, appropriate, cost-effective, and evidence-based care is provided to all members, have created inefficiencies within healthcare systems. Thus, healthcare systems have implemented supplemental processes to reduce burden and ensure efficiency, timeliness, and appropriate care. Objective Evaluate implementation outcomes of two initiatives related to PA for medications: a common record that records all PA-related information that was integrated into the health record and an auto-routing of specialty prescriptions to a hospital-owned specialty pharmacy. Methods We conducted semi-structured interviews with medical staff to understand their experience, acceptability, adoption, and feasibility of these initiatives guided by Proctor’s Framework for Implementation Outcomes. Transcripts were analyzed using consensus coding. Results Eleven medical staff participated in semi-structured interviews. The two initiatives were analyzed together because the findings were similar across both for our outcomes of acceptability, adoption, and feasibility. Participants found the implemented initiatives to be acceptable and beneficial but felt there were still challenges with the new workflow. The initiatives were fully adopted by only one clinic site within the healthcare system, but limitations arose when adopting to another site. Individuals felt the initiatives were feasible and improved workflow, communication, and transparency. However, participants described future adaptations that would help improve this process including improved standardization, automation, and transparency. Conclusion The acceptability, adoption, and feasibility of two initiatives to improve the PA process within the one clinical site were well received but issues of generalizability limited the initiatives adoption system wide.
format	article
author	Laney K. Jones Ilene G. Ladd Christina Gregor Michael A. Evans Jove Graham Michael R. Gionfriddo
author_facet	Laney K. Jones Ilene G. Ladd Christina Gregor Michael A. Evans Jove Graham Michael R. Gionfriddo
author_sort	Laney K. Jones
title	Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
title_short	Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
title_full	Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
title_fullStr	Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
title_full_unstemmed	Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
title_sort	evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process
publisher	BMC
publishDate	2021
url	https://doaj.org/article/348ad5c51dcc4bafa10a3d2fa1a3e401
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Evaluating implementation outcomes (acceptability, adoption, and feasibility) of two initiatives to improve the medication prior authorization process

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