Managing medication renewals in a healthcare setting can be a complex task, particularly when patient requests come in through various channels: phone calls to clinics or call centers, patient portal requests, messages to nurses, and more. Ensuring that these requests are processed efficiently and routed correctly for approval or further action is key for maintaining patient satisfaction and outcomes.
With the advent of Artificial Intelligence (AI) a lot of organizations are moving towards automated refill processes that function across channels. This allows an automated agent to manage the prescription renewal process through voice or text channels, which presents a cost savings to the provider but also creates new challenges in the process. A well-structured workflow that leverages the Electronic Health Record (EHR) can help streamline this process. Here are some key considerations for an efficient medication refill workflow:
1. Centralized Intake System
Funnel all refill requests into the EHR. This ensures that every request is tracked with the associated patient, and that subsequent communication and actions can be managed within the EHR, where users spend most of their time.
Challenge: Identifying the patient with the EHR
When a patient contacts you about a prescription renewal it’s important you properly identify them. Patient identification usually requires 4 or more data elements to reach a conclusive match. Often these are: first name, last name, date of birth, and phone number. This is easy enough to collect via a human agent, but more difficult using AI.
Key considerations to keep in mind as you design your patient identification process includes:
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What data can an AI agent reliably collect?
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Does the collected data allow for a conclusive patient match?
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What should happen if there isn’t a conclusive patient match?
2. Request Routing
After requests are input into the EHR they are often routed to clinical support staff who triage the request. The support staff will then initiate the correct action such as cuing up an electronic medication order for the prescribing provider to sign, contacting the patient, or contacting the pharmacy.
Challenge: Routing to the correct support staff
EHRs use inbox-like functionality to route messages to staff. The inboxes rely on groups of users who work that inbox. There are often many different inboxes and staff members for an AI agent to choose from, making the identification of the correct inbox for each refill difficult to automate.
The typical thought process for identifying the right inbox can be:
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Ensure you can verify the correct medication order to be renewed
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Define how the organization manages their support inboxes.
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Do they have department-specific inboxes? Location? Some other concept?
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Identify how those inboxes can be programmatically related to the medication order
Each of these steps will require scoping and conversation with the health system support personnel to fully understand. Take your time and make sure you document details as you uncover them.
3. Tracking and Follow-Up
Create a mechanism to log the request details as well as any follow-up actions taken by the staff, such as scheduling a patient visit or calling the pharmacy. This ensures that every request is resolved in a standardized manner and staff can easily access all information related to the request if they need to update the patient on their request’s status
Challenge: Centralizing request information in one place
When using an AI agent to field requests it’s important to understand that they won’t be clicking buttons inside the EHR. You must implement an integration that creates a new encounter in the patient’s record for each renewal request. This encounter should include a note with the request details. Staff can then add additional notes within this encounter to document their follow-up actions.
Fortunately, Epic’s EHR has an Incoming Transcription HL7v2 interface (MDM) that can create this encounter and note, as well as route the encounter to the indicated inbox. The interface allows you to specify the encounter type and note type that will be created, and define which inbox to send the data to.
4. Patient Communication
Keep patients informed about the status of their refill requests to reduce uncertainty and improve patient satisfaction, and use your AI agent to reach out to the patient to collect more details as-needed. You can use the patient’s preferred communication method, which is often captured discreetly in the EHR. Adding it into the renewal request note will make it easily accessible for staff who may not use the EHR’s communication tools to contact the patient.
Challenge: Identifying the preferred method of communication
The preferred communication method is available via the Patient FHIR resource, typically as the first option listed within the Patient.Contact element. Consider presenting this to the patient during AI agent interaction to confirm that this is the method they would like to use for this renewal.
At Farseen Advisors we have the expertise to help organizations navigate this and other healthcare technology challenges. For more insights and detailed guidance on healthcare technology workflows and integrations, explore our website at www.farseenadvisors.com or contact us directly at sales@farseenadvisors.com. Let us help you navigate the complexities of healthcare IT and achieve your strategic goals.