Over the past decade, Healthcare Informatics has recognized healthcare leadership teams who have gone above and beyond in their use of information technology solutions with the Innovator Awards.  But those innovators could not have achieved such success without dedicated vendor partners. To that end, Healthcare Informatics announces the winners of the second annual Leading Edge Awards, honoring vendors whose combination of expertise and innovation are shaping the future of healthcare systems.  One of two 2016 winners in the category of Clinical Workflow is CoverMyMeds, a Columbus, Ohio-based company leading in electronic prior authorization solutions.  Matt Scantland, co-founder and Principal at CoverMyMeds, talks to Healthcare Informaticsabout the important of prior authorization to controlling healthcare costs.

Healthcare Informatics: Tell me about CoverMyMeds’ vision for clinician workflow in healthcare. 

Matt Scantland:  What we do at CoverMyMeds is help patients get the drugs they need to live healthy lives.  It’s an important mission.  We found the best way to do that is to make the prior authorization process easier.  Because problems with prior authorization is something that you see day-in and day-out in the pharmacy and in the doctor’s office.  It frequently results in something we call prescription abandonment, meaning the doctor wrote a prescription but once the patient encounters the prior authorization process, they don’t make it through that process and don’t end up getting their prescription.

We see prescription abandonment, outside of the CoverMyMeds ecosystem, up to 40-50 percent of the time when a prescription requires prior authorization.  It’s a very common and significant problem.  The result of prescription abandonment is that patients aren’t getting the important drugs their doctors have prescribed.  They aren’t getting any alternative treatments either.  And it’s a big problem—because many of these drugs treat chronic illnesses.  So the patient’s disease progresses, they end up getting sicker, and they become a more expensive patient to care for.

This is one of the main reasons why we spend so much in avoidable healthcare costs.  This prescription abandonment, a type of non-adherence to care and patients taking the drugs they need, is one thing that drives somewhere around $350 billion a year in avoidable medical spending.

Read the full story at Healthcare Informatics.