Callen-Lorde Community Health Center in New York City has transformed its long-acting injectable (LAI) HIV prevention program through a series of targeted electronic health record (EHR) optimizations, dramatically increasing patient access and care coordination.
During a recent Becker’s Healthcare podcast episode, Stephen Sukumaran, Director of the LAI program at Callen-Lorde, described how rethinking digital workflows and cross-team collaboration helped overcome some of the most persistent operational hurdles in LAI PrEP (pre-exposure prophylaxis) delivery.
Mr. Sukumaran’s team offers a clear example of how technology, when thoughtfully designed, can make HIV preventive care more accessible and sustainable.
Here are four key takeaways from the conversation:
1. Addressing insurance barriers through EHR integration
Mr. Sukumaran described the initial barriers to delivering long-acting PrEP at Callen-Lorde, which serves more than 23,000 patients annually, many of whom face complex insurance coverage challenges. Approximately half of patients are enrolled in Medicaid or Medicare, increasing the risk of coverage disruptions and administrative delays.
“In New York state, we bill as a pharmacy or medical benefit. If medical benefit, we’re able to utilize the 340B savings that support administrative and clinical burden,” Mr. Sukumaran said. “But plans appear to resist this with hurdles like prior authorization.”
Payer variation, credentialing mismatches and higher-than-average denial rates frequently disrupted care. In some cases, the primary care provider listed on a patient’s insurance needed to match the provider administering the injection, creating additional barriers. Monthly Medicaid eligibility checks further increased staff workload and the risk of missed appointments.
To address these challenges, Callen-Lorde embedded insurance verification directly into its EHR workflows. Electronic prior authorizations were integrated so requests could be auto-populated with patient and prescription data, enabling real-time responses and reducing manual processing.
The EHR also delivers payer-specific prompts and dynamic alerts based on patient records, allowing staff to anticipate requirements before appointments occur. These changes helped reduce errors, prevent last-minute cancellations and improve continuity of care for patients navigating complex coverage environments.
2. EHR standardization drove a 150% increase in LAI appointments
Before optimization, Callen-Lorde’s LAI program relied heavily on fragmented spreadsheets and manual workflows. “We were relying on about five to six separate Excel spreadsheets,” Mr. Sukumaran said. Insurance verification alone took 20 to 40 minutes per patient, per appointment.
Only a limited number of providers were trained to screen patients for LAI eligibility, and documentation varied widely across teams. These inefficiencies made onboarding new patients difficult and threatened the program’s ability to scale.
To streamline workflows, Callen-Lorde created an LAI optimization workgroup and leveraged an existing tool within their EHR known internally as “Express Lane.” The tool consolidates documentation, lab orders, insurance details and internal referrals into a single interface.
“Our template includes the initial LAI prep prescription for insurance verification, an internal referral for tracking, and a clinical checklist which guides a provider in documenting and screening what’s needed,” Mr. Sukumaran explained.
The impact was significant. Weekly LAI appointments increased by 150%, and the number of patients initiated on LAI PrEP doubled. The time from screening to initiation dropped from several months to just 14 days.
3. Cross-team collaboration enabled success
Mr. Sukumaran emphasized that technology alone did not drive success. Progress depended on close collaboration across clinical, operational and administrative teams.
Callen-Lorde formed a cross-functional LAI workgroup that included clinicians, IT, scheduling, billing and operations leaders. The group meets twice weekly to review upcoming appointments, verify insurance coverage and resolve barriers before patients arrive.
This shared accountability ensured that EHR tools were used consistently and adapted as payer requirements and clinical needs evolved. The collaborative model also strengthened communication across departments, allowing staff to guide patients more seamlessly from education and eligibility through initiation, adherence and retention.
“Everyone plays a role in ensuring our patients move seamlessly through the process, from education and eligibility to initiation, adherence and retention,” Mr. Sukumaran said. “Collaboration transforms a program from a set of siloed services to a well-coordinated comprehensive prevention system.”
4. EHR optimization supports equity and scalability
As Callen-Lorde expands its LAI program to include newer prevention options, the same EHR infrastructure continues to support growth. With increasing interest in long-acting HIV prevention and heightened payer scrutiny, Mr. Sukumaran said scalable digital coordination is essential.
“EHR-based coordination for long-acting PrEP can serve as a model for how we use data and integration to close gaps in access,” he said. “It’s not about technology for its own sake. It’s about making sure people who could benefit from long-acting PrEP don’t fall through the cracks.”
By aligning technology, workflows and collaboration, Callen-Lorde demonstrates how thoughtful EHR optimization can advance preventive care while addressing operational realities faced by safety-net providers.
