The American Hospital Association said it supports standardizing electronic prior authorization processes, but urged the Office of the National Coordinator for Health Information Technology to test the program before any regulatory action is taken.
Standardized use has the potential to save patients, providers and utilization review entities significant time and resources and can speed up the care delivery process, AHA said in a March 18 letter to ONC. A judicious approach is needed to ensure that it does not place undue burden on healthcare payment processes, however.
"Any substantial change in the technology and/or standards used in healthcare information exchange should be sufficiently tested to ensure functionality, analyzed to establish projected return on investment, and incorporated according to an appropriate glide path to minimize systematic disruption," AHA said.
The process should include careful consideration of the transaction's scalability, privacy and necessity of access to the transmitted health information, the AHA said. It needs to have the ability to complete administrative tasks in a real-world setting, rather than a controlled environment such as an HL7 Connectathon.
Real-world testing will provide important data on beneficial improvements such as reduced delays and elimination of administrative burden, AHA said. Proof of adequate return on investment is critical to convincing providers and plans to make the significant technology investment and workflow adjustments needed.