Much of the innovation in medicine is concentrated in specialty therapies, but the systems that enable patients to access them have not kept pace. Fragmented workflows and disconnected handoffs continue to delay treatment starts and add complexity for care teams.
During a recent webinar hosted by Becker’s Healthcare and CoverMyMeds, CoverMyMeds leaders David Ward, vice president of business development; Andrew Berrigan, senior director of product management and Cyrus Peyrovian, vice president of technical product management discussed how connected data, automation and clinical workflows can help close those gaps.
Here are five key takeaways from the conversation.
1. Portal fatigue
CoverMyMeds research shows patient care teams use upwards of nine different digital applications or portals.[1] Cyrus said many organizations are sitting on backlogs of administrative work still awaiting benefit verification or prior authorization.
“One thing I’ve seen throughout my career is that the care teams doing this work are incredibly dedicated, but they’re often navigating through fragmented systems, portals and requirements. Providers and their teams experience immense portal fatigue,” he shared.
Patients feel it too. Research CoverMyMeds conducted with Nielsen found about 85% of specialty patients reported barriers in the access process,[2] which David attributed to infrastructure that was never built around specialty therapies.
2. Handoffs create risk
Specialty medications now account for more than half of U.S. medicine spending,[3] yet the path to treatment remains a series of disconnected steps, each often with its own system and owner.
Andrew said that is where health system leaders should focus. “The biggest risk usually isn’t inside any one of those steps. It’s in between them. Every handoff is another chance for something to stall.”
Cyrus noted prior authorization raises the stake because there’s often just one opportunity to submit a complete request.
“If information is missing or it’s inaccurate, it can lead to denials or delays in care.”
3. Interoperability is foundational
Patient care teams spend more than 13 hours a week on prior authorization, according to CoverMyMeds research.2 Andrew said the biggest gains come from earlier benefit information, prior authorization inside the EHR and clear visibility into status.
“In my view, interoperability only matters if the data that’s exchanged supports the next best action. The bar should be coordinated action, not just connectivity for its own sake,” he shared.
Cyrus said that connectivity is the foundation for automation that flags missing documentation before a request goes out. Recent CoverMyMeds data shows 88% of prior authorization determinations in a community oncology setting were returned the same day.[4]
4. Automation leads to scaling, but doesn’t replace clinical judgement
Cyrus said most access work follows repeatable processes suited to automation and AI, while still requiring clinical oversight.
“One of the biggest mistakes an organization could make is viewing AI as a replacement for clinical expertise,” Cyrus said.
David recommended starting with a few high-workload therapeutic areas, building internal champions and expanding from there. Andrew added that trust grows when the system shows its work, with auditability and review designed into the workflow from day one.
5. Building an enterprise capability
Andrew said leaders cannot choose between the workflows their teams use and the infrastructure beneath them.
“If you only optimize the workflow, it breaks when you try to scale,” he said. “If you only build a foundation, you’ve built a bridge to a workflow that nobody will come back to.”
His challenge for leaders is to map every place where benefit information, documentation or prior authorization status leaves the EHR. David urged treating specialty access as an enterprise capability rather than a silo.
All three stressed that the ultimate guide post is reducing work from the journey holistically instead of moving it into a different silo.
- [1] Specialty Access and Affordability, data on file, 2025.
- [2] Nielsen research conducted for CoverMyMeds, 2026.
- [3] U.S. Medicine Use Trends 2026 | IQVIA (iqvia.com).
- [4] FastAuth and The US Oncology Network analysis of 250,000 medical prior authorization cases, March 2026.
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