Automate Your Prescription Workflow and Save Staff Time

A prescription workflow involves more than sending a prescription to the pharmacy. It includes the steps needed to create, review, transmit, change, renew, and follow up on prescriptions. And each step can require review, routing, approval, and more that add to staff and provider workloads. Standardizing the processes and automating routine tasks with your electronic health record (EHR) can reduce manual work and make managing prescriptions more efficient. 

This article covers the why and how of standardizing and automating the prescription workflow for ambulatory practices.

Understanding the Prescription Workflow

A typical prescription workflow can look like the following. 

Patient need → medication review → prescription creation → clinical checks → approval/signature → pharmacy transmission → change/renewal requests → follow-up 

The volume of repetitive work involved in that workflow can take up more staff and provider time than necessary. 

For many ambulatory practices, renewals are one of the most repetitive parts of that workflow — and one of the best places to standardize and automate. But the workflow can also cover new prescriptions, and prescription changes or exceptions. 

According to the American Medical Association (AMA), primary care providers receive between 10 and 25 refill requests daily and spend an average of 30 minutes a day responding to them. Research published in the Annals of Family Medicine on EHR workload trends showed that messages for prescription refill requests increased by 19.5% for the timeframes examined.

Each request kicks off a chain of steps. And when that chain isn’t standardized or automated, inefficiency and delays can result. In contrast, automated prescription workflows can reduce administrative burden in ambulatory care settings. 

Why Standardize Before You Automate 

Improving the prescription workflow starts with standardization. Without a standardized workflow, many of the steps require repeated manual review, routing, and follow-up. In an article on EHR inbox burden, the AMA stated that for one practice with 5.6 FTE primary care providers, processing prescription renewals required 7.65 hours of administrative work each day. For that practice, that equals enough time to require a full-time staff member to enter requests. And refills made up 16% of total EHR inbox volume, according to the AMA article.

Standardization is creating a consistent process for how requests are handled, while automation uses technology to complete or simplify steps within that process. 

Standardizing your prescription workflow involves laying out a consistent approach that staff and providers follow for every request. For example, it may define one intake channel, such as requiring patients initiate refills with their pharmacy. It may also include clear staff roles, clinical approval criteria, consistent protocols by medication type, and setting rules for when labs or office visits are needed. 

Questions to ask to help you document and then standardize your process include:

• How do we want requests coming into, or moving through, the practice?
• Who reviews requests first?
• Which requests can staff handle without provider review?
• Which requests require clinician review?
• What information has to be present before a request is routed?
• What clinical requirements, such as labs, monitoring, or visits, need met, if any? 
• How do we identify duplicates?
• How do we handle exceptions?

Standardization reduces unnecessary variation and gives staff and providers a consistent process to follow. By itself, it can reduce the burden on the entire team. 

Automating Your Standardized Prescription Workflow

An automated prescription workflow lets your practice execute that standardized process faster and with less manual interaction. Implementing automation before standardizing can diminish your benefits, because the automated process will simply automate inconsistencies or be harder to put into place. 

As you look into automation, decide what parts of the process you want to automate, making sure your current technology supports those steps. Focus on predictable, rules-based work and routing, while keeping human review for exceptions and decisions that require clinical judgment. 

Here’s what an optimized automated prescription workflow may look like:

Prescription need or request → Clinical and medication review → Routing/checks → Approval and signature → Electronic transmission → Changes, renewals, and follow-up 

If the request is for a refill, here’s how that breaks down:

1. The request is received electronically in the EHR from the pharmacy, patient portal, or another electronic channel.
2. The system checks the request. Some EHRs automate checks against predefined criteria, such as whether the patient is due for a visit or required lab work.
3. The request is routed appropriately. Routine requests and exceptions are routed to the appropriate staff member or provider according to established rules.
4. The prescription is reviewed and approved. The request is reviewed and approved according to established protocols, and requests requiring clinical judgment routed to the appropriate clinician. 
5. The prescription and follow-up are handled electronically. The approved prescription is sent to the pharmacy, and the patient can be notified or prompted to take the required next steps.

Note: Not all EHRs automate every step, and some actions require clinical judgment or human approval. Automation typically involves role-based permissions to determine who can sign and approve and who can’t (which can be part of your standardizing your process).

Prescription Workflow Automation Basics Using Azalea Health

An ambulatory EHR, like Azalea’s, with or without add-on solutions can help you automate your standardized prescription workflow. 

The Azalea Health Ambulatory EHR integrates with DrFirst to automate and improve workflow efficiency. 

Here’s how it works:

With Azalea’s integrated e-prescribing workflow powered by DrFirst, renewal requests arrive electronically and are ready to act on — right from the notification bar. Providers can review up to 10 requests at a time, choosing to renew, deny, change, or forward each one with just a few clicks. Built-in pharmacy notes and internal comment fields keep communication clear and documented. And when the provider is ready, a single signature executes everything electronically —there’s no paper, no callbacks, and no delays. 

A More Efficient Practice Starts with a Smarter Workflow

Ambulatory practices benefit from a standardized and automated prescription workflow. Both can improve clinic operations so that providers and staff focus their time and energy on decisions that require clinical judgment.

When you standardize and automate your prescription workflow, you can free up time each day and week for providers, staff, and patients. From the initial request to the follow-up, routine steps can be automated and repeated across your operation.