Dr. Colin Banas on Fixing the Medication Journey with AI, Automation, and Real-Time Data

The journey from diagnosis to a filled prescription is more of an obstacle course than a straight line. When writing a prescription, the provider must weigh not just clinical appropriateness but the potential access, affordability, and adherence barriers a patient may face. Even a small bump in adherence can make a meaningful difference. Health systems tied to CMS star ratings, for example, can see transformative financial and quality impacts from just a 1% to 2% increase in adherence for chronic conditions like diabetes and heart failure.

Having real-time clinical and benefits data in the workflow empowers a richer, more informed conversation with the patient at the point of prescribing to encourage adherence. Providers can immediately see which medications are covered under the patient’s plan, whether a prescription requires prior authorization (PA), and what lower-cost therapeutic alternatives may be an appropriate choice, accounting for both clinical needs and financial reality.

If a medication requires PA, electronic prior authorization (ePA) technology integrated within the EHR workflow can automatically start an ePA submission, pulling in relevant data from disparate systems. In addition, smart alerts can let prescribers know when the prescription must be sent to certain pharmacies, which is particularly important for specialty medications and drugs within limited distribution networks. In combination, these technologies relieve friction, eliminate delays from fax and phone tag, and allow fill status to be tracked in real time—so the prescription doesn’t fall into a black hole between approval and fulfillment.

When technology aligns with the medication journey, it makes getting patients started on a prescribed therapy more efficient—and more human. That progress is measurable, too: higher adherence, better patient outcomes, and stronger performance on quality metrics.

Cost is the usual suspect—and for good reason. Three in ten adults say they haven’t taken medication as prescribed because of cost, according to a KFF survey. There are several barriers beyond affordability, however, that are just as consequential: prior authorization delays, lack of clarity on prescription instructions, and concerns about side effects.

Technology can remove barriers that stand between a clinical decision and a patient’s ability to start and stay on their medications. For example, patient engagement tools can send personalized messages on behalf of the provider, guiding patients along the specialty medication journey to reinforce trust and reduce uncertainty. Patients receive a convenient link to educational content explaining why the medication was prescribed, how it helps manage their condition, and what the potential side effects are. Answering these questions upfront can cut through the confusion and second guessing—before Dr. Google starts chiming in.

Beyond education, these tools connect patients with copay cards or patient support programs shortly after their prescription is sent to the pharmacy when it can make the greatest impact. They also provide timely updates on prior authorization decisions and reminders on when and where to pick up their medication. These touchpoints make it more likely that a prescription is picked up and used as directed.

Because specialty medications may fall under pharmacy or medical benefits—sometimes both—getting patients approved for a prescribed therapy often means diving headfirst into a confusing maze of rules and requirements with little transparency. For medical practices that prescribe a high volume of specialty drugs, such as oncology and rheumatology, an inefficient PA workflow isn’t just frustrating—it directly impacts patient outcomes. For instance, 80% of oncologists reported patients experiencing disease progression due to PA delays.

Technology platforms that integrate payer rules, ePA tools, and pharmacy coordination are beginning to close these gaps. By resolving roadblocks before the prescription reaches the pharmacy, patients can start their medication therapy far more quickly—improving adherence and outcomes.

This level of integration is vital because it drives not only efficiency but also better outcomes. Specialty therapies are often prescribed for serious, progressive conditions, and delays can lead to disease advancement. A connected, transparent process enables faster decision-making, improves adherence, and reduces the risk of therapy abandonment.

We’re entering a new phase where AI is becoming less about hype and more about help. We like to think of it as augmented intelligence—not artificial. The focus is on keeping a human in the loop while tapping into AI’s speed, breadth, and agility to make care safer and more effective. One of the most meaningful use cases is what I call a “clinical co-pilot”—a system that steps in when needed, whether that’s summarizing a patient’s history, flagging potential gaps in therapy, or helping clinicians make faster, better-informed decisions.

For patient engagement, AI is transforming how healthcare providers connect with patients by making automated communication feel personal and timely. Instead of generic reminders, for example, patients can receive refill alerts that include manufacturer coupons—addressing patients’ cost concerns in the moment. Soon, AI agents will act more like care concierges, helping patients stay on track with treatment throughout their care journey.

What makes these innovations promising is their ability to work quietly in the background—augmenting care without disrupting workflows. The focus now is on refining these tools to further reduce administrative burdens and improve patient outcomes.

Clinicians didn’t go into medicine to chase paperwork, so it is not surprising that administrative burden is one of the most-cited drivers of burnout. Giving time back to clinicians is probably the most valuable gift we can offer in today’s healthcare environment.

A prime example is the time-consuming PA process, which pulls clinicians away from direct patient care. When prescribers can view PA requirements in real time, submit pre-populated forms using data from multiple systems, and can track everything in one place, they are freed to focus more on patients and less on paperwork.

Another example is how e-prescribing is evolving beyond the clunky process built years ago, but still in use today. Modern systems do more than transmit a prescription—they pull in information the pharmacy needs, like necessary clinical context and missing prescription instructions—leading to smoother workflows for clinicians. They also factor in opportunities for financial assistance and pharmacy location, helping patients start therapy faster and at a lower cost.

Begin with the challenges your teams encounter every day, whether it’s unclear benefit information, time-consuming documentation, or delays starting patients on therapy. These common pain points are ideal opportunities for AI and automation to make a meaningful impact.

The best solutions integrate with existing workflows and support measurable outcomes. Metrics like time-to-therapy, prescription fill rates, and reduction in administrative tasks per prescription should guide investment decisions. Beyond the numbers, solutions must also enhance the experience—for both patients and clinicians.

Ultimately, AI and automation should not be seen as just technical upgrades. Rather, they are strategic tools that support the broader goals of value-based care, provider sustainability, and improved outcomes.