ICYMI: Heard at HIMSS25

Picture it: Las Vegas in February with 25,000 of your closest healthcare technology colleagues.

HIMSS25 proved to be equal parts inspiring and tiring. But after your feet stop hurting, your focus returns to how healthcare is hurting and the memorable conversations and stories that highlight the real impact of innovative technology in helping healthcare heal itself.

I spoke with some of healthcare’s leading voices and Surescripts Network Alliance participants, who reinforced the importance of collaboration in solving challenges and meaningfully improving healthcare for clinicians and the patients in their care.

Here's what we heard at HIMSS25:

“Interoperability really does help support patients,” said Dr. Michael Blackman, Chief Medical Officer, Greenway Health.

“The way we innovate and help healthcare heal itself is, number 1: collaboration,” said Lauren Hackenberg, PharmD, Senior Director, Provider Capability, Optum Rx.

“If we work together, we can figure out the solutions in a much easier and effective way,” said Nicole Harrington, Vice President, Chief Pharmacy Controlled Substances Officer, CVS Pharmacy.

“Prior authorizations and automating that is a step in that direction,” said Dr. Danny Lee, Chief Medical Informatics Officer, Johns Hopkins Community Physicians.

“Rethinking the entire experience and not putting more and more manual processes in front of [clinicians],” said Jason Sherwin, Senior Director, Healthcare Business Development, CLEAR.

“Artificial intelligence has real potential to take on some of that administrative burden,” said Dr. Nele Jessel, Chief Medical Officer, athenahealth.

“Take the administrative stuff that providers are having to do and find ways to automate,” said Angie Odham, System Executive Director, UNC Health.

Digging deeper: getting it right the first time with prior authorization automation

During a panel discussion at HIMSS25, Optum Rx noted a 100% accuracy rate for approvals supported by Surescripts’ groundbreaking Touchless Prior Authorization technology. This means prior authorizations for medications are approved in seconds as opposed to days or weeks with no rework – solving one of the leading causes of burnout for care providers and non-adherence for patients.

“Our standard process has prior authorizations approved in 8.5 hours. This capability and innovation reduced [the time it takes] down to the 29 second mark,” Lauren Hackenberg, Senior Director, Provider Capability for Optum Rx, shared during the discussion. “It’s absolutely fantastic. Patients can now have access to these medications [at the] pharmacy before they even leave the office.”

Hackenberg added, “we're getting it right the first time—the frustration comes [from] the administrative burden and the back and forth. So, if we can get this right the first time, in addition to the 88% reduction in appeals, we're seeing a 75% reduction in lack of information denials.”

“That speaks to that back and forth...of just making sure, did we get this information? Is it the right information? We are running 100% accuracy. When we think about it... it’s true codification. It is not a large language model and there's no AI [being used in the technology]. The 100% accuracy really speaks to getting it right the first time,” she said.

Why it matters: systemic innovation for the win-win-win

One challenge that all sides of healthcare can agree on is process inefficiency that contributes to burnout and can restrict patient access to treatments. Technologies often solve just one part of the problem for one part of the patient care team, ultimately shifting the burden to another care provider.

As a result, tensions between payers and providers run high, fueled by time-consuming processes like prior authorization.

To truly solve healthcare’s challenges, we must collaborate and engage in systemic innovation. It means technology that is a win-win-win for clinicians, care managers and of course, patients.

One example is from UNC Health, following the recent implementation of Touchless Prior Authorization technology.

During the panel discussion, Angie Odham, System Executive Director for UNC Health, explained what systemic innovation means in practice, noting that, "we [prescribers] didn't have any training. We actually had a silent go-live for a week and then we announced it the next week. They [prescribers] didn't even know what was happening.”

“And we are at a 43% rate that's getting approved of the ones [prior authorizations] that are going through. We're very excited about that.” She also urged other health systems and health plans to “get signed up quick because it's really worth it.”