In the pursuit of operational excellence, Banjo Health aimed to revolutionize the way clinical criteria are managed and integrated into decision trees for Prior Authorization (PA). The traditional method was time-consuming, leading to inefficiencies and delays in PA processing.
Objective
To significantly reduce the time required for clinical criteria entry, both for new trees and updates, utilizing Composer, a tool designed to streamline these processes.
Methodology: Time in Motion Studies (TIMS)
Two distinct TIMS were conducted to compare the efficiency of clinical criteria entry with and without Composer.
- Insulin Clinical Criteria Entry:
- Legacy Process: A manual approach took 49 minutes.
- With Composer: The process was reduced to 14 minutes.
- General Clinical Criteria Entry:
- Legacy Process: The manual entry required 73 minutes.
- With Composer: Time was significantly cut down to 18 minutes.
Results
The implementation of Banjo’s Composer led to a remarkable improvement in efficiency:
- For Insulin Clinical Criteria, there was a 70% increase in process efficiency, saving 35 minutes.
- For General Clinical Criteria, the process became 75% more efficient, saving 55 minutes.
These findings underscore Composer's impact on operational productivity, streamlining the management of clinical policies and criteria with considerable time savings.
Conclusion
The Time in Motion Studies clearly demonstrate the significant efficiency gains achievable with Composer in the management of clinical criteria for PA processes. By reducing entry times from nearly an hour to just minutes, Banjo Health empowers healthcare providers and pharmacists with a faster, more streamlined approach to policy management, enhancing the overall healthcare delivery system.
