10 Things Nurses Say They Need Right Now

1. A central location for medication information and resources

Most nurses spend precious time seeking out medication information for their patients — and most are using multiple resources to find this important information. This is primarily because medication information hasn’t been, historically, located in a single, trustworthy source. Nurses are usually searching for this information after a prescription has been sent to the pharmacy.

More than half of nurses report using online medication resources — 80 percent are doing this at least a couple times each week.

2. A clear picture of the medications covered by a patient’s plan

The medications covered under a patient’s health plan vary depending on the plan’s formulary. This information isn’t easy to keep track of, especially when medication requirements change at the pace they do.

In the words of one oncology nurse: “It's all very confusing and frustrating. I often spend more time being a medication concierge than a registered nurse.”

3. Seamless communication with providers

Ninety-seven percent of nurses report providing medication information to their prescribers. Common reported examples include prior authorization (PA) requirements, symptoms and allergies, patient medication history and patient plan formulary information.

While most of these interactions occur in-person, more than half of nurses said they also interact through the EHR, where questions and tasks require a physician response. The more attentive the prescriber, the better the communication can flow from nurse to provider to patient.

4. A way to prospectively submit prior authorization requests

Out of 10 core responsibilities identified in the survey, one of the lowest satisfaction levels reported was with PA.

“Prior authorization for medications takes up way too much of my time each day,” said one gastroenterology nurse. “I don’t feel like a nurse anymore. I feel like a ward clerk.”

The responsibility typically falls on the nurse to initiate a conversation with their patient about a PA request, and most feel it’s their responsibility to find alternatives. This step occurs often after the prescription has been sent to the pharmacy and a rejection returned.

Real-time benefit check (RTBC) solutions can surface PA requirements for certain medications earlier in the workflow, and some at the point of prescribing. This allows prescribers to initiate prospective requests and relieve some PA burden, allowing them more time with patients.

5. More efficient pharmacy communication

Unfortunately, prospective PA isn’t always a possibility, due to medication choice or solution availability. Throughout each day, nurses are in contact with pharmacies regarding prescription and PA status updates, medication availability and to discuss alternative medication information. This game of telephone can be a time suck — only 29 percent of nurses surveyed reported feeling satisfied with the length of time spent on pharmacy phone calls.

With solutions used at the point of prescribing, some of this can be avoided. These solutions can offer up formulary alternatives and even patient choice solutions that can resolve prescriptions not covered by insurance at the pharmacy.

6. Easy access to current patient medication info

Do most patients know their medications by heart? More than 40 percent of nurses reported less than half of their patients know this information. Of course, it’s a lot to keep track of — nearly half of respondents said most of their patients take between six and 10 medications.

Also critical to the patient journey is medication history, specifically tried-and-failed medication information. This data can be used to build a case for PA requests for non-covered medications — as well as future therapy plans. Ninety-four percent of respondents are digging through previous documentation to find medications the patient has previously tried and failed. This is more administrative time spent scavenging for data that could be collated and listed in an efficient solution built into an EHR or workflow tool.

7. Real-time plan formulary and benefit updates

“It's very difficult to keep up with rules that can change daily, especially with Medicare patients,” said an oncology nurse. “Each insurance company requires a different medication, a different form for the same medication … and, if it’s Medicare but the same insurance company, even a different form.”

Benefit formularies can change at any time, but there aren’t often health-system processes in place to update this data. This leads to a pharmacy traffic jam of rejected claims and subsequent paperwork, as well as phone calls to find a way to cover the medication — or to find an alternative. Naturally, this work often lands on the care team.

Through direct connections with payers, reliable point-of-prescription solutions can update formulary and benefit information in real time, preventing later hassle.

8. Help finding medication alternatives

When healthcare staff exhaust all avenues for accessing the originally prescribed medication, the next adventure begins: Find a suitable, accessible alternative.

Most nurses feel responsible for this task — 75 percent said they feel responsible for finding covered alternative medications and financial assistance options if cost and/or coverage are issues for their patient. In fact, this was the second-most cited reason nurses said they contacted the pharmacy.

By the time a nurse is searching for an alternative, they’ve likely already been through a round of phone calls and paperwork about the medication not covered or rejected by the plan. Nurses and providers may have fewer workflow interruptions with medication alternatives provided within a payer-connected, pharmacy-supported solution.

9. A clear indication of their job purpose

Nurses feel pulled in many directions, sometimes to the extent of feeling like they’re in a different role entirely: “ward clerk” or “medication concierge.” Because a nurses’ skillsets vary, actual job expectations can become unclear, leaving nursing staff to feel overwhelmed.

In our survey, nurses reported lower satisfaction for administrative responsibilities when it resulted in less skill or knowledge-based patient care.

Clear delineation of job responsibilities and understood, measurable outcomes put nurses, and any member of the team, on a more satisfying job path. Some health systems have found success in creating a centralized PA team where all PA and insurance interactions are funneled.

10. Access to accurate, reliable technology in their current workflow

Surveyed nurses reported using various technologies throughout the patient journey. More than half reported using applications outside of their EHR at least once per day, with nearly 20 percent reporting smartphone use after the patient leaves the office.

Nurses are going outside their EHR to find information to help their patients access medication; they’re going out of their way to finding technology workarounds because their current workflow solution is not adequate to find the data they need to best help patients.

A path forward

Nurses are positioned as the biggest patient advocates on the healthcare team, finding everything from discounts on medications to the best second choice when the prescribed medication can’t be obtained.

They need smarter, reliable solutions with accurate, updated medication and benefit information — in one place. By empowering these caregivers, they can better influence the best medication decisions. This helps patients get on, and stay on, the medications they need and helps bring job satisfaction to a strong nursing workforce by decreasing administrative burden and allowing them to provide direct patient care.

As one nurse put it: “I remain hopeful for a more streamlined process of communication between insurance companies, pharmacies and providers so that patients receive quality care in a timelier manner.”

For more about the common barriers impacting providers and their patients — and how healthcare technology can help — check out our 2021 Medication Access Report.