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Designing for Efficiency: Improving Prior Authorization Workflows
Designing for Efficiency:
Improving Prior Authorization Process
I designed an integration that gives doctors real-time authorization predictions into Epic EHR, the electronic health record system doctors use daily. Doctors now can focus more on patients instead of paperwork .
Role
Lead Designer
Employer
Fig Medical
Platforms
Epic EHR System
Duration
2 month
Background
What is Prior authorization (PA)? It's the process of getting approval from health insurer for perception or medical treatment. It usually causes weeks-long delays that can be dangerous for patients waiting for necessary care.
The company is streamlining the workflow by integrating into the EHR and analyzing clinical patient data using NLP to predict outcomes, make suggestions for improvement, and optimize patient scheduling.
The core issue:
Doctors are working blind. When they submit authorization requests, they don't know:
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Whether the request will be approved or denied
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What specific documentation is required
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How long the process will take
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What alternative treatments might be pre-approved
The challenge:
How might we enable doctors to focus on patients, not paperwork?
The Impact:
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Prevents dangerous delays like the founder's mother experienced
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Faster treatment access reduces risk of condition deterioration
I collaborated with the co-founders and engineering team to design workflows that would seamlessly integrate predictive intelligence into clinical decision-making.
Approach
I conducted systematic workflow analysis and discovered that the core problem wasn't paperwork—it was doctors' complete lack of visibility into authorization outcomes.
Designed within Epic's rigid existing design system created some constraints, as I had to design predictive intelligence features that felt native to their established interface patterns. I created a decision-support system with three logical pathways: high approval probability, low approval probability, and conditional approval. By embedding these AI-powered insights directly into Epic's existing information architecture, I ensured zero workflow disruption while maximizing data utility for clinical decision-making.
Impact
Prototyped and demoed UX improvements that secured $150K in VC fudning by improving clinical efficiency and minimizes authorization delays.