Dimensionalizing the Patient Journey: 5 Tactical Changes That Remove Access Barriers

In our recent webinar, Dimensionalization of the Patient Journey, CoverMyMeds thought leaders — Megan Wetzel, Vice President of Product, Access & Affordability; Mike Cohn, Vice President of Network Operations; and Miranda Delatore, Vice President of Product — explored how understanding the full scope of a patient’s experience can reshape how they start and stay on therapy.

Here are five key takeaways from the conversation:

#1. See the Whole Patient

Medication access and adherence are influenced by more than clinical data. Transportation, work schedules, language barriers, caregiver support and technology access all play a role in whether a patient begins treatment. And as Miranda highlighted, “Unfortunately, accessing medications is still a challenge for people across the country. More than half of patients are concerned about the cost.”^{[0]CoverMyMeds Patient Survey 2023} To help close these gaps, care teams should look to adopt tools that surface a fuller picture of the patient. Integrated care coordination platforms and predictive analytics can help providers identify barriers before they disrupt treatment.^{[0]National Institutes of Health. (n.d.). CARE for Health™: Integrating clinical research with routine care. Retrieved from https://commonfund.nih.gov/clinical-research-primary-care.}

#2. Guide Patients Through a Fragmented System

For many patients, the healthcare system feels like a maze. Fragmentation – or a lack of collaboration between stakeholders – creates confusion. “Patients often bear the brunt of fragmentation through delays and timely access to care,” said Mike. Improving interoperability and embedding education and affordability support at the point of care can help streamline the journey. Digital infrastructure that delivers insights helps care teams to proactively address drop-off points and design tools that meet patients where they are.

#3. Help Reduce Delays Before They Happen

Prior authorization (PA), when done proactively, can be a powerful lever for improving medication access. “Our guidance is to find a company that can handle both prospective and retrospective prior authorizations,” emphasized Mike. Electronic prior authorization (ePA) can also connect providers, pharmacies, PBMs and health plans in near real time, enabling quicker decisions and fewer disruptions. Optimized workflows and interoperable systems are key to making this process more streamlined.

#4. Use AI and Automation to Amplify, Not Replace, Human Oversight

AI and automation can help reduce friction and streamline routine tasks, but clinical judgment remains paramount. And as all thought leaders reiterated, AI must be integrated responsibly and at scale to support all medications and health plans. “The true power of AI lies in supporting and enhancing the clinical experience, not replacing it,” said Megan. AI and automation can help predict prior auth needs, flag missing documentation and identify likely barriers to care — all while preserving the nuance of human decision-making.

#5. Make Collaboration Non-Negotiable

Dimensionalization, or seeing the patient as more than their diagnosis, requires a connected ecosystem. Without seamless data exchange across stakeholders, understanding the full patient journey is nearly impossible. “Collaboration between all the stakeholders and ecosystem allows for a data exchange,” shared Megan. Technology solutions, aligned metrics and shared standards are essential to building a care path that adapts to patients’ changing needs.

Putting Patients at the Center

Dimensionalization is more than a framework — it’s a call to action. As Megan concluded, “If the journey doesn’t work for the person, then it doesn’t work.” By leveraging systems that reflect the realities of patients’ lives, we can help more people start and stay on therapy — and build a healthcare experience that truly works for everyone.

To learn more, watch the full webinar here.