Dr. Salzbrenner looks to streamline ‘prior authorization’

If you’ve ever received a prescription from your physician and gone to the pharmacy to fill it, only to find out there is a delay because of your insurance company, you’re no doubt familiar with the term “prior authorization.”

“Prior authorizations are the bane of a doctor’s existence,” said Stephen Salzbrenner, MD, a psychiatrist at UNMC. “It’s one of the top sources of burnout among doctors, right up there with electronic medical records.”

As someone who has spent hours tracking down the right medication acceptable to an insurance company so he can get his patient’s prescription approved, Dr. Salzbrenner has had his share of frustration with the process.

In 2017, he decided something had to be done and that’s when he came up with the idea for a software solution that would allow providers to complete the prior authorization process at the point of care.

With input from Rod Markin, MD, PhD, associate vice chancellor for business development at UNMC and director of UNeTech, Jeffrey P. Gold, MD, chancellor of UNMC, and Nebraska Medicine CEO Jim Linder, MD, Dr. Salzbrenner began to build his prototype and founded Breezmed, a company from which he will one day launch the platform. H4 Technology, a healthcare software company in Omaha, is building the software.

The value of his idea recently garnered the attention of the National Institutes of Health, which awarded Breezmed a $300,000 grant. The state of Nebraska also noted the significance of the idea and awarded Dr. Salzbrenner’s company an additional $100,000 grant, bringing the total to $400,000.

“It’s a credit to Dr. Salzbrenner that he has received this funding,” said Joe Runge, JD, associate director of the UNeTech Institute, an arm of UNeMed, the technology transfer and commercialization office for UNMC.

“Both the NIH and state recognize the scope of the problem of prior authorizations as a contributing factor to physician burnout,” Runge said.

Breezmed will help physicians make an informed treatment decision based on what medications are available to prescribe, are evidence-based and meet prior authorization criteria. If a prior authorization is needed, Breezmed will automate its completion and submission at the point of care, he said.

Dr. Salzbrenner has partnered with Trish Wonch Hill, PhD, research coordinator in the Methodology and Evaluation Research Core Facility at the University of Nebraska-Lincoln, to conduct social science research on the current barriers and challenges of the prior authorization process.

“We want to understand what doctors experience now, how prescribers and others are currently informed about prior authorizations and apply that knowledge to Breezmed to make it as efficient and streamlined as possible,” Dr. Hill said.

Howard Liu, MD, chair of the UNMC Psychiatry Department, said: “I know just how difficult it is to transition from concept to product in the health care market. This federal grant is a recognition of the tremendous work that Dr. Salzbrenner has put into not only developing the idea of Breezmed, but of learning the process of becoming a health care inventor. That is invaluable expertise for our trainees and colleagues to have on our team.”

“I’m a fixer. Nothing drives me crazier than seeing inefficiencies and knowing there is a better way,” Dr. Salzbrenner said.

To that end, Dr. Salzbrenner said he hopes that once launched, Breezmed will give doctors more time doing what they went into medicine to do in the first place — helping their patients.

Said Dr. Salzbrenner: “The entire prior authorization process is like a virus that is going to eat away at providers’ passion for the medical profession and I want to vaccinate myself and others against that.”