Inspiration

Prior authorization slows care and burns staff time. We wondered: could we make PA feel like “press submit and move on,” right inside the EHR—no new portals, no fax-chasing?

What it does

ASAP (Prior Auth Streamlining App) is an EHR-embedded workflow that:

Shows a Requirements Card at order time (PA needed? policy + checklist).
Auto-fills PA forms from the chart and only asks for missing items.
Submits via modern rails (simulated PAS/ePA for hackathon) and
Tracks status (Pending → Approved/Denied/RFI) in a single in-EHR inbox.

How we built it

Frontend: Next.js + TypeScript, SMART-on-FHIR launch (PKCE), three screens: Requirements Card → Smart Form → Status/Timeline.
Backend: FastAPI/NestJS with endpoints for coverage/requirements, DTR-style autofill, PAS-style submit/status, PDF export, and an audit log.
Data: Epic sandbox (Patient, Coverage, Meds, Conditions, Observations, Imaging, DocumentReference) + tiny formulary JSON (plan + RxNorm) for tiers/PA/alternatives.
Interoperability: CRD/DTR/PAS patterns (mocked for speed), FHIR R4 reads, CDS Hooks-shaped CRD call, PDex-compatible formulary shape.

Challenges we ran into

EHR auth nuances: SMART v2 + aud + exact redirect URIs.
Payer unevenness: not all rules are computable; we designed a hybrid rail with graceful fallbacks.
Data mapping: turning messy chart data into a clean, policy-ready packet.
Timebox: shipping three crisp screens with believable end-to-end behavior in ~36 hours.

Accomplishments that we're proud of

A working in-EHR flow that goes from order → requirements → autofill → submit → decision.
Instant-approval demo case when criteria are fully met, and a realistic RFI/Appeal branch when they’re not.
Packet PDF + Appeal letter generation that looks production-grade.
Clear, human reason strings and policy snapshot so staff understand why.

What we learned

Standards are your friend: CRD/DTR/PAS + PDex give a clean mental model.
Small formulary datasets dramatically improve PA guidance and “covered alternatives.”
The biggest UX win is “zero new portals”—keep everything in the EHR frame.
Measure impact early: cycle time, first-pass approvals, and touches avoided tell the story.

What’s next for ASAP (Prior Auth Streamlining App)

Real rails: connect to live CRD/DTR/PAS endpoints + clearinghouse/X12 fallback.
Pharmacy depth: RTBT real-time costs and full NCPDP ePA.
Multi-EHR adapters (Epic → Oracle Health → athena).
Security & scale: SOC 2, detailed provenance, org-level analytics.
Pilot with a clinic in high-volume lines (imaging, DME, specialty meds) to validate ROI.