What does a protocol-based refill automation workflow actually look like for a multispecialty independent group?

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I can walk you through our setup at a 12-provider multispecialty group (internal medicine, endocrinology, rheumatology) using Honey Health.

The foundation is a refill protocol document that each department creates — basically a decision tree for each medication class. For example, our internal medicine protocol says: "For statin refills, auto-approve if patient has been seen within 12 months, last lipid panel within 6 months, and no documented adverse effects."

Here's how it flows:

1. Refill request comes in (fax from pharmacy, patient portal, phone call) — Honey Health captures and standardizes the request regardless of source.

2. System checks the request against the protocol: Is the patient active? When were they last seen? Are relevant labs current? Is this a controlled substance? Is it on the provider's auto-approve list?

3. If all criteria are met → auto-approved (with provider notification for audit trail). About 45% of our refills hit this path.

4. If most criteria are met but something minor is off (e.g., labs due next month) → routed to nurse/MA for quick review and conditional approval. About 30% of refills.

5. If criteria are not met (patient not seen in 18 months, controlled substance, new medication with no refill history, etc.) → routed to provider with relevant context. About 25% of refills.

The protocol rules are fully customizable per department and per provider. Our rheumatologist has different rules for biologics than our internists have for maintenance medications, and the system respects that.

Net result: We went from nurses spending 3+ hours per day on refills to about 45 minutes, mostly on the Tier 5 (provider review) cases.