Pharmacy | Infographic
The Operational Questions Behind Specialty Pharmacy’s AI Ambitions
AI readiness looks different from one pharmacy workflow to another. Knowing where AI can create value starts with examining the work itself, the challenges involved, and the conditions needed to support it.
Inovalon’s 2026 Specialty Pharmacy Market Survey captures how pharmacy leaders are thinking about future technology priorities, current growth pressures, and the operational realities shaping AI readiness.
AI Is Rising Alongside Interoperability and Data Priorities
What pharmacy leaders value in future technology
Pharmacy leaders want AI, but they also recognize the importance of connected systems and accessible data. Building these capabilities together can help create the conditions for automation to deliver value.
AI ambitions are raising the stakes for interoperability
Workflow Inefficiency Is Not Always a Technology Problem
While pharmacy leaders are looking ahead to AI, interoperability, and advanced data, they are also navigating immediate pressures on growth.
What is limiting pharmacy growth today?
Workflow inefficiencies1
Staffing/workforce capacity1
Reimbursement and financial pressure1
Technology limitations1
Find the source of the friction
Workflow inefficiency is ranked above technology limitations. But “workflow inefficiency” describes a symptom, not its source.
Before applying technology, pharmacy leaders need to understand what is creating the friction.
What is underneath the workflow problem?
Too many steps
Duplicate work, unnecessary tasks, or inconsistent procedures add effort without value.
Information gaps
Staff search across systems, re-enter data, or work around missing information.
Broken handoffs
Work stalls between teams, systems, patients, providers, and payors.
Frequent exceptions
Missing information or unusual circumstances require manual intervention.
Undocumented workarounds
Progress relies on staff knowing requirements or next steps that aren’t built into the workflow.
External requirements
Payer rules, documentation, authorization, and billing requirements add steps the pharmacy can’t eliminate.
Skilled staff on admin work
Repetitive administrative tasks take time away from work requiring specialized judgment.
The source of the problem should shape the intervention
Pharmacy workflow automation may be appropriate for some of these problems. Others may be better addressed through integration, rules-based automation, configuration, workflow redesign, or removing unnecessary steps.
Automating an inefficient process without understanding its source can reinforce the very problems the technology is intended to solve.
AI Readiness Is Decided Workflow by Workflow
AI readiness is often discussed at the organizational level. But the conditions that support AI and pharmacy workflow automation can vary from one pharmacy workflow to another.
More Repeatable
More Variables to Evaluate
Repeatable intake process
May be better prepared for automation
Multipayer prior authorization
Multiple systems, payer requirements, a higher degree of clinical oversight
AI adoption depends on more than interest
Snowflake and Hakkoda research shows growing interest in agentic AI across healthcare, while highlighting the importance of data maturity, interoperability, and workflow integration in supporting its implementation.
Six Considerations Before You Automate a Workflow
Evaluating a pharmacy workflow automation opportunity means looking at the conditions surrounding the work.
AI READINESS STARTS HERE
Workflow
Where does work slow down, repeat, or require manual intervention? Which steps could be redesigned or eliminated?
Context
Does the right information reach the right people at the right point in the process? Is there enough context to determine what should happen next?
Connectivity
Can information move across the systems, teams, and handoffs involved, or would the use case address only one part of a fragmented process?
Exceptions
What happens when information is missing, circumstances fall outside the routine process, or the technology is uncertain?
Human accountability
Which decisions require clinical judgment, validation, or human oversight?
Outcomes
What should improve, such as time to therapy, staff capacity, turnaround times, rework, or operating costs?
A closer look at data activation
CareMetx research shows a gap between collecting data and putting it to work:
reported partner data was not standardized or normalized
reported data that was not actionable or could not trigger workflow actions
HAVING DATA
≠
HAVING
USABLE DATA
The AI Decision Starts Before the AI Investment
Before investing in AI, pharmacy leaders need a clear view of the outcome they want to improve and whether the workflow is ready to support that use case.
Readiness can help leaders decide where to act
Looking at AI readiness at the workflow and use-case level can help distinguish:
Where the conditions are stronger today
The use case has a defined problem, clear outcome, repeatable workflow, usable information, and clear boundaries for exceptions and human judgment.
Where foundational work should come first
The opportunity may be meaningful, but workflow, data, system, or operational issues need to be addressed before AI is likely to deliver the intended value.
Where a workflow isn’t ready yet, begin with the foundational work. Fixing it can change what becomes possible.
Bring the decision back to the patient
For specialty and infusion pharmacies, the most important outcome is what happens downstream for the patient.
Those delays were associated with scattered systems, back-and-forth communication, and inefficient prior authorization processes.
A strong place to start is with the workflows behind these delays. Focus on where AI can shorten the wait, give skilled staff time back for work that requires their expertise, and reduce rework.
Explore What’s Possible With Inovalon’s ScriptMed®
See how ScriptMed’s interoperability, data capabilities, and evolving AI functionality can support your pharmacy, reduce time to therapy, and free up staff capacity.
1. Inovalon. 2026 Pharmacy Leader Survey (n=75), conducted at NHIA, Asembia, and NASP, April to September 2026.
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