Podcast Summary: Strengthening LAI Prep Care with EHR Optimization at Callen-Lorde Community Health Center

Becker’s Healthcare Podcast | December 12, 2025
Host: Lucas Voss (Becker’s Healthcare)
Guest: Steven Sugimara, Director of the LAI Program at Callen-Lorde Community Health Center

Episode Overview

This episode delves into how Callen-Lorde Community Health Center is leveraging Electronic Health Records (EHR) to tackle the complex operational challenges of delivering Long-Acting Injectable PrEP (LAI PrEP) care to vulnerable and underserved LGBTQ+ communities. Guest Steven Sugimara shares actionable insights on insurance navigation, workflow optimization, multidisciplinary collaboration, and the transformative impact on patient access and outcomes.

Key Discussion Points & Insights

1. Introduction to Steven Sugimara and Callen-Lorde’s Mission

• Background: Steven Sugimara outlines his public health experience focusing on sexual minority and vulnerable populations, and his current efforts directing the LAI program at Callen-Lorde (00:43).
• Mission: “We provide welcoming and supportive health care for the LGBTQ community all across New York City, regardless of their ability to pay.” — Steven Sugimara (00:53)
• Approach: Passion for improving outcomes for underserved populations through data innovation and community partnerships.

2. Major Barriers to LAI PrEP Access

Steven describes a web of challenges in delivering LAI PrEP care, specifically for populations facing economic and insurance instability (01:38–03:33):

• Reimbursement Complexity:

  • Different insurance plans with varied prior authorization requirements
  • Inconsistent policies between pharmacy and medical benefits
  • “Plans appear to resist...with hurdles like prior authorization.” (02:26)

• Credentialing & Scheduling:

  • PCP alignment required by insurers
  • Coverage gaps for underinsured patients—especially those frequently losing coverage due to job loss
  • High reliance on Medicaid, with monthly verification needs (02:55)

• High Denial Rates:

  • “We’re seeing denial rates well beyond what we typically see for other procedures or injections.” (03:25)
  • Payers delay approvals, risking the clinic having to cover the cost

3. Workflow Streamlining via EHR Optimization

To address operational complexity, Steven describes a systematic approach to improvement (03:53–05:35):

• LAI Optimization Workgroup:

  • Cross-functional group with clinical, leadership, billing, scheduling, and IT representation
  • Regular meetings to identify bottlenecks and standardize care processes

• Standardized Templates & Documentation:

  • Moved from using multiple cumbersome Excel spreadsheets to a unified EHR template
  • Template includes:
    • Initial LAI PrEP prescription
    • Integrated insurance verification
    • Internal referral system
    • Clinical checklist for eligibility and patient education

• Impact:

  • “Following this optimization, we saw a 150% increase in weekly LAI appointments—doubling the number of patients initiated on LAI PrEP and persisting.” (05:28)
  • Drastically reduced time from referral to LAI initiation: “...from months to about 14 days.” (05:32)

4. Game-Changing EHR Tools: Electronic Prior Authorization & Medication Records

Steven highlights powerful EHR features that made staff jobs easier and expedited patient care (06:04–06:42):

• Electronic Prior Authorizations:

  • Real-time processing and data auto-population reduce staff workload and patient wait times
  • “This has significantly decreased staff burden while improving patient experience as patients wait less time to be initiated on LAI.” (06:20)

• Medication Administration Record (MAR) Integration:

  • Enables providers to instantly check for drug-drug interactions as part of the LAI screening process

5. The Human & Collaborative Element

The success of the LAI PrEP program depends on seamless teamwork (07:18–08:03):

• Multidisciplinary Coordination:

  • Frequent team huddles (“twice weekly to review all upcoming LAI appointments”)
  • Proactive identification and resolution of potential care or coverage barriers

• Quotes:

  • “Collaboration transforms a program from a set of siloed services to a well-coordinated comprehensive prevention system.” (07:38)
  • Results: improved access, higher patient satisfaction, stronger adherence, and measurable community health impact

6. The Big Picture: EHR Optimization as a Model for Innovation & Equity

Steven closes with a broader perspective on technology as a driver of public health (08:24–09:05):

• Not Just Tech for Tech’s Sake:

  • “Leveraging electronic health records isn’t about technology for its own sake. It’s about making sure people who could benefit from long acting PrEP don’t fall through the cracks.” (08:26)

• Model for Prevention & Equity:

  • EHR-driven coordination can serve as a template for equitable access to preventive care in other domains
  • Emphasizes need for continuous teamwork between all stakeholders, including data and clinical teams, pharmacists, and community organizations

Notable Quotes & Timestamps

• “Plans appear to resist this with hurdles like prior authorization.” — Steven Sugimara (02:26)
• “We’re seeing denial rates well beyond what we typically see for other procedures or injections.” — Steven Sugimara (03:25)
• “Following this optimization, we saw a 150% increase in weekly LAI appointments... doubling the number of patients initiated on LAI PrEP.” — Steven Sugimara (05:28)
• “This has significantly decreased staff burden while improving patient experience as patients wait less time to be initiated on LAI.” — Steven Sugimara (06:20)
• “Collaboration transforms a program from a set of siloed services to a well-coordinated comprehensive prevention system.” — Steven Sugimara (07:38)
• “EHR-based coordination for long acting PrEP can serve as a model for how we use data and integration to close gaps and access across many preventive services.” — Steven Sugimara (08:35)

Important Segments & Timestamps

• Introductions & Background: (00:32–01:38)
• Key Challenges in LAI PrEP Care Delivery: (01:38–03:33)
• Steps to Optimize Workflows via EHR: (03:53–05:35)
• EHR Tools Driving Impact: (06:04–06:42)
• Importance of Team Collaboration: (07:18–08:03)
• Closing Reflections on Tech & Equity: (08:24–09:05)

Tone & Language

The conversation balances pragmatic, operational details with an empathetic, community-focused outlook. Steven blends technical expertise with a passion for health equity, while Lucas prompts practical insight and context. The tone is collaborative, optimistic, and solutions-oriented.

Takeaway

Callen-Lorde Community Health Center’s success with LAI PrEP program optimization demonstrates the transformative potential of well-designed EHR workflows, cross-departmental collaboration, and a relentless focus on patient equity. Their model showcases how technology and teamwork can de-complicate access to vital preventive health services—offering lessons for all healthcare organizations serving marginalized communities.