Background: Increasing numbers of oncology patients require oral therapies provided by specialty pharmacies. Our experience indicates patients receiving care in a facility without specialty pharmacy dispensing capabilities are at a disadvantage in receiving their medications in a timely manner. Methods: Metastatic prostate patients receiving oral hormonal therapies were identified for chart review. Findings indicated the median time to medication receipt by the patient was 25 days. Interviews with the team, staff and patients revealed that multiple factors contributed to the delays. Patient expectations were to receive prescribed agents within 7 days. Review of our Community Clinics, who employ a centralized process and have relationships with specialty pharmacies, indicated that medications were received by patients within a week. Successful interventions necessitated the patient partnering with the healthcare team to improve efficiencies and reduce time to drug delivery. Results: Delays were multifactorial and extremely difficult to ascertain from chart review. Reasons for delay were clearly noted in 19 out of 97 patient records out of which over 47% charts indicated the pre-approval process as the cause for the delay. Patients were educated regarding the specialty pharmacy process, the name of the prescribed drug and the pharmacy where the prescription was sent. The patient education sheet encouraged patients to become partners in the process and advised them to check with their insurance for their approved specialty pharmacy. If the approved pharmacy varied from the pharmacy initially chosen, patients were asked to notify the clinic staff to initiate a new prescription to the correct pharmacy. Patient response to the education sheet has been positive. Impact on median time to delivery is not yet known. Conclusions: Streamlining the authorization process of specialty pharmacies would benefit oncology patients, as we identified that most delays occur in specialty pharmacy processing. Healthcare facilities may consider increasing patient education or obtaining a specialty pharmacy dispensing license in order to minimize delays for oncology patients receiving oral oncology medications.