Change Healthcare on Monday unveiled the most recent version of InterQual 2019, its flagship clinical decision support technology.
WHY IT MATTERS
In addition to thousands of new content updates, the company says InterQual is now configured with an eye toward hospital at home models, which have been shown to lower mortality rates and generally improve outcomes and lower costs.
InterQual is able to offer payers and providers evidence-based guidelines to help identify patients who might be good candidates for home-based care programs. Specifically, Change Healthcare has worked with experts in these emerging models to develop and equip InterQual with criteria for seven acute conditions that might be suitable for management in the home.
Change officials also said the platform’s InterQual AutoReview and InterQual Connect functions will enable better interoperability between electronic health records and care management systems.
AutoReview offers real-time updates of the clinical data from the EHR over the first 24 hours to gather a more complete picture of an admitted patient, according to the company, and can be automatically populated with data pulled from the EHR.
With the addition of new molecular diagnostic tests, specialty drugs and imaging recommendations, the platform offers more granular criteria to help providers assess outpatient care, gain insights that can help manage opioid patients and generally help enable better physician decision-making.
THE LARGER TREND
As patient populations age and hospital staff and resources are stretched thin, home-based care will only become more prevalent in the years ahead. With telehealth and remote patient monitoring gaining traction at health systems nationwide, these new approaches to care will be key to providers’ efforts to manage value-based reimbursement.
ON THE RECORD
“As more organizations move into value-based relationships, developing creative solutions that help us achieve the triple aim of improving the patient experience, improving the health of populations, and reducing the per capita cost of health is paramount,” said Laura Coughlin, RN, vice president of strategy and clinical development with Change Healthcare, in a statement.
“Innovative programs like hospital in the home can help to move the nation toward these goals, but payers and providers need guidance about which patients can be safely managed in this setting. We have invested in the criteria to support customers with programs in place and those who are interested in establishing a program.”
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