Latest release includes immediate access to InterQual COVID-19 criteria, further integration of medical conditions with mental health and substance disorders, and addition of AI Natural Language Processing to increase accuracy and automation
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With the COVID-19 pandemic putting unprecedented pressure on all facets of the healthcare system, the need for appropriate utilization is more important than ever. Acute care facilities need to maximize available bed capacity through careful admission screening, continued stay management, and post-acute transition planning. Additionally, patients who do not have COVID-19 benefit from appropriate care transitions, helping to significantly reduce the possibility of exposure.
To support healthcare stakeholders,
InterQual 2020 also expands the reach of InterQual AutoReview™, its medical review automation solution, which is now enhanced with Natural Language Processing models. With these models, trained by expert physicians, InterQual AutoReview can identify diagnostic information, such as the presence of pneumonia with accuracy as high as 98%, from unstructured clinical narratives. This helps reduce the administrative burden of not only retrieving and reviewing information, but also interpreting narratives.
Among the additional new and enhanced content included in this latest release are the following features:
- Admission guidance for e-cigarette or vaping product use-associated lung injury (EVALI)
- New criteria for Medicare Durable Medical Equipment aligned with national and local coverage determinations
- InterQual Acute Pediatric criteria codified to work with InterQual AutoReview Episode Day 1 reviews for approximately 80% of non-trauma admissions
- Pediatric Physician Admission Guide, which summarizes the differences in severity and treatment criteria between the Observation and Acute levels of care
- Further integration of medical conditions with mental health and substance use disorders
“Clinical decision-making and care management have always been challenging, but clinicians today are facing new and highly complex utilization issues,” said
InterQual 2020 criteria and software enhancements are available immediately on Download Connect, a secure software distribution platform. The new InterQual criteria is also available in all cloud applications immediately, with no installation required. Users can view and evaluate the new criteria now and decide when to make the switch at any time.
To request access to InterQual COVID-19 criteria at no cost, providers and payers can register at https://inspire.changehealthcare.com/InterQual-Covid-19.
For more information on