“InterQual 2017 identifies the essence of what is needed to foster faster, safer, and better clinical decisions,” Dr. Jackie Mitus, general manager and senior vice president for Decision Management at Change Healthcare, said in a statement. “For 40 years, our focus has been on supporting appropriate care while streamlining administrative burdens. This year we’re bringing more clinical intelligence, more automation, and more know-how to the forefront, all so the clinician can devote more time to direct patient care. That’s at the heart of what we do.”
The new system allows for smarter and simpler decisions; it can automate more than 400 Medicare National and Local Coverage Determinations for inpatient and outpatient surgical procedures. It allows for earlier and faster decisions; care managers can use the program’s Initial Review Criteria to determine appropriate level of medical care for emergency department admissions.
The program also allows for safer, evidenced-based decisions via a new level of care features and criteria, new care planning criteria, updated behavioral health criteria and updated InterQual Coordinated Care content.