Change Healthcare InterQual 2018 Brings Efficiency, Automation, and Innovation to Clinical Decision Support

May 14, 2018, 9:00 AM
Empower Smarter Health Choices

NEWTON, Mass., May 14, 2018 - Change Healthcare today unveiled InterQual® 2018, the latest edition of the company's flagship clinical decision support solution. InterQual 2018 delivers updated and enhanced clinical criteria as well as new disruptive technology such as InterQual AutoReview™, providing real-time automation of the InterQual medical review using clinical data from the EHR. The result is a more informed, collaborative, and streamlined healthcare ecosystem.

"We continue to invest to make InterQual's rich, evidence-based clinical guidance available to more users, more readily in their workflow, to support safe, cost-effective decision making," said Jackie Mitus, M.D., general manager and senior vice president of Decision Support with Change Healthcare. "It's all about ubiquitous access to industry-leading information integrated at relevant points in the course of clinical care no matter who or where you are. The result is truly transformational."

InterQual is regularly updated with rigorously objective clinical criteria. This year's release benefits from a new proprietary literature surveillance system that automatically analyzes over 3,000 medical literature sources daily and flags newly published information for the clinical team to critically appraise. As a result, nearly two-thirds of existing InterQual content has been updated to reflect the latest, best evidence. This helps ensure clinicians and workflow automation solutions—such as InterQual AutoReview and InterQual Connect™—have the latest evidence to help support appropriate decisions.

InterQual 2018 includes hundreds of new content areas to maintain its emphasis on the most current and challenging aspects of healthcare such as:

  • Addressing Social Determinants of Health: The expansion of the Care Management information to include Admission Considerations helps organizations consider significant social or safety concerns that can help aid in decision-making.
  • Battling the Opioid Crisis: To further enhance the collection of InterQual Criteria and tools that support the management of patients with opioid use disorder, Proactive Care Management Guidance has been added to the Substance Use Disorders criteria. This will help to ensure the most relevant evidence-based care is delivered to patients, across the continuum, caught up in this epidemic.
  • Enabling Emergency Department (ED) Case Management: The expansion of the Initial Review Criteria to cover the most common conditions that account for >90% of the ED admissions1, and the introduction of InterQual AutoReview, helps to address one of the costliest decisions in healthcare: whether to admit a patient, and if so to what level of care.
  • Supporting the Aging Population: The expansion of Medicare Advantage Plans means it is more important than ever to leverage InterQual evidence-based criteria to support clinical decisions. This year, staying current with changes to Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) required updating over 350 procedures and adding almost 50 new ones. Additionally, CMS' decision to remove knee replacements from the Inpatient Only list of procedures led to the addition of evidence for the safe use of the outpatient setting for knee replacements to the Procedures Criteria.

Change Healthcare InterQual evidence-based criteria and technology solutions help improve clinical decision-making and care management across the medical and behavioral health continuums of care. The InterQual clinical development team synthesizes the most current, best evidence into a fully referenced decision support tool. InterQual's development process is founded on rigorous review of the literature and includes extensive peer review with panels drawn from nearly 1,000 practicing clinical experts across the United States.

1 Internal analysis based on data from: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), Nationwide Emergency Department Sample (NIS), 2011, the CDC/NCHS, National Hospital Ambulatory Medical Care Survey, and survey of current customers.

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