Clinical Decision Support Solutions
Clinical decision support solutions for healthcare providers, payers, and government agencies that enable clinically appropriate medical utilization and care decisions informed by evidence-based criteria.
Hospitals and health systems need to understand how inappropriate ordering impacts patient outcomes as well as resource utilization, costs, and downstream reimbursement from CMS and private payers. CareSelect’s data-centric approach helps you benchmark and improve order appropriateness and comply with important federal mandates.
InterQual provides actionable, evidence-based clinical intelligence and automated processes to support appropriate care, align payers and providers, and optimize resources. Our solutions transform utilization management into an efficient, proactive, risk-reducing function via medical review automation.
Payers and providers can reduce their administrative burden, speed response time, and improve collaboration by automating the prior authorization process. Our integrated medical review and connectivity solution automates prior authorizations, even those needing a medical review, within existing payer and provider workflows.
Bridge the gap between payers and providers to effectively manage care for your high-risk members and patients.
Create a customized, workflow-integrated care management program using patented patient assessments that address common care barriers and merge condition components.
For providers with increased exposure to CareSelect Imaging, ordering appropriateness increased by:
CareSelect data published in "Improved Appropriateness of Advanced Diagnostic Imaging After Implementation of Clinical Decision Support Mechanism," Journal of Digital Imaging, February 25, 2021.
For one facility using CareSelect Lab, the number of labs per discharge decreased by:
Riverside Medical Center data, published in: "Aligning the Lab with the Hospital’s Strategic Priorities," white paper
For patients admitted to hospitals that rely on InterQual® Criteria, hospital stays were shorter by:
Sources: Change Healthcare 2018 analysis of two randomly matched sample groups of 809 hospitals each.