Change Healthcare Launches InterQual® 2021 Solution Providing Guidance on Telehealth, Social Determinants of Health, & the T...
22 April 2021 - 1:00PM
Business Wire
The robust suite of InterQual® criteria has
been updated to reflect the latest clinical evidence and provide
frontline clinicians with valuable, relevant decision support.
Today Change Healthcare (Nasdaq: CHNG) unveiled InterQual® 2021,
the latest edition of the company’s flagship clinical decision
support solution. The new release features four new Medicare
criteria modules in addition to a significant number of
evidence-based content updates and enhancements, including new
guidance on caring for COVID-19 patients, addressing social
determinants of health, and the appropriate use of telehealth.
“As an Associate CMO overseeing utilization review at a large
health system, I have been using InterQual criteria since 2014.
Through the years, the criteria have undergone frequent updates
that are in line with evolving clinical evidence and literature,”
said Kalyana Kanaparthy, MD, Rochester Regional Health. “These
updates are critical as medicine evolves. I continue to see
InterQual® criteria provide a superior evidence-based screening
tool for hospital admissions.”
This release marks the first development cycle led by Monique
Yohanan, MD, MPH, who assumed the role of InterQual® Chief Medical
Officer. With a clinical background that spans the care continuum,
including inpatient hospital, primary care, extended care, and
house calls, Dr. Yohanan is board certified in Internal Medicine
and Geriatric Medicine and has extensive expertise in the
development of medical necessity criteria.
“When I first joined Change Healthcare in September 2019, I was
impressed with the rigor of the team’s approach to developing
unbiased, evidence-based content,” said Dr. Yohanan. “My goal was
to maintain that integrity while building on the objective criteria
we offer to support patient-centered care.”
Change Healthcare also relied on the broad and diverse clinical
perspective brought by its three new medical directors:
- Sarah Johnson, MD, MS, practicing clinician in substance use
facilities, board certified in Psychiatry, Neurology, and Addiction
Psychiatry
- Katy Kehl, MD, practicing intensivist at Mount Auburn Hospital,
board certified in Internal Medicine, Pulmonary Disease, and
Critical Care Medicine
- Judith A. Melin, MD, MA, FACP, physician at Beth Israel Lahey
Health, board certified in Internal Medicine
For example, Dr. Kehl’s experience working in the ICU at the
frontlines of the pandemic helped inform InterQual®
condition-specific criteria to address the diagnostic testing,
imaging, and inpatient management of COVID-19 patients. More than
500,000 reviews have been completed nationwide using the InterQual®
Covid-19 criteria, which will continue to be updated as the related
evidence evolves.
The 2021 release incorporates guidance on the use of telehealth
throughout the InterQual® Outpatient Rehabilitation and
Chiropractic, Behavioral Health, and Ambulatory Care Planning
criteria, and includes additional guidance to help case managers
address their patients’ social determinants of health as care
progresses. By supporting proactive, ongoing needs assessment
regarding factors such as housing, transportation, and food
insecurity, the guidance helps organizations intervene in a timely
manner to improve health outcomes.
The robust suite of InterQual® criteria has been updated to
reflect the latest clinical evidence, providing frontline
clinicians with valuable, relevant decision support. Based on new
research and evolving standards of care, more than half of the
existing InterQual® criteria were impacted by these changes. As
always, these changes went through a rigorous critical appraisal
and peer review process to defend against bias.
This marks the launch of four new modules to the Medicare
criteria Powered by InterQual®, which converts Medicare policies
into the solution’s trademark question-and-answer format: Medicare
Molecular Diagnostics and Lab, Medicare Imaging, Medicare Pharmacy,
and Medicare Behavioral Health. Clinicians can easily access the
information they need within their workflow, instead of struggling
to find and apply local and national coverage guidelines from
disparate sources.
About Change Healthcare
Change Healthcare (Nasdaq: CHNG) is a leading healthcare
technology company focused on insights, innovation, and
accelerating the transformation of the U.S. healthcare system
through the power of the Change Healthcare Platform. We provide
data and analytics-driven solutions to improve clinical, financial,
administrative, and patient engagement outcomes in the U.S.
healthcare system.
For more information on Change Healthcare, please visit our
website, hear from our experts at Insights; Follow us on Twitter;
Like us on Facebook; Connect with us on LinkedIn; and Subscribe to
us on Apple Podcasts, Google Podcasts, and YouTube.
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Change Healthcare Katherine Wojtecki External Communications
630-624-9142 katherine.wojtecki@changehealthcare.com
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