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McKesson previews software for extracting clinical data from EHRs

InterQual Auto Review promises to streamline medical reviews and prior authorizations.
By Tom Sullivan
11:12 AM
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ORLANDO - McKesson is showing an early version of its InterQual Auto Review software here at HIMSS17. The product, which comes out of a partnership with the National Decision Support Company, automates medical necessity reviews by tapping into patient data residing in electronic medical records.

The software ties NDSC’s automation engine, which processes some 3 million data transactions every month, into InterQual’s technology for evidence-based content and automated review.

“InterQual AutoReview takes discrete data from the EMR and pulls it into our engine that feeds into InterQual Connect to automate evidence-based content and serve clinicians the results they need to see, all in one screen,” said Nilo Mehrabian, vice president of decision management products at McKesson Health Solutions.

InterQual Connect, which McKesson released last year, integrates the evidence-based capability into the clinician workflow to decrease administrative expense, Mehrabian said. McKesson’s strategic direction has been to make that process easier for providers and payers and enables them to collaborate better.

“AutoReview brings efficiency in completing these reviews,” she added. “It’s more objective than subjective and improves care for patients as well as increasing efficiency for nurses because they can spend more of their time looking at the exceptions or patients that are not low-hanging fruit.”

Because the software advances exception-based utilization, clinicians only need to manage exceptions that cannot be processed automatically. The new version is estimated to cover about 30 percent of ED admissions. McKesson plans to expand support to 41 conditions, which will cover more than 90 percent of admissions. Mehrabian said that, at present, approximately one-third of cases get auto-reviews.  

The software also enables McKesson to be a facilitator of easing prior authorization because once the medical necessity review is conducted, that claim is submitted to payers for authorization, so having that data come directly from the EHR is going to be helpful, she said.

The product is still in development. “We are right now in the beta early adopter phase and hope to go general availability later in the year,” Mehrabian said. McKesson is in Booth 3479.