SANTA CLARA, Calif. — September 28, 2021 — Based on its recent analysis of the North American clinical decision support system (CDSS) market, Frost & Sullivan recognizes Change Healthcare with the 2021 North America Customer Value Leadership Award. Its CDSS InterQual® and CareSelect® solutions provide self-built and third-party, evidence-based guidelines that aid providers and payers in decision-making. Powered by advanced technology combining predictive analytics, machine learning, robotic process automation and natural language processing, its CDSS leverages artificial intelligence to advance value-based care and improve payer-provider communications.
“Change Healthcare’s CDSS validates care and order appropriateness, drives cost- and resource-optimized clinical decisions, and standardizes and streamlines care decision workflows. It integrates clinical criteria, electronic health records data, and the care management system’s foundation to ensure seamless payer and provider connectivity,” said Unmesh Lal, Director at Frost & Sullivan. “Essentially, Change Healthcare advances value-based care with improved customer satisfaction by providing measurable positive outcomes such as reduced utilization, appropriate patient placement and services, shorter length-of-stay, and lower administrative costs.”
The company’s flagship InterQual® solution is easily accessible by clinicians within existing workflows. It employs an evidence-based content development process involving a team of 60 clinicians performing a rigorous literature review and a panel of over 1,000 expert peer reviewers. Over 3,000 sites are monitored with a proprietary analytics tool to alert the team as soon as new literature is published. The InterQual transparency solution can be hosted on the payer organization’s provider and member portals and enables members and providers to view the content used for authorization.
Change Healthcare is transforming utilization management by combining artificial intelligence and automation with this evidence-based criteria to help remove administrative burden and payer-provider friction. InterQual AutoReview uses robotic process automation to complete the medical review and layers in predictive analytics to provide early insights for level of care placement, length of stay management and discharge preparation. InterQual Connect enables the automation of prior authorizations requiring clinical data submission, streamling the process for payers and providers and speeding care for patients.
Meanwhile, the CareSelect solution enables providers to access CDS on-demand at the right time and setting. It seamlessly harnesses the clinical workflow to extract targeted information from installed leading EHR systems. The CareSelect® Imaging solution, a CMS Qualified Decision Support Mechanism, enhances imaging appropriateness within existing EHR, ordering workflow in compliance with the Protecting Access to Medicare Act (PAMA) while the CareSelect® Lab solution reduces unnecessary lab test utilization to decrease costs, raise care quality, and control financial risks. Its other solutions include CareSelect® Blood and CareSelect® Risk Assessor to assess the probability of breast cancer.
“With an extensive client base, Change Healthcare’s clinical decision support system services more than 4,000 provider facilities, over 1,000 health systems, across 3,400 acute hospitals, representing nearly 70% of admissions. It facilitates more than 150 million annual transactions and is now expanding adoption beyond acute care facilities to other sites of care,” noted Supriya Lala, Best Practices Research Analyst at Frost & Sullivan. “By improving efficiencies and delivering measurable outcomes, Change Healthcare’s CDSS is expected to continue improving customer relations and drive long-term business growth.”
Each year, Frost & Sullivan presents this award to the company that demonstrates excellence in implementing strategies that proactively create value for its customers, focusing on improving the return on the customers’ investment in its services or products. The award recognizes the company’s unique focus on augmenting the value that its customers receive, beyond simply good customer service, leading to improved customer retention and customer base expansion.
Frost & Sullivan Best Practices awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analyses, and extensive secondary research to identify best practices in the industry.