McKesson InterQual 2015 sets new standard for peer-reviewed evidence-based clinical content
McKesson Health Solutions unveiled InterQual 2015, the latest edition of the company’s flagship decision support solution. This release introduces 55 new and enhanced evidence-based clinical content areas and extensive updates—including the industry’s first admissions criteria to include comorbidities, criteria for 29 new specialty drugs and 33 new molecular diagnostic tests plus support for gene panels, and much more—ensuring payers and providers have the latest guidance reflecting the most current, best evidence for improved decisions across the continuum of care.
“There is tremendous variation in care and cost in healthcare, and the shift to value-based models is increasing the focus on cost and outcomes,” said Jackie Mitus, MD, Senior Vice President and General Manager of Decision Management for McKesson Health Solutions. “With InterQual 2015, we’re helping ensure payers and providers have the evidence-based content they need for the challenges they face today—such as the increase in patients with comorbidities—so they can ensure the most appropriate decisions and highest quality care.”
Medically complex patients are on the rise, with more than 141 million Americans now suffering from comorbid conditions. Over 40% of heart failure patients have five or more chronic conditions. COPD is another leading cause of adult hospitalizations, where comorbidities are a common or contributing cause. Moreover, 29% of those with a medical disorder have a comorbid mental health condition. McKesson first addressed comorbidities in 1978 as part of InterQual’s Continued Stay Criteria and has continued to enhance comorbidities criteria since. InterQual 2015 introduces comorbidity assessments in the admissions criteria, starting with Heart Failure and COPD. And of particular importance are the behavioral health comorbids now included. Now medically complex patients who should be admitted can be more effectively evaluated at the primary review level. InterQual 2015’s Acute Adult Level of Care Criteria helps promote care quality and minimize the administrative delays, costs, and inefficiencies of medical director reviews for patients who should be admitted but might not meet criteria for the primary condition alone.