Improving Utilization Review Efficiencies at Critical Access Hospitals

25 beds. 96 hoursOne person? For those serving as the utilization review resource at critical access hospitals, efficiency is critical. That’s why Whitman Hospital & Medical Center in Colfax, Washington turned to Xsolis to help improve the utilization review process and reduce denials through a real-timedatadriven solution. Karri Waldea utilization review nurse at Whitman Hospital, recently shared her experience of going through the implementation process with Xsolis and the improvements she has already seen in her department, which she runs as a one-person show. 

Getting Comfortable with the Technology

The idea of using artificial intelligence in UR was overwhelming to Karri because she didn’t feel tech-savvy enough to be able to understand.   

“When I first started, I felt like I was in information overload,” says Karri. “But within literally a couple of weeks of using Xsolis’ tool, I was so amazed at how simple it was.” 

Xsolis trainers helped her every step of the way, showing Karri how to look at the real-time tools, like the proprietary Care Level Score™ and trending graphs, and soon she realized how easy and efficient the platform was. 

This is literally how the patient is doingwhat’s going on in realtime,” says Karri. “Xsolis extrapolated information directly from our medical records, and there was no way to look at it and go I don’t think they really meet that criteria. It was very objective.” 

That objective, real-time data is central to clients’ successes as its this information that is then relayed to payers and decreases the time spent doing back and forth, therefore reducing denials. For Critical Access Hospital UR nurses, like Karri, this efficiency is essential.  

“Xsolis made it so much simpler to be a one-person show,” Karri says. 

Advice for Other CAH Leaders

Change is never easy. Add in artificial intelligence, and it sounds even more challenging. But the truth is, it’s not. Karri learned that firsthand with the implementation of Xsolis at Whitman Hospital. NO matter if you have 25 beds or 700 beds, the technology creates efficiencies that benefit all. For Karri, those efficiencies have made her first work at a critical access hospital a “saving grace.” 

“Once you’ve learned the process, it’s so much more efficient, and I can’t stress that enough,” shares Karri. “Efficiency has been the saving grace for me as a single user. I could not actually do my job by myself without Xsolis.” 

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