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Tackling COVID-19: Remote Go-Lives, Payer Connections, and More

by XSOLIS Insights, on Apr 7, 2020 6:00:00 AM

Now, more than ever, hospitals must get appropriate reimbursement so they can continue caring for their communities.

Amid this crisis, XSOLIS is pivoting to better support our partner hospitals and health plans: by offering new discharge prioritization reporting for affected hospitals, our team is harnessing data to help ensure that beds are maximized. For clients who have moved utilization review functions to a remote setting, CORTEX acts as a single source of truth for patient data that is available online at any time, giving staff the flexibility to work digitally. For clients who were in the midst of implementing the technology, our white-glove, hands-on approach to staff training and education during go-live has moved virtual, keeping projects on track and ensuring staff will have this powerful tool at their fingertips at this most important time. And given the increased importance of instant, collaborative communication, XSOLIS is offering CORTEX to health plan and provider clients so they can reduce the administrative burden of utilization review and refocus their attention towards each patient.

Discharge Prioritization Reports – LOS, Analyzed

Bed throughput and effective discharge timing are essential during this crisis. Since CORTEX updates patient data in real time directly from the electronic medical record, it gives case management and utilization review teams a birds-eye view into changes in acuity that can ensure patients are discharged appropriately and quickly. A collaborative effort from XSOLIS’ Reporting, Product and Data Science divisions has produced a new Discharge Prioritization Scoring Report: this report uses predictive analytics to identify a potential appropriate discharge “window” for each patient by looking at up to 3 predicted DRGs and their associated GMLOS. Simply put, staff now know which patients are nearing the average discharge date of their DRG, allowing for prioritized discharge assessment for those patients. This functionality is currently being tested and refined with clients and even clients that do not have the premium Predictive DRG feature set will have access to this report during the crisis.

Enabling Effective Remote Work for Staff

CORTEX, XSOLIS’ technology platform for Precision Utilization Management, offers a comprehensive, clinically-centered view of medical necessity, wellness, acuity and more to give case management and utilization review staff the insight they need to optimize throughput, ensure reimbursement and reduce the administrative burden that keeps them from patient care. It receives data in real time from the electronic medical record, continuously updating predictions throughout the patient's stay and alerting staff to changes in patient acuity or status conflicts. All that, AND it is cloud-based, allowing users to securely access the platform remotely to conduct their work.

XSOLIS client hospitals have taken advantage of this opportunity to move teams or parts of teams to remote work, especially staff members who are immune-compromised or at greater risk. This flexibility has allowed for continued productivity and increased safety for the teams.  

Remotely Adopting New Software

XSOLIS typically takes a hands-on approach to CORTEX implementation at its client hospitals: XSOLIS staff will conduct multiple trainings and assessments onsite at the hospital(s) leading up to and during go-live, ensuring that hospital staff has the skills they need to make the most out of the system. With COVID-19, this approach has shifted to a remote go-live experience, which consists of virtual classroom training, guided virtual 1:1 sessions with experienced trainers and comprehensive workflow consultations online. “Over the past few weeks, users and our client organizations have responded incredibly well to this change,” said Matt Brink, Director of Learning and Education at XSOLIS. “I’ve spent time with users from multiple states and multiple facilities across the nation, all from my home office. We’ve been able to keep the same user-centered approach as always but adding flexibility and safety through virtual work.”

The Director of Case Management at a facility in the Pacific Northwest concurred after her hospital implemented CORTEX in late March 2020: “In this [COVID-19 pandemic] setting, the solutioning required to ensure a successful go-live has been agile and creative. We are already seeing a return in our ability to adjust UM staffing as we prepare for the surge to come. This flexibility would not have been possible without the functionality offered by Cortex.”

Payer Connectivity Initiative

XSOLIS’ Payer Relations team is working with payer and provider partners across the nation to set up CORTEX as their communication platform, reducing or eliminating the manual work associated with traditional utilization review. With the COVID-19 response in motion, several payers – national and regional – are broadening their use of CORTEX to reduce the administrative strain on both sides. As one NY-based hospital leader put it, XSOLIS is "really trying to fix the UM issues that payers and providers have by providing a language that hospitals and payers can talk about patients/members to ensure the patients meet medical necessity."

For all provider clients that have implemented CORTEX, adding a payer partner is a smooth and seamless process. And if you are interested in utilizing CORTEX, our nationwide payer connections can provide even more value for your organization. For more information on expanding or creating payer and provider connections through CORTEX, email sales@xsolis.com.

Topics:Patient FlowHealthcare AnalyticsInnovationReimbursementPayer-Provider AlignmentThe Future of HealthcareCOVID-19