Using AI to Reduce the Administrative Burden of Healthcare

Artificial intelligence has become a buzzword: misunderstood, misused, miscommunicated. Yet much of the buzz is warranted because the real-world impact of AI can be large and drastic, especially when it is applied to solving big problems with big sets of data. Healthcare has some big problems and even bigger sets of data but big solutions are here, especially for forward-thinking organizations like FL-based AdventHealth.

As part of the American Case Management Association’s 2020 Virtual Conference, Xsolis leaders Michelle Wyatt and Heather Bassett yesterday presented a session entitled “Using AI to Reduce the Administrative Burden of Healthcare” to conference attendees. The session focused on two key themes: first, the what and why of AI and how AI is poised to positively impact healthcare. Second, how Xsolis client AdventHealth has brought AI into their utilization management process across their 40+ hospitals nationwide.

Utilization management is changing: no longer is the status quo of “checking boxes” acceptable. Subjectivity needs to become a thing of the past; the administrative burden of healthcare must be lifted. That’s where artificial intelligence that supports clinical staff can make a real impact. For instance, at AdventHealth, utilization management staff use CORTEX, Xsolis’ Precision Utilization Management platform, now known as Dragonfly, to assess patient cases in real-time with the support of artificial intelligence. Dragonfly [CORTEX] interfaces directly with AdventHealth’s Epic electronic medical record to offer AdventHealth UM staff a real-time, AI-driven workflow technology to conduct their medical necessity reviews. Staff receive immediate alerts on patient changes, can escalate cases for physician advisor review, and can communicate clearly defined medical necessity directly with their payers, all from within Dragonfly [CORTEX].

This approach has redefined the role of utilization review at AdventHealth from an operationally driven model to an appropriately revenue-generating function. The positive impact on the utilization management function has been profound: better data, better workflow, better results. As Lynn Leoce, Executive Director of Clinical Documentation and Care Coordination for AdventHealth, has stated, “our partnership with Xsolis allows us to leverage technology and innovation to advance [our commitment to providing the highest quality of care for our patients].”

If you are registered for the ACMA Virtual National Conference, you can view the session on demand.

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