The University of Tennessee Medical Center (UTMC) selected Xsolis to replace EMR-bound utilization management workflows that drove a high observation rate and left revenue uncaptured. After a phased rollout of Best in KLAS Physician Advisor Services and the Dragonfly platform, UTMC gained shared clinical visibility, stronger throughput, and measurable ROI.
When the UM process relies on an EMR alone, the gaps are predictable: limited visibility, no way to prioritize reviews, and teams working from different versions of the truth. UTMC saw those gaps clearly. So did its new Medical Director of Utilization Management.
This post provides details about why UTMC chose Xsolis, told through the perspective of the physician advisor who helped lead the change.
As Medical Director of Utilization Management at the University of Tennessee Medical Center (UTMC), Dr. Mark Reddington’s, DO, MSc, CHCQM-PHYADV, role centers on ensuring each patient is in the right status-spending most of his day completing case reviews and peer-to-peers.
Dr. Reddington joined UTMC just a few months before the go-live of Xsolis’ Best in KLAS Physician Advisor Services, and he quickly identified the department’s most pressing pain points as review inefficiencies and fragmented team communication. Both stemmed from workflows managed entirely within the EMR.
The path to Xsolis began when UTMC recognized that those inefficiencies were creating a measurable downstream impact. The observation rate was too high, and too few peer-to-peer reviews were being completed to successfully appeal cases that warranted inpatient status. The result was that revenue was being left on the table.
Faced with a clear need to take action, UTMC identified Xsolis as the right partner to streamline physician advisor (PA) and UM workflows, close revenue gaps, and build a more sustainable approach to utilization management.
As Dr. Reddington explained:
“Our leadership wanted a vendor with not only longevity in the utilization management space, but proven ROI and outcomes. Xsolis stood out for its depth of experience and results.”
To set the partnership up for success, UTMC took a phased approach to implementation.
This first phase went into effect in March 2025, centered on Xsolis’ Physician Advisor Services, including access to the Dragonfly Advise platform. Dragonfly Advise is an AI- and ML-driven workflow tool that synthesizes clinical data to help PAs efficiently evaluate and support case status decisions for escalated cases. The results of Phase One gave UTMC the confidence to expand the partnership further.
As Dr. Reddington noted:
“We saw a strong return on investment, increased efficiencies, and improved throughput, which led us to adopt the full Dragonfly platform.”
Building on that momentum, Phase Two began in November 2025. It expanded UTMC’s implementation to include Dragonfly Utilize, Xsolis’ AI-driven utilization management platform, and GenAI Initial Review, which uses generative AI to produce concise, comprehensive clinical summaries, further accelerating the review process and reducing administrative burden on the teams.
With Dragonfly in place for more than six months, one of the most impactful benefits has been the ability for PAs and UR nurses to communicate across a shared platform, with both teams working from the same real-time clinical information.
Xsolis’ Care Level Score™ (CLS™), powered by real-time predictive analytics and machine learning, provides that shared clinical foundation. Dr. Reddington appreciates that the CLS delivers a full clinical picture of each patient, empowering clinicians to apply their expertise rather than rely solely on traditional criteria.
For Dr. Reddington, the value of having both teams working within Dragonfly comes down to transparency and prioritization; two things EMRs were never designed to provide.
“EMRs aren’t built for utilization management, which creates significant data gaps,” he explained. “Xsolis’ Dragonfly platform provides visibility throughout the UM process, including clear direction on which patients should be prioritized for review.”
For physician advisors considering Xsolis’ Physician Advisor Services and Dragonfly, Dr. Reddington’s message is straightforward. Partnering with Xsolis allows your health system to direct focus where it’s needed most, whether that’s a high observation rate, missed inpatient-only procedures, or short-stay Medicare Advantage cases creating downstream issues.
The ability to prioritize cases, improve cross-team visibility, and streamline workflows frees clinicians to apply their expertise where it matters most, delivering outcomes that simply can’t be achieved by relying on the EMR alone for PA and UM workflows.
Looking ahead, UTMC and Xsolis are focused on leveraging Xsolis reporting to identify ongoing opportunities and translating those insights into action plans with the dedicated Account Team.
With GenAI Initial Review now in place, both the UR and PA teams can expect continued efficiency gains, meaningful time savings, and more streamlined payer interactions. Dr. Reddington is confident the partnership will continue to deliver and credits the Account Team relationship as a key part of that foundation.
As he put it, “Xsolis stands out for feeling like a true partnership. From the initial sales demos to our ongoing Account Team relationship, I’ve felt comfortable throughout the process. Our Account Team meets us where we are, partnering with us and using reporting to identify opportunities for improvement.”
UTMC chose Xsolis to resolve review inefficiencies and fragmented team communication caused by managing workflows entirely within the EMR. Leadership wanted a vendor with longevity in the utilization management space plus proven ROI and outcomes. The goal was to lower a high observation rate, complete more peer-to-peer reviews, and close revenue gaps.
UTMC used a phased approach. Phase One, effective March 2025, deployed Xsolis' Physician Advisor Services and Dragonfly Advise. Phase Two, beginning November 2025, added Dragonfly Utilize and GenAI Initial Review after strong Phase One results.
Dragonfly Advise supports physician advisor workflows, helping PAs evaluate and document case status decisions for escalated cases. Dragonfly Utilize supports utilization review nurse workflows, providing a complete view of every patient to confidently support medical necessity and ensure the right care at the right time. UTMC adopted Advise in Phase One and added Utilize in Phase Two.
EMRs were not built for utilization management, which creates significant data gaps. They lack the visibility and prioritization that UM teams need to know which patients to review first. The Dragonfly platform provides visibility throughout the UM process and clear direction on case prioritization.