AI Pediatrics: Medical Necessity Insights for Pediatric Populations 

Clinical information for Pediatrics 

XSOLIS harnesses the power of predictive analytics and artificial intelligence to make pediatric patient data actionable in real time. That helps pediatric nurse case managers and other staff make the right determination each time. AI in pediatrics takes the burden off of your team.

XSOLIS ensures effective prioritization of cases, whether by the right staff or by exception. No longer do you have to wait for technology that serves your needs. With XSOLIS, you're equipped to succeed.

Improved Efficiency 

Nurses generally follow a simple process for their daily census: working their way down the list. They often have no choice but to use an all-or-nothing approach, giving all cases equal priority.

CORTEX uses artificial intelligence and machine learning to identify cases that are mostly at risk. This helps nurses spend more time on the most complex and time-critical cases.r.

• Nurses can start on high-priority, high-risk cases to best utilize their time>
• Helps standardize workflows in pediatric case and disease management
• Patient data flows over from the EMR directly into the platform

The average CORTEX client sees a 30% efficiency gain.

Better Payer Communications

CORTEX turns what’s often an adversarial process into a more collaborative and positive one.

With CORTEX, payers and providers see all of the patient's data per encounter in real time. Time-wasting and frustrating faxes, emails, and calls are no longer a concern.

CORTEX serves as the dependable single source of truth on medical necessity for each case. That empowers both payers and providers to start their review on common ground.

• Gets payers and providers on the same page using the same tool
• Significant reduction in case touches, administrative work, and appeals burden
• Cases are statused upfront expediating the review process

Up to 40% of inpatient cases can be automated with 99% accuracy.

Appropriate Inpatient Conversions

XSOLIS Analytics provide recommendations on the appropriate status of a patient based key contextual information. It takes labs, vitals, medical history, orders, meds and procedures into account.

If the recommended status is different from the current actual status, the UR team will be notified of the conflict.

• 24/7 monitoring of all patient information 
• Find Inpatient opportunities as soon as the patient qualifies 
• Identify opportunities earlier in the shift to allow time for resolution 

Appropriate observation rate reduction of 8.7 % is typical for CORTEX users in their first year.