With hospital staff often overloaded with high caseloads, the ability to prioritize patients is crucial. Case managers have a lot of work to get done every day, and typically use paper based methods to manage their work. Hospital systems lack standardization in their prioritization process and decision-making, which may lead to avoidable payer denials for the patient and administrative burdens for hospital staff.

MCG Health, part of the Hearst Health network, combines evidence-based medical guidelines with data science to support the best care for each patient and inform important decisions in healthcare. MCG’s transparent assessment of the latest research and scholarly articles, along with insightful analytics, provides the vetted information needed to feel confident in every care decision. MCG Health and ThoughtWorks partnered on MCG’s first AI product to market: Indicia for Effective Focus, a hospital system application that connects machine learning with evidence-based guidelines that aims to make hospital workflows more efficient and effective for case managers.

Indicia for Effective Focus prioritizes cases using machine learning from real-time patient data through their electronic health record (EHR) for the case manager to continually monitor the best level of care for patients. The solution is used to organize and identify any cases that may be in an improper status (inpatient care, observation care, discharge). It uses a risk algorithm based on MCG’s clinical evidence to identify changes to the status required. This solution helps focus efforts on the cases that most need attention.

By using cutting-edge technology and an evidence-based prioritization model, Indicia for Effective Focus enables:

1. Effective and efficient case management using patient-centric, evidence-based algorithms for quicker classification
2. Workload transparency for hospital leadership across departments or health systems with reduction of administrative burdens 
3. Fewer claim appeals by reducing preventable payer denials

Early adopter feedback for Indicia for Effective Focus across several hospital systems has been very positive. The solution is now widely available and MCG continues to onboard new clients. MCG Health is really excited about continuing to add more evidence-based and AI features to make Indicia for Effective Focus a more integrated, cohesive experience for end users.