InterQual to manage care across Rotherham

Rotherham Health and Social Care Economy Partnership is deploying an evidence-based decision support and care management system developed and widely-used in the US.

The partnership between Rotherham NHS Foundation Trust, NHS Rotherham, and Rotherham Social Services was developed in July 2008, to meet national imperatives to use health services appropriately.

It is now rolling out McKesson’s InterQual, which is used in more than 3,700 US hospitals and also supports the Medicare and Medicaid services. Rotherham chief executive Brian James told E-Health Insider: “We’ve been working with InterQual for the past two years.

“It was piloted for a week in South Yorkshire in 2004, where it showed that a very significant number – around 25-30% – of people were occupying acute beds that they didn’t need to be. Since InterQual went live here last week, we have already identified a number of acute beds that are not needed.”

The partnership has been working to make sure that acute beds are being used appropriately, that patients are discharged from hospital in a timely fashion and that they receive appropriate support in the community. InterQual will be used to support these objectives.

Neil Spragg, vice president of business intelligence and commission at McKesson said: “InterQual isn’t just about keeping people out of hospital to cut costs. If people need to be admitted, they obviously will be.

“It’s about providing the right level of care. Some patients need to be in a healthcare treatment centre, but not in a high cost bed; so in that case there will be a step-down – but in many other cases there will need to be a step-up.”

McKesson started to develop InterQual around 30 years ago. It provides online access to clinical decision support tools and best practice advice, based on medical evidence from both the US and international sources.

It can interface with existing systems, using HL7 standards. Within a hospital, it can be used to help medical staff decide whether a patient should be admitted or taken to another service; whether they are receiving the right level of care and whether they should be discharged.

So far, it has been implemented in three departments of Rotherham General Hospital; older people, orthopaedics and emergency admissions to the medical assessment unit. James wants to have ten to 12 wards live over the next six months, but also wants to see it used across the local health community.

“I wanted to be able to work with the primary care trust and borough council to implement it across the whole community,” he said.

“Using the same tool to help determine whether an individual patient requires admission or not, whether they are at the right level of care, and when it is appropriate to discharge benefits all parties and creates a win-win situation.

“The primary care trust avoids the cost of an avoidable admission and the foundation trust can reduce the cost of in-patient stays.”

Rotherham NHS Foundation Trust is about to announce the award of a contract for a new electronic patient record system outside the National Programme for IT in the NHS.

In a recent interview with EHI, James emphasised that re-organising workflows to improve efficiency was one of the major factors behind the move.

Related articles: Waiting not an option: an interview with Brian James

Link: McKesson’s InterQual product suite