Xsolis推出GenAI同行评审概要，助力医院医师顾问开展工作
Xsolis Launches GenAI Peer-to-Peer Synopsis to Arm Hospital Physician Advisors
须知事项
医疗AI及利用管理技术公司Xsolis宣布其GenAI Peer-to-Peer Clinical Synopsis解决方案正式全面上市。
该解决方案直接应对同行评审拒付复核关键的24至72小时监管和商业窗口期，使医师顾问在与健康计划医疗主管沟通前，即可即时获得自动生成的医疗必要性综合分析。
该解决方案会自动扫描纵向电子病历（EMR）中的生命体征、实验室检查结果、当前治疗方案和每日临床进展，构建逐日医疗必要性叙述和严重程度概况。
面向时效性支付方复核的自动综合分析
这项新功能作为附加功能直接嵌入Dragonfly Advise®中。Dragonfly Advise®是Xsolis为医院医师顾问团队打造的专用工作流平台。当支付方发出拒付决定且案件升级为同行评审时，生成式AI引擎会自动导入纵向电子病历，扫描实验室数值、生命体征变化趋势、当前用药医嘱、床旁护理记录和多学科进展记录。
软件基于这些原始数据生成结构化的逐日临床概要，重点突出：
严重程度指标：标记支持住院收治而非观察状态的特定诊断指标、血流动力学不稳定情况和合并症恶化情况。
医疗必要性依据：将医师治疗方案置于客观临床标准的背景下进行阐释，说明为什么无法在较低医疗强度的环境中安全提供护理。
讨论要点准备：提供简明的病例概览，使顾问无需花费15至20分钟手动重建病历，即可参与与支付方的沟通。
扩展Dragonfly GenAI产品组合
此次发布标志着Xsolis已在其Dragonfly®平台上部署的第三项生成式AI功能上线，该功能与现有的自动生成申诉信和初始医疗必要性审查工具共同构成产品组合。
在此前与总部位于Indiana的Beacon Health System开展的一项为期三个月的运营试点中，Xsolis的GenAI医疗必要性审查工具将平均病历审查时间缩短了68%，使每个病例的审查时长从15分钟降至4.7分钟。
多个医疗系统已经签署协议，将Peer-to-Peer Clinical Synopsis整合至其利用管理（UM）和医师顾问运营中，企业级实施工作将在未来数月陆续展开。即将推出的路线图增强功能包括支持将概要直接导出至医师顾问在与支付方通话期间使用的第三方通信工具中。
“同行评审是拒付流程中对时效性要求最高的环节之一，而医师往往需要在管理完整的临床和行政工作流的同时准备评审，”Xsolis联合创始人兼CEO Joan Butters表示。“通过呈现最相关的临床事实，我们可以减少重建病例所需的工作量，帮助医师顾问做好准备后参与沟通，并揭示复杂病历中容易被忽略的细节。”
What You Should Know Healthcare AI and utilization management technology company Xsolis announced the general availability of its GenAI Peer-to-Peer Clinical Synopsis solution.
Directly addresses the critical 24- to 72-hour regulatory and commercial window for peer-to-peer denial reviews, giving physician advisors an instant, automated synthesis of medical necessity before speaking with health plan medical directors.
Automatically scans the longitudinal electronic medical record (EMR) for vital signs, lab results, active therapies, and daily clinical progress to construct a day-by-day medical necessity narrative and severity profile.
Automated Synthesis for Time-Sensitive Payer Reviews
The new capability is embedded directly as an add-on feature within Dragonfly Advise®, Xsolis ’ dedicated workflow platform for hospital physician advisor teams. When a payer issues a denial and a case is escalated for a peer-to-peer review, the generative AI engine automatically ingests the longitudinal electronic medical record—scanning laboratory values, vital sign trajectories, active medication orders, bedside nursing notes, and multidisciplinary progress records.
From that raw data, the software generates a structured, day-by-day clinical synopsis highlighting:
Severity Indicators:
Flags specific diagnostic markers, hemodynamic instability, and comorbid escalations that warrant inpatient admission over observation status.
Medical Necessity Rationale:
Contextualizes physician treatment plans against objective clinical criteria, articulating why care could not be safely delivered in a lower-acuity setting.
Point-of-Discussion Prep:
Provides a concise case overview so the advisor can enter the payer conversation without spending 15 to 20 minutes manually reconstructing the chart.
Expanding the Dragonfly GenAI Portfolio
The launch represents the third generative AI capability Xsolis has deployed across its Dragonfly® platform, joining existing tools built for automated appeal letter generation and initial medical necessity reviews.
In a previous three-month operational pilot conducted with Indiana-based Beacon Health System, Xsolis’ GenAI medical necessity review tool reduced average chart review times by 68%, cutting review durations from 15 minutes down to 4.7 minutes per case.
Multiple health systems have already signed agreements to integrate the Peer-to-Peer Clinical Synopsis into their utilization management (UM) and physician advisor operations, with enterprise implementations rolling out over the coming months. Upcoming roadmap enhancements include enabling the synopsis to export directly into third-party communication tools used by physician advisors during payer calls.
“Peer-to-peer reviews are among the most time-sensitive points in the denial process, and physicians are often preparing for them while managing a full clinical and administrative workflow,” said Joan Butters, Co-Founder and CEO of Xsolis. “By bringing the most relevant clinical facts forward, we can reduce the work required to reconstruct the case, help physician advisors enter the conversation prepared, and surface details that are easy to miss in a complex chart.” Reader Interactions