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Work utilization and DUR case reviews

Work assigned review cases from a shared worklist: utilization management (UM) reviews for admissions and length of stay, and drug utilization reviews (DUR) for pharmacists.

Before you start​

  • UM reviews: you need the Utilization Management Nurse role. Go to Utilization Management → Case Reviews.
  • DUR reviews: you need the Pharmacist / MTM Specialist role. Go to Pharmacy → Drug Utilization Reviews.
  • Both pages show a Live badge — cases come from your organization's case review service in real time.

Steps​

  1. Open the worklist. Cases are listed with status and priority.
  2. Use the filters to narrow the list by status and priority, and expand a row to preview key details (for UM cases, the admission criteria).
  3. Click a case to open it in the review screen. Depending on the case type you can:
    • Review the criteria checklist against the documentation.
    • Review the length-of-stay analysis (UM cases).
    • Read and reply to queries on the case.
    • Attach documents that support your review.
    • Record a determination to complete the review.
  4. Click Back to worklist to return and pick up the next case.
  5. For UM, use New review on the worklist to start a manual intake when a case wasn't created automatically.

Tips / Troubleshooting​

  • The actions available inside a case depend on your role — for example, only reviewer roles can record a determination.
  • If the worklist is unexpectedly empty, check your status filter first; completed cases drop out of the default view.
  • If your session has expired you'll be returned to the sign-in page — sign back in and the worklist reloads.