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Overview of Key Performance Indicators

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Overview of Epic’s Key Performance Indicators
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Members of the Epic community have identified a number of metrics that help measure their
organizations' profitability and quality of care over time. We have collected these metrics as key
performance indicators (KPIs) to help you identify areas where your organization is already strong, as
well as opportunities during and after your transition to Epic.
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In our experience, organizations that effectively track and respond accordingly to KPI metrics are
more successful with meeting their operational objectives than organizations that do not track KPIs.
For this reason, tracking and reporting on KPIs is part of Epic’s Good Install Program and a focus of the
Clinical Operational Readiness (CORe) and Access and Revenue Cycle Readiness (ARCR) programs.
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Organizations that have been successful using KPIs to meet their operational goals have employed a
three-part strategy that includes assigning owners, setting goals, and comparing their performance
with peers for ongoing improvement.
Assign Owners
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We assign owners to each KPI through the CORe and ARCR programs, aligning the change
management that occurs during the implementation with performance management at go-live and
beyond. Each owner is accountable for documenting pre-live baselines and targets that are used to
measure performance beginning at go-live. These owners also ensure there are processes in place for
achieving performance goals after you are live with Epic.
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The individual who owns each metric needs to work with your organization’s project team and subject
matter experts to determine a regular schedule for data collection. For most KPIs, Epic recommends
collecting pre-live data monthly for one year before your go-live. After you are live with Epic, owners
manage KPI performance using Epic dashboards and reports.
Set Goals
Early in your implementation, you work with Epic to set clear, measurable goals, and communicate
the goals to your project team and operational leadership. Strong goals can:
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Emphasize the importance of consistent improvement throughout your organization.
Help your staff understand that the Epic implementation is an opportunity to improve your
organization’s overall efficiency and effectiveness.
Determine whether you need to track additional metrics as part of your implementation.
Give KPI data collection a clear purpose.
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Compare Through Cogito Benchmarking
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During the install, Epic and your project team configure your system to show pre-live KPI baselines
and targets on Radar dashboards to reflect your performance in Epic. Epic also enables your system to
automatically submit de-identified data to Epic for benchmark comparison across the Epic
community. You can compare your metrics to those of all participating organizations or define peer
groups for specific comparisons by size, location, or different organizational attributes (such as
academic, community, pediatrics, trauma, or Stage 7). Comparing your data to that of your peers can
highlight areas where you are particularly successful or have opportunities for improvement.
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KPI Listing
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This section lists all of Epic’s recommended KPIs, with a description of the metric and the recommended operational owner. More details about
each of these metrics are included in the operational workbooks for the CORe and ARCR programs.
Clinical KPIs
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Metric Name
This Metric Shows…
ED - Percent of ED
Visits Left Without
Being Seen
The weekly and monthly percentage of patients who leave the ED before being clinically
assessed. Use this metric as a measure for lost revenue. If the percentage of patients who
leave the ED without being seen is high, it often represents a process breakdown in the
department that's affecting clinicians' productivity.
Emergency
Department Nurse;
Emergency
Department Physician
ED - Median Arrival to
ED Depart Time
The median duration between a patient's arrival and the time the patient leaves the ED. This
metric is the most universal measure of an ED's productivity and throughput. A high median
patient length of stay is often the first sign that there is a breakdown in one or more critical
workflows in the department.
Emergency
Department Nurse;
Emergency
Department Physician
ED - Median Admit
Decision to Admit
Time
The time between a transfer request (when a clinician entered the transfer order or the
inpatient bed was requested) until the transfer is confirmed by the inpatient unit. Use this
information to evaluate the efficiency of your transfer workflows and make more efficient
staffing decisions. The ED is a high-traffic area, and improving admission times from the ED
helps ED staff treat more patients.
Emergency
Department Nurse;
Emergency
Department Physician
ED - Arrival to Triage
and Arrival to Room
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The average duration between the time when the following metrics occur. This metric
indicates whether there are any throughput issues with the triage workflow or a backup in the
waiting room due to patients waiting for a bed:
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ED - Triage Time
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Owner
Emergency
Department Nurse
A patient arrives and the patient is triaged
A nurse finishes triage and the patient is roomed
The average triage time. Follow up with nurses who are taking longer than expected to
complete triage and coach these nurses on how to improve their average triage time. Contact
nurses who consistently complete triage quickly to recognize their efficiency and determine
whether they have time-saving techniques to share with their peers.
Emergency
Department Nurse
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Metric Name
This Metric Shows…
Owner
ED - Disposition to
Discharge
The median duration between the disposition decision and the time the patient is discharged
from the ED. Use this metric to evaluate physician and nurse productivity and make more
efficient staffing decisions.
Emergency
Department Nurse;
Emergency
Department Physician
Facility Level of
Service Distribution
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The distribution of hospital charges across the five levels of service. Monitoring this metric is
essential to make sure that hospital charges are documented at the same level of service as
they were pre-live.
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ED - Facility
ED - Facility
ED - Facility
ED - Facility
ED - Facility
Level of Service - Level 1
Level of Service - Level 2
Level of Service - Level 3
Level of Service - Level 4
Level of Service - Level 5
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Emergency
Department Nurse
ED - Median Arrival to
Provider First Seen
Time
The median duration between a patient's arrival and the time an attending physician first sees
the patient. The ED is a high traffic area, and this metric can help you evaluate physician
productivity and make more efficient staffing decisions so your ED staff can treat more
patients.
ED- Roomed to
Provider and Provider
to Disposition
The median duration between a rooming a patient and the time the patient sees a provider
and the median duration between seeing a provider and disposition. Helps evaluate and
monitor provider efficiency and promote throughput.
Emergency
Department Physician
Professional LOS
Distribution
The distribution of professional charges across the five levels of service. Monitoring this metric
is essential to ensure that physicians are documenting at the same level as they were pre-live.
Emergency
Department Physician
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Emergency
Department Physician
ED - Professional Level of Service - Level 1
ED - Professional Level of Service - Level 2
ED - Professional Level of Service - Level 3
ED – Professional Level of Service - Level 4
ED – Professional Level of Service - Level 5
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Metric Name
This Metric Shows…
Owner
Number of ED Visits
The number of patients who arrived in the ED per day.
Emergency
Department Nurse;
Emergency
Department Physician
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Clinical Pathology
Turnaround Time
Compliance
The percentage of clinical pathology tests that met their established turnaround time. Use this
metric to measure how consistently your organization delivers diagnostic information on time.
If some labs or tests consistently don't meet their turnaround times, you might adjust staffing,
complete process review, or provide additional training for lab or other clinical staff.
Lab Director
Anatomic Pathology
Turnaround Time
Compliance
The percentage of anatomic pathology cases that were completed within their prescribed
turnaround time. Use this metric to measure how well your organization delivers diagnostic
information on time. If some labs or tests consistently don't meet their turnaround times, you
might adjust staffing, complete process review, or provide additional training for lab or other
clinical staff.
Lab Director
Average Turnaround
Time of STAT CBC,
Troponin, and
Protime INR Tests
The average turnaround time for STAT CBC, Troponin, and Protime INRs. Use this metric to
understand how quickly your lab processes high priority lab work. If some labs or tests
consistently don't meet their turnaround times, you might adjust staffing, complete process
review, or provide additional training for lab or other clinical staff.
Lab Director
Average Frozen
Section Turnaround
Time
The average turnaround time for frozen section anatomic pathology cases. Use this metric to
understand how efficiently your lab processes high priority anatomic pathology specimens. If
some labs or tests consistently don't meet their turnaround times, you might adjust staffing,
complete process review, or provide additional training for lab or other clinical staff.
Lab Director
Average Call Time
The average time it takes lab staff to call a provider about a critical result. Use this metric to
determine how quickly your lab staff communicate about critical results. If lab staff
consistently take a long time to communicate results, you might provide them with additional
training or process review.
Lab Director
The percentage of laboratory procedures that had results corrected after verification. Use this
metric to gain insight into the accuracy of your lab's result reporting and how often physicians
are exposed to incorrect results.
Lab Director
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Corrected Results
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Metric Name
This Metric Shows…
Owner
Test Census
How many tests your lab processes. Use this metric to understand your lab's output and
efficiency month to month.
Lab Director
Barcoding
Compliance
How often nurses are not scanning medication and patient barcodes during medication
administration. Use this information to identify medications with high override rates,
determine why users are not scanning barcodes, and track overall compliance by department
and user.
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Inpatient Nurse;
Inpatient Quality
Owner; Cancer Center
Director; Cancer
Center Nurse;
Invasive Nurse;
Inpatient Pharmacy
Manager
Barcoding Near
Misses
How often nurses scan a medication barcode, receive a warning that the patient doesn't have
an associated order for the medication, and don't override the warning and administer the
medication. Use this information to see how often barcoding helps prevent potential
medication administration errors. This metric is a good indicator of quality of care.
Inpatient Nurse;
Inpatient Quality
Owner; Inpatient
Pharmacy Manager
Required
Documentation
Completion
The patients on the log-in unit who, at any given time, have no outstanding required
documentation elements for admission, shift, or discharge.
Inpatient Nurse
Fall Risk Patient
Identification and
Intervention
The real-time number of patients in the log-in unit who have been screened for fall risk. Of
those patients with a high fall risk, this metric also shows the number with application of a care
plan or other clinical intervention meant to mitigate fall risk.
Inpatient Nurse
Pressure Ulcer Risk
Identification and
Intervention
The real-time number of patients in the log-in unit who have been screened for pressure ulcer
risk, typically using a tool such as Braden Score. For high-risk patients (that is, patients with a
low Braden Score), this metric also shows the number with application of a care plan or other
clinical intervention meant to mitigate the risk of pressure ulcer development.
Inpatient Nurse
The real-time number of patients in the log-in unit with charting indicating that they have a
central line, and that it is being appropriately charted against according to organizational
policy.
Inpatient Nurse
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Central Line Bundle
Charting Compliance
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Metric Name
This Metric Shows…
Owner
Ventilator Bundle
Charting Compliance
The real-time number of patients in the log-in unit with charting indicating that they have a
ventilator, and that it is being appropriately charted against according to organizational policy.
Inpatient Nurse
Readmission Risk
Patients
The real-time number of patients in the log-in unit with charting and other risk-factors
indicating that they are at risk for readmission.
Patient Falls (per 1000 The number of patient falls recorded per 1000 patient days.
Patient Days)
CLABSI (Central LineAssociated Blood
Stream Infections)
per 1000 Line Days
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The number of hospital-acquired central line-associated blood stream infections per thousand
central line days. To be included in this metric, the patient must have an LDA with the type
specified and one of the following:
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Inpatient Nurse
Inpatient Quality
Owner
Inpatient Quality
Owner
A hospital problem from the diagnosis grouper that is not marked as present on
admission.
Lab results with the specimen source specified.
Lab results with the specimen type specified.
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CAUTI (CatheterAssociated UTI) per
1000 Line Days
The number of hospital-acquired urinary catheter-associated UTIs per 1000 line days.
VAP (Ventilator
Associated
Pneumonia) per 1000
Vent days
The number of hospital-acquired ventilator-associated pneumonia infections per thousand
ventilator days.
Inpatient Quality
Owner
Readmission Rate
(Overall)
The number of inpatients with a hospital admission in the last 30 days who were readmitted in
that 30 day period for any reason.
Inpatient Quality
Owner
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Record Completion
Time
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The average time taken to complete anesthesia documentation, meaning the time between
the patient moving into recovery and the last addendum to the record, or the close encounter
event if no addendum has been made. If the record has not been closed within 30 days, 30 days
is counted as the time to close that record. Lower values are preferable for this metric.
Inpatient Quality
Owner
Anesthesia Manager
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Metric Name
This Metric Shows…
Owner
Records Closed
Within 3 Days
The percentage of anesthesia encounters that have been closed within 3 days of the patient
moving into recovery.
Anesthesia Manager
Postprocedure Note
Compliance
The percentage of anesthesia encounters that have a postprocedure note written and signed
within 48 hours of the patient moving into recovery.
Anesthesia Manager
Total Cases
The total count of all anesthetic procedures complete for the past month.
Anesthesia Manager
Total Minutes
The total amount of anesthesia minutes billed for the past month.
Oncology Visit
Volume
The number of appointments in the oncology department and appointment adherence. Use
this information to evaluate staffing and track productivity and workload as well as how
adherence to appointments is affected by policies, seasonal shifts, or random events.
Protocol Adherence
The volume and type of changes physicians are making to a patient’s treatment plan
compared with the original regimen. Use this information to ensure that providers are
following your organization’s best practices and identify protocols that need to be updated for
physician ease of use.
Cancer Center
Director; Cancer
Center Physician
End of Life
Chemotherapy
The percentage of patients who received chemotherapy within 14 days of end of life. Use this
information to evaluate your compliance with regulatory standards for the use of
chemotherapy for terminally ill patients.
Cancer Center
Director
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Anesthesia Manager
Cancer Center
Director
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Metric Name
This Metric Shows…
Owner
Study Turnaround
Time
The time, per department, between a technologist marking an exam complete and the
cardiologist/radiologist signing the study. Use this information to determine
cardiologist/radiologist productivity. A low turnaround time can positively affect patient care
and increase referring provider satisfaction.
Cardiologist
Physician; Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager; Radiology
Manager;
Interventional
Radiology Manager;
Mammography
Coordinator; Chief
Breast Imaging
Radiologist;
Radiology
Information System
Administrator
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Cardiologist
Productivity
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Your cardiologists’ productivity as a whole or by individual user. Physicians or managers might
choose to follow up with physicians with low performance rates to see if they are having
trouble using the system and to help identify ways that they can complete their work more
efficiently.
Cardiologist
Physician; Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager
Orders Entered by
Physicians (CPOE
Percentage)
The percentage of orders entered into the system by your organization's physicians. Because
CPOE is a large part of Meaningful Use requirements, it is important to monitor CPOE usage
and encourage physicians to enter their orders electronically.
Cardiologist Physician
Transfer Medication
Reconciliation
Compliance
The percentage of transfer reconciliation events where medications were reconciled. This
metric compares the time of transfer with the time of transfer medication reconciliation to
determine whether medications were reconciled.
Cardiologist
Physician; Inpatient
Pharmacy Manager
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Metric Name
This Metric Shows…
Owner
Discharge Medication
Reconciliation
Compliance
The percentage of discharge reconciliation events where medications were reconciled. This
metric checks whether a physician took action on each medication for the inpatient encounter
to monitor adoption of medication reconciliation.
Cardiologist
Physician; Inpatient
Pharmacy Manager;
Inpatient Physician
Orders Placed by
Source
Where users are placing orders. This metric helps determine if the users are digging
through the system to find orders or placing them from Order Sets.
Cardiology Visit and
Case Volume by
Month
The total number of cardiology procedural appointments and cases. Use this information to
evaluate productivity and workload.
Cardiologist Physician
Door to Intervention
Time
Your location’s average time from hospital arrival to primary PCI for emergent STeMI cases.
Cardiologist
Physician; Cardiology
Administrator;
Invasive Labs
Manager
Door to Intervention
Time <90 Mins
The number of emergent confirmed STeMI cases that receive primary PCI within 90 minutes of
hospital arrival.
Cardiologist
Physician; Cardiology
Administrator;
Invasive Labs
Manager
Unsigned Studies
Studies that have not been signed. Use this metric to follow up and find possible problems that
are preventing studies from being signed.
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Cardiologist Physician
Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager
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Metric Name
This Metric Shows…
Owner
Charge Router
Reconciliation
A summary of the number of accessions released from the Charge Router review workqueues,
grouped by service area, workqueue, and then user. Only charges that have an associated
accession number are selected. This metric can help ensure that the Charge Router is properly
set up and functioning correctly.
Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager
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Appointments
Without Orders
A list of appointments that do not have an attached order. Because Cupid is orders-based, it is
important that all appointments have an attached order in Epic before the appointment.
Cardiology
Administrator;
Cardiology Manager
Final Cardiology
Studies Without
Result Text
Imaging studies from the last month that are marked as final but do not include a narrative nor
an impression. The chief cardiologist, unit supervisors, and cardiology managers can use this
metric weekly to find finalized cardiology studies that are missing a narrative and impression
and help ensure that cardiologists document results.
Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager
Cardiology No Show
Appointments
The total number of cardiology no show appointments per facility. This metric is useful for
identifying trending patient turnout for cardiology appointments.
Cardiology
Administrator;
Cardiology Manager
Schedule Utilization
How much of your modalities' schedules are booked with appointments. This metric indicates
how effectively your modalities are being used so you can optimize schedules.
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Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager; Radiology
Manager;
Interventional
Radiology Manager;
Mammography
Coordinator
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Metric Name
This Metric Shows…
Owner
Cardiology Visit and
Case Volume
Departmental volume. Use this high-level overview of the volume of imaging procedures in a
department to identify trends in workload over time.
Cardiology
Administrator;
Cardiology Manager;
Invasive Labs
Manager
First Case On-Time
Starts
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The percentage of first cases each day, scheduled within a specified date range, that started
on time.
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Cardiology
Administrator;
Invasive Labs
Manager; Invasive
Nurse; Operating
Room Manager
*Also an Access and
Revenue Cycle KPI
Technologist
Productivity
Your technologists' productivity as a whole or by individual user.
Cardiology Manager
Exams Begun
and Not Ended
Invasive imaging studies that are not at a status of Final after one month, which likely indicates
that the studies are overdue for finalization or other actions.
Cardiology Manager
Posted/Unposted
Logs
A list of posted and unposted logs that meet the location and date criteria that you specify.
The report can help track those cases with complete documentation and those without.
Invasive Labs
Manager
Case Cancellations
The number of cancellations in each location and adds them together for a total number of
cancellations. This metric helps you increase productivity by letting you investigate why
cancellations are happening.
Invasive Labs
Manager; Invasive
Nurse
Prophylactic
Antibiotic Medication
Administration
Compliance
A core measures statistic. The Joint Commission reports on the number of surgeries in which
antibiotics were required but not administered within an hour prior to the procedure. This
metric complies with Joint Commission standards for stopping infection and measuring
patient safety.
Invasive Nurse
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Metric Name
This Metric Shows…
Owner
Percentage of Charts
Completed the Same
Day as the Patient’s
Appointment
The percentage of charts that were completed on the same day as the patient's appointment
and the total number of closed and open encounters by provider. Use this information to
determine how many charts are open well past the visit date, which can adversely affect
reimbursement time. If a large number of charts are open well past the visit date, encourage
providers to close their charts in a timely manner.
Ambulatory Director;
Ambulatory Office
Manager
Average Number of
Visits per Provider per
Day
The average number of face to face visits per provider per day.
Ambulatory Director;
Ambulatory Office
Manager; Outpatient
Specialties Owner
Percentage of EPrescribed
Medication Orders
The percentage of medication orders that were e-prescribed. The metric excludes medications
that cannot be e-prescribed, including controlled medications.
Ambulatory Provider
Supply Usage
Supply usage based on surgical log documentation across all locations in the previous month,
grouped by location, service, and supply type.
Director of Materials
Management
Logs Missing
Verifications and
Timeout
Documentation
Log verification and timeout documentation compliance, which allows charge nurses and
managers to gain an overview of how well the surgical staff is complying with timeout and
verification checks for each log.
Operating Room
Charge Nurse
Primetime Room
Utilization
The utilization of the OR during primetime. The numerator is the total number of minutes that
cases are in room during primetime while the room template has Open Time. The
denominator is the total number of minutes that are in primetime while the room template
has Open Time.
Block Utilization
The percentage of available block time that was used by various surgeons, surgeon groups,
and services. Use this information to determine how efficiently surgeons, surgeon groups, and
services are using the time allocated to them.
Operating Room
Manager; Surgeon
Average room turnover in minutes between consecutive cases in the same room. Turnover is
defined as the duration between the previous case’s Out of Room time and the following
case’s In Room Time.
Operating Room
Manager
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Turnover - Same
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Operating Room
Manager
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Metric Name
This Metric Shows…
Owner
Surgical Volume Cases
The case volume by counting the cases that have the In Room event documented. Cases that
are canceled or voided are not included in this metric.
Operating Room
Manager
Surgical Volume Minutes
Case volume by counting the minutes between the documented events In Room and Out of
Room. Cases that are canceled or voided are not included in this metric.
Case Cancellation
Rate
A percentage measure of how many scheduled cases are cancelled or rescheduled to another
day, for each day in a selected timeframe. A canceled case is any case that was scheduled to
take place but was not performed.
Operating Room
Manager
Verbal Order
Turnaround
The average number of days it took a provider to sign a home health or hospice order.
Overall Home Care
Lead
Quality Review Days
The average number of days between an encounter that generates an OASIS data set and the
lock date for that set. This data is processed one week after the lock occurred to allow time for
syncing, so no values from the last six days are available.
Overall Home Care
Lead; Home
Health/Hospice
Quality Review Lead
Home Health
SOC/ROC Timeliness
The average days between Start of Care encounter and Date of Physician-Ordered Start of
Care (M0102).
Overall Home Care
Lead; Home
Health/Hospice
Clinician Lead; Home
Health/Hospice
Scheduling Lead
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MyChart Bedside
Activation Rate
The percentage of patients you’ve activated for MyChart Bedside since your go-live. A
suggested target is 75%.
MyChart Activation
Rates
The number of patients that are seen who have a status of MyChart Active. Use this metric to
evaluate whether MyChart Bedside has an effect on your MyChart activation rates. Activating
the patient for MyChart counts the patient towards meeting the H219 Meaningful Use Stage 2
measure.
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Operating Room
Manager
Patient Experience
Lead
Patient Experience
Lead
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Metric Name
This Metric Shows…
Owner
MyChart Activation
Rate Before and After
Hospital EncountersMyChart Bedside
The MyChart activation rate for patients who are active on MyChart Bedside over a defined
period. Compare to the rate for non-Bedside active patients. Activating the patient for
MyChart from Bedside counts the patient towards meeting the H219 Meaningful Use Stage 2
measure.
Patient Experience
Lead
Percentage of
Outpatient Test
Results Released
Online
The percentage of outpatient test results that have been released through MyChart. Releasing
results online instead of by phone or through the mail saves time for your staff and saves the
cost of postage. Online results are also a patient satisfier because the results are permanently
available to the patient and can be seen alongside the patient's other results.
Ambulatory Director
Organizational No
Show Rate
The percentage of patients who fail to show up for their appointments. The convenience of
online scheduling and online appointment cancellation can help patients stay on top of their
appointments.
Ambulatory Director
Total Number of
Patients on MyChart
The number of patients who have logged into MyChart. Use this information to understand
the effect of your patient portal, such as the marketing impact or the number of patients who
connect with your organization electronically. If you're tracking relative improvements in the
MyChart population compared to your overall patient population, the total number of
activated patients allows you to calculate the absolute gains from making MyChart available
to patients.
Ambulatory Director;
Ambulatory Office
Manager
Patient Visits with
MyChart Status
The number of patients who have a status in MyChart. Compare this metric to total patients
visiting for Meaningful Use requirements. Patients get a MyChart status when they are offered
the service of MyChart and are activated, have a code generated, or decline the service.
Ambulatory Director
Patients Logged In to
MyChart
The total number of patients who logged in to MyChart over a specific period of time. You can
compare this number to the total number of patients with an active MyChart account to see
how well you're using the patient portal to keep patients engaged. Patients accessing their
information are required for Meaningful Use Stage 2.
Ambulatory Director;
Ambulatory Office
Manager
The number of users who log in and use the proxy feature in MyChart without having a
MyChart account for their own health record. This information can help you understand how
patients who can't manage their own health due to their age are having their care managed.
Patients accessing their information are required for Meaningful Use Stage 2.
Ambulatory Director
52
E
0
8
E
E
c
i
p
6
6
C
3
6
I
U
U
Non-Patients Logged
In to MyChart
E
4
8
B
0
4
3
1
A
-C
:
D
E
4
1
0
F
E
A
D
14
1
FC
Metric Name
This Metric Shows…
Owner
Mobile Users Logged
In to MyChart
The number of users who log in to MyChart using mobile applications. Patients accessing their
information are required for Meaningful Use Stage 2.
Ambulatory Director
Patient Visits with
MyChart Active
Status
The number of patients who are seen who have a status of MyChart Active.
CPOE Percentage
The percentage of orders entered into the system by your organization’s physicians. Use this
information to track system usage and identify decreases in overall medication errors at the
prescribing phase.
Inpatient Physician
Admission
Medication
Reconciliation
Compliance
The percentage of encounters in which the PTA medications list is up to date. Use this
information to monitor physician adoption of admission medication reconciliation.
Inpatient Physician;
Inpatient Pharmacy
Manager
Problem List Updated
at Admission
The percentage of admissions with an active hospital problem on the problem list within 24
hours of admission. An up-to-date problem list indicates consistent and appropriate use of the
system by providers, and out-of-date problem lists indicate areas that might need additional
training or process review.
Problem List Updated
at Discharge
The percentage of admissions where an update other than a deletion was made to the
problem list within a certain number of hours before or after discharge.
Inpatient Physician
Readmission Rate
The percentage of inpatient admissions that were discharged during a certain time period and
resulted in a readmission. High readmission rates can reflect poor quality of care and increased
costs.
Inpatient Physician
4E
8
2
5
-6
6
E
0
8
E-
B
0
4
3
1
A
-C
3C
6
0
F
:
D
E
A
D
E
4
1
Ambulatory Office
Manager
Inpatient Physician
I
U
U
c
i
p
E
15
1
FC
Metric Name
This Metric Shows…
Owner
Radiology Exam
Volume
The number of imaging orders that have reached a status of final.
Radiology Manager;
Interventional
Radiology Manager;
Mammography
Coordinator; Chief
Breast Imaging
Radiologist;
Radiology
Information System
Administrator
E
4
1
2
5
6
6
E
0
8
E
E
4
8
Technologist
Turnaround Time
The amount of time, per department, between a technologist marking an exam begun to
completing the study.
Radiology Manager;
Interventional
Radiology Manager;
Mammography
Coordinator
Hospital Billing
Revenue
The amount of hospital billing revenue per department.
Radiology Manager;
Interventional
Radiology Manager;
Mammography
Coordinator
Professional Billing
Revenue
The amount of professional billing revenue per department.
B
0
4
3
1
A
-C
C
3
6
:
D
I
U
U
0
F
E
A
D
Radiology Manager;
Interventional
Radiology Manager;
Mammography
Coordinator
c
i
p
E
16
1
FC
Metric Name
This Metric Shows…
Owner
Department
Accessibility Report
The number of days in the future until a set procedure can be scheduled.
Radiology Manager;
Interventional
Radiology Manager;
Mammography
Coordinator
Mammography
Screening Exam
Callback Rate
E
4
1
2
5
6
E
4
8
The monthly callback rate for screening mammography exams for your entire organization.
6
E
0
8
E
Mammography
Coordinator; Chief
Breast Imaging
Radiologist
Mammography
Mammography outcomes and statistics as required by the Mammography Quality Standards
Quality Standards Act Act (MQSA). View information about assessments and recommendation usage for associated
procedures and pathology counts.
Mammography
Coordinator; Chief
Breast Imaging
Radiologist
OB Essential Delivery
Documentation
Delivery summaries that are missing key pieces of information. These data items are:
gestational age, delivery date/time, delivery method, preterm labor, placenta date/time,
placenta removal, estimated blood loss, living status, Apgar 1, Apgar 5, birth weight, birth
length, and delivering clinician.
Obstetrics Nurse
PC-01 Elective
Delivery
Patients with elective vaginal deliveries or elective cesarean sections at >= 37 and < 39 weeks
of gestation completed. This metric is the same as The Joint Commission’s Perinatal Care Core
Measure PC-01.
Obstetrics Nurse
PC-03 Antenatal
Steroids
Patients at risk of preterm delivery at 24 0/7-32 0/7 weeks gestation receiving antenatal
steroids prior to delivering preterm newborns. This metric is the same as The Joint
Commission’s Perinatal Care Core Measure PC-03.
Obstetrics Nurse
B
0
4
3
1
A
-C
C
3
6
:
D
I
U
U
0
F
E
A
D
PC-05 Exclusive
Breast Milk Feeding
Exclusive breast milk feeding during the newborn's entire hospitalization. This metric is the
same as The Joint Commission's Perinatal Care Core Measure PC-05.
Obstetrics Nurse
Formulary
Compliance
The number of non-formulary medication orders after verification. This information helps
determine the most common non-formulary medications for potential formulary inclusion.
Inpatient Pharmacy
Manager; Pharmacy
Subject Matter Expert
E
c
i
p
17
1
FC
Metric Name
This Metric Shows…
Owner
Pharmacy
Turnaround Time
The efficiency of your pharmacy staff’s medication verification. Reduced turnaround time can
greatly improve downstream efficiency and patient satisfaction.
Inpatient Pharmacy
Manager; Pharmacy
Subject Matter Expert
Percentage of
Dispenses from ADS
The percentage of total dispenses that come from Automated Dispensing Stations (ADS). This
information helps identify certain units with low dispense rates so the pharmacy can analyze
how to change ADS stock and improve efficiency.
Inpatient Pharmacy
Manager; Pharmacy
Subject Matter Expert
Dispense Preparation
Compliance
Barcode scanning compliance during preparation of dispenses. This information can be used
to identify pharmacies or users with low compliance rates and allow pharmacy managers to
determine if intervention is necessary.
Inpatient Pharmacy
Manager; Pharmacy
Subject Matter Expert
Dispense Preparation
Near Misses
How the Dispense Preparation activity prevents dispenses from being prepared incorrectly.
Managers can determine which medications are causing the most alerts when prepared using
the Dispense Preparation activity to pinpoint potential areas of improvement in the workflow
and medication build and to identify users that might benefit from additional training in
Dispense Preparation.
Inpatient Pharmacy
Manager; Pharmacy
Subject Matter Expert
Medication Warning
Override Rate
The ratio of medication warnings overridden by clinicians in comparison to total number of
warnings displayed. This information can be used to determine the effectiveness of active
medication warnings and determine whether more focused filtering or suppression of
warnings is necessary.
Inpatient Pharmacy
Manager
2
5
6
E
4
1
E
4
8
6
E
0
8
E
B
0
4
3
1
A
-C
C
3
6
F0
Medication Warnings
per Order
The ratio of medication warnings shown to clinicians per order. This information can be used
to determine whether clinicians are being over-alerted, and if changes to interaction setting
filters are necessary.
Inpatient Pharmacy
Manager
Number of Orders
Changed at
Verification
The number of times a pharmacist has to change an order at verification. This information
helps determine how efficiently and accurately physicians are placing medication orders.
Inpatient Pharmacy
Manager
Restraint Compliance
Overall documentation compliance for violent and non-violent restraints
Inpatient Nurse
A score for patients based on the volume of documentation in their chart indicating that their
treatment team might be using the EMR in a manner that causes safety issues.
Inpatient Nurse
:
D
I
U
U
c
i
p
Workflow Safety
Metrics
E
E
A
D
18
1
FC
Metric Name
This Metric Shows…
Owner
Month-End AR
Balance for
Orthopeadic
Departments
This metric measures the total accounts receivable (AR) dollars in revenue cycle billing
systems (not an adjusted dollar amount from finance).
Outpatient
Specialties Owner
Work RVUs for
Orthopeadic
Providers
This metric includes the sum of malpractice Relative Value Units (RVUs), overhead RVUs, work
RVUs, and total RVUs for the previous month, grouped by revenue location and department.
Transplant Center
Phase Volumes
This metric measures a transplant center's patient volume.
Transplant
Progression Times
This metric measures the number of days between phases for referral to evaluation, referral to
waitlist, and evaluation to committee review.
Outpatient
Specialties Owner
Complications
These metrics measure the rate of specific complications for post-transplant patients.
Outpatient
Specialties Owner
Readmissions or
Returns to OR
This metric measures the rate of readmissions or returns to the operating room for posttransplant patients.
Outpatient
Specialties Owner
52
E
0
8
E
C
3
6
0
F
E
A
D
Access and Revenue Cycle KPIs
E
4
8
6
6
B
0
4
3
1
A
-C
E
4
1
Outpatient
Specialties Owner
Outpatient
Specialties Owner
Metric Name
This Metric Shows…
Owner
Visit Volume
The total number of visits completed throughout your facility. Use this information to
evaluate productivity and workload and make more efficient staffing decisions.
Practice Patient Access
Director; Professional
Revenue Integrity Lead;
Outpatient Specialties
Owner
:
D
I
U
U
c
i
p
E
19
1
FC
Metric Name
This Metric Shows…
Owner
Schedule Utilization
The amount of open time on your providers' schedules compared with the amount of time
on their schedules that's booked for appointments. Use this information to see how
effectively your providers' time is being scheduled and to identify ways you could improve
the efficiency of provider schedules.
Practice Patient Access
Director
4E
8
2
5
No Show Rate
Compares the number of patients who appear for their appointments with the number of
patients who do not show up. Use this information to identify departments with a high
volume of no-shows so you can take steps to decrease the no show rate in those
departments.
E
0
8
E
E
4
1
6
6
*Also a Clinical KPI
Practice Patient Access
Director
Copay Collection Rate The percentage of copays collected. Use this information to identify departments with a
lower percentage of collected copays so you can take steps to improve upfront payment
collection.
Practice Patient Access
Director
Copay Collection
Dollars
The total dollar amount of copays collected. Over time, you can use this information to
monitor copay collection levels, identify areas where the copay dollars are lower than
expected, and take steps to improve upfront payment collection.
Practice Patient Access
Director
Accessibility (Third
Available
Appointment)
The number of days (not counting non-worked days) until the third available appointment
slot, a common industry-wide business metric. Use this information to estimate provider
accessibility. You can average the number of days across providers to determine the average
level of accessibility throughout your organization. (The metric uses the third available
appointment instead of the next available appointment to prevent a recent cancellation
from skewing the data.)
Practice Patient Access
Director
The total number of incoming referrals to your organization. Use this information to
determine the number, types of service, and sources of referrals coming into your
organization.
Referrals Lead
Incoming Referral
Volume
B
0
4
3
1
A
-C
C
3
6
:
D
I
U
U
0
F
E
A
D
Internal Referral
Volume
The total number of referrals sent within your facility. Use this information to determine the
number, types of service, and sources of referrals that are staying within your organization.
Referrals Lead
c
i
p
The total number of referrals sent outside of your facility. Use this information to determine
the number, types of service, and sources of referrals that your providers are sending outside
your organization.
Referrals Lead
Outgoing Referral
Volume
E
20
1
FC
Metric Name
This Metric Shows…
Owner
Outgoing Referral
Percentage
The percentage of outgoing referrals generated at your facility. Use this information to
compare the number of referrals your providers are sending outside your organization and
the number they are referring to other providers in house.
Referrals Lead
Kiosk Check In Rate
The percentage of check-ins completed by patients at a kiosk with no problems. Use this
information to see how often and how successfully patients use your kiosks. This information
can give you an idea of the amount of check-in work being diverted from front desk staff as a
result of the kiosks.
Welcome (not
associated with any
ARCR workbooks
currently)
Kiosk Redirect Rate
The percentage of attempted kiosk check-ins that result in the patient being redirected to
the front desk. Use this information to identify the main reasons patients are redirected to
the front desk. You might learn that you can change workflows or interfaces so patients can
complete kiosk check-ins more often.
Welcome (not
associated with any
ARCR workbooks
currently)
Discharge Effective
Time Versus Entry
Time
The average number of minutes between patients' discharge effective times and their
discharge entry times. Use this information to determine whether patients are being
discharged from your hospitals in a timely manner.
Hospital Patient Access
Director; Bed Planning
Director
Average Length of
Stay
The average inpatient length of stay. This commonly tracked metric can reflect the overall
quality of care and efficiency of your organization.
Hospital Patient Access
Director; Bed Planning
Director; Hospital Case
Management /
Utilization
Management Director;
Inpatient Physician;
Inpatient Quality
Owner; Outpatient
Specialties Owner
2
5
6
C
3
6
:
D
I
U
U
Hospital Account
Verification Rate
c
i
p
E
4
8
6
E
0
8
E
B
0
4
3
1
A
-C
0
F
E
A
D
The percentage of hospital registrations that are complete. Use this information to
determine the percentage of complete registrations for accounts billed out of Resolute
Hospital Billing.
E
4
1
Hospital Patient Access
Director
E
21
1
FC
Metric Name
This Metric Shows…
Owner
Encounter
Verification Rate
The percentage of encounter registrations that are complete. Use this information to
determine the percentage of complete registrations for accounts billed out of Resolute
Professional Billing.
Hospital Patient Access
Director
Inpatient Days
The count of inpatients at midnight and same day inpatient discharges. Any patients that
had an overnight inpatient bed charge.
Transfer Turnaround
Time
The time between a bed request and when the patient is confirmed in that bed (by a transfer
confirmation). Use this information to compare your average transfer turnaround time
against your goal time.
Hospital Patient Access
Director; Bed Planning
Director
Admission Time: ED
to IP
The time between a transfer request (when a clinician entered the transfer order or the
inpatient bed was requested) until the transfer is confirmed by the inpatient unit. Use this
information to evaluate the efficiency of your transfer workflows and make more efficient
staffing decisions. The ED is a high-traffic area, and improving admission times from the ED
helps ED staff treat more patients.
Bed Planning Director
Discharge Efficiency:
Order by 10 A.M.
How well you are meeting organizational goals for placing the discharge order by 10 A.M. on
the expected date of discharge.
Bed Planning Director
Discharge Efficiency:
Discharge by 1 P.M.
How well you are meeting organizational goals for completing discharges for patients by 1
P.M. on the expected date of discharge.
Bed Planning Director
Delinquency Rate
The percentage of encounters that are out of compliance with documentation. Use this
information to determine how compliant your organization is with timely completion of
clinical documentation. This information can help identify areas and users who might need
additional training or process review.
HIM Director
Percentage of New
Patients That Are
Potential Duplicates
How often users create new patients that are potential duplicates in Epic. Use this
information to determine whether front-end users are searching for and selecting patients
correctly. Duplicate patient records represent potential patient safety issues, so a large
number of potential duplicates might indicate that certain departments or users need
process review or additional training.
HIM Director
E
0
8
E
E
4
8
6-
B
0
4
3
1
A
-C
3C
6
0
F
:
D
I
U
U
c
i
p
2
5
6
E
A
D
E
4
1
Hospital Patient Access
Director
E
22
1
FC
Metric Name
This Metric Shows…
Owner
Overall Potential
Duplicate Rate
The current percentage of patients that are actively marked as potential duplicates of some
other patient.
HIM Director
Outstanding AR Days
for Uncoded DNB
Accounts
The number of uncoded AR days past your organization's min hold days. Use this
information to gauge how much AR is held up in coding.
Dollar Amount Held
Up Due to Missing or
Incomplete Physician
Documentation
The dollar amount held up in coding due to missing or incomplete physician documentation.
Use this information to identify clinical users causing accounts to bottleneck in coding and
who therefore need additional follow-up.
Coding Manager
Simple Visit Coding
Success Rate
The total number of accounts that were successfully completed using simple visit coding.
Coding Manager
Number of Claims
Rejected Due to
Coding Errors
The number of claims that were rejected by clearinghouse organizations due to coding
errors.
Coding Manager
Number of Open
Chart Correction
Cases
The number of open chart correction cases. Use this metric to monitor the use of the Chart
Correction workspace and activity and the volume of outstanding or open chart correction
cases.
HIM Director
Mortality Rate
The rate at which patients in the hospital expire. Use this information to gauge how often
individuals pass away while in your hospital.
Coding Manager
Case-Mix Index
The average diagnosis-related group weight for the hospital population, based on all payors.
Coding Manager;
Overall Hospital
Revenue Cycle Lead
4E
Coding Manager
8
2
5
-6
6
E
0
8
E-
B
0
4
3
1
A
-C
C
3
6
:
D
0
F
E
A
D
E
4
1
I
U
U
c
i
p
E
23
1
FC
Metric Name
This Metric Shows…
Owner
Net AR Days
The total net patient accounts receivable (system balance less allowances) divided by
average daily net patient revenue (charges less allowances for uncollectible accounts,
discounts for charity care, and contractual allowances for third-party payors).
Overall Professional
Revenue Cycle Lead;
Professional Finance
Lead; Hospital Finance
Lead; Home
Health/Hospice Finance
Lead
2
5
6
6
E
0
8
E
Month-End AR
Balance
The total AR dollars in revenue cycle billing systems (not an adjusted dollar amount from
finance).
Collection Ratio
B
0
4
3
1
A
-C
The payments for the month divided by gross charges for the previous month.
C
3
6
Charges
0
F
E
A
D
The total gross charges posted less charge voids/reversals.
I
U
U
Charge Detail
c
i
p
Work RVUs
E
:
D
E
4
1
E
4
8
Overall Professional
Revenue Cycle Lead;
Professional Finance
Lead; Overall Hospital
Revenue Cycle Lead;
Home Health/Hospice
Finance Lead
Overall Professional
Revenue Cycle Lead;
Professional Finance
Lead; Overall Hospital
Revenue Cycle Lead;
Hospital Finance Lead
Professional Revenue
Integrity Lead; Hospital
Revenue Integrity Lead;
Home Health/Hospice
Billing and Claims Lead
The total gross charges by grouper posted less voids based off of calendar days.
Professional Revenue
Integrity Lead
The total work RVUs (Relative Value Units).
Professional Revenue
Integrity Lead
24
1
FC
Metric Name
This Metric Shows…
Owner
Average Daily
Revenue
The average daily revenue based on the past 91 days for a specified summary level, total
gross charges less total charge voids for the last 91 days divided by 91.
Professional Revenue
Integrity Lead; Hospital
Revenue Integrity Lead;
Hospital Revenue
Integrity Lead; Overall
Home Care Lead
Adjustments
2
5
6
6-
E
4
1
E
4
8
The total adjustments posted (debit and credit, including refunds) except for adjustments
that move AR to/from active AR to/from bad debt AR.
Professional Payment
Posting Lead; Hospital
Finance Lead
Undistributed Credit
Volume
The total dollar amount of credits left undistributed, unmatched, or unapplied.
Professional Payment
Posting Lead
Copay Dollars
Collected
The total dollar amount of copays collected.
Professional Payment
Posting Lead
4-Week Average
Denials
The average 4-week denied dollars divided by average 4-week dollars for all claims sent.
Professional Insurance
Follow-up Lead
Contractual
Adjustments
The total dollar amount of posted contractual adjustments
Professional Insurance
Follow-up Lead;
Hospital Contract
Performance Lead
E
0
8
E
B
0
4
3
1
A
-C
C
3
6
Insurance AR Aging
by Aging Bucket
The amount of insurance AR broken out by aging periods since the service date as a
percentage of total AR.
:
D
I
U
U
Total Insurance AR
c
i
p
Outstanding Denials
E
0
F
E
A
D
Professional Insurance
Follow-up Lead;
Hospital Insurance
Follow-up Lead
The dollar amount in insurance AR.
Professional Insurance
Follow-up Lead
The total balance of charges with unresolved payor denials.
Professional Insurance
Follow-up Lead
25
1
FC
Metric Name
This Metric Shows…
Owner
True Versus Residual
Self-Pay
The total dollars of self-pay without an original coverage compared to dollars of self-pay
after insurance.
Professional Self-Pay
Follow-up Lead
Self-Pay AR Aging by
Aging Bucket
The amount of self-pay AR broken out by aging periods since the service date.
Month-End AR
Dollars in Self-Pay
The total amount of accounts with a self-pay balance. This metric includes accounts that are
truly self-pay (the patient has no insurance) as well as residual self-pay (the amounts that
become self-pay once the insurance has paid its portion).
E
0
8
E
B
0
4
3
1
A
-C
Posted Denials
The total denied amount for payor denials posted, resolved or outstanding, posted in the
time period.
Outstanding Denials
The total balance of claims with unresolved payor denials, not including pending appeals.
System AR Days
4E
8
2
5
6
6
3C
6
0
F
The total receivable dollars, expressed in days of revenue based on a 91 day average daily
revenue, in the revenue cycle billing system.
:
D
I
U
U
E
A
D
E
4
1
Professional Self-Pay
Follow-up Lead;
Hospital Self-Pay
Follow-up Lead
Professional Self-Pay
Follow-up Lead;
Hospital Self-Pay
Follow-up Lead; Home
Health/Hospice Finance
Lead
Professional Self-Pay
Follow-up Lead;
Hospital Self-Pay
Follow-up lead
Hospital Insurance
Follow-up Lead
Hospital Finance Lead;
Home Health/Hospice
Finance Lead; Overall
Professional Revenue
Cycle Lead;
Professional Finance
Lead
c
i
p
E
26
1
FC
Metric Name
This Metric Shows…
Owner
AR Aging Percentage
of AR > 90 Days
The amount of AR greater than 90 days since discharge date as a percentage of total AR.
Overall Hospital
Revenue Cycle Lead;
Overall Professional
Revenue Cycle Lead;
Overall Home Care
Lead
2
5
6
E
4
1
E
4
8
6-
Month-End Candidate The total balance for accounts that are past the minimum hold days but have not yet
for Billing
produced a clean claim or statement out of Epic.
Overall Hospital
Revenue Cycle Lead
Month-End Coding
AR Dollars
The total dollar amount of unbilled accounts that have not completed coding but are past
the minimum holding period.
Overall Hospital
Revenue Cycle Lead
Month-End Coding
AR Days
The total dollar amount, expressed in days of revenue, of unbilled accounts that have not
completed coding but are past the minimum holding period.
Coding Manager;
Overall Hospital
Revenue Cycle Lead
Cash Posted
Total cash posted less voids and reversals. Do not include refunds, as those are treated as
adjustments.
Hospital Payment
Posting Lead;
Professional Payment
Posting Lead; Overall
Home Care lead
E
0
8
E
B
0
4
3
1
A
-C
C
3
6
F0
Charity Adjustments
Total adjustments posted for a specified summary level and time period that are classified as
charity adjustments. This metric does not include bad debt adjustments.
Hospital Self-Pay
Follow-up Lead
Bad Debt
Adjustments
The total amount of bad debt adjustments from active AR to bad debt AR (placements) less
transfers from bad debt AR to active AR (returns).
Hospital Self-Pay
Follow-up Lead;
Hospital Finance Lead;
Professional Self-Pay
Follow-up Lead; Home
Health/Hospice Finance
Lead
I
U
U
:
D
c
i
p
E
A
D
E
27
1
FC
Metric Name
This Metric Shows…
Owner
Self-Pay AR Aging by
Aging Bucket
The amount of AR classified as self-pay within each aging bucket as of a snapshot in time.
Hospital Self-Pay
Follow-up Lead
Days of AR in Claim
Edit Workqueues
The number of days of revenue held up in claim edit workqueues.
Claim Acceptance
Rate
4E
8
2
5
E
0
8
E
6
6
B
0
4
3
1
A
-C
The total billed amount of accepted claims in the system.
Unposted Cash
Any payments deposited and not posted or processed in remittance.
C
3
6
:
D
0
F
E
A
D
The percentage of total claims loaded that adjudicated without manual intervention. This
includes claims that were adjudicated as either clean or denied, as well as pended claims
automatically resolved by the system, such as claims sent to a third party for repricing.
I
U
U
c
i
p
Professional Billing and
Claims Lead; Hospital
Billing and Claims Lead;
Home Health/Hospice
Billing and Claims Lead
The total percentage of claims accepted by the clearinghouse as clean upon submission from Professional Billing and
Epic.
Claims Lead; Hospital
Billing and Claims Lead;
Home Health/Hospice
Billing and Claims Lead
Dollars of Claims Sent
Total Auto
Adjudication Rate
E
4
1
Professional Billing and
Claims Lead; Hospital
Billing and Claims Lead;
Home Health/Hospice
Billing and Claims Lead
Professional Payment
Posting Lead; Hospital
Payment Posting Lead;
Home Health/Hospice
Billing and Claims Lead
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
E
28
1
FC
Metric Name
This Metric Shows…
Owner
Internal Auto
Adjudication Rate
The percentage of internal claims loaded that adjudicated without manual intervention. This
includes claims that were adjudicated as either clean or denied, as well as pended claims
automatically resolved by the system, such as claims sent to a third party for repricing.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
External Auto
Adjudication Rate
2
5
6
E
4
1
E
4
8
The percentage of external claims loaded that adjudicated without manual intervention. This Tapestry AP Claims
includes claims that were adjudicated as either clean or denied, as well as pended claims
Lead
automatically resolved by the system, such as claims sent to a third party for repricing.
6
E
0
8
E
Includes new claims only; adjustments to existing claims are not counted.
Percent of Total EDI
Claims
The percentage of total claims loaded in the system electronically, rather than manually
entered from paper or scanned in (OCR claims).
B
0
4
3
1
A
-C
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
Percent of Internal
EDI Claims
The percentage of internal claims loaded in the system electronically, rather than manually
entered from paper or scanned in (OCR claims).
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
Percent of External
EDI Claims
The percentage of external claims loaded in the system electronically, rather than manually
entered from paper or scanned in (OCR claims).
C
3
6
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
F0
Total Pending Claims
Inventory (Number of
Claims)
The total number of pending claims in the system.
Internal Pending
Claims Inventory
(Number of Claims)
The number of pending internal claims in the system.
External Pending
Claims Inventory
(Number of Claims)
The number of pending external claims in the system.
I
U
U
:
D
c
i
p
E
A
D
Tapestry AP Claims
Lead
Tapestry AP Claims
Lead
Tapestry AP Claims
Lead
E
29
1
FC
Metric Name
This Metric Shows…
Owner
Total Pending Claims
Inventory (Dollar
Amount)
The total billed amount of pending claims in the system.
Tapestry AP Claims
Lead
Internal Pending
Claims Inventory
(Dollar Amount)
The total billed amount of internal pending claims in the system.
External Pending
Claims Inventory
(Dollar Amount)
The total billed amount of external pending claims in the system.
Total Claims Volume
(Number of Claims)
The number of claims received and entered in the system, including paper and electronic
formats.
E
4
1
2
5
6
6
E
0
8
E
B
0
4
3
1
A
-C
E
4
8
Tapestry AP Claims
Lead
Tapestry AP Claims
Lead
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not be counted.
Internal Claims
Volume (Number of
Claims)
The number of internal claims received and entered in the system, including paper and
electronic formats.
External Claims
Volume (Number of
Claims)
The number of external claims received and entered in the system, including paper and
electronic formats.
Total Claims Volume
(Dollar Amount)
The total dollar amount (billed amount) of claims received and entered in the system,
including paper and electronic formats.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not be counted.
C
3
6
0
F
E
A
D
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not be counted.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
Internal Claims
Volume (Dollar
Amount)
I
U
U
c
i
p
External Claims
Volume (Dollar
Amount)
E
:
D
The total dollar amount (billed amount) of internal claims received and entered in the
system, including paper and electronic formats.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
The total dollar amount (billed amount) of external claims received and entered in the
system, including paper and electronic formats.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
30
1
FC
Metric Name
This Metric Shows…
Owner
Total Claims
Turnaround Time
The average length of time, in days, between claim creation in the system and claims
payment batch is accepted, or claim included in your pay cycle.
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
Internal Claims
Turnaround Time
The average length of time, in days, between internal claim creation in the system and
claims payment batch is accepted, or claim included in your pay cycle.
Includes new claims only; adjustments to existing claims are not counted.
External Claims
Turnaround Time
2
5
6
6
E
0
8
E
E
4
1
E
4
8
The average length of time, in days, between external claim creation in the system and
claims payment batch is accepted, or claim included in your pay cycle.
Tapestry AP Claims
Lead
Tapestry AP Claims
Lead
Includes new claims only; adjustments to existing claims are not counted.
Total Average
Pending Age
The average length of time, in days, for all pended claims, between when the claim enters a
pending status, and when the claim is changed to clean or denied.
Tapestry AP Claims
Lead
Internal Average
Pending Age
The average length of time, in days, for pended internal claims, between when the claim
enters a pending status, and when the claim is changed to clean or denied.
Tapestry AP Claims
Lead
External Average
Pending Age
The average length of time, in days, for pended external claims, between when the claim
enters a pending status, and when the claim is changed to clean or denied.
Tapestry AP Claims
Lead
First Call Resolution
The percent of CRM calls that are resolved immediately, without additional follow up
required.
B
0
4
3
1
A
-C
3C
6
0
F
E
A
D
Tapestry Customer
Service Lead
Aging
The average age of unresolved CRMs organization-wide.
Tapestry Customer
Service Lead
Number of CRMs
Created
The number of CRMs created organization-wide.
Tapestry Customer
Service Lead
Average Referral
Processing Time
The average length of time required to reach a final decision on a referral/authorization.
I
U
U
:
D
Tapestry Utilization
Management Lead
c
i
p
E
31
1
FC
Metric Name
This Metric Shows…
Owner
Average Referral
Notification
Processing Time
The average length of time required to complete a referral notification.
Tapestry Utilization
Management Lead
Pending Referral
Inventory
The total number of pending referrals in the system.
Clearinghouse Claim
Acceptance Rate
The percentage or claims that are clean upon submission to the clearinghouse.
Average Census
The average census throughout the agency.
Billable Visit Rate
Total number of billable visits completed throughout your agencies per 100 patients. This
information helps you evaluate expected revenue, productivity and workload, and make more
efficient staffing decisions.
RAP Candidate for Bill
The total AR balance for PPS accounts that are past minimum hold, but have not billed due
Home Health/Hospice
to an open assessment encounter, incomplete quality review, or RAP billing or edits. This can Billing and Claims Lead
exclude payors who reimburse episodically, but not prospectively.
Month-End Final
Candidate for Billing
The total balance for accounts that are past the minimum hold days but have not yet
produced a clean claim or statement out of Epic.
:
D
2
5
6
6
E
0
8
E
B
0
4
3
1
A
-C
C
3
6
E
4
1
E
4
8
Tapestry Utilization
Management Lead
Hospital Billing and
Claims Lead
Overall Home Care
Lead
Home Health/Hospice
Billing and Claims Lead
Home Health/Hospice
Finance Lead
0
F
E
A
D
I
U
U
c
i
p
E
32
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