1 Overview of Epic’s Key Performance Indicators 14 EF C 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. 28 4E 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. 0E 6 -6 5 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 40 BE -8 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. 06 3C -C A1 3- 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: EF 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. DA D: Compare Through Cogito Benchmarking Ep icU UI 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. 1 FC KPI Listing E 4 1 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 E 4 8 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 6 E 0 8 E B 0 4 3 1 A -C C 3 6 F0 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: : D I U U ED - Triage Time c i p 2 5 6 E A D 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 E 2 1 FC 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 52 E 4 8 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. 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 E 0 8 E E 4 1 6 6 B 0 4 3 1 A -C 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 3C 6 0 F : D I U U c i p E A D 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 E 3 1 FC 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 E 4 1 52 E 4 8 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 E 0 8 E B 0 4 3 1 A -C C 3 6 : D I U U c i p Corrected Results E 6 6 0 F E A D 4 1 FC 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. E 4 1 4E 8 2 5 E 0 8 E 6 6 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 B 0 4 3 1 A -C C 3 6 I U U : D Central Line Bundle Charting Compliance c i p 0 F E A D E 5 1 FC 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 2 5 6 E 4 8 6 E 0 8 E 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: E 4 1 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. B 0 4 3 1 A -C 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 C 3 6 : D I U U Record Completion Time c i p 0 F E A D 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 E 6 1 FC 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 E 4 1 4E E 0 8 E B 0 4 3 1 A -C 8 2 5 6 6 Anesthesia Manager Cancer Center Director C 3 6 : D 0 F E A D I U U c i p E 7 1 FC 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 2 5 6 E 4 8 6 E 0 8 E B 0 4 3 1 A -C Cardiologist Productivity E 4 1 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 C 3 6 I U U : D c i p 0 F E A D E 8 1 FC 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. E 0 8 E 52 E 4 8 6 6 B 0 4 3 1 A -C C 3 6 : D I U U 0 F E A D E 4 1 Cardiologist Physician Cardiology Administrator; Cardiology Manager; Invasive Labs Manager c i p E 9 1 FC 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 2 5 6 E 4 1 E 4 8 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. 6 E 0 8 E B 0 4 3 1 A -C 3C 6 0 F : D I U U E A D Cardiology Administrator; Cardiology Manager; Invasive Labs Manager; Radiology Manager; Interventional Radiology Manager; Mammography Coordinator c i p E 10 1 FC 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 2 5 6 E 4 1 E 4 8 The percentage of first cases each day, scheduled within a specified date range, that started on time. 6 E 0 8 E B 0 4 3 1 A -C 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 C 3 6 I U U : D c i p 0 F E A D E 11 1 FC 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 E c i p E 4 8 6 E 0 8 E B 0 4 3 1 A -C C 3 6 F0 : D I U U Turnover - Same Room 2 5 6 E 4 1 E A D Operating Room Manager 12 1 FC 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 4E 8 2 5 E 0 8 E 6 6 B 0 4 3 1 A -C C 3 6 0 F E A D 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. I U U : D E 4 1 Operating Room Manager Patient Experience Lead Patient Experience Lead c i p E 13 1 FC 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 © 2015-2016 Epic Systems Corporation. All rights reserved. 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